Feeling Good Podcast | TEAM-CBT - The New Mood Therapy

Defeat Perfectionism  and Discover the Art of Self-Acceptance Part 1 of 2 This Is for Everyone--Shrinks AND the General Public! On Wednesday, July 9, 2025, Dr. Jill Levitt and I did a FREE, two-hour webinar on one of the most common causes of stress and feelings of inadequacy--perfectionism. More than 2200 individuals registered, reflecting the widespread interest in this topic. Although perfectionism causes lots of suffering, it's not easy to get rid of this mindset because it can promise and sometimes deliver tremendous benefits, too! Rhonda and I will be presenting this webinar on the podcast in two parts. This week, in Part 1 you'll learn About the many emotional consequences of perfectionism How to identify the perfectionistic beliefs that fuel anxiety, procrastination, and shame How and why these beliefs can trigger immense emotional pain How to use Positive Reframing and the Cost-Benefit Analysis to melt away your resistance to change. You can take a look at the workshop handout if you CLICK HERE! Next week, in Part 2, you'll learn many powerful methods to crush the distorted thoughts that trigger perfectionism, including Identify the Distortions Explain the Distortions The Externalization of Voices The Acceptance Paradox The Counter-Attack Technique The Feared Fantasy Technique Self-Disclosure Relapse Prevention Training And more! This live, practical training will equip you with powerful, research-backed techniques to help yourself and your clients transform perfectionism into peace, power, self-acceptance, and emotional freedom, all illustrated with dramatic video clips from an actual TEAM CBT session with a woman struggling mightily from brutal self-criticisms, self-doubt, and sleepless nights, due to the very perfectionism that has catapulted her into an incredible career. Thanks for listening today! Jill, David and Rhonda

TEAM for Troubled Couples A New Twist! Today we are joined by a favorite guest, the brilliant Thai-An Truong. Thai-An is a Licensed Professional Counselor (LPC) and Alcohol and Drug Counselor (LADC). She is the first Certified TEAM-CBT Therapist and Trainer in Oklahoma. She has found TEAM-CBT to be life-changing professionally and personally and is passionate about training other therapists in this "awesome approach." In her private practice, Thai-An specializes in the treatment of trauma and OCD. To learn more about her TEAM-CBT Trainings, visit www.teamcbttraining.com Thai-An has been featured on many Feeling Good Podcasts focusing on Depression and social anxiety (Live demonstration, 187) Postpartum Depression and Anxiety ( 218) How to Get Laid (Ep. 264) OCD ( 283) Grief (Ep 344) Now Thai-An adds an important dimension to the TEAM Interpersonal Model—working with trouble couples, as opposed to working with individuals with troubled relationships. She also describes a new way to use Positive Reframing to reduce patient resistance to giving up David's famous list of "Common Communication Errors," and she adds five new errors to the list. At the start of the podcast, Thai-An described a woman who complained that her husband often "shuts down" when they are communicating about a sensitive topic, and she wondered why. Thai-An decided to invite him to join the session so his wife could find out why. This really opened things up, and the wife discovered that her husband shut down because he was feeling inadequate when she pointed out all the things that were wrong with the house, and he was taking her comments as criticism. However, the more he shut down, the more she complained, and this pushed him away even further since her criticisms intensified his feelings of inadequacy. Thai-An then used Positive Reframing to help her see why he shut down. One of Thai-An's new ideas was to use Positive Reframing to cast our list of "errors" on the "Bad Communication Checklist" in a positive light, just as we do with the negative thoughts and feelings of people who are using the Daily Mood Log. By siding with the patient's resistance and listing all the good reasons NOT to change, nearly all patients paradoxically let down their guard and powerful urges to oppose change. Instead, they open up and become receptive to the many methods for challenging distorted thoughts. Thai-An has observed the same phenomena with troubled couples. When they see the GOOD reasons to why they or their partners use dysfunctional ways of communicating, they paradoxically let down their guard and become more willing to use the Five Secrets of Effective Communication. She says: Positive reframing started to open them up to each other, and helped them see each other in a more positive light. At the same time, they discovered that they shared the same values. Voicing the good reasons to maintain the communication errors as well as the cost of change (e.g., it'll be hard work, I'll have to focus on changing myself, it'll be vulnerable) allowed each partner to melt away their resistance to change. David comment: This is an excellent example of a "double paradox." Once again, instead of trying to "help," which often triggers intense resistance, the therapist sides with the resistance, and this paradoxically triggers strong motivation to change! Thai-An reminded us that it's important to go through the TEAM structure before moving forward with tools to help the couple change. For testing, she asks both partners to complete the version of David's Brief Mood Survey that includes the Relationship Satisfaction Scale, and asks both to complete the Evaluation of Therapy Session at the end. She makes sure both partners rate her empathy toward them at 20/20 (perfect scores) before proceeding to the next steps. During the Assessment of Resistance, she begins to work with David's Relationship Journal to get a specific moment in time of conflict. Then when they do Steps 3 and 4, where they identify their own communication errors and their impact on their partners, she does positive reframing of the bad communication errors, which you can see here, along with five new errors that Thai-An has listed below.   The Bad Communication Checklist* Instructions. Review what you wrote down in Step 2 of the Relationship Journal. How many of the following communication errors can you spot? Communication Error (ü) Communication Error (ü) 1.      Truth – You insist you're "right" and the other person is "wrong."   10.   Diversion – You change the subject or list past grievances.   2.      Blame – You imply the problem is the other person's fault.   11.   Self-Blame – You act as if you're awful and terrible.   3.      Defensiveness – You argue and refuse to admit any imperfection.   12.   Hopelessness – You claim you've tried everything and nothing works.   4.      Martyrdom – You imply that you're an innocent victim.   13.   Demandingness – You complain when people aren't as you expect.   5.      Put-Down – You imply that the other person is a loser.   14.   Denial – You imply that you don't feel angry, sad or upset when you do.   6.      Labeling – You call the other person "a jerk," "a loser," or worse.   15.   Helping – Instead of listening, you give advice or "help."   7.      Sarcasm – Your tone of voice is belittling or patronizing.   16.   Problem Solving – You try to solve the problem and ignore feelings.   8.      Counterattack – You respond to criticism with criticism.   17.   Mind-Reading – You expect others to know how you feel without telling them.   9.      Scapegoating – You imply the other person is defective or has a problem.   18.   Passive-Aggression – You say nothing, pout or slam doors.     * Copyright ã 1991 by David D. Burns, MD. Revised 2001.   Thai-An Truong's 5 Additional Communication Errors: Shut down—You shut down and ignore the other person or give them the silent treatment. Avoidance—You hide your feelings and avoid talking about hard topics, or disconnect through some form of escape. Rejection—You make threats to leave – "I'm done with you," or "I can't deal with this anymore," or "I want a divorce." Control—You insist that the other person "needs" to behave or communicate differently, or "should" or "shouldn't" behave the way they do. Invalidation—You tell the other person they shouldn't feel the way they feel. Here's how Thai-An did the Positive Reframing with this couple. First she asked the wife, "Why might your partner suddenly want to "shut down" and stop communicating during a conflicted exchange?" She also asked, "What does this do for the person who is shutting down?" This is the list of positives they came up with. Shutting down . . . Keeps me safe and protects me from more criticism Protects my partner from hurtful comments I might make. Shows that I value our marriage and my partner's feelings. Shows my love for my partner, and for myself. It shows that I'm feeling hurt and want to be appreciated. Guarantees that I won't make things worse. Shows that I want to protect myself from becoming overly vulnerable and getting invalidated again. Shutting down feels less risky than sharing my feelings. Once she saw why he shut down, she realized the negative impact of her complaints, and began to provide more genuine words of appreciation to him. He said that this meant so much to him and made all the hard work worth it. Her common communication errors included "truth" and "making complaints." He realized, again through positive reframing, that she also wanted validation, that raising children can be hard, and that she ALSO wanted appreciation for how well she was keeping up with the home and the care of their children. So, when she wasn't getting validation and appreciation from him, she was even more likely to complain to try to voice her perspective. Once he was able to stop shutting down, and instead began to make more disarming statements, use feeling empathy, and stroking, she was much less likely to complain. They also realized they had the same values of wanting healthier communication and to provide a safe and happy home for their children. Was this effective? Both went from 10/30 and 11/30 on the relationship satisfaction scale (shockingly poor scores) to 26/30 by the end of the relationship work together (extremely high scores indicating outstanding scores on my Relationship Satisfaction Scale.) Thai-An provided us with a cool Positive Reframing document for all of the communication errors. You can check it out if you CLICK HERE. I (David) pointed out that Positive Reframing can also be used in conjunction with the Relationship Journal in another way. In step one of the RJ, you write down one thing the other person said, and you circle all the many feelings they were probably having, like hurt, alone, anxious, angry, sad, unloved, and many more. In step two you write down exactly what you said next, and circle all the feelings you were having. This would be an ideal time to do Positive Reframing of your partner's negative feelings, so as to shift you perception that the other person is "bad" or "to blame" or some negative interpretations that you may be making. This reframing might be helpful in the same sense that my technique, Forced Empathy, can sometimes cause a radical shift in how you see the person you're at odds with. Announcements On January 4, 2024, Thai-An Truong will be offering a 14-week training program in TEAM couples therapy for mental health professionals. The class will meet weekly from 11:30 to 1:30 East Coast time. To learn more, please go to Courses.teamcbttraining.com/relationships There will be a 4-day TEAM-CBT Intensive November 6-9, 2023, in Mexico City, at the Hotel Camino Real.  To learn more, please go to:  https://teamcbt.mx/welcome Thanks for listening today! Let us know what you thought about our show! Thai-An, Rhonda, and David

Menopause-- The End? . . . or the Beginning? Rhonda starts today's podcast, as usual, with a warm endorsement from Sally, a podcast fan who really liked Podcast 355 on the topic of "Relationship Problems: Be Gone!" She said the role-play demonstrations were "incredible" and especially helpful. We'll keep that in mind and see if we can do some more role-playing demonstrations in future podcasts, along with instructions so you can practice at home, as well. This can be extremely helpful if you want to master the techniques we describe. They may sound simple, but they're not! In our recent podcast on free practice groups (put LINK), you can find many virtual practice groups you can join from home to practice many of the techniques in TEAM-CBT with like-minded colleagues and become part of the growing TEAM-CBT community. We now have many excellent and free practice groups for the general public as well as and training groups for shrinks. Today, Mina returns to the show with a new problem—pre-menopausal symptoms that are scaring her and casting a shadow on her future as well as her marriage with her husband, Maurice. Menopause is a topic that freaks many people out, due to feelings of anxiety and shame which can sometimes be intense. Today, menopause will be out in the open and front and center. However, Meina is confused because so many problems and feelings are swirling around in her head, and she doesn't quite know where to start. At the start of the session, Mina's Brief Mood Survey indicated mild depression, severe anxiety, moderate to severe anger, and greatly diminished feelings of happiness and relationship satisfaction, thinking of her husband, Maurice.f If you review Mina's Daily Mood Log. you can see that the Upsetting Event is irregular periods due to menopause. You can also see that Mina is struggling with fairly feelings of depression, anxiety, shame, inadequacy, loneliness, embarrassment, hopelessness, frustration and anger, and she's giving herself some intensely negative messages, like "My body is falling apart," and "My husband will leave me," and "I'll get osteoporosis and die in pain like my grandmother," and more. During the initial Empathy phase of the session, Mina described quite a lot of personal and professional concerns, as well as somatic complaints of various kinds. Sometimes, in the past, Mina has developed numerous somatic complaints that terrify her, because she has interpreted them as possible serious diseases, like multiple sclerosis. However, excellent physical evaluations rarely or never provide any medical evidence or explanation for her symptoms. This pattern of obsessing about somatic symptoms is actually quite common. Many general practice doctors report that as many as a third of their patients complaining of pain, dizziness, and so forth do not have any medical disease that could possibly explain the symptoms. In fact, in his classic book, Caring for Patients, the late Dr. Allen Barbour from Stanford reported that about half of these types of patients experience a disappearance of their somatic symptoms when they identify some conflict or problem that they've been avoiding, and then take steps to express their feelings or solve the repressed problem. Pretty much every time, this has been true of Mina, too. It often turns out that she is upset about something she is sweeping under the rug, and the Hidden Emotion Technique has proved extremely helpful in pinpointing the hidden feeling or conflict. Then, as soon as she acts on this information, and expresses her feelings, the somatic problems immediately disappear. So, our first task in today's session was to see if the same thing was happening. It turned out that she was quite upset with her husband, Maurice, so we did a Relationship Journal to see if we could get a better understanding of what was going on. Her complaint was that Maurice did not want to talk about "difficult feelings." Instead, he suggests they go for a nature walk or watch a movie. So, she felt sad, anxious, rejected, hurt, frustrated, and alone. But, as is the case nearly 100% of the time, when we examined a brief interaction between them—what did he say and what did she say next—it became clear that she was actually pushing him away and putting him down. This was understandably painful for Mina to see, and a bit embarrassing, but she was super brave, and saw how she could use the Five Secrets to respond to Maurice in a radically different and more inviting manner. As an aside, the person who seeks treatment for a relationship problem will nearly always discover that they have actually be causing the very problem they're complaining about. If Mina's husband had come to us for help, he would have made the exact same shocking discovery—that HE was causing the problem he was complaining about. I call this strange but fascinating phenomenon the "theory of interpersonal relativity." Mina feared abandonment, but discovered that her real problem was that she was rejecting her husband, and forcing him to reject her! Although this type of sudden insight can be tremendously painful, it is also liberating at the same time. That's because people discover that they have far more power than they thought. Mina felt helpless, but was actually pulling the strings. Once you "see" this, you have the option of moving in a radically new and more rewarding direction. Mina promised to send a follow up once she's had the chance to try a new approach during her interactions with Maurice. We have our fingers crossed! In addition, we worked with Mina's negative thoughts and feelings on her Daily Mood Log, starting with Positive Reframing, which she found helpful. What did her negative thoughts and feelings show about her that was positive and awesome, and how were they helping her? Then we did several rounds of Externalization of Voices and she was quickly able to knock her negative thoughts out of the park, with incredible results that you can see if you examine the emotions goal and outcome columns on her emotions table HERE. As you can see, there was an immediate and dramatic reduction in all of her negative feelings. We publish these TEAM-CBT sessions because we believe that the vast majority of mental health professionals do not know how to trigger rapid and extreme changes in how people think, feel, and interact with others. It is our hope that these podcast live therapy sessions, in conjunction with our weekly training groups, will make mental health professionals aware of what's now possible, and how TEAM-CBT actually works. We try to make it look simple, but it requires tremendous training, practice, and commitment. Rhonda and I have strong, tender feelings toward our dear colleague, Mina, and we are deeply indebted to her for making herself vulnerable in a public forum so that we can all learn and feel much closer to one another. Personal work is one of our finest teaching tools. In addition, feelings of respect, love, and connection are so often missing in our embattled and hostile political and world environment these days. We cannot change the world, but we can definitely make our own small ripples in the pond, and work on changing ourselves. If you'd like, you can take a look at Mina's Brief Mood Survey and Evaluation of Therapy Session at the end of the session.  Thanks so much for listening today! Rhonda, Mina, and David

Ask David: Featuring Matt May, MD 1. Nick asks: "What if you want a positive relationship with someone who does not want the same thing?" 2. Debbie asks: Hi David, I can't stop ruminating and obsessing about weird states of minds or when I was afraid of harming someone or remembering. Everyone says to let go but why do I hang on. Where in your book can you help me? 3. Dean asks: I'm having trouble sleeping. What should I do? 4. Kathy asks a question about social anxiety / panic and the hidden emotion technique. Note: The answers below were generated prior to the podcast, and the information provided on the live podcast may be richer and different in a number of ways. 1. Nick asks many general relationship problems that all need specific examples. Dear David, Thank you for all the amazing work you do. Your books and podcasts have helped me to understand and start to transform a lot of negative and unwanted frames that I carry around. I'm also working with a Level 3 therapist who I found through the Feeling Good Institute. One area I'm working on is building my empathy skills using the Five Secrets model. I see how powerful it is in situations where both people are open to a positive relationship. But I struggle with the idea that each of us creates our own interpersonal reality, and can always create a positive outcome regardless of the other person. Can you help me understand how to apply the technique to some challenging situations? - What happens if you want a positive relationship with the other person, but they fundamentally do not? I find that this situation leads the other person to react to the Five Secrets with anger or indifference. Or they view you as weak for exposing your emotions and vulnerability, and try to exploit them for advantage over you. Is it even worth trying to have a positive relationship with such a person? David's reply I try not to impose on people who do not want a positive relationship with me. You could also provide a specific example, as I always insist on having! These vague questions to my ear are kind of useless. Matt's reply David, you've said that the cause of all relationship problems is Blame.  I agree with this and sense that Nick's question is driving at that point, as well.  If someone doesn't want to participate in our definition of a 'positive' relationship, the approach that is most in line with the 5-Secrets and Empathy is to let go and stop demanding the other person change.  That's the cause of the problem:  trying to force people to do things, our way, regardless of what they want.  This will cause them to resist and will damage the relationship. David, you have also talked about the opposite mindset of blame, where we can wield 5-Secrets honestly and effectively, the concept of 'Open Hands'.  When we have the attitude of 'Open Hands', we can welcome other people and receive them or gracefully let go. This mental state avoids conflict and the 'blame game' in a healthy, non-avoidant way. For example, if someone says, "I don't want to have a relationship with you".  We might reply, using the 5-Secrets, 'You're right, I've been disrespectful and inappropriately pushing you too hard in the direction of having a relationship with me.  I appreciate your letting me know, clearly, that this isn't something you want.  While I can imagine you might be angry with me, I'm sure you don't want to talk about that, but prefer, instead, to end the relationship as quickly as possible.  I'm feeling awkward and would like to get out of your hair as soon as possible, too.  What can I do to facilitate ending this relationship in a way you would be satisfied with?" To put it another way, while you can maximize your chances of having a positive interpersonal experience with someone, using these communication skills, the 5-Secrets, they are not 'mind control' and trying to use them that way will only make matters worse, hence the importance of the internal mindset of 'open hands', accepting others' preferences and being willing to let go, perhaps grieve, refocus our attention elsewhere, if that's not what they want.  Otherwise, we are in the 'chasing' and 'blaming' role, which is doomed to fail, as has been discussed on previous podcasts. It may also be useful to consider whether it's actually possible to 'not have a relationship' with someone.  My sense is that there is, in fact, a relationship, even between total strangers and between people who have decided, mutually, to end their relationship.  We could point out how those two types of relationships might differ, say, if you were to bump into each other in a grocery store.  In the latter example, you might be expected to try a bit harder to avoid contact, with an agreed-upon, 'ex' than you would, with a stranger.  There are rules and expectations and ways in which both people think about the other person and define their 'relationship', even if you are saying that it has 'ended'.  The conflict comes when we don't have the same agenda and don't agree on the terms and rules of the relationship. There are many other related topics, including the 'gentle ultimatum', 'interpersonal decision making' and 'blame CBA' which could be useful for Nick. Nick continues - What if you believe the other person does have a fundamental desire for a good relationship, but they are so attached to their anger, fear or depression that their only reaction is hostility and defense? Perhaps such a person can't or won't admit to their emotions, and rejects the empathy. Should you keep trying, and at what point if any should you give up? David's reply Need a specific example! I may have mentioned that! Matt's reply:  A specific example sure would help!  The problem seems related to the 'blame game' which we just talked about.  We are demanding the other person change, and stop being so hostile and defensive.  Instead, consider using Interpersonal Decision Making and look at the three options that are available, in any relationship.  If you decide to take responsibility for the relationship, try the Relationship Journal, so you can see through the blame that is causing the problem.  You could also use positive reframing to admire their hostility, defensiveness, anger, fear and depression. Nick continues: Perhaps there are mistaken or lying about the facts, and unwilling to admit it. Or you disbelieve what they say because it doesn't match their actions or is calculated to deflect blame. For example, you may have a conflict over who cleans the house. The objective fact is that you do this 80% of the time and have done it the last 5 times in a row, while the other person has consistently left garbage lying around. Yet the other person says "I feel like you never do housework and I am always the one cleaning, and I'm sick of it". How can you find truth in such a statement? David's reply Work this out on a Relationship Journals. Write down what you said next, and follow th steps clearly spelled out in Feeling Good Together. Or, I could send you one. Matt's Reply Disarming is really challenging because it requires us to let go of our version of the 'truth', at least temporarily, in order to see the other person's truth.  People often don't want to do that, even for a moment!  Furthermore, if the other person is angry, they are likely to distort the truth in their statements, for effect, to be more persuasive.  The problem with this, is that it will call our attention to the lies they are telling, tempting us away from seeing their truth.  Without knowing more about the situation, I could only guess at what their 'truth' is.  Here are some possibilities, though:  Is it possible that they have some reasonable expectation for us to do more of the cleanup than them?  Are they offering something else in the relationship that offsets their lack of cleaning?  Do they do the majority of the cooking?  Do they do the shopping?  Do they pay more of the bills?  Also, were they the last one to do the cleaning?  When they clean, do they spend more time on it or do a more thorough job?  When they clean, do they clean up their things as well as yours?  Do you do that?  You stated that they leave their 'garbage lying around'.  Is that how they see it?  Is it possible that they put their things precisely where they wanted them to be and didn't want you 'tidying up'? The point is that disarming requires seeing the bigger picture, not just the one data point that best supports your blaming them.  Try to see past this and, if you can't, considering Interpersonal Decision making and the Blame CBA, where you would write down the good reasons to blame the other person and insist that your version of the truth is complete and correct and that theirs is wrong and bad. Nick carries on - What should you do in situations where you both have attachments to other incompatible goals? In Lee's case on episodes 96-98 of your podcast and Chapter 27 of Feeling Great, both Less and his wife had the same fundamental values with regard to raising their daughter. So once he applied the Five Secrets, they were able to move past their ego defenses and share the same perspective. But what if there is a zero-sum situation where both of you have different core values? For example, choosing a grade school for your child. One parent sincerely believes in their core values that their child will benefit from attending a rigorous school where they will be challenged and grow. The other parent sincerely believes in their core values that children should be in a relaxed environment where they can play as much as possible. Can the Five Secrets help with this type of conflict? David's reply Read the chapter in Feeling Good Together on the idea that the attempt to solve the problem IS the problem, and the refusal to solve it is the solution. I think you've got some work to do! Now we'll see if you do it! Matt's Response In this case, you could agree to disagree and let a professional decide what would be best for your

What can I do if I relapse? Good Morning Dr. Burns, I will make this email quick, as I'm sure you have several other emails to read through. First off, thank you so much for your research and contributions to TEAM CBT! My mother introduced me to this form of therapy in 2022, and it has been a big help in overcoming my extremely painful perfectionism anxiety. Unfortunately, after graduating from university, I've begun relapsing once again. As such, I would like to ask a few things Carlos: (His remaining questions will be answered on Podcast 494.) Is it harder to get out of a relapse than the first time? I feel as if my relapse has been a lot trickier to get out of, despite the fact I have more tools and techniques. David's response. This depends entirely on whether you've done Relapse Prevention Training to prepare for relapses ahead of time. You can read all about it in the last chapter of my most recent book, Feeling Great. You can also learn about RPT on a number of podcasts, and even hear me doing it live with many individuals at the end of their personal work. Here are two examples randomly chosen among dozens I have published. 427: https://feelinggood.com/2024/12/16/426-ask-david-dreading-the-day-solving-mother-daughter-problems-romance-and-more/ 389: https://feelinggood.com/2024/03/25/389-the-story-of-amy-part-2-of-2/ And you'll a great many more if you look. Just use the search function on my website and you'll find a wealth of podcasts on RPT. Short answer: If you HAVE recovered and done RPT (takes 30 minutes) it will usually be much easier for you to smash your negative thought(s), using the same methods that helped you the first time. If you HAVEN'T recovered and done RPT, it may be much more challenging. Thanks for the important question, Carlos!

Download the incredible Feeling Great app today for FREE at FeelingGreat.com! This is my $99 GIFT for you.  - Dr. David Burns

Meet the Fantastic—and Controversial—Dr. David Healy Psychiatric Drug Companies-- What Are They NOT Telling Us? Today, we are thrilled to interview the famed and courageous Dr. David Healy. I have admired his work for many years, but never imagined I'd have the chance to meet him and chat with him. First things first. You may know Dr. David Healy for some of his highly controversial books, like "The Antidepressant Era," "Let Them Eat Prozac," and "Pharmageddon." But who is he, really? According to AI, Dr. David Healy is a prominent Welsh psychiatrist, psychopharmacologist, and critic of the pharmaceutical industry known for his research on antidepressants, their links to suicide, and exposing industry practices like ghostwriting and disease-mongering, operating through initiatives like RxISK.org to promote drug safety. He has a long history of challenging Big Pharma, facing academic backlash (like losing a University of Toronto post) for his views, and serving as an expert witness in legal cases involving psychotropic drugs, advocating for greater transparency and patient safety.  Healy initially worked with pharmaceutical companies, gaining firsthand knowledge of how SSRIs were marketed despite their trial weaknesses, focusing on the oversimplified serotonin hypothesis. He then became a vocal critic, highlighting issues like ghostwriting articles and manipulating academic opinion to sell drugs, leading to conflicts with industry-funded institutions. He founded RxISK.org, a platform for patients to report adverse drug reactions, aiming to make medicines safer. His strong stance (on research linking SSRI antidepressants to increased suicidal thoughts and urges) led to intense and corrosive controversy, including losing a professorship at the University of Toronto (though later settled as a visiting role) and harassment, noted here and here. In recent years, he has acted as an expert witness in cases involving drug-related suicides and homicides, bringing issues to regulators.  In essence, Dr. David Healy is a significant, often controversial, figure dedicated to drug safety, academic integrity, and patient awareness in psychiatry, challenging established narratives and industry power.  Taking a deeper dive, AI has added this critically important information: David Healy has discussed numerous examples of conflicts of interest that mainly involve the influence of the pharmaceutical industry on medical research, publication, and practice.  Key examples he has highlighted include: Ghostwriting of Articles: Pharmaceutical companies hire medical communication firms to draft research articles or reviews, and then get prominent academics or clinicians to put their names on the papers as the sole or primary authors, a practice known as ghostwriting. The named authors often have little to no involvement in the actual research or writing. Hiding or Misrepresenting Data: Drug companies have concealed unfavorable data or miscoded raw data on drug risks, such as the link between antidepressants and suicidal acts. This manipulation can make a drug appear safer or more effective than it actually is. Biased Clinical Trial Design: Healy notes instances where clinical trials are designed with "tricks," such as using inadequate or excessive doses of comparison medications to make the company's own drug look superior. Marketing-Driven Education: A large portion of continuing medical education (CME) classes for doctors are sponsored by industry. Healy argues this leads to a bias in the information presented to doctors, with an emphasis on the benefits of brand-name drugs rather than an objective assessment of all treatment options. Gifts and Payments to Physicians: Drug companies spend billions annually on marketing directed at doctors, including free samples, sales visits, and small non-educational gifts or lunches. Healy points out that while many doctors believe these gifts don't affect their own prescribing, studies show they influence prescribing patterns and create subtle biases. Industry Influence on Academia: Healy's own experience with a job offer being rescinded at the University of Toronto, which had received a large donation from a drug company (Eli Lilly), is a prominent case he uses to illustrate how industry funding can infringe upon academic freedom and stifle critical research. "Disease Mongering": Healy argues that the pharmaceutical industry often engages in "disease mongering," marketing conditions to the public and physicians to create a market for their products rather than simply addressing genuine medical needs.  So that hopefully gives you some idea of the scope of his work, and his vision of transparency and integrity in the reporting one the effectiveness and risks of psychotropic medications. In our conversation today, he emphasized the importance of listening to patients who describe side effects of medications, such as SSRIs, in described the efforts of Big Pharma to suppress such complaints, giving psychiatrists "talking points" to reassure and quiet concerned patients. In general, a main focus of his career has been to challenge and confront the efforts of drug companies to suppress negative information about their products and troublesome and dangerous side effects. He said that one of the rationales the drug companies use is to say that disseminating that type of information will discourage many potential patients from using their products, and therefore miss out on the potential benefits of the medications. In fact, they have a name for this, "treatment hesitancy," and discourage open discussion of negative effects for this reason. I asked Dr. Healy if he's experienced direct negative pushback from drug companies, and he gave a surprising answer—he said no, that the major pushback he's gotten has actually been from colleagues—psychiatrists who have bought the party line disseminated by the drug manufactures. For example, when he gave his famous talk at the University of Toronto on the increase in suicidal urges associated with SSRI antidepressants, a famous psychopharmacologist, Dr. Charlie Nemeroff, got him fired. Here's the story on Dr. Nemeroff, According to AI: In the late 2000s, Nemeroff faced investigations and sanctions from Emory University for failing to disclose significant speaking and consulting fees from pharmaceutical companies like GlaxoSmithKline, raising questions about research integrity and conflicts of interest, notes The BMJ and The New York Times.  Although the antidepressant effects of SSRIs are controversial and hotly debated, their effects on the nervous system are not. Dr. Healy's research indicates that they have a suppression effect on the nervous system, which dulls the senses, and this can happen within 1 to 2 days. One of the more troublesome of these effects is called "genital numbing," which affects 9 out of 10  people talking SSRIs. This can result in difficulties with sexual arousal and greatly delayed orgasm, and apparently these effects can persist long after drug discontinuation. He said that these sensory effects can develop quickly, within a day or two of starting the medications. Even more chilling, he said that the problem can actually get worse when you discontinue the medication, and can sometimes persist for life. In addition, quite a few individuals have "bad trips" on SSRIs, although a minority clearly have "good trips." He said the best thing to do for a bad trip is to take the patient off of the medication immediately—and NOT increase the dose. He confirmed my impression that a common error with all antidepressants is to increase the dose—which simply increases the side effects. In addition to the genital numbing described above, he said the SSRIs cause "emotional numbing," which means a decreased capacity for joy as well as sorrow. One of the main activities in David Healy's life has been listening to patients, rather than discounting their complaints when they describe negative effects of medications. When asked about what alternatives to drugs he might recommend to someone struggling with depression, he said that sometimes, just doing nothing will be helpful, since most mood problems clear up spontaneously in 12 to 14 weeks. He said that most are simply human problems, not "mental disorders," but real-life problems, like relationship conflicts or social issues. Although we did not discuss it extensively on the show, I would point out that skillful, drug-free therapy with TEAM CBT can sometimes help as well, and that recent research has confirmed rapid often dramatic mood improvements with individuals using the Feeling Great app, which has been entirely free to anyone since the summer of 2025.  Finally, we do not advise anyone to discontinue or modify the dosages of any medications you have been prescribed without consultation with your doctor. The information in the Feeling Good podcast is of a strictly educational nature, and is not intended as treatment or medical advice. We thank you for listening to today's shocking but incredibly important dialogue with one of the pioneers and champions of greater ethical integrity and transparency in the psychiatric profession. It is sad, indeed, that we don't have more visionary critical thinkers like Dr. David Healy! David (H), Rhonda, and David (B)

Ask David, #491, featuring our beloved Dr. Matthew May. Can Introverts be helped? How can we enhance our happiness? What's the best movie to watch if your father rejected you? How can I identify my feelings? The answers to the first two questions are brief and were written prior to the show. Listen to the podcast for a more in-depth discussion of each question. Today's Questions Anonymous asks: Can an introvert become more extroverted? Or are these personality traits "fixed" and unchanging? Seve asks: I know that TEAM can be super helpful for negative thoughts and feelings, but what are the best tools to enhance happiness and become the person we want to be? I have a patient whose father rejected her when she was young. What would be a good movie that I could recommend for her? Anonymous asks: I don't know how to identify my feelings. Can you help?   Today's Answers Question #1 Anonymous asks: Can an introvert become more extroverted? Or are these personality traits "fixed" and unchanging? Dear Dr. Burns, I hope this message finds you well. I would like to ask you a question regarding personality traits. Some articles suggest that introversion and extraversion are relatively stable characteristics—meaning that an introverted person cannot truly become more extroverted, and vice versa (or at least not to a great extent). They also propose that introverts tend to lose energy in social situations and recharge when alone, whereas extroverts gain energy from social interaction. I'm very curious to know your thoughts on this topic. Do you believe an introverted person can become more extroverted? And in your view, is an introvert's need for solitude more of a true "need" or a "want"? Thank you very much for your time and for the inspiration your work has provided to so many of us. Warm regards, Anonymous David's reply If you like, I can make this an Ask David question for an upcoming podcast! It's a cool question and raises many questions: Do "personalities" even "exist?" Is this like the question, "Do we have a self?" It also focuses on the issue of whether we can change and grow, or whether there is some invisible barrier beyond which we can grow any further, due to some inherent "limit" due to our "personality type." Best, david   Question #2 Dr. Dear David: I know first-hand how helpful TEAM CBT can be to address negative thoughts and emotions but our path to a happier life and to the person we want to be never really ends.  Are there any other tools that Dr. David may have come across and can suggest for someone's growth? Thank you, Steve David's Answer Great question, and I'll give you a (hopefully) great answer on the podcast! But here's the quickie answer. Focus on one specific moment when you'd like to be feeling happier, or when you need help on become the person you want to be, and then use a Daily Mood Log, Habit / Addiction Log (HAL), or Relationship Journal, depending on what's needed. This is the exact same fractal concept we use in all of TEAM CBT! Warmly, david   Question #3 Hi podcast crew: I have a patient whose father rejected her when she was young. What would be a really good movie to recommend do her? David's Answer Sadly, I lost my notes from this podcast, but in general David and Matt found this question somewhat offensive, as it suggests you can chase a problem (father rejected me) with a method, in this case recommending a good movie. We, instead, would recommend TEAM CBT, which is real therapy, and not gimmicks. Movies can be rewarding, but that's not the same as effective therapy! Rhonda asked David and Matt what was wrong with recommending a movie in the same way we recommend books for clients to read.   Have a listen to hear their response.   Question #4 Anonymous asks: I don't know how to identify my feelings. Can you help? David's Answer Rhonda said one of her clients could not identify their feelings, unless they have the Feelings Chart in front of them.   David thought that anyone could identify their feelings and explained. One simple way is to identify a specific moment when you were upset and wanting help. Think about what was going on, who wee you with, where were you, etc. Then review the Feeling Words charts, which I will link to, to see how many, and which ones, resonate with how you were feeling at that time, or how you may still be feeling. Feeling Words Chart with Five Secrets, v 2 Another way is to draw a Stick Figure of yourself, and put a bubble above its head. Then imagine the Stick Figure is upset and put the Stick Figure's negative thoughts and feelings in the bubble. They don't have to be your feelings and thoughts, just make some up. Do it now—on paper! DON'T just think about it. That never works! Have you done it yet? No? That's what I suspected. If you ever DO want the answer to your question, so the stick figure on paper and then write me back. Thanks! Finally, you can listen to the podcast on "I Feel" Statements, and spend one week telling five people a day how you feel, using words from the Feeling Words Chart. For example, when checking groceries you could tell the clerk, "I'm feeling happy because we have such beautiful weather today." Or, "I'm feeling really frustrated with politics this morning!" Or whatever.  Thanks for listening today! Matt, Rhonda, and David

Sexting, Bullying, and Social Media-- A Compassionate, Practical Guide for Parents of Teens Today, we welcome back one of our favorite guests, Taylor Chesney, director of the Feeling Good Institute in New York City. Taylor specializes in TEAM-CBT with children and adolescents and brings a rare combination of clinical expertise and real-life wisdom as the mother of four. Parents everywhere are worried about social media, sexting, porn, bullying, and the fear that their kids are doing "who knows what" behind closed doors. In this episode, Taylor offers a refreshing and deeply practical message: the solution isn't better apps, stricter rules, or surveillance—it's connection. Why Blaming Technology Misses the Point Teen brains are still developing. They're impulsive, thrill-seeking, and wired for belonging and validation. Give teens instant access to peers and social media, and mistakes are inevitable. Taylor emphasizes that technology itself isn't good or bad—it amplifies what's already happening in a teen's emotional world. The real question isn't how to eliminate technology, but how parents can guide kids in using it safely and thoughtfully. The Real Protective Factor: Communication Parents often ask, "What app should I install?" or "How do I stop this?" Taylor suggests these questions lead to dead ends. What truly protects teens is a relationship where they feel: understood rather than judged supported rather than interrogated safe coming to parents after a mistake As Taylor explains, for most teens it's not if they'll face a difficult online situation—it's when. The goal is to make sure they come to you when it happens. How to Talk So Teens Will Open Up Using the Five Secrets of Effective Communication, especially the Disarming Technique, parents can shift from policing to coaching. Instead of: "Why were you on your phone?" Try: "Help me understand what was going on for you." This approach reduces secrecy and increases trust. Porn, Sexting, and Shame Discovering porn or sexting can trigger panic and anger in parents—but shaming almost always backfires. Taylor suggests responding with curiosity and empathy: "What was that like for you?" "What do you understand about the difference between porn and real intimacy?" Sexting often begins innocently—seeking connection, validation, or closeness—but once an image is sent, control is lost. Open conversations help teens think ahead without feeling judged or controlled. Parents can also teach teens simple, self-respecting responses like: "I care about you, but I don't need to send that to prove it." Bullying and Online Drama Online bullying mirrors real-life dynamics—but faster, more public, and more permanent. Taylor shares concrete skills teens can use: Pause before responding Don't engage when emotions are high Exit or mute toxic chats Involve an adult early Helpful phrases teens can practice include: "This chat is getting mean—I'm stepping out." "I'm not comfortable with this." "Let's take a break." The Big Takeaway Mistakes—by teens and parents—are inevitable. The real danger isn't errors; it's secrecy. When kids know they can come to their parents without fear of shame or punishment, they make better decisions and recover more quickly when things go wrong. As Taylor puts it: "The kids with the best relationships with their parents make the best decisions." Thanks for listening, and heartfelt thanks to Taylor for this wise, compassionate, and deeply reassuring conversation. — David, Rhonda, and Taylor

Download the amazing Feeling Great app today for FREE at FeelingGreat.com! This is my $99 GIFT for you.  – Dr. David Burns

Meet Richard Lam-- Master TEAM CBT Teacher and Therapist! Today we chat with Richard Lam. Richard is a licensed Marriage and Family Therapist in private practice in Mountain View, California. He is a graduate of Palo Alto University. He currently provides short-term therapy for anxiety, OCD, habits/addictions, depression, and relationship concerns using Cognitive Behavioral Therapy. Richard also trains other therapists in David Burn's model of CBT called TEAM-CBT Therapy. He is a certified Level 5 Master Therapist and Trainer in TEAM-CBT Therapy.  And today, Richard has gifts for you! They are fantastic! See below! I began by asking Richard how he got interested in teaching. When he was first learning, he was tutored by Dr. Angela Krumm, an advanced TEAM CBT practitioner and one of the three founders of the Feeling Good Institute. He was loving the training, but one day she said, "That's all I can teach you. Now you have to start teaching!"  And that started the wagon rolling down the hill. Richard is particularly interested in developing free self-help tools for patients, but also runs a special training class for TEAM CBT therapists who themselves want to become trainers. It meets in-person at the FGI office on Mondays from 12 to 2 PM. If interested, contact Richard (contact information is at bottom of show notes.) Richard is one of our most articulate TEAM CBT teachers, and is renown for some of his live demonstrations of specific techniques, like Forced Empathy. He has created a series of multi-page interactive teaching guides for a variety of techniques, so you can learn exactly how to do the Double Standard Technique, or the Externalization of Voices in a simple, clear, step-ty-step manner. Here are links to several examples. Check them out and feel free to share them with your patients if you are a TEAM therapist.  These links are all kick ass! Check them out and do the exercises. You'll be glad you did! Link to Double Standard Technique Link to Externalization of Voices  Link to Externalization of Resistance Link to I Feel Statements, Part 1 Link to I Feel Statements, Part 2 Link to Feared Fantasy Link to Forced Empathy Link to Forced Empathy Handout Link to Future Projection, for Habits Link to Paradoxical Ultimatum Richard tells us that mental health works a lot like physical health. When we don't regularly care for our bodies, things start to deteriorate and the same is true for our minds. These tools give you a way to keep nurturing your mental health so you can maintain a strong, healthy mind. Richard and I also discussed Acceptance--one of the most difficult concepts for patients and therapists alike to "get." I was delighted to learn he has a five-point plan to help people grasp this concept. Richard's Five Steps to Acceptance 1. The Win-Win Principle: How can I see this loss as a win? In high school, Richard had a patient whose heart was set on making the varsity basketball team, and was heartbroken when he only made the junior varsity team. But then he got to thinking that it would be fun to be the start on the JV team because his best friend is also going to be in JV. He relaxed and started to enjoy his practices with the team.  And He was promptly promoted to the varsity team!  2. Remember the butterfly effect!  Richard described getting angry and frustrated when he was late for an important appointment, and the car in front of him was moving slowly and caused a delay at a red light. His first impulse was to get angry and insist it SHOULDN'T have happened. But then, in reflection, he thought: "Wait a minute. This delay will change the entire trajectory of the rest of my life. And who knows, this could have save my life from some future tragedy if the trajectory of my life had been on time."  3, Growth mindset I have always thought of this important idea in simple terms. There is really no such "thing," from a Buddhist perspective, as "success" or "failure." These are just experiences. But often things do not turn out as one hoped. Instead of caving in, giving up, or feeling depressed or frustrated, although those are perfectly reasonable human experiences, you can accept your failure and view it as an opportunity for growth and learning. Our 9 month old grandson has reminded me that when we are learning to walk, we "fail" constantly, falling over, etc. But these are steps in learning that eventually culminates in the ability to walk--which is a miracle! 4. The spiritual view Acceptance can be thought of as letting go of judgement. Richard treated a woman who was angry at God because she could not have children, and she had always dreamed of having a big family. But from a medical perspective, her anger and constant agitation were actually the main reason she couldn't get pregnant. Shen she began working on reducing her anger using TEAM CBT, she was able to relax, and accept her fate with greater in peace. And then she suddenly got pregnant!  I, David, have seen this on many occasions. Check out Podcast #7f9, one of our most popular podcasts ever, with Daisy: "What is the Secret of a Meaningful Life?" Or Podcasts 268 - 269, featuring live work with our beloved Dr. Carly Zankman. Or #349: "What if my family rejects me?" All of these podcasts were amazing, and resulted in rapid pregnancies! 5. Empathy vs anger Richard described getting VERY angry when someone broke into his car and stole a bunch of stuff, but then asked himself why they did it. He realized that they were probably struggling and desperate for money--for drugs, for food, for family. Understanding someone's story can help lower the anger that you feel. Richard, Rhonda, and David

Let's face it. We ALL procrastinate. Attempts to "help" nearly always backfire. Dr. David Burns gets it. Procrastinators don't want help — they want something that actually works. In his upcoming free webinar on February 25, Dr. Burns introduces his paradoxical approach and ten powerful TEAM CBT tools that deliver results.  Sign up now at FeelingGoodWebinar.com. Everyone is welcome! Therapists can purchase two CE credits if they attend the live event. See you there!

(featured photo shows David, his wife Yvonne, and son, Joey, when young) Meet the Incredible Dr. David Antonuccio, Part 2 of 2 Shrink, Songwriter, and Hero Today we continue our conversation with my dear friend and esteemed colleague, Dr. David Antonuccio, a true scholar, clinician, researcher, musician, and champion of scientific transparency. The Nicotine Patch Study David revisited his landmark research on the nicotine patch, a costly trial involving roughly 600 participants who were randomly assigned to receive either a real nicotine patch or a sham patch. The goals were to assess safety and efficacy. The safety data looked reassuring. However, the efficacy findings were unexpected: the placebo patch worked just as well as the active nicotine patch in reducing smoking. The sponsoring company published the safety data but refused to publish—and refused David access to—the efficacy findings, which showed no advantage for the nicotine patch. You can check the link to the NEJM article here.  David writes: "Notice the 48 week follow-up data were excluded in this paper despite the fact that they were available. That really annoyed me. I also now believe that the original version of the paper was ghostwritten and ghost analyzed by the industry folks.in other words.  I'm not sure that the authors ever had access to the "raw" data before they were analyzed." This was important because there was a decrease in smoking DURING the study among those wearing the patch, and getting their "fix" of nicotine that way. . . but what happened AFTER the study?  David writes: "Here is the link to the follow up paper that emphasized efficacy and included the 48 week follow-up data." Notice that this paper was not published until three years later, when the Nicotine Patch had already been heavily advertised and sold on the market. This early experience in his career revealed the tension between marketing interests which focus on sales, and scientific interests which focus on truth and transparency—a daunting and frustrating pattern that would emerge again and again in his career. Expert Testimony in a Tragic Criminal Case David then described expert testimony he provided in a deeply troubling legal case. A 72-year-old woman, happily married for 50 years and a respected kindergarten teacher, had recently been prescribed Paxil, along with Ambien and Ativan. She abruptly, and without memory, woke up in the middle of the night and stabbed her husband 200 times and was subsequently arrested for homicide. There was no jury trial; instead, a plea bargain was used to determine sentencing. Dr. David Antonuccio was called as an expert witness in her defense. He described Dr. David Healy's research documenting a significant increase in both suicidal and violent urges among some patients taking SSRIs, especially Paxil. He argued that this woman's bizarre behavior was consistent with a drug-induced dissociative or fugue state. Based in part on David's testimony, the charge was reduced to manslaughter, and the judge sentenced her to time served, allowing her to return home to her children. For more on this topic: David Healy's Research on SSRIs and Homicidal Urge SSRIs Called on Carpet Over Violence Claims Black Box Warnings and Patient Rights David also emphasized the urgent need to revise Black Box warnings to reflect the full range of possible toxic or dissociative effects of psychiatric medications—not just suicidality. He has long advocated for a Patient Bill of Rights to ensure scientific transparency and informed consent. A Surprising Conversation with Dr. John Nash David shared a fascinating personal story about calling Dr. John Nash, whose life inspired the award-winning film A Beautiful Mind. In the movie, Nash's recovery from schizophrenia  is portrayed as medication-dependent. However, Nash told David directly that this was not true—the medication narrative was added to the script, possibly out of concern that portraying his recovery without meds might discourage viewers from taking prescribed medications. Nash said: "What saved me was the support of family and friends." Music, Truth, and "Buzz" David is also a talented songwriter. One of his songs, "Buzz," addresses the emotional and ethical issues surrounding electroconvulsive therapy (ECT). The inspiration came from a man in the Midwest who was legally ordered to undergo ECT against his will. A widespread public outcry ultimately convinced the judge to rescind the order. Forgiveness and "In the Air Tonight" One of David's favorite songs is Phil Collins' "In the Air Tonight," which he sees as a deeply spiritual musical meditation on forgiveness—a theme David considers one of the most powerful psychological forces we possess. David explains that the Phil Collin's song is about forgiveness, but more indirectly and specifically about the songwriter's inability to forgive. And yes—David sang it live for us on the podcast! You might be interested in this chapter that David coauthored on the science of forgiveness Thank you for joining us today. And heartfelt thanks to you, Dr. David Antonuccio, for your gifts of enlightened skepticism, ethical courage, incisive scientific thinking, and soulful musical talent. David, Rhonda, and David

Stories from a Giant and Gadfly Discover the Protest Music of RainFall!-- like "The Antidepressant Blues!" Today, we are delighted to spend some time with a dear friend and highly esteemed colleague, Dr. David Antonuccio. David is a retired Clinical Psychologist and Professor Emeritus in the Dept. of Psychiatry and Behavioral Sciences at the University of Nevada, Reno, School of Medicine. In addition to his academic work, David had his own clinical practice for 40 years. He has published over 100 academic articles and multiple books, primarily on the treatment of depression, anxiety, or smoking cessation. Since his retirement from practice in 2020, he has been making music as part of a duo called RainFall, with his musical partner Michael Pierce. Their music can be found on Spotify, Apple music, and Soundcloud, among other streaming services. I first became familiar with David when a colleague recommended his article entitled: "Psychotherapy versus medication for depression: challenging the conventional wisdom with data," which was published in Professional Psychology: Research and Practice way back in 1995. The article blew my socks off. In the first place, he had come to the many of the same conclusions I had come to, that antidepressants had few "real" effects above and beyond their placebo effects. However, he also had incredible insights into some of the problems and loopholes with drug company research studies on antidepressants, so I tried to get as many colleagues and students as possible to read that article. Here is the article link Although I had never met David, he became my hero. One day, while I was giving one of my two-day CBT workshops in Nevada, I was singing his praises and urging participants to read that classic article, but, unexpectedly, some people started chuckling. At a break, I asked someone why people had been laughing. They said, "Didn't you know that David Antonuccio is here attending this workshop? He was out visiting the bathroom when you were singing his praises, so he didn't hear you!" And that's how we met! I couldn't believe my good fortune in meeting this brilliant and humble man in person. And to my good fortune, we became good friends right off the bat and eventually did a lot of fun professional work together, like our exciting conference challenging the chemical imbalance theory of depression which we called the Rumble in Reno. I was also proud to be included as a co-author in a popular article with David and William Danton reviewing the brilliant work of Irving Kirsch. Kirsch had re-analyzed all the data on antidepressants in the FDA archives and concluded that the chemicals called "antidepressants" had few, if any, clinically significant effects above and beyond their placebo effects. In that paper, we also emphasized the ongoing power struggle between the needs of science and the needs of marketing. Science is devoted to discovering and reporting the truth, based on research, regardless of where it leads, while marketing, sadly, is ultimately loyal to the bottom line, even if deception is required. Here is the link to our article: And here is the full reference: Antonuccio, D. O., Burns, D., & Danton, W. G. (2002). Antidepressants: A Triumph of Marketing over Science? Prevention and Treatment, 5, Article 25. Web link: http://journals.apa.org/prevention/volume5/toc-jul15-02.htm I was sad when David retired from his clinical, teaching, and research career a number of years ago in order to spend more time on creating and recording music because, a passion he'd put on the shelf during the most active years of his career. I felt we'd lost an important and courageous leader in the behavioral sciences, and felt an emptiness, like an important pioneer was suddenly missing. The following link provides a highly readable brief overview of David's career focus and interests. I was thrilled to learn just recently that David has partly resumed his role as gadfly of the behavioral sciences, rejoining the fight for science, ethics and for truth, regardless of where that leads or whose feathers are ruffled. And now, we sit down together to reminisce about his personal life and experiences with many of the greats in our field, like Dr. David Healey, Irving Kirsch, and others who have also stood up for the truth, based on their research, in spite of intense opposition from the establishment. And, today David also brings us his music, with his colleague, Michael Pierce, RainFall. Some of his music has psychiatric / psychological themes, like his "Antidepressant Blues," Some of David's music has humanistic and political themes. He said: Here's a song we just released yesterday that i will assume would not be relevant to the podcast. It is called Final Embrace and was inspired by a heart-breaking international wire photo of a Salvadoran immigrant father hugging his daughter, both deceased, in the rio grande in 2019. Here's the link to the original news story. David's two-man group, RainFall, wrote and recorded the original acoustic version of this song in 2020. He explains: We decided to record a more dynamic updated version of the song with some electric guitar chords, electric bass, and drums. We are calling it "Final Embrace Electric". The story is still heart-breaking, and it still makes me cry to sing it. Here is a link to the new version of the song, And here are the heart-breaking lyrics: Final Embrace Electric (For Oscar and Valeria) By RainFall (David Antonuccio and Michael Pierce) I'm sorry I couldn't help you I'm sorry you lost your life You took a deadly risk I'm sorry for your wife What were you supposed to do? Stay home and watch your family die? Or take a chance at freedom Reach for the sky Some say you should have known better They say that you are a criminal But they don't know your fear, your pain, your hunger For them it's the principle Some say we were here first It's not our problem Despite your dire thirst We're full, no more asylum Let's ask them what they would do If their family were faced with danger If they're honest, they'd take the chance Hope for kindness from a stranger You tried to get in the front door But it was slammed closed So you swam the deadly current Despite the perilous flow You never lost your grip Though the river was not crossable Only another parent can know How that is even possible Everyone can tell you loved your daughter Even in that place You never let her go It was your final embrace I'm sorry I couldn't help you I'm sorry you lost your life You took a deadly risk I'm so sorry for your wife Everyone can tell you loved your daughter Even in that place You never let her go It was your final embrace Your final embrace It was your final embrace It was your final embrace   Thank you for joining us today. Stayed tuned for Part 2 of the David Antonuccio interview next week! David, Rhonda, and David

"Doctor, why won't you ever tell me how you really feel?" Therapist Self-Disclosure-- Featuring Dr. Carly Zankman This week, Dr. Carly Zankman joins us to discuss a really interesting and controversial topic—self-disclosure by a therapist. When is it helpful? And when is it an ethics violation? When I was a psychiatric resident, my supervisors (mainly psychoanalytic) cautioned me NEVER to share my feelings with patients. This felt really awkward at time, but is there some wisdom in that advice? And if so, what IS the wisdom? How does it work or help? And if that rule—never sharing your feelings or personal life--is too rigid, then when and how should we share our feelings and personal experiences with our patients? What is the goal, and what are the best practices? As most of you know, I have often been extremely critical of what I was taught as a psychiatric resident, thinking the teachings were based more on tradition than on science or data. And when it came to never share your feelings, I sometimes used to think about this issue along these lines: Let's assume that one of our jobs is to help our patients become more vulnerable and genuine, by sharing how they really feel inside instead of acting fake and always presenting a happy or professional face to the world. That goal seems reasonable, and it's a prime goal of a great many therapists. But how are we supposed to accomplish that goal by acting fake and hiding our own feelings? That just did not seem to make sense to me! But there are lots of traps when it comes to sharing your feelings. What if the patient is attracted to you, or vice versa? What if you do not like the patient, or feel turned off by them or annoyed with them? In today's podcast, we will try to sort out some of these questions, with help from the vivacious and brilliant Carly Zankman, Psy.D. (INSERT CARLY'S BIOSKETCH AND BRIEF DESCRIPTION OF HER TEAM CBT CLINICAL WORK IN MOUNTAIN VIEW, California. Carly described being taught similar things in graduate school, cautioning the students against opening up in a personal way during sessions. However, one of her supervisors listened to one of her sessions with a patient, and said, "the greatest gift you bring to therapy is just opening up and bringing your own, genuine and authentic self into the room." Carly described being taught similar things in graduate school, cautioning the students against opening up in a personal way during sessions. However, one of her supervisors listened to one of her therapy sessions with a patient, and said, "Your greatest gift is bringing your own, genuine and authentic self into the room," and from that point forward, everything shifted in how she viewed her role in the therapeutic relationship. Carly describes working with a patient recently and receiving a 19 / 20 on the Empathy scale at the end of the session. Although 9 out of 10 therapists would say that's a terrific, near-perfect score, on our scoring key it is rated as a failing grade. That's because the patient is telling you that you didn't quite "get" something about them, or didn't quite connect with them in a completely warm and supportive way. Carly's patient was a 40 year old recently re-married woman with a new baby, and struggling with a lot of regret, guilt, shame, depression, and anxiety. Carly decided on a hunch it might be a good idea to share her personal story, since she saw this woman as a mirror image of herself. Carly asked the patient if she wanted Carly to share her story, and this patient lit right up and was excited. It turned out to be tremendously helpful and was what she needed to believe Carly's empathy was real and not phony. The patient said that in the past she'd had many therapists, but none of them had ever share their personal experiences or feelings. Why was that so helpful? How does it work? And what are some red lines that you do NOT want to cross as a therapist? These are just a few of the ideas we discussed on today's podcast. We listed and briefly discussed a few of the many situations where it might NOT make sense to share our feelings or experiences with patients. Rhonda pointed out that if you've had a traumatic experience and you're feeling quite depressed, anxious, or angry, and have not yet had the chance to do your own personal work, it would not be the best idea to share it with your patient, because you might be using the patient as your own therapy or support network. You also would not share feelings of sexual or romantic attraction to a patient strong personal feelings of unresolved depression, anxiety, or anger Some feelings you might share with your patient, but only if you have the great therapeutic skill to do so in a helpful, illuminating way, such as feelings of dislike or anger toward the patient. We also discussed the danger of therapy degenerating into a paid friend relationship, and asked how that differed from the work of Dr. Irvin Yalom, the famous Stanford psychiatrist who taught us that developing a genuine human relationship between the therapist and patient IS the goal of therapy. Finally, we exchanged ideas about the model of therapy as a "corrective emotional experience," and none of us seemed to take kindly to that model of therapy. Thanks for listening today! And thanks for the illuminating information from our brilliant and bubbly guest, Dr. Carly Zankman! Thanks for listening today! Carly, Rhonda, and David

Helping a Loved One with Schizophrenia Treating OCD! My Hands Might Be Contaminated! How To Mend an Angry, Broken Heart 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. Joel asks: How can we use TEAM CBT to help a patient or loved one struggling with schizophrenia? Jean asks: Since CBT won't work with OCD, should we use exposure or the Hidden Emotion Technique instead? Jim asks: When someone has objectively hurt you, like your partner has had an affair, how do you get over that pain?  And here are the answers. Question #1  Dear Dr Burns, I learned from you that the foundational principle of CBT is that our emotions, and ultimately our behaviors, are rooted in thoughts or beliefs. Are there emotional and/or behavioral disorders (perhaps like schizophrenia) that are rooted in abnormal neurobiological brain pathologies, rather than in distorted cognitions or self-defeating beliefs? And if so, is TEAM CBT relevant to helping those suffering from these "psychoses"?  With much gratitude, respect, and affection, Joel Question #2 Dear Dr. Burns: I'm curious if you have thoughts about the problem of talking back to the obsessive thoughts in OCD.  Thank you, Jean Question #3 Dear Dr. Burns: When someone has objectively hurt you, like your partner has had an affair, how do you get over that pain?  I am not having thoughts that I did anything wrong, or there is something the matter with me, I feel sad, hurt and confused and angry. Jim Thanks for listening today! Matt, Rhonda, and David

Live Work with Madeleine I'm Helpless! Part 3 of 3 Today, we are pleased to present the live and unedited follow-up session with Madeleine, a loving mother who became terrified when she realized that her oldest beloved daughter might be in mortal danger during her hear abroad while in college.  Part 3 of 3 We were a bit rushed near the end of M = Methods in Part 2 because of a mistake that I (David) made. I forgot that we had extended this webinar by 30 minutes, so we wouldn't be rushed at the end, so I wrongly concluded we were running out of time when we weren't! In order to complete our work, we scheduled Part 3 several weeks later to do the following critical pieces of the work with Madeleine. Additional work with the Externalization of Voices to make sure she could knock all of her self-critical thoughts out of the park. Cognitive Flooding, using the magazine article she was triggered by to prompt the anxiety. The idea is to make yourself as anxious as possible for as long as possible, until the anxiety and panic eventually loses its punch and becomes boring. This will be one of the first times we have illustrated this technique live in a video-recorded session. Any other loose ends that may have emerged since our first session with the wonderful Madeleine! We did some cognitive flooding, urging Madeleine to close her eyes and describe her most terrifying fantasy involving her daughter's abduction by a sociopathy. We encourage her to make herself as anxious as possible, and within minutes she was at 100% and sobbing. Then we did some "memory" rescripting as we had promised her at the start, and part way through there was an unexpected surge of anger, that seemed to come from out of the blue, although the circumstances of the fantasy were clearly more than enough to trigger rage.  Using the technique called "Affect Bridging," I asker her whether the anger she was now feeling might trace back to some earlier traumatic event in her life, perhaps when she was young, and this was confirmed. She described a profoundly troubling indecent involve her mother and dad shortly before they got divorced.  There was a tremendous amount of emotion packed into today's follow-up session, almost non-stop, in fact. We look forward to seeing Madeleine's end-of-session Brief Mood Survey and Evaluation of Therapy Session. Jill and David assigned follow-up homework for her, including 15 minutes per day reading the terrifying article from People Magazine that had initially triggered her in the beauty salon.  We want to thank you, Madeleine for your courage in being so open and real, and for giving us all a unique opportunity for some incredible learning, and also the chance to get to know you at a deep a genuine level! Thanks for listening to these three podcasts. We hope you enjoyed them and learned something useful and helpful, especially if you've also been struggling with feelings of depression and anxiety, or if you're a mental health professional wanting to take a deeper dive in to how TEAM CBT can sometimes produce extremely rapid healing, even from severe feelings of depression, anxiety, and despair.  Madeleine, Jill, Rhonda, and David Following the session, Madeleine sent us the following feedback on the session via email: Hi Jill and David, Completed after session yesterday, but in my state of emotional fatigue, forgot to hit send! Brief Mood Survey after session: Depression: 3 / 20 (minimal) Suicidal urges: 0 / 12 (none) Anxiety: 8 / 20 (mildly elevated) Anger: 9 / 20 (mild/moderately elevated) Happiness: 12 / 20 (low) Relationship Satisfaction: 29 / 30 (nearly perfect) Evaluation of Therapy Session Empathy: 20 / 20 (perfect score) Helpfulness: 20 / 20 (perfect score) Satisfaction: 8 / 8 (perfect score)  Commitment: 8 /8 (perfect score) Neg feelings: 4 (high, range = 0- 4) Difficulties with Q: 2 (medium, range = 0- 4) What did you like the Least: exposure was pain. It feels very heavy and exhausting. And i understand, necessary to healing. What did you like the Most: David's "bridging" my affect states to discover my rage source. Jill's keeping us on track and making connection from my present worry about daughter's safety to past feelings of betrayal, losing trust, and resulting anger in my dad, a trusted figure. You both hit the nail on the head so many times in the session to uncover the deeper, ugly, messy, dark pools that lie within me i choose to keep safely sealed tight and out of the light. Postscript: I just completed day 1 of exposure in re reading the awful article. All the anxiety and fear resurfaced along with new feelings of revenge, determination, appreciation for the authors who are perhaps trying to help the family by publishing this. Ick. Best Regards, Madeleine  Again, a big thanks to you Madeleine, and we will watch closely as you continue your courageous daily exposure work, and look forward to the day when you have won this battle!  Warmly, david

Live Work with Madeleine I'm Helpless! Part 2 of 3 Today, we are pleased to present the exciting conclusion of our work with Madeleine, a loving mother who fears that her eldest daughter might be in mortal danger during her year abroad. Last week, you heard about the T = Testing and E = Empathy phase of the live work with Madeleine, a mother feeling intense panic and helplessness and inadequacy because she fears that her daughter could be in grave danger of abduction and worse. This week, we will focus on A = Paradoxical Agenda Setting, using the Miracle Cure Question, Magic Button, Positive Reframing, and Magic Dial to see if we can melt away her resistance to change. You can see the Emotions table of the Daily Mood Log Madeleine during the Magic Dial portion of the session if you Click Here As you can see, she wanted to reduce her negative feelings somewhat, but thought she still wanted to keep them fairly elevated, since she still sensed that her daughter might be in real danger, and clearly did not want to abandon her. This is one of the significant refinements in TEAM CBT. First, we want to bring the patient's resistance to full conscious awareness. Second, we want patients to full grasp that their negative thoughts and feelings do NOT result from some "defect" or "mental disorder," but rather from what is most beautiful and awesome about them as human beings. After the Magic Button, David and Jill went on to the final, M = Methods portion of the TEAM session, using tools such as Identify and Explain the Distortions, the Double Standard Technique, and the Externalization of Voices, with the Acceptance Paradox, the Self-Defense Paradigm, and the CAT (Counter-Attack Technique). We will, of course, do numerous role reversals to see if we can get Madeleine to a "huge" victory over her many distorted thoughts. You can see the Daily Mood Log Madeleine prepared at the end of the session if you Click Here As you can see, the reductions in negative feelings were dramatic, but in several areas (anxiety, inadequacy, frustration and anger), Madeleine's negative feelings were still minimally elevated. That is one of the reasons we decided to schedule an additional session together several weeks later to see if we could intensify Madeleine's responses to her negative thoughts, and hopefully due some Cognitive Flooding to complete her "treatment." At the end of these show notes, you will find an email from Madeleine after the session that includes her end-of-session scores on the BMS and EOTS. You will also see comments submitted by many participants who attended the webinar live. This email below from Madeleine following the session shows her end of session scores on the Brief Mood Survey as well as the Evaluation of Therapy Session at the end of her session with Jill and David. Hi David, Yes, here are my BMS & ETS score totals after the extended session. Please let me know if you have any questions. A relapse prevention session would be nice; however, I hesitate to accept your offer as you all are so busy. Please know that I am practicing the PTs and keeping the NTs in check for now. Thank you again a million times over😊. Yes, Feel free to use the recording however you like. Like I said, it's the least I can do to contribute to your generous and vitally important work. You are both very inspiring in so many ways. Much gratitude, Madeleine Brief Mood Survey (BMS) Depressed 0 / 20 (complete elimination of depression) Suicidal 0 / 12 Anxious 2 / 20 (near-complete elimination of anxiety) Angry 0 / 20 PF 36 / 40 (dramatic improvement in Positive Feelings) RS 29 / 30 (large improvement in Relationship Satisfaction) Evaluation of Therapy Session (ETS) Empathy 20 / 20 (perfect) Helpfulness 20 / 20 (perfect) Satisfaction 8 / 8 (perfect) Commitment 8 / 8 (perfect) Neg feelings 1 (0 – 4) (uncomfortable at times!) Difficulties w/ answering the questions honestly 0 (0 – 4) (no difficulties) What did you like the least? Crying and blathering in front of all those people. Fortunately, I wasn't able to see any faces except yours😉 What did you like the most? Jill's "smooth as silk" empathy skills, David's laser sharp questions, Jill's rephrasing & untangling of the PT to "unlikely," David's having me write powerful PR stuff down, Jill & David's EOV - so strong, David counterattacking my neg thoughts with "sociopath," Jill's double std delivered in a very gentle way. I never felt rushed! Feedback for Madeleine from the chat during the session Comments for Madeline: Madeline!!! I want you as a therapist. Your ability to show how to feel and describe the feel is courageous and admirable. Thank you. Thank you for sharing Madeline, I can completely relate with you as a mother when we worry and has no control on their actions Definitely relate to Madeleine and appreciate her vulnerability. Thank you for your transparency, Madeleine. We appreciate it and can empathize I totally relate. My children are 30 and 32, I parented in the 90"s;  i was trying to break the abuse cycle, so i missed nurturing their emotions and building their self esteem. My children give me so much grace and say how much they love watching me as a grandparent. I am so proud of the grandmother I am!!!! I am so grateful to be a part of their journey and blessed to have a second chance at creating that safe space for all of them. wow.  this event really open up the deeper pain in your life.  Feel honored that you are opening up to us. I'm so much appreciating Madeleine's being vulnerable and her sweetness and maternal care/nurturance and how David and Jill are working with her.  Helpful learning experience.  Thank you all. Thank you Madeline! It was brave and kind of you to share your story for today's demo!! Shows she is courageous n strong woman I am in awe over how Madeleine's resistance to looking at inadequacy actually brought out the most amazing positives and core values. Beautiful! I also just got the chills She is great mother She is caring person cares for others Madeleine is so incredibly courageous sharing her story here being so vulnerable too I appreciate how real this is and thank you all for the work you do for helping Madeleine through this and for providing  this very inspirational training :) As a mother and also deep empath, much of what she is sharing definitely resonates.  I hope she's able to continue working with her struggles and strengths to heal and feel better sooner than later 💗 Madeleine, it means so much to hear you. I was in trouble with an abusive boyfriend when I was college aged. I would have given anything to have my mother give me support at that time. I felt completely alone navigating the relationship and unable to get out. I needed an "adult in the room". Just hearing and seeing you right now is huge for me. Your daughters are lucky to have you! It's clear that you have their back and I'm sure they know it. I feel like you bring your whole heart to being a mother, truly beautiful and awesome! Thank you so much for volunteering today. Hi Madelyn, I'm also a mother like you. I am a sensitive person like you and worry about how evil the world is. I worry for my daughter's future. My daughter has a beautiful sensitive, innocent soul. The fact that we feel this way shows that we are kind emphatic people. The only way not to suffer about these issues is to be a sociopath, to be part of the satanic community that is responsible for the ugliness in the world. I don't want to be part of this evil community. It is our political systems responsibility to spread the stoic values that make just, reason/logic driven people, brave, kind and educated driven people. As for myself, I'm proud of who I am and find peace and comfort in studying stoicism. I believe that if we all learned about stoicism our world would be a much better place. And there's just as many Creeps and Sociopaths in your hometown as abroad. What's increasing her safety is knowing she has an open line of communication to her mom. That kind of girl is not such a target. Creeps are looking for girls without strong roots, without "backup". Girls with a a major insecurity to fill. Your type of parenting is exactly what's made her safer. Just to add to externalization of voices if we're allowed or supposed to! In case Madeline sees this chat, I feel compelled to share that I studied abroad in the spring semester 1998, in Jerusalem at Hebrew University.  I turned 21 that semester (as did my group of new friends).  Hands down it was the most formative and important experience of my life to build trust in myself, feeling able to navigate the unexpected, land somewhere totally new and make new friends and figure things out.  My worried mother heard all kinds of yucky things in the news that was happening there (things that I never saw).  We navigated our safety, traveled on weekends and breaks.  And since, I have regularly offered the recommendation, both solicited and unsolicited, about the incredible merits of studying abroad,  Of course, our mama-bear hearts will be called to protect our babies.  And, sounds like your girl is gritty and brave, open to new experiences, adventurous, and eager to experience life! Madeline's empathy and compassion and  counterattack stating "I taught her to see the Beauty in the world "is profound and amazing and reverberates for coaching and self empathy! Wonderful Madeline, David and Jill! Thank you Madeleine for being so vulnerable, honest, and open to aid our learning.  SO touching and relatable. M's standard for herself and parents is so very high and unattainable! She is doing way more than most by just caring this much.

Live Work with Madeleine I'm Helpless! Part 1 of 3 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. Part 1 of 3 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 Click Here 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, I'm totally responsible for how she's turned out. 95% I was not present enough for her. 95% She may not trust that I'm there for her. 60% She's anxious and insecure and a people-pleasure, and she's also perfectionistic, and it's all my fault. 75% 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: How accurately did we understand how you were thinking? How accurately did we understand how you were feeling inside? 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!

Past Projection vs. Memory Rescripting Why Can't I Lose Weight? Do Demons Cause Negative Thoughts! Featuring Our Beloved Dr. Matthew May 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. Rhonda asks: What's the difference between Past Projection and Memory Rescripting? Slash asks: How do I overcome my resistance to losing weight? Constantina asks: Do negative thoughts come from demons?   And here are the answers! 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.   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   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