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

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

Ask David: Chasing, Commitment Problems Sadness as Celebration Is Autism Increasing?  The answers to today’s questions are brief and were written prior to the show. Listen to the live discussion for a more in-depth discussion of each question. Today’s live podcast discussion with Rhonda, Matt, and David was very energetic and hopefully inspiring for all of you! Today’s questions. Aurora asks about a dating problem—the guy I’m dating doesn’t want to “commit.” What should I do? Ana asks: I’m 48 now, and about 25 years ago, I was diagnosed with infertility—a devastating moment for someone who had dreamed of becoming a mother since childhood. Through therapy, prayer, and especially your book Feeling Good, I’ve done deep healing. I truly feel at peace most of the time. My life is full and joyful. But I’ve noticed that certain dates—especially Mother’s Day and Christmas—still bring sadness. Not overwhelming or constant, but a familiar ache that surprises me even now. I use my CBT tools and move through it, but part of me wonders: should I be “over this” by now? Brittany asks: Is autism really on the increase? The following questions will be included in the next Ask David podcast. We did not have time to include them today. Ollie asks: How do you motivate a procrastinating patient to do the hard work of facing the task they’ve been putting off? Owen asks: Should I complete a full Daily Mood Log each day? Owen asks: Is it okay to copy the positive reframing from a previous DML when relevant? Zainab asks: Is friendship a basic human need?   1. Aurora asks about a dating problem—the guy I’m dating doesn’t want to “commit.” What should I do. Hi Doctor Burns, I have been dating a guy exclusively (both only seeing each other) but he doesn’t bring up wanting commitment to being in a relationship. He wants to see me in all his free time but tends to plan dates last minute if he does and assumes we will hang out at his place when we get together. He knows I’d like a relationship but said we are working towards that and that it’s putting unnecessary pressure when I mentioned it. I’m not sure how long to wait and asking directly for what I’d like (him planning dates in advance) doesn’t really help as he quickly got defensive and I then went to using the five secrets. Any advice? Thank you for everything you do, I love your books and podcast so much. They have truly changed my life. You and Rhonda make me smile every day that I listen. If you do by chance use my question would you not include my name? Aurora David’s response Yes we can address this during an Ask David. It’s great timing since we just had several podcasts on dating questions, Quick answer, and we’ll go deeper in the podcast, but it sounds like you’re being a bit too available and letting him use you and take you for granted. Remember the Burns Rule: “People ONLY want what they CAN’T get, and NEVER want what they CAN get!” So being more unavailable, letting him know you have other plans (which may simply be not to see him at the last minute), all the while being sweet. When he says he is not interested in a commitment just now, you can use the Five Secrets of Effective Communication, and play the role of “shrink,” not “available lady.” Ask him about that, express curiosity, encourage him to talk. These methods (5 secrets) are an art form, spelled out pretty clearly in Feeling Good Together. Pressing him for a commitment is guaranteed to drive him away. You want HIM to be the chaser, and YOU to be the chased. Also, a Daily Mood Log on thoughts that make you anxious about him, and working toward letting go of “needing” him. Warmly, David Aurora responds to David This is amazing Dr. Burns, thank you so very much! I am so humbled you took the time to read my email, use my questions, and give such a helpful reply. And yes how about the name Aurora! Thank you and Rhonda. Your work has truly changed my life and I am so deeply grateful for all you do. Aurora   2. Ana asks about living with infertility. Hi Dr. Burns, I hope you’re well. I had the honor of corresponding with you and Dr. Rhonda last year about my relationship with my mother, and I’m still so grateful for your generosity and the space you gave me on the podcast. Today I write about a different part of my story. I’m 48 now, and about 25 years ago, I was diagnosed with infertility—a devastating moment for someone who had dreamed of becoming a mother since childhood. Through therapy, prayer, and especially your book Feeling Good, I’ve done deep healing. I truly feel at peace most of the time. My life is full and joyful. But I’ve noticed that certain dates—especially Mother’s Day and Christmas—still bring sadness. Not overwhelming or constant, but a familiar ache that surprises me even now. I use my CBT tools and move through it, but part of me wonders: should I be “over this” by now? Or is it normal that something so deep still stirs, even after years of healing? I sometimes question whether I’m simply very good at coping (I’m an Enneagram 3—always performing strength) or if there’s still more I need to process, like the moment both of my sisters-in-law announced their pregnancies during the darkest part of my grief 😓💔. But then again, maybe occasional sadness is just part of living with love and loss. Thank you for reading—and for your work, which has meant so much to me. Warmly, Ana David’s Response Hi Ana, My website is a little clunky now, but if you search “Sadness as Celebration” you may find one or more podcasts that address this concept. In simple terms, your sadness is an expression of your love, and your core values as a human being, as a woman. So you might want to continue to experience that  occasional sadness forever. Of course, if it is having a negative effect on your llfe, that would be different, but it doesn’t sound that way. Acceptance, with gratitude, could be one path. Could we use this on an Ask David, with your first name or possibly some other name? In other words, if you could press our Magic Button and “be over it,” would you REALLY want to press that button? What does your sadness say about you and your core values that’s positive, even awesome? Warmly, david Ana replies Dear Dr. Burns, Thank you so much for your kind and thoughtful response. What you said makes so much sense — it’s so wise, so true, and also so simple. I appreciate it deeply. The idea that my sadness is an expression of love and core values feels incredibly freeing. I only wish I didn’t feel guilty or “broken” when these feelings creep in from time to time. Your perspective helps me see them differently — not as setbacks, but as moments of connection with something I’ve loved dearly. Yes, please feel free to use this in an Ask David episode. I’d be honored. You’re welcome to use my first name, Ana. With gratitude, Ana David’s reply Thanks again, Ana. As an aside, you “got it,” I believe. Your sadness is an expression of your love, and likely also makes you more compassionate toward others. And more. The sadness you feel, arguably, is not a “defect,” or something to be defeated, but something beautiful that can be accepted and welcomed. If you think it is “too much,” you can write down your Negative Thoughts and look for distortions, of course. Warmly, david Rhonda suggested that we give the numbers of the podcasts that deal with the interesting topic of “Sadness as Celebration.” They include #s174, 252, 253, and 304 (this last being my experience with loneliness and grief while driving across the Nevada desert as a medical student.)   3. Brittany asks if autism is on the increase? Hi Dr. Burns, I’ve noticed in the last few years the term autism being used much more commonly and now seems to be a broader term. I watched a show last night where an actual autism center was showing their test they use. It was pictures of people’s eyes and you had to guess if they were feeling sad, happy, frustrated, etc. They said autistic people have a hard time telling what others are thinking/feeling. Well I took the quiz and got half wrong. They also described autistic people as being awkward socially, having a hard time adjusting to new surroundings, disliking loud noises. Well that also describes me but by no means would I say I’m autistic. I think they are throwing personal preferences and social anxiety into the umbrella term autism. I know you did that podcast on ADHD where you said you don’t treat ADHD, you treat people. What are your thoughts on the way autism seems to be diagnosed these days? Of course I’m sure you would just treat whatever problem the person wanted to work on, not the so called disorder. But still, do you find it frustrating how often people are deemed to be autistic these days? -Brittany David’s reply I might be a bit autistic, too! Join the club. It's the latest thing, and super broad boundaries, just like you said. And like you said, I treat the person, not the so-called "mental disorder." Also, I did an informal study on shrinks, and they had no idea what patients were feeling even after a two + hour interview with the patient! Warmly, david PS I'll make this another ask David, it's a good one! Rhonda wrote: David:  What do you think of putting the link to the autism facial recognition test in the show notes? Great idea, Rhonda, so here’s the link. Remember, we are not endorsing the validity or reliability of this scale, nor are we recommending it for any medical or psychological assessment! David Check out the Autism Test Thanks for listening today! Matt, Rhonda, and David  

Ask David: The Fear of Being Abandoned Living with Someone Who's Depressed Can Someone Else's Depression Depress You! The answers to today’s questions are brief and were written prior to the show. Listen to the live discussion for a more in-depth discussion of each question. Today’s questions. Negar asks: How can I overcome my fear of being alone or being abandoned? Stan asks: What are your tips on living with someone suffering from anxiety or depression? They can sometimes be demanding or argumentative! Stan Asks: How can we protects ourselves from not feeling down during and after spending social time with anxious and / or depressed people because they express anxious or depressing thoughts to us. It seems to me that we must start to believe the distorted negative thoughts that the anxious or depressed person transmits to us, so we start to feel the same negative emotions the other person feels.   1. Negar asks: How can I overcome my fear of being alone or being abandoned? Thank you very much You know, doctor, one of the problems I have had since childhood was that I always worry about being alone and losing the people I love. My mind becomes conditioned and a lot of negative obsessive thoughts come to my mind, even the smallest irrelevant and random external events create a sign and increase stress But I will not stop trying But I am very eager to know what you think about the mind and the irrelevant and random patterns that it relates to negative events and how to get out of this cycle You can even put this as a podcast or clip on YouTube, I think it would be very welcome because I have seen many people who have this problem🙂😇 David’s response Hi Negar, Sure, we can have a question on the fear of being alone / abandoned, and the many ways of overcoming this problem. Copying Rhonda, my co-host. It is covered in detail in the first part of my book, Intimate Connections. Methods we can discuss include: Dailly Mood Log Empathy Positive Reframing Deserted Island Fantasy Cognitive Flooding Please Predicting Sheet Experimental Technique Examine the Evidence Downward Arrow / Identify Self-Defeating Belief(s) (SDB) Cost-Benefit Analysis for SDB Hidden Emotion Technique Externalization of Voices (with Acceptance Paradox, Self-Defense Paradigm, and CAT, or Counter-Attack Technique) Identify and Explain the Distortions Warmly, david   Dear Dr Burns Thank you for all the effort you put into the podcasts, video clips and other material, which I find so helpful. They are a great addition to the books you have written. They are very inspiring and  life changing in my case. I have two questions that I would be very grateful if you would discuss in one of your ask David podcasts, if you think they are worth discussing. 2. Stan ask about living with an anxious or depressed person who can sometimes be argumentative or demanding. Do you have any advice for family members or housemates that live with a person suffering from anxiety or depression. No one wants to make the situation worse and maybe there are some suggestions. I know it can be very difficult living with someone who is anxious or depressed. An anxious or depressed person might sometimes be very demanding or argumentative. They might also sit around doing almost nothing all day or they might have odd sleeping hours for example.  They may make unreasonable requests or be overly sensitive and when hurt lash out at others for example. David’s Reply I would strongly recommend the podcast on “How to Help and How NOT to Help!” Will explain a bit more on the podcast. David   3. Transference of Negative Emotions? Why do we feel bad and how can we protects ourselves from not feeling down during and after spending social time with anxious and / or depressed people because they express anxious or depressing thoughts to us. It seems to me that we must start to believe the distorted negative thoughts that the anxious or depressed person transmits to us, so we start to feel the same negative emotions the other person feels. When this happens we might start to avoid contact with the other person which might make them feel worse. As always I would really appreciate your thoughts on the above two matters, if you think it is worth an Ask David question Thank you again. Kind regards Stan David’s Reply Negative feelings do not “transfer” between people. Only your own thoughts can affect the way you feel. Will explain more on the show! If you’ve been making the mistake of trying to “help,” it would make sense that you would feel upset, frustrated, maybe even angry. But it is your own dysfunctional way of interacting with the depressed or anxious person, and your own negative thoughts, that are 100% responsible for how you feel! But I will need to spell this out on the show! Thanks for listening today! Matt, Rhonda, and David

Dating, Part 3 Flirting Secrets, Safety, and More! Today we feature, Dr. Leigh Harrington and Dr. Angela Krumm, who will tell us how to flirt and date skillfully. Both Leigh and Angela are highly advanced TEAM CBT therapists and beloved friends and long-time members of our TEAM Community. Bio sketches for both go here. Include the idea that Leigh is a psychiatrist who specializes in social anxiety, relationship problems, bad habits, and depression, as well as traversing difficult situations with grace. Angela is a clinical psychologist and co-founder of the Feeling Good Institute in Mt. View, California. She specializes in social anxiety, teaching flirting skills, treating phobias, as well as health and lifestyle changes. Leigh and Angela, let me know what you want for your contact information at the end of the show notes, like email, website, whatever you prefer in case listeners want to contact you. Also, if you have recent pics we can use in the show notes, that’s cool, too, but not required. Rhonda began the show, as usual, with a warm-hearted endorsement, this one from a fan who greatly appreciated Dr. Taylor Chesney’s recent podcast on how to communicate with teenagers who may seem rebellious and out of control. The listener said it helped tremendously in her interaction with her 15 year old stepdaughter. I was not surprised, as Taylor is always filled with great wisdom and awesome advice in her teachings—something I also appreciate tremendously. The take-home message was to use the Five Secrets of Effective Communication, instead of trying to control them. Form a meaningful and loving relationship. It will pay off in the long run, and in the short run as well! Leigh began today’s podcast with a focus on safety when dating strangers, having fun on your dates, how to avoid dating the “wrong” people, how to tame your “dating addiction,” and how to set yourself up for success. Angela then taught us how to generate a fun and meaningful conversation with people you meet, and how to flirt and get things started in a positive direction. She explained that she went through a divorce when she was still young, and got lots of help in her flirting skills from several dear colleagues, including Maor Katz, Jacob Towery, and Stephen Pfleiderer. Mastering these skills was very helpful, and is now more than happy to share the incredible tips she picked up at that time, as well as her personal experiences, which culminated in a successful second marriage and family with an awesome hunk of a guy she met, using these skills. Leigh described how she works with patients who are shy by going out with them to public places where they can encounter and interact with strangers so as to confront and overcome inhibitions and intense anxiety. She said this kind of dramatic experience can have a sudden beneficial impact. She described taking a patient to a drugstore to ask a clerk about the best products for a toenail fungus. The clerk was exceptionally helpful and friendly. Leigh emphasized the power of sharing vulnerabilities to enhance connection with others. Angela said she does the same, going out with patients to approach strangers on the street with innocuous “openers” like asking questions, asking for recommendations, asking someone to settle a debate or something you’re puzzling over, finding a connection/something in common, or giving compliments. Although these things may seem overly easy to folks who have never struggled with social anxiety, they can be huge accomplishments for people who have struggled with social anxiety. For example, if you’re at the grocery store, you might position yourself near someone new and make a comment that seemingly could be directed at them or at no one at all. Something like, “There are so many types of apples. How does anyone pick?” These types of openers are low stakes and give the other person a chance to respond and strike up a conversation or simply move on. In general, she reminded us that it’s a cognitive distortion to assume that people will find out attempts to talk to them irritating or burdensome. Most people appreciate positive attention and like being helpful. Or, if you’re at the grocery store, you might say “Oh, there are so many types of apples here today. I’m not sure which type to buy.” You can also ask strangers for advice; this can be effective because people like to be helpful and it sets them at ease. Angela has prepared a guide describing many valuable flirting skills which you can see if you click here! She also included some invaluable dating tips on avoiding dating the wrong people, safety, and more, which you can see if you CLICK HERE Angela explained many additional key concepts, like Angela explained many additional key concepts, like False time-constraints (taking the pressure off others by keeping initial asks for time short; keeping initial dates short to leave others wanting more) How to decide how much to share when deciding to try to deepen emotional intimacy. Physical and emotional intimacy—how much should you share, and when? Angela suggested that you can use a hierarchy of sharing – testing the waters by sharing things that aren’t too vulnerable for you. Then observe their responses. If they respond respectfully, you can go a bit deeper. So, in a sense, you are doing experiments to guide the ship. This is less stressful than thinking you are being judged and that you have to “perform.” It’s important NOT to chase. For example, once you start dating someone, you might say, “I can only date you once per week.” Then the other person can ask, “Well, why not twice a week?” Now you’re the chased, and not the chaser! Angela says that “It’s always smart to be a little less than 100% available.” It’s great to work to keep your life full and active so you can set these limits genuinely. I have shared some of these tips with young people who are dating. Sometimes they protest and say, “I shouldn’t have to play games like that.” Here’s my (David's) answer: “In fact you DON’T have to play games. And if your current approach is working well for you, that’s cool. But if you find you’re getting left behind too often, you might have to rethink your strategies, and stop believing that you know all the answers! Humans are manufactured to certain specifications—they are very predictable. And, if you’re smart, you can use that knowledge to your advantage, instead of being gullible and overly idealistic. Leigh provided more invaluable information on the important topic of safety when dating. She does not give out her phone number, and especially not her address, for the first X number of dates. Also, you need to attend to your instincts, such as “I have a funny feeling about this person, but I’m not sure why!” LISTEN to that inner voice. She advises, if you feel SAFE you can have more fun, greater freedom, and more enjoyment. Angela said you can also ask for consent before you touch, but you can do it in a flirty way, such as: “You look like you want to kiss me. Is that right?” Of, “I know I’ll really regret it if I don’t ask you to kiss me.” Leigh advised noticing body language. Where are they looking? Notice their eyes, and make contact with their eyes. Their eyes will nearly always be sending a signal. Leigh said that early in a potentially exciting relationship, you may be waiting for a signal from the other person between dates. For example, have they called or texted you? But you don’t have to wait. You can take the initiative. For example, you can send them a good night text, and see if they respond. You can even do it a couple times. This is a good experiment to see if there are some embers burning while you fan the flames a little. Thanks for listening today! Rhonda and I want to thank Angela and Leigh for such thoughtful and illuminating teaching. We hope it brings some courage and love into your life! Leigh, Angela, Rhonda, and David  

Dating, Part 2 Do you need some love? Expert dating advice today! Today we feature two of our favorite people, Dr. Kyle Jones and Dr. Carly Zankman, who will discuss many aspects of dating. Both Kyle and Carly are advanced and highly effective TEAM CBT therapists with tons of experience in dating, and of course, in treatment. They share their personal experiences, as well as their considerable therapeutic expertise, in this highly energetic podcast. They cover a wide range of topics including ghosting, dealing with people who give you the run-around, negative self-fulfilling prophecies, Rejection Practice, how to avoid “chasing” (which Kyle calls the “Temptations Trap”) so you can be the one who’s being chased instead of the one who’s doing the chasing, the importance of being playful and how to make dating fun. The also encouraged avoiding some of the common kinds of negative self-talk, like “This date will suck,” or “I’ll always be alone,” or “People shouldn’t be so superficial,” etc. Kyle and David discussed Kyle’s first Sunday hike. Kyle had just been rejected by his boyfriend, and was feeling super down, telling  himself he was a reject and a loser. They describe how Kyle change his internal dialogue during the hike, and began to talk to himself as a winner, as an awesome, hot, sexy guy, which lifted his mood tremendously. Then David suggested a strategy designed to turn the tables on his ex-boyfriend: “Just go to a gay singles bar tonight and pick up some good looking guy and get laid! If you do that, I can guarantee your Ex will come crawling back, and then you can kick some sand in his face!” Abd that’s exactly what happened! David emphasized the importance of looking your best, in terms of clothing and appearance, when dating, as well as the resistance that some people have (mostly men) who insist they “shouldn’t have to play the gain.” I described my collaboration with a salesperson at the King of Prussia Bloomingdale’s named Kuniko Finkelstein when I was in clinical practice in Philadelphia. I used to refer my single guys to her for a “sex uniform,” and she would select extremely sexy and appealing outfits for them. We highlighted the self-centeredness and foolishness of telling yourself that women or men should love me for the way I am. They say, “I shouldn’t have to play the game.” Of course, you DON’T have to play the game, but if you don’t, you may and probably will end up alone! And once you DO learn how to “play the game,” your chances of finding a deep and meaningful love relationship go way up. About Kyle and Carly Kyle Jones, PhD, is a licensed clinical psychologist with a private telehealth practice serving clients throughout California. He is a Level 4 Advanced TEAM-CBT therapist and trainer.  Kyle specializes in helping individuals navigate anxiety, relationship challenges, and obsessive-compulsive disorder (OCD), with a warm, and evidence-based TEAM approach. In addition to his clinical work, Dr. Jones co-leads The OCD Consultation Group, a monthly peer forum for clinicians dedicated to enhancing their skills in treating OCD. He also serves as adjunct faculty at Palo Alto University, where he teaches in both the master’s and doctoral programs in clinical psychology. A proud alumnus of UC Santa Barbara, Dr. Jones recently joined the alumni council for the Department of Psychological and Brain Sciences, mentoring students and supporting the next generation of mental health professionals. Carly Zankman, PsyD., is a Clinical Psychologist and Level 4 Advanced TEAM-CBT therapist and trainer based in Mountain View, California.  She specialized in working with younger adults and teens, helping them recover from anxiety and other mood challenges, such as social anxiety and fears of rejection and vulnerability, low self-esteem, trauma, and relationship issues.  Carly loves using TEAM-CBT and Exposure Methods to help her clients overcome their fears, create deeper, genuine connection, and live more authentic, joyous lives! Since 2021 the Feeling Great Book Club has been a way for people across the world to come together in learning and practicing powerful self-help CBT Tools in a group book club format guided by your transformative book Feeling Great and facilitated by Brandon a Vance and Heather Clague, two psychiatrists expert in TEAM CBT. The Awesome Feeling Great Book Club Returns! It includes: - Large Group Demonstrations - Small Group discussions and practice, facilitated by former book club members. - Some small groups specifically for those using the Feeling Great App   - Two 12 week online groups starting mid September and going until the first week in December, - meeting 80-minutes a session - either Mondays at 4pm or Wednesdays at 8:30am Pacific Time so they can be accessible to people all over the world. Cost is $240 for the series, sliding scale down to whatever you can afford. For more detail and to register, go to www.FeelingGreatTherapyCenter.com/Book-Club

Dating, Part 1 Navigating the Dreaded (But Sometimes Needed) Dating Apps! Today we started a series on one of my favorite topics: dating. When I was in clinical practice in Philadelphia, a large proportion of my patients self-identified as single, without partner, so this was one of my favorite problems to help people with, and why I wrote the book, Intimate Connections, which included my some of my personal experiences learning about dating during my medical school days at Stanford. Our special guests include our own TEAM CBT expert, Jacob Towery, MD, who presents the free annual two-day marathon on shyness called “Finding Humans Less Scary.” He will be presenting this program at Esalen as well from September 8 – 12, 2025. Check out the September 8 - 12 shyness workshop at the beautiful and dramatic Esalen in the Big Sur! We are also joined by two wonderful young ladies: Sydney, who graduated in 2024 from University of Santa Cruz, and Sophie, who recently graduated from UC Berkely. They will give us some first-hand experiences and suggestions in the navigation of dating apps. Jacob said that after his divorce in 2012, until 2020, he went on a lot of dating apps and met nearly 200 women this way, exploring both short and long-term types of dating. He said it is sometimes difficult to figure out what someone is really looking for on an app, whereas in person it is easier. The group described the tendency to treat people as objects and ghost them when you decide you’re not interested. He recommended, instead, to treat people with dignity and care, even if you’re not romantically interested in them. He said that whether you’ve been on one or many dates, don’t just ghost someone. Instead, you can let someone down gently if you aren’t interested. For example, at the end of a first date in which you don’t find yourself attracted to the other person, you could say “I didn’t feel a spark but I enjoyed our time together. Thanks for hanging out with me.” This will make it clear to the other person you won’t be asking for another date, but in a kind way, and prevents them wondering for days if you will ask them out again. In addition, he advised that initially, don’t just text people back and forth endlessly. Instead, get into real life ASAP. Meet them for coffee or ice cream or whatever would be fun. That way you can find out whether or not there’s a spark of interest. Jacob also recommended using a recent photo of yourself. If you use an older photo of yourself, the other person may be disappointed when they meet you! Jacob recommended being honest about what your interests are, and what you are looking for. Are you just looking for casual dating? Are you only looking for something that may evolve into a long term relationship? Are you interested in having children? What are your interests or hobbies? The group discussed many topics, like is it okay for a woman to take the initiative and ask people out they are interested in? It’s easy to get overwhelmed by having too many offers, too many to select from. And the whole process can be incredibly exhausting. How do you make conversation in a way that will turn the other person on and make them interested in you? What’s the secret? How do you overcome the fear of rejection? And what if you protect yourself from the fear of rejection by hiding personal information about yourself. For example, you may think that if you didn’t really open up to the other person, their rejection will be less painful because they didn’t see your so-called “real” self. Jacob emphasized the importance of being playful and creative when dating. People really like to have fun. Being overly serious or heavy can be a turn-off. Thanks for listening today! Future topics will include how to flirt, how to change the way you think when you’re rejected, making people chase you, how to get close, and more! Rhonda, Jacob, Sydney, Sophie, and David

What's the Latest on The Feeling Great App? Featuring Jason Meno and Adam Holman  Adam Holman and his loving cat! The featured photo is Jason Meno, also a cat lover! Today we focus on a number of exciting updates in the Feeling Great app, and are delighted to be joined by our esteemed colleagues, Jason Meno and Adam Holman who have recently created and launched to new V2 version of the Feeling Great chatbot, which includes greatly increased horsepower, in terms of rapid and dramatic reductions in 7 negative feelings, including feelings of depression, anxiety, guilt / shame, inadequacy, loneliness, hopelessness / discouragement, and anger. The latest data indicates reductions of more than 60% in all of these feelings within the first 90 minutes of chatbot use in most new users, and more than 70% reductions in repeat uses in the same amount of time. This is absolutely phenomenal and far surpasses my expectations 50 years ago when I first imagined and visualized this app. In addition, the new version of the app also causes fairly dramatic increases in seven positive feelings at the same time--a highly desirable feature that was lacking in most previous versions of the app. Jason and Adam also described a number of exciting, user-friendly features like two-way verbal communication with the app so you no longer have to type your dialogues (although you can if you prefer that mode.) Another new feature is long term memory, so the bot will remember you and be able to summarize your previous sessions, and more. In addition, to illustrate exactly HOW the app works, we did a live demonstration with Jason, who has been struggling with several of his negative thoughts, like "This app might not reach the hundred of millions of people around the world who need it." His belief in this thought was 80%, and the thought triggered strong feelings of hopelessness, sadness, guilt, anxiety, frustration, anger, and inadequacy.  This is a valid concern since we must rapidly boost sales if we hope to break even and stay in business, We tried a number of methods that weren't effective, following the app's philosophy of 'failing as fast as we can," including Positive Reframing and Paradoxical Magnification, that did not help at all. In fact, Positive Reframing simply triggered increased resistance. Then we tried a method that has been really helpful for Jason in the past, Externalization of Resistance, and he was able to successfully challenge all the really GOOD reasons to cling to his negative thoughts. At the end, his belief in the thought was reduced from 80% to 20%, which was satisfactory to Jason as he said that some worrying is realistic and keeps him on his toes continually adding amazing new features to the app. If you've been struggling with low self-esteem or negative feelings or low self-esteem, you might want to check the latest version of the Feeling Great app. You can take a free ride and check it out. You've got absolutely nothing to lose but a couple hours of your time, and a life of greater joy and happiness to gain. Rhonda, Jason, Adam, and I appreciate all of you, and thank you for joining us today!  

Teen Troubles? Don’t Freak Out! Featuring Dr. Taylor Chesney Today, we are thrilled to welcome Dr. Taylor Chesney to our podcast on troubled teens—what actually works! Taylor has been on a number of previous podcasts, and has been a beloved member of the TEAM community for many years! We were lucky to have her here in person as a member of our weekly TEAM CBT training group for several years until she and her husband finally returned home to New York in 2014 where she established her booming clinical practice working with kids and teens. She and her husband, Gregg, have four children of their own, ranging from 11 to 2 ½, so she brings a great deal of practical experience to complement her brilliant technical skills. Taylor will teach us how parents can deal effectively with troubled and impulsive and often smelly and irritating teens. I think you will find her message highly practical and inspiring, and perhaps the opposite of the ways you may have reacted to frustrating teenagers in the past. She says her goal is to help parents feel more confident in dealing with their teens and to teach them how to develop greater teamwork, love and understanding by integrating the Five Secrets of Effective Communication into their daily parenting toolkit. She says that “teen brains are different. They act out impulsively when angry, and can be hard to tolerate at times, or even often.” The goal is to learn to see the world through their eyes, and to become comfortable with being uncomfortable with their behavior. Remember that teens are supposed to be irritable and angry as they grow more and more independent, which is healthy. Compared to an adult brain that is more developed, has better impulse control, and “should be” able to tolerate emotions better. She thinks that parents can often do a great deal more than a shrink, especially if the parents are willing to learn how to listen and connect more effectively with their children. She says, “teen brains are changing constantly. Teens are frustrating. They are angry, disorganized, and want more than anything to spend time with their friends. They often complain, and might say that a party they went to was “lame and it sucked because the parents were there, constantly hanging around. They don’t trust us!” Don’t argue or contradict them, or try to teach them “good lessons”. Instead use Thought Empathy, Feeling Empathy, and Disarming. Summarize their words and feelings, and find truth in what they are saying. For example, you might say, “That does sound disappointing, having the parents there supervising all the time. I wouldn’t be surprised if you feel frustrated and ticked off.” You want them to talk! And they WILL talk if you listen instead of trying to fix or control them. Suppose your teen says, “My teacher sucks. I turned my homework in late, so he deducted 5 points. But I was up late helping my friend on the phone, and I forgot.” You could say, “That sounds super frustrating. I know how much you care about your friends, and would do anything to help them out. It sounds super frustrating that you got marked down on your homework. I know that school is super important to you, too.” In other words, your goal is to provide support and warmth, rather than trying to discipline or scold them. They want to please you, but if you put them down when they are complaining, that will push them away and will cast a shadow on your relationships with them. You’ll get frustrated and the tension will escalate, and you may end up shouting at them in exasperation. Then you’ll get down on yourself as well, and you may feel like a bad mom or a bad dad. Taylor points out that if we can’t model calmness at those moments of tension, then our kids won’t learn how to be calm in the midst of conflict, either. They’ll just learn to shout and argue—the very behavior that you’re modeling. Suppose you ask them to do the dishes, but 30 minutes later they still haven’t started. They got distracted. The idea is to use “Gentle Parenting,” showing some patience, warmth and understanding instead of flying off the handle. This does NOT mean giving in, but rather showing kindness when you have to remind them to do their chores. You might say, “I know you’ve got so much going on, and it can be hard to keep up with everything.” Your kids will become more and more independent as they gradually evolve from grammar school, where they are highly dependent on you, to middle school and then to high school. During this process, you gradually evolve from being highly controlling and protective to being more of an influencer and creating a loving relationship, a friendship, with your child. At the same time that you attend to changes in your “outer dialogue” with your child, it’s important to notice your “inner dialogue.” This refers to the way you talk to yourself about our child, and these messages can sometimes be huge barriers to using the Five Secrets of Effective Communication. For example, if you tell yourself that your child is “bad,” this may trigger strong feelings of anger and resentment which will make it vastly more difficult, or almost impossible, to use the Five Secrets. Taylor reminds us that “if you can’t or won’t learn to see the world through your children’s eyes, you are essentially rejecting them and their world, and you will not be able to connect with them. But many parents resist or reject this strategy for a variety of reasons. For example, you may confuse empathy with being weak, or giving with giving in. You may be afraid that if you empathize, your children will walk all over you and run wild. But in point of fact, if you yell and lose your cool, you’ve lost the battle. You simply cannot force them to go to sleep, or to eat what you want them to eat, or to do what you want them to do. And if you fight your battle at the height of the conflict, when the negative feelings are their most intense, you lower the odds of success dramatically. Give them the message of love, even at the height of the battle. It’s not about control, but connection. We demonstrated these beautiful ideas during the podcast with some role-playing and role-reversals. Taylor, your message was crystal clear, simple, powerful, and inspiring. Rhonda and I and all of our fans are indebted to you for visiting today! A big hug and thanks! Taylor, Rhonda and David

450: ASK DAVID, Featuring Dr. Matthew May "All About Anger" Is resentment ever rational or logical? Are perceptions of injustice always present when people feel angry? What’s the best way to respond to an angry criticism? The following answers were written prior to the show. Tune in for the in-depth, live discussions of these cool questions. 1. Mark asks: Is RESENTMENT ever RATIONAL? Is there any rational, logical reason to hold a grudge?  Hey David: I often have interesting thoughts at night – especially after consuming gummies or cannabis cookies before bed! Of course, it’s logical to learn from experiences and refuse to trust or give more money, time, labor, loan possessions, and so forth to someone that screwed us over.  We don’t ever want to be deceived, ripped off, etc., multiple ties, but beyond self-protective behaviors and assertiveness, is there ANY logical, rational reason to hold a grudge or maintain resentment? David’s reply: Thanks Rationality is not one of the strong cards in dealing with any form of anger. Motivational interventions are usually more effective, at least initially. That’s because when we’re angry we usually WANT to feel angry and we won’t take kindly to anyone telling us that our thoughts are WRONG! David 2. Mark asks: Are perceptions of injustice always present when people feel ANGRY? It seems to me that there is almost always some self-talk related to feeling unjustly treated – whether road rage, marital/couple conflicts, etc. I am eager to hear your thoughts/feel free to use any of this in your writings, podcast, blogs, etc. David’s reply: Yes, most if not all, feelings of anger are associated with thoughts of injustice, unfair behavior and similar kinds of thoughts. 3. Rhonda’s 5-Secrets question. In the course of a conversation that I was having with a colleague of mine (not a TEAM therapist), she told me that she felt I was criticizing her. I immediately went into a 5-Secrets frame of mind and tried to disarm her…saying, “Well you are right, I am feeling critical.”  I also used the other 5 steps except I did not offer any stroking because I was not feeling very positive toward her. She said, “Then if you are being critical of me now, you must be critical of me ALL the time.” How would you respond to that? Thank you! Rhonda David’s response We role-played this in real time, and discussed the power and challenge of genuine disarming, and illustrated it. Matt, Rhonda, and David thank you for joining us today, and hope you enjoyed the dialogue!

Stories from My Hippy Days, Part 2 Featuring David and Rhonda A year or more ago we did a Part 1 podcast on stories from my days as a Stanford Medical student in the late 1960s. This was the Hippy Era and the famous “Summer of Love.” A young man, Clyde, recently asked if we’d do Part 2, since we didn’t get to all the stories the first time around. As an aside, there are more stories, so if you like them, we’d be happy to do a Part 3 as well. 1. Husain Chung and the crazy teen from LA: When a stallion wants to run, you run with the stallion!” 2. A frightening encounter with Vic Lovell: And a mentor’s advice on how to handle it. 3. Bar next to the Free University Coffee House: Outrageous works, even with the Hell’s Angels. 4. The bearded man on the quad near the Stanford Student Union—Telling me to “sit with open hands” 5. Ken Kesey and his merry pranksters walked into the Stanford Student Union—they were dressed in pajamas or clown outfits and Neil Cassady was juggling hammers. 6. The tape recorder experiment: Bizarre week, unexpected conclusion. 7. Encounter at the Medical School: “Psychiatry and Psychotherapy—Are they Relevant or Obsolete?” Featuring Hussain Chung 8. Missing the medical school graduation ceremony: Didn’t pick up my diploma until years later. 9. Homeless in Carmel Valley: Saved by Ramadan, Subud and Bapak. Thanks for tuning in today! And keep your requests, questions, and feedback coming. Your satisfaction and happiness are our top goals! Rhonda and David

448: Ask David, featuring Adam Hollman Relationship woes--what should I do? How can animals have feelings if they can't think? How often should I fill out the Daily Mood Log? Why can't husbands express their feelings?   Today we are joined by Adam Holman, LCSW. Adam has recently left his full time clinical practice in Arizona to join our Feeling Great app team here in San Francisco. I think you’ll be delighted by his warmth and wisdom. Although he works with us full-time, he still practices one day per week and specializes in X depression, anxiety, and screen addiction(e.g. video game addiction and more.) He has appeared on two previous Feeling Good Podcasts, # X and # Y. We are delighted to have Adam as the honored guest on today’s Ask David podcast! Here are the questions for today’s Ask David. They were all written before the podcast. If you listen to the podcast, you will get much more information and perspective. The Questions Hello Dr Burns. I hope you are doing well. I participated in the webinar held on 18th of April. It was a good experience for me and I would like to thank you and your team in arranging for that. Far asks: if You have a relationship problem, but also feel inadequate. Should you use the Daily Mood Log for the internal problem of inadequacy and the Relationship Journal for the actual dialogue? Moritz points out that animals, who don’t think in words, still have intense emotional reactions, including fear and anger. For example, when a deer spots a predator, like a cayote, it feels terror and instantly runs to get away. Doesn’t this prove that terrifying events can cause feelings directly? In other words, that makes it seem like thoughts or cognitions are NOT necessary to feel emotions. What do you think? Rob asks: How often do you fill out your own daily mood journals? Do you do one every day? Would you be willing to share recent examples of your own journals with podcast listeners? Brittany asks: Why won’t my husband share his feelings? (Or, we could ask, why can’t men express their feelings?)  The Answers 1. Far asks: If you have a relationship problem, but also feel inadequate. Should you use the Daily Mood Log for the internal problem of inadequacy and the Relationship Journal for the actual dialogue? Hello Dr Burns. I hope you are doing well. I participated in the webinar held on 18th of April. It was a good experience for me, and I would like to thank you and your team for arranging it. May I ask a question? When there is a relationship problem it should be addressed by the relationship journal and interpersonal downward arrow and not by the cognitive method as far as I know. What about when there is a relationship problem together with strong feelings of depression and frustration as a result of an internal dialogue of being inadequate and defective. Should this component be addressed by the cognitive method and straightforward technique? Thanks a lot. Far Kom David’s Reply This one just came in, so we’ll answer it live.   2. Moritz: Are thoughts REALLY necessary to have emotional reactions to events? Hi David, first of all, thank you for the podcast, and in particular for answering my question about how you help people with schizophrenia or bipolar disorder, which came out a few weeks or months ago. I just finished listening to episode 430, where you stated that that negative thoughts can cause negative emotions (this part I'm totally on board with), but also hypothesized that probably only negative thoughts cause negative emotions. Did I understand that correctly? (If not, please ignore the rest of this email, it won't make any sense). I'm kinda confused about this claim. This is totally not my area of expertise, but I'm under the impression that fear is much older and more "primitive" than (at least conscious) thought, from an evolutionary point of view. It would seem unlikely that an old evolutionary feature in the brain would only be triggered from a newer feature. My other source of confusion comes from my own comparison with animals. It is my impression that basically all mammals show some kind of fear response, but we don't attribute thoughts to all of them, never mind full-blown self-reflective, conscious thoughts. So at least in the mammals with simpler brains, it seems likely that fear (and other negative emotions) could be triggered pretty directly without going through negative thoughts first, and it would also be quite surprising if we didn't all contain the same mechanisms, since we share most of our neural architecture with all mammals. Do you think these considerations are valid, and if yes, are they compatible with your approach? After listening to your podcast, my own mental model of negative emotions is something like this: stimuli can cause negative emotions directly; this happens in all mammals when the stimulus goes away, negative emotions also ebb and go away after a certain time, unless something keeps them alive in humans (and likely in at least some mammals), thoughts also can trigger emotions, and so they can disable the natural dampening of negative emotions. This mental model might explain satisfy both the evolutionary considerations, and explain the data you've gathered from the Feeling Great app. I admit I feel a bit silly writing you this, because you spend so much more mental energy on these topics, so it seems unlikely I have anything to contribute that you and your team didn't think of. So, sorry for the long rambling, and I hope you still find something interesting in it, or maybe you can clear up some of my confusion about your model. Best regards, Moritz David’s reply Thank you for your thoughtful comments. I think they are awesome, and definitely not “silly.” Here’s my take on it, for what it’s worth, and I just speculate, too. All animals, including human animals, have perceptions. When a dear spots a cayote, the "stimulus" is a perception of a dangerous predator. This "cognition" triggers the emotion. People think cognition means sentences involving words, but my understanding is quite different. The idea is that any kind of conscious perception can trigger emotions, including sudden fear or anxiety. The perception might simply be an image, which is also a type of cognition or perception, that can suddenly trigger great fear. When I see a rock climber on TV, this "picture" or “perception” stimulates a powerful physiological fear reaction. That's because I "see" the picture as being incredibly dangerous and imagine falling. Thanks, david Might use as an ask David follow up, if that's okay! Moritz replies Ok, "simple" cognition without explicit thought can be enough to trigger emotion, got it. Feel free to use that as an Ask David if you want. Regards, Moritz David’s final reply Thanks, yes, it is the perception of danger that triggers the fear. Terrific! As another example, you could argue that when the airplanes flex into the World Trade Center in New York on 9/11, everyone felt terrified, horrified, and devastated, and it was the event that caused these feelings. Doesn’t this prove that thoughts, or cognitions, are not required to have powerful feelings? It would seem like you didn’t have to put a thought in your mind to feel fearful when watching the horrifying images on TV. What do you think, Moritz? Well, here’s my answer. It is not true that everyone had the same feelings watching that horrifying scene. We all had our own unique reactions, depending on how we were thinking about it. And of course, some people felt joy, glee, and more, and did NOT have negative feelings. That’s because they thought about the event quite differently. For example, Osama Bin Lauden and his followers when watching were delighted, and like thinking, “Those Americans finally got what they deserved!” Same event—radically different emotional reactions. All of your emotions result from your thoughts. The positive and negative events of our lives do not, and cannot, affect us directly. We have to interpret the event first and give it meaning. Thanks! David   3. Rob asks: How often should you do Daily Mood Logs? Do YOU fill out your own Daily Mood Logs? Hello Rhonda and David: I hope you're both doing well. I'm a long-time listener to your podcast, and I shared an endorsement that you included in podcast episode 333 about two years ago. While listening to an episode recently, some questions occurred to me that I wanted to share with you. How often do you fill out your own daily mood journals? Do you do one every day? Would you be willing to share recent examples of your own journals with podcast listeners? I can understand how you might not want to do this and certainly respect your right to privacy, but I thought also it might be interesting for listeners to hear. I would be honored if you would share your thoughts with me when you have a moment. Rob Robinson All the replies to this excellent question will be spontaneous and live on the podcast.   4. Brittany asks: Why can’t my husband express his feelings? Hi Dr. Burns, I have a question. This is something that frequently comes up in arguments with my husband. Here is an example from yesterday: Me after finding out he was upset the night before I said: “Why did you tell me everything was fine and it’s all in my head if you were upset?” Husband: I shouldn’t have to tell you. You should be better at reading me. I feel annoyed because when I did ask him if he was upset the night before, he denied it then put the blame on me the next day that I should be able to read his mind. That doesn’t seem fair. I don’t suppose I could put that in my five secrets response though as it wouldn’t make the problem better. What do you think? I guess I should probably do the relationship journal. -Brittany David’s reply Hi Brittany, Here’s my quick assessment. Your first statement to him when he said he’d been upset sounded a bit blaming. In other words, he was trying to express his feelings openly and told you

Perfectionism Update Featuring Adam Holman Today we are joined by Adam Holman, LCSW. Adam has recently left his full time clinical practice in Arizona to join our Feeling Great app team here in San Francisco. I think you’ll be delighted by his warmth and wisdom. Although he works with us full-time, he still practices one day per week and specializes in X depression, anxiety, and screen addiction(e.g. video game addiction and more.) He has appeared on two previous Feeling Good Podcasts, # X and # Y. We are delighted to have Adam as the honored guest on today’s Ask David podcast! Today’s questions come all the way from North Macedonia! Dear Dr. Burns, Thank you so much for your kind response. I’d be truly honored if my questions could be considered for a future episode of your Ask David podcast. Your work has been a key influence in my research on perfectionism and its cognitive-behavioral aspects. Here are a few brief questions I’m currently exploring: How has your view of perfectionism evolved since Feeling Good? What strategies have you found most effective for challenging perfectionistic thinking in therapy? Is perfectionism often rooted in a fear of not being “good enough”? How does it typically manifest in academic or professional environments? If you happen to include any of these in a future episode, I’d be grateful if you could let me know so I can tune in. Thank you again for your time and for the lasting impact of your work. Warm regards, Mitko Toshev Doctoral Student Faculty of Pedagogy University “St. Kliment Ohridski” – Bitola North Macedonia David’s Reply Yes, this will make for an excellent podcast with a refresher on perfectionism, featuring questions from Mitko and a spirited discussion with Adam, Rhonda and yours truly! We had an in depth discussion of all the latest bells and whistles in the treatment of perfectionism with TEAM CBT. This included the two very different but complementary approaches to treating depression or any of the 23 common Self-Defeating Beliefs. So, if you’ve ever struggle with the thought that you’re not good enough, or that you SHOULDN’T have made this or that mistake, this podcast will be right up your alley! Thanks, Mitko! david

446 Who am I? Medical Help that Saves Children’s Lives Featuring Dr. Rachel Sewall: “I want to shout from the mountain tops!” Today we hear from Rachel Sewell, M.D., a Stanford pediatric endocrinologist who provides medically necessary care for transgender and gender diverse young people. She shares how in a time when there is a lot of inaccurate information being spread about this vulnerable population she will continue to advocate for them by providing education and accurate information, including by being a guest on this podcast. She says:          When I was a medical student, I wasn’t initially sure what type of medical practice I would pursue.     However, I always knew I’d be an advocate for LGBTQ+ patients . As a first-year medical student, I trained and worked in the emergency room. I quickly realized, as did my mentors, that I enjoyed and was excellent at  working with children, so I  focused on pediatrics. That summer I had the chance to do research in endocrinology which is the study of all  hormones. Think of hormones as messages that travel throughout our bodies delivering important information. Hormones are responsible for so many important functions including keeping our bones healthy, helping us grow, using the energy from our food, and causing kid bodies to change into adult bodies. My work with transgender and gender diverse children and teens involves providing  evidence-based holistic  care with a skilled team of clinicians. More than anything,   my patients want to be respected, heard, and allowed to thrive. .  In providing them care,I bear witness to intense conversations, emotional highs and lows, as well as the purest examples of joy. Throughout it all, it is my privilege and pleasure to provide them gender affirming care. During this episode we reviewed definitions of gender identity vs the sex assigned to someone at birth. We review the common times when young folks share their gender identity with the people in their lives as well as what it means to be cisgender vs transgender. We discuss sexual orientation and gender identity and how these are complicated and independent aspects of everyone’s sense of self. Rachel continued, Medically necessary care for transgender and gender diverse patients is life-saving. Imagine, you know you are male but your body has a period every month. This can be profoundly distressing and results in gender dysphoria. Gender dysphoria is the intense discomfort that results from your identity not aligning with your body and negatively impacts people’s everyday lives. Now imagine being told that there are safe and effective ways to avoid experiencing that distress. I have had numerous patients say that the care they receive has saved their life. When people hear gender affirming care it often leads them to think of care provided to transgender and gender diverse people but everyone deserves access to gender affirming care. Because it is simply a model of care that recognizes the importance of and validates people’s identities and experiences. Other examples of gender affirming care include being able to take a medicine to help prevent hair loss on your head or undergoing a breast reconstruction surgery after having breast tissue removed in the fight against cancer. When discussing possible ways to support a patient’s identity I tell families that there is no one size fits all. Everyone’s journey is completely unique. For some patients, having their legal documents align with their chosen name is the most important thing. For others, they alter their gender expression, aka the way they present themselves to and interact with the world around them with things like hair changes, makeup, clothes etc. to align with their identity. For some folks it is important to pursue hormone therapy. And for some they will end up pursuing surgical interventions when they are adults. I also discuss that the timing of sharing your gender identity if it does not align with your sex assigned at birth varies tremendously. But regardless of age, gender-affirming medical care  always makes a tremendous difference in  peoples’ lives! Rhonda and I are deeply grateful to Rachel for giving us this wonderfully patient and clear education in a field that was not even covered, to the best of my knowledge, when I was a medical student at Stanford. We hope your voice today, Rachel, will be heard by many, and will hep to bring greater peace, acceptance, love and understanding to our many podcast fans. Thanks! Rachel, Rhonda, and David

Secrets of Superb Interviewing-- How to Be Everyone's Number 1 Choice! Today we feature our beloved Kyle Jones, Ph.D, a clinical psychologist who suggested we might do a really cool podcast on the interviewing skills featured in Chapter 16 of my Feeling Good Handbook. Rhonda and I are absolutely delighted to welcome Kyle for his third appearance on to the Feeling Good Podcast. (Rhonda had to excuse herself after introducing this episode because she was not feeling well) In that chapter on interviewing skills, I listed the five basic principles of successfully interviewing for a job, for admissions to a school, or really almost any type of interview at all. I have to warn you that these ideas may be unfamiliar, and will definitely be quite different from what you've been taught about winning interviews. #1: Be personable and friendly. Don't try to impress the person who's interviewing you! #2 Make them sell themselves to you. #3 Be honest, but present yourself in a positive light. #4 Don't get defensive. #5 Punt when you don't know the answer to the question. To illustrate the first idea, I told a story from Dale Carnegie's book on How to Win Friends and Influence People, in which he describes his interview with a wealth and powerful man in the hopes of soliciting a donation  for the Boy Scouts of America. This was back in the era many years ago when the Scouts were still very popular. The receptionist who made the appointment warned Dale Carnegie that he would have only 15 minutes, and emphasized that her boss was 100% meticulous about time. He started exactly on time, and ended exactly on time, whether or not you were done, so he better talk fast once the interview started. When the time came, and Dale Carnegie entered the office, the receptionist again reminded him that he'd be kicked out after 15 minutes no matter what! As he walked in, Dale Carnegie spotted a trophy fish proudly displayed on the wall above the rich man's desk, and asked, if the wealthy man he'd caught it. himself, The rich man said he had caught it in lake so and so. Dale Carnegie got excited and said, "I fish there too. Where, exactly, were you fishing on the lake when you caught this fish?" The man told him where his favorite fishing hole was, and they become engrossed in a vibrant conversation about the joys of fishing. Suddenly, the office door opened, and the receptionist appeared and said the time was up. On the way out, the wealthy man said, "Oh, I forgot to ask you what the purpose of the interview was." Dale Carnegie said, "Oh, I'm sorry, I forgot to mention that I am trying to raise money to support the Boy Scouts of America." The man replied, "You'll receive a check in the mail tomorrow for a million dollars." And those were the days when that was an enormous amount of money. What's the moral of the story? Relate to the person who's interviewing you as a person, and show an interest in them, instead of pitching your talking points and trying to impress them. People usually make decisions influenced greatly by how much they like the person they are talking to. Don't try to be impressive. Aim for friendly, real and human. How do you do this? Well, let's say that you have an interview with a law firm, hoping to get hired, and you're just out of law school. I used to be the shrink for the University of Pennsylvania Law School, and at the time there were too many law school  graduates looking for too few job openings, and almost no one was hiring. They referred despondent and panicky students to me who'd had a string of rejections. At the time, the top firms had at least 50 to 100 top notch candidates for every position. Was there any hope of starting their careers? I told them to do some research on the person who was going to interview them, or on their firm. Find something interesting about them. Then, at the start of the interview you can say something like this: "I'm so excited to meet you because I've been following your work for some time. I was amazed and blown away by your strategy in the X, Y, and Z case, and I was wondering if you're still using that approach in litigation and how it's been working out? I'd love to hear more about your work, and how you came up with the approach you're using, and what you like the best about this firm." This will get them to talking about themselves. DON'T try to impress them with how great you are . That will just bore them, or turn them off, and it will certainly put you under pressure to perform. This pressure will probably make you anxious, and your  anxiety and insecurity will show. Instead, impress them with how great THEY are. They'll love you! I trained the students in this doing role-playing of imaginary job interviews. Every student I trained in this approach became the #1 choice at every firm they interviewed at! This approach is not just for law students, it's for every type of job, as well as interviews for college, graduate school, and more. Here's the underlying idea. People don't really care much about you. They care about themselves. This is true of all of us. So, use this to your advantage, and you'll suddenly be super happy and glad you were OTHER centered and not SELF centered! Does this mean you should hide your own skills and accomplishments? Of course now. You can answer questions about what you offer with humility and integrity. But that alone will rarely be enough. #2 Make them sell themselves to you. Let's say you're applying for graduate school, and it's very competitive. Again, they have 100 brilliant candidates for every position. Suppose the interview says something challenging, like "As you know, all the top candidates in the Unites States apply to us here at Harvard. Most of them were #1 in the their college classes and several have already been nominated for Nobel Prizes. Why should we be interested in you?" This, of course, is absurd, but I'm taking the worst imaginable question in an interview. Yikes! This sounds impossible, right? How in the world could you respond? Actually, it's easy. You can just say, "Gosh, I don't know if I'd be a good fit here. That's what I'm hoping to learn today. Maybe you can tell me what you're looking for in a top notch candidate. What kinds of candidates have gone on to be stars, and what types have been disappointments? Then I can give you a better answer on whether or not I might be a good fit. Although I love your company, and I'm so impressed with your own career, I wouldn't want to accept a job unless I was convinced I could really contribute to your firm." Is this realistic, or just some David fantasy? During my senior year in college, I was planning to go to graduate school in clinical psychology, since I'd majored in philosophy and psychology seemed like a way more practical career.  However, my college adviser said that medical school would be a far better choice because medications were becoming more and more important in treating mental illnesses, and only psychiatrists could prescribe drugs. I told him that I'd never had any interest in being a medical doctor, and wasn't even a premed student, so there was no way I could get into medical school. I hadn't even had a single biology class in college. He said "That won't be a problem I don't think. You've got the gift of gab, and they probably won't even notice." So, I applied to a number of medical schools and landed an interview at Stanford, and several others. My interview was with someone in the Anatomy Department which was located in the basement of the museum on campus. I went down the stairs and into a room where I met the man who was interviewing me. I said, "It's a bit dark down here. Is this where the medical students dissect their cadavers?" He said, "Absolutely. But it's actually pretty awesome down here. In fact, my laboratory his just down the hall. I said, "Oh, could I see your laboratory? I'd love to take a look and find out what kind of research you do." He seemed excited and as we walked into his lab I noticed all kinds of fancy equipment and read the name on one of them, so kind of photometer or something. I had no idea what it was, but said, "Oh, I see you have an X, Y Z photometer. (or whatever it was). Do you use this in your research?" He said, "Oh, absolutely, it's extremely important in my research." I asked him about the research he did. He excitedly started explaining it, and for the most part I had no idea what he was talking about, but kept expressing interest and asking him for more and more information. I was terrified that he'd ask me questions about my undergraduate work and my research, which of course did not exist. I'd never done any research! Just philosophy classes and such. Well, we had quite the conversation, but after a while he suddenly looked at his watch and said, "Oh, my goodness. We were only supposed to talk for 15 minutes, and we've been talking for nearly two hours. I have to rush over to the medical school quad for an important meeting I'm almost late for. Why don't we walk over in that direction together?" As we were walking out of the basement, he said, "Oh, my goodness, I forgot to ask you who you are and where you're from." I said, "Oh, I'm David Burns from Amherst College." He said, "Well, David Burns, I want you to know that you're the kind of young man we need at the Stanford Medical School.!" I said, "It's really kind of you to say that, but I'm afraid I won't be able to come to the Stanford for medical school." He said, "That's nonsense? Of course you can come! Do you think Harvard is going to make you a better offer? We'll top anything they offer." I said, "Oh no, sir, that's not it. You see, my father is a minister, and we don't have much money, and I've heard that attending medical school would cost more than one hundred thousand dollars. And he believes that borrowing money is a sin." He said, "David Burns, I'm the head of the admissions committee, and that's where I'm headed right now. And I'm going to

I’m angry! A Once-UndocumentedImmigrant Speaks from the Heart-- Live Work with Sunny, Part 2 Last week you heard Part 1 of the Live work with Sunny, who’s struggling with radically conflicting emotions. On the one hand, he has finally achieved his dream of an incredibly happy and fulfilling life, but he is frequently plunged into profound despair, fear, and anger because of the increasingly adverse political climate for people who are “different”—in gender identity, sexual orientation, nationality, political beliefs, skin color, and more. And he is shocked, fearful, and angered by the mean-spirited treatment so many are receiving—and which Sunny has endured throughout much of his life as well. Today, you will hear about how we set the A = agenda for our session with Sunny, along with the M = Methods we used. You can find Sunny’s goals for each negative feeling at the end of the Positive Reframing, and at the end of M = Methods, if you Click here His scores on the Empathy and Helpfulness Scales in the Evaluation of Therapy Session were perfect. Here are some of the take-home lessons from this session with Sunny. 1.  Unhealthy negative feelings result from distorted negative thoughts, like “I’ll be miserable forever.” Healthy negative feelings, in contrast, result from thoughts that are realistic and, for the most part, undistorted. Healthy negative feelings do not usually require any kind of “treatment,” but skillful empathic listening and support will nearly always be appreciated. 2.  Empathy can be very powerful, and it is absolutely necessary for a meaningful therapeutic relationship, but empathy alone is not enough to change the way someone feels. 3.  Finding compassion for someone who has harmed you, while extremely challenging, can also bring you peace. 4.  Emotions such as anger, sadness, and anxiety are important protective instincts. And one can feel these emotions and be compassionate and loving at the same time. 5.  As a therapist it can be tempting to either assume that you can’t help a patient because their feelings are “normal,” or to try to cheerlead or problem-solve for a patient to cheer them up, but the TEAM-CBT model allows us to collaborate with the patient, understand when and how they want to change, honor their resistance to change, and offer them the tools they need to change in a way that honors their values. Thank you so much for listening and joining us. Rhonda, Jill and I are deeply indebted to you, Sunny, for your courage and vulnerability last week and today, letting us into your world on such a personal level. We love you and will always be grateful to have you in our lives, both professionally and personally! Sunny, Rhonda, Jill, and David

I’m angry! A Once-UndocumentedImmigrant Speaks from the Heart-- Live Work with Sunny, Part 1 Sunny Choi is a beloved member of the TEAM community. He grew up in Hong Kong before emigrating with his family to the United States when he was 11 years old. He graduated from UCLA with a major in engineering, completed a master’s degree in Engineering Management at Stanford, and developed a successful career in high tech Silicon Valley companies. However, he left his work to pursue additional graduate training in clinical social work because he discovered that his strongest call was to help individuals who were being marginalized by American culture and suffering. He then obtained an MSW degree with a specialty in Community Mental Health from California State University. We were fortunate when Sunny discovered and joined our free Stanford TEAM CBT training group, and blossomed into an expert TEAM therapist and beloved colleague and friend. Today, Dr. Jill Levitt and I worked with Sunny because he requested a session to work on his own troubled feelings concerning the recent political developments. He emphasized that he wanted to do personal work, rather than focusing too heavily on the current political controversies and battles. You can find the Daily Mood Log (DML) that Sunny prepared just prior to his session if you click here As you can see, at the top of his DML, he described the upsetting event as tearing up when he was teaching a class and discussing a case of a transgender Mexican American man, and he began reflecting on his own memories of growing up as a gay male and undocumented immigrant. Sadness and anger were the two strongest negative feelings (rated 70 and 80, respectively on a scale from 0 to 100), although he was also moderately anxious, guilty, rejected, hopeless, and frustrated. You can also see the ten negative thoughts he recorded on his DML, and how strongly he believed each one, on a scale from 0 (not at all) to 1000 (completely.). During the session he added three more thoughts: 11.  I (shouldn’t be) living such a happy and pleasurable life when others are suffering. 70% 12.  I should be helping others more. 80% 13.  I have to figure out the correct way to be thinking and feeling. 50% At the start of the session, he said that he felt vulnerable and nervous discussing such personal feelings, memories, and thoughts. He also said that after doing much personal and professional work, he was generally happy and loving, but felt profoundly disturbed when he thought about so many people who are suffering. He said, “Many of my clients are being deported. And those who are gay are worried that they’ll lose access to their medications.” These were the kinds of thoughts that triggered his feelings of guilt. During the empathy phase, Jill mentioned that she felt honored to be talking to Sunny today and proud to be a member of a community where you can reach out when you’re suffering. She added that she felt torn, as I did, because it seemed to us that many of his negative thoughts were realistic, and not distorted, and that it makes sense to feel sad, anxious, worried, and angry. For example, his first negative thought on his DML was, “The world is much more unstable and dangerous now.” Sunny emphasized that most of the time he does feel happy, especially when involved with friends and family, and doing the things he loves. But then he gets confused and guilty, wondering if it is right to feel happy when things are looking so dark for so many people. It certainly makes sense to feel unhappy when, as Sunny said, some of his clients and friends have lost their jobs and people in the LGBTQ+ community are afraid they’ll get deported. And we’re all afraid to speak up and talk about diversity, which has become a dirty word that can get you into trouble. And when Sunny thinks about this, he feels profound sadness and compassion. But as previously noted, this has caused confusion for Sunny, and he struggles with feelings of guilt about the fact that he is truly happy so much of the time. He’s happy about his beautiful life, his marriage, and more—this, in fact, is his happiest he’s ever been. Here’s how he puts it: “I used to be undocumented. The experience and the hostility and bias I confronted traumatized me. And when I heard Trump talk about all the ‘murders and rapists’ invading our country from Mexico, I became tearful. I feel angry—they don’t think we’re human. “I want people to be more compassionate. . . . To say we’re rapists and criminals, it’s not okay. . . it’s mean, and it’s very harmful to mental health. . . . It’s like repeatedly poking at someone who is recovering from a terrible wound, and it hurts.” Jill was touched, and found Sunny’s vulnerability heart-warming, beautiful, and refreshing. Rhonda reminded us that unless we are Indigenous Native Americans, all Americans are descended from immigrants. In my own case, all my ancestors came from Sweden in the late 1800s during the potato famine. Sunny pointed out the European immigrants have not been discriminated against in the same way as the Africans, Asians, Latinos, Islamic, and dark-skinned individuals: “Let’s be open. It’s racism. I felt it right from the start.” Sunny gave us an A+ on empathy, and then we worked to set the agenda for the session. What did Sunny hope to get from the session? What did he want help with? What changes was he hoping for? He said: “Maybe my feelings are appropriate, but some may be too intense. My goal is to find peace; to have hope, and to try to do something to help. . . I want to feel proud of who I am and what I stand for. I want to try to be loving and compassionate, even to people who don’t have the same beliefs and values. . . . Although that can be incredibly challenging!” When you listen to today’s podcast, you will hear the T = Testing and E = Empathy portions of the session. Next week, you will hear the A = Paradoxical Agenda Setting and M = Methods portions along with the conclusion, including the final T = Testing to evaluate his end of session scores on the Brief Mood Survey and Evaluation of Therapy Session. Thank you for joining us. Rhonda, Jill, Sunny, and I appreciate all of you!

Ask David: The Awesome Hidden Emotion Technique Featuring Matthew May, MD with Rhonda and David The following answers to Ask David questions were written prior to the live podcast where Matt, David, Rhonda, and others discuss the questions in real time. Their answers may differ from Dr. Burns responses listed below. 1. Michael asks: How did you invent the Hidden Emotion Technique? It’s been incredibly helpful to me! Hello, Dr. Burns, Your lifelong work continues to be invaluable to me and so many others, and I apologize if this question was answered on a previous podcast. To my knowledge, it hasn't been. I was wondering how you discovered or created the hidden emotion model? I recently struggled with inexplicable death anxiety that came on every night since college started back up, and I was at a loss, until I remembered the hidden emotion model and wondered if there was something I wasn't acknowledging? Sure enough, I discovered I was actually quite resentful of my new schedule not allowing me to easily fit the gym into my schedule unless I wanted to forgo valuable sleep. Once I had addressed this resentment, the death anxiety vanished. I would love to know how this wonderful technique became part of your phenomenal practice! -Sincerely, Michael Polus. David’s reply You can read all about it in When Panic Attacks, when I learned about it accidentally based on an interaction with a patient who was stuck. Perhaps we can answer it on a podcast. Thanks! david   2. Janie asks: How can I help a patient who ruminates? My client ruminates, that is she experiences repetitive thoughts about conversations and gets stuck in the negative feelings that come from dwelling on those thoughts and conversations. She has referred to it as repetitive thinking about conversations that were distressing in some way. She replays the conversation in her head, and evaluates and re-evaluates her responses. She then plays the conversation using possible different responses she COULD have used and worries whether these would have been better responses. The first individual is a friend where the friendship is very challenging and interwoven into many parts of my patient's life. My patient ruminates about conversations and wonders over and over if she said the right thing or wonders how the friend took what was said. It is a loop that my patient often gets stuck in for long periods of the day. The second individual is my patient's husband. With him, she ruminates about how to say things to him so she can motivate him to be involved in the ways she wants him to be. We will work on these relationships using the 5 secrets eventually, but first she'd like to work on the rumination because it takes up so much of her time. How can I help her? David’s Reply I would recommend TEAM CBT in a step-by-step manner. I do not, in general, like to throw techniques at people based on a description of a problem. Motivational techniques to reduce resistance and bring resistance to conscious awareness. Paradoxical Cost-Benefit Analysis Dangling the Carrot / Gentle Ultimatum / Sitting with Open Hands The Hidden Emotion Technique What If / Downward Arrow Technique ERP (Exposure plus response prevention) Many other techniques inspired by methods a and b above (TEAM CBT) Feared Fantasy: confronting her worst fear Five Secrets of Effective Communication Work on acceptance: she is perfectionistic and self-critical Hidden Emotion: anger Thanks for listening (and reading the show notes), David, Rhonda and Matt

Ask David My friend won’t say thank you! Dating Anxiety Religion vs. Psychotherapy We want to remind you about an awesome virtual workshop on habits and addictions that Dr. Jill Levitt and David will be presenting on March 28, 2025 We will feature powerful new paradoxical techniques that will blow your socks off. It will be from 8:30 to 4:30 and you will earn 7 CE credits while having fun and learning how to heal yourself AND you patients. Check it out! It's less than two weeks away, some check it out while you still have time! You'' LOVE it and LEARN a LOT! Registration and More Information Here! As is so often the case, the answers to these questions that appear in the show notes were email replies to the person before the show. To get the full discussion, make sure you listen to the actual podcast, as the answers often evolve in unexpected ways when the “experts” hash it out! Today’s episode is chock full of personal stories (some racy), expert Five Secrets advice and demonstration,  philosophical / spiritual discussion, and secrets of successful (and racy) dating. 1. Brittany asks: What can I do say to a friend who does not say “thank you” when I pay for our meal or drive a long distance just to see them? 2. Jaydipe asks: How can I get over my anxiety around attractive women? 3. Ali asks: Can religious beliefs cause or intensify feelings of anxiety? (David will talk about the synergies between TEAM CBT and spirituality in all religions. He will also mention the potential antagonisms.)   1. Brittany asks: What can I do say to a friend who does not say “thank you” when I pay for our meal or drive a long distance just to see them. Hello David and Rhonda, I have a friend who typically does not say thank you to me when I pay for a meal out or drive us a long distance. I am someone who always says thank you even if the other person just bought us $10 worth of fast food or gave a short ride. I find myself feeling resentful towards my friend for not saying anything when I pay and drive us around all day. It makes me feel like they don’t appreciate it. At the same time, talking about it and sharing my feelings would then feel like I’m asking them to say it, and then it would not feel authentic. I have said something about it in the past, and they were like I’m sorry, thank you. But it didn’t mean much at that point. Is this one of those annoying traits I just learn to accept? Thank you, Brittany David’s reply Well, you could just use a gentle I Feel statement, which might be paradoxically stronger, but combined with Stroking. Like this, "Jennie, you know I think the world of you, and greatly enjoy our times together, but when I pay for lunch, or drive a distance to hang out with you, you rarely ever say "thank you," and then I feel hurt and unappreciated." Something like that combines Stroking with I Feel and might be effective. But I always rate myself on what I do, or say, and not so much on how the other person reacts. You could, perhaps, also ask if they are upset with you about something that they’ve had trouble expressing to you. Best, david 2. Jaydipe asks: How can I get over my anxiety around attractive women? Hi David Many thanks for the podcast I’m struggling with social anxiety and talking to attractive women and I’ve watched all the podcasts relating to it. I think deep down I have a shame around finding women attractive, so I find it difficult to express interest in them. I find that I can talk to them easily during activities like climbing or co workers, but even on dates with women I can’t seem to take things forwards playfully like you’d expect on a date. I’m too serious and I think that turns people off. I feel like I’m under the spotlight and I have to impress them otherwise they won’t like me. I know this isn’t true and I’ve been trying to get myself to do exposure therapy by asking girls for their numbers and being rejected so it helps with that. Also, I struggle with societal expectations, I hear women say that they don’t want to be approached or talked to or anything so I just end up avoiding them because I don’t want to annoy them, but it holds me back from getting the sex and relationships I want Any help much appreciated Thanks, Jaydipe David’s Reply I have included your excellent question on an upcoming Ask David. In the meantime, have you read my book on dating, Intimate Connections? Best, david PS Should I use your first name, or a fake first name? 3. Ali asks: Can religious beliefs cause or intensify feelings of anxiety? Dear Dr. Burns, After reading your books, I’ve started to recognize that many of my anxious beliefs seem to have a religious background. For example, in the Bible, there’s a verse from John 5:14: “Later Jesus found him at the temple and said to him, ‘See, you are well again. Stop sinning or something worse may happen to you.’” Here’s where I struggle: I want to live my life freely, which includes things like being with different girls before marriage (something I already do). But according to religion, this is considered adultery and a sin. Another verse that weighs heavily on me is from Matthew 5:27-29: “You have heard that it was said, ‘You shall not commit adultery.’ But I tell you that anyone who looks at a woman lustfully has already committed adultery with her in his heart. If your right eye causes you to stumble, gouge it out and throw it away. It is better for you to lose one part of your body than for your whole body to be thrown into hell.” I often find myself looking at beautiful women on the street, which Christianity teaches is sinful, and this sometimes leads to feelings of guilt. I wonder: do I need to leave religion altogether to break free from these negative, self-critical thoughts? I also have other related thoughts that seem to link my faith with the good things happening in my life. For instance: My life is going well right now. My parents are alive, my brother is getting married, I’m healthy, and I’ve been fortunate in many ways. I’ve had incredible experiences, like participating in two Erasmus+ exchange programs in Poland and Lithuania during university, volunteering in Latvia for a year, and even having my New Zealand visa approved in a highly competitive process (only 100 spots for 85 million people, and the application closed in 5 minutes!). I often think that these blessings are because I believe in Jesus, follow the Bible, and try to live as a good person who avoids sin and doesn’t deceive others. But then these anxious thoughts arise: I should always be thankful or pray, or else my life will fall apart. If I leave religion, something bad might happen—my parents could fall ill or pass away, and it would all feel like my fault for turning away from Jesus. Without faith, I’d lose my good fortune(luck), my appearance, and my opportunities. Wherever I apply to would be rejected, then I would understand that it was Jesus in the first place doing all of these things in my life, not me or vice versa! I'd find a terrible job, terrible working environment, terrible mutual relationships. Then everything would be my fault and I'd tell myself I should have believed in him in the first place but now I deserve everything that happens to me! These thoughts are overwhelming, and I’d love to hear your perspective on how to approach and challenge them. Thank you so much for your time and the invaluable insights you share in your work. Warm regards, Ali David’s reply Hi Ali, Sorry you are struggling with so many restrictions, judgments, and inhibitions! I can imagine it triggers anxiety, guilt, inadequacy, resentment, discouragement, and more. You can let me know! If you want, I can include this as an Ask David question on a podcast, with your first name, or a fake first name. Let me know if this works for you. Also, what religion are you? I know that many religions around the world can be very fundamentalistic and super strict in their teachings. My own religious upbringing had a touch of rigidity, too. Best, david Ali’s response to David Hello again, Actually, my family comes from the Christian (Orthodox-Armenian) minority in Turkey, where I was born and raised. So, I am an Orthodox Christian. You're absolutely right that I struggle with many restrictions and judgments. I’d love for you to include this as an "Ask David" question on a podcast since I haven’t seen any episode (and I’ve listened to most of your recent podcasts, including number 408: Do You Believe in God? Does God Exist?) that addresses this topic. By the way, I already use an alias, so "Ali" is a fake name, but you’re welcome to use it in your podcast! Here’s a quick DML (Daily Mood Log) to clarify what I’m dealing with: The Upsetting Event: Doing my daily half-hour Bible reading before bed and coming across certain verses. Emotions: Sad: 60% Anxious/Worried: 70% Inadequate: 60% Guilty/Bad: 90% Abandoned: 70% Pessimistic/Discouraged: 80% Stuck: 75% Angry/Resentful: 75% Tricked/Duped: 80% Although I don’t consider myself a devout Christian, over the past few years, I’ve started reading the Bible—the Old and New Testaments. Initially, I read them in my native language, but now I read in English to fully understand the content. Growing up in the church, I believed everything the priest taught. However, encountering some events and stories that seem illogical to me has made me question my beliefs. I often feel tricked and wonder if I’ve truly believed in all this. At the same time, I feel anxious and worried, as if questioning or criticizing my religion is a betrayal of God. Please let me know if you need any additional information. Ali David’s reply Thanks, Ali, this is super. I was also raised in a somewhat strict Christian (Lutheran) home, and as a child had plans to become a minister, like my dad. In college, I learned critical thinking, and began to question some of what I was taught when I was growing up. For example, there seemed to be a bit of a bias again