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

262: A Country Doctor, Part 2 of 2: "Nothing I do makes a difference!"

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A Country Doctor, Part 2 of 2

A = Assessment of Resistance

At the end of the moving and tearful empathy phase, we asked Jillian about her goals for the session, which included the ability to

  • enjoy my work
  • to give away all of my certificates
  • set limits with my patients
  • feel happy with what I do
  • not have to fear my work anymore!

After Jillian said she would be willing to press the Magic Button to achieve all these goals instantly if we had one, we suggested Positive Reframing first. to see what might be lost of she suddenly achieved all these goals. You can creview the Positive Reframing that we did together.

Here’s Jillian’s Emotions table at the end of Positive Reframing, showing her goals for each emotion when we used the Magic Dial. The idea is to dial each feeling down to a lower level that would reduce your suffering while still allowing you to preserve all the awesome things about you!

 

Emotions % Now % Goal % After Emotions % Now % Goal % After Sad, blue, down, unhappy 80 15   Embarrassed, foolish, humiliated, self-conscious 50 10   Anxious, nervous 90 20   Hopeless, discouraged, pessimistic, despairing 100 0   Bad 70 0   Frustrated, stuck, thwarted, defeated 90 5   Inferior, inadequate, incompetent 95 5   Angry, mad, resentful, annoyed, irritated, upset, furious 100 10  

 

Jillian said that the Positive Reframing really opened her up, especially when we read the list of positives out loud. It kind of shocked her in a good way so see that her negative feelings were not really problems, defects, or symptoms of one or more “mental disorders,” but the expression of what was most beautiful and awesome about her as a human being, and as a physician.

This Positive Reframing is one of the unique aspects of TEAM-CBT. Although we are encouraging the patient to keep the symptoms, rather than pressing the Magic Button that makes them disappear, it paradoxically eliminates or drastically reduces the resistance to change, and opens the door to the possibility of ultra-rapid recovery.

M = Methods

We asked Jillian what Negative Thought she wanted to work on first, and she chose #9: “I’m not having a big enough impact.” She believed this thought 100%.

First, we asked Jillian to identify and explain the cognitive distortions in this thought, and she focused on these: Should Statement; Self-Blame, All-or-Nothing Thinking, Mental Filtering, and Discounting the Positive.

In retrospect, I think I spotted two additional distortions: Emotional Reading (I feel I’m not having a positive impact, so I must not be having a positive impact) and Mind-Reading (my patients expect me to have the answers to all their problems and judge me when I don’t have all the answers.)

Then we challenged the Negative Thought, and Jillian she was able, with a little help and a role reversal, to crush it, as you can see here.

Usually, crushing one Negative Thought is about all you really have to do, because once the patient blows one Negative Thought out of the water, there is usually a kind of “cognitive click,” and the brain suddenly changes, and all the positive circuits suddenly get fired up. It’s amazing to behold, and you will hear it for yourself!

The damn did suddenly break, and Jillian could clobber the rest of her Negative Thoughts fairly easily, using a combination of Self-Defense, Self-Acceptance, and a lot of the CAT technique. She suddenly appeared to be a radically and delightfully different person during the Externalization of Voices. You can see her final Daily Mood Log here.

You can see her feelings on the Emotions table at the end of the session.

Emotions % Now % Goal % After Emotions % Now % Goal % After Sad, blue, down, unhappy 80 15 0 Embarrassed, foolish, humiliated, self-conscious 50 10 0 Anxious, nervous 90 20 0 Hopeless, discouraged, pessimistic, despairing 100 0 0 Bad 70 0 0 Frustrated, stuck, thwarted, defeated 90 5 0 Inferior, inadequate, incompetent 95 5 0 Angry, mad, resentful, annoyed, irritated, upset, furious 100 10 0

Jillian’s scores on my Happiness Test on the Brief Mood Survey also soared to 100% and her ratings of Jill and David on Empathy and Helpfulness tests were also perfect.

After the workshop, Jillian sent this email.

Hi Jill and David,

As I drove home tonight from my office, I actually felt like my heart had been opened. My chest didn't feel as tight and locked-up like it normally does. It felt so relaxed. I put my baseball cap on, rolled the windows down, and listened to 90's country music (my favorite) on my drive and sang loudly. I have spent the last hour checking my new superpowers. There have been negative thoughts, but telling them to "shut the heck up. I am not listening to you" has been quite liberating. I even was greeted by my 4 year old when I got out of the car. I knelt down and hugged her without the worry of being a rotten mom, but rather one of feeling like I am the perfect mom for her, flaws and all.

Thank you for this opportunity. I took a chance to email you in the first place after listening to a podcast weeks ago. I thought there would be no chance in heck that I would be selected. I am glad I had this remarkable opportunity and grateful to have worked with both of you.

Much love and admiration,

Jillian

I hope you enjoy it as much as we did. Again, a big hug and thanks to the star or our podcast, Dr. Jillian Scherer who gave us all an incredible gift today!

Thanks for listening. I hope you learned a ton and were moved emotionally. Write and let us know what you think!

Jillian and Jill joined Rhonda and me for a two plus month follow-up at the end of the recording of part 2. She is still glowing and doing great, and emphasized the three main experiences that led to her amazing breakthrough: 1. When we did the Downward Arrow, she discovered that she had an underlying belief that she "should" or "must" make some kind of enormous, amazing contribution through her clinical work. Letting go of that internal demand was an enormous relief. I (David) think of this as one of the four "Great Deaths" of the "self," or "ego." 2. Learning to talk back to the relentless inner chatter that is always saying, "you're not good enough," using the CAT (Counter Attack Technique.) 3. Reframing the negative thoughts and feelings, and seeing the inner beauty in her suffering.

David again emphasized that TEAM-CBT is not just about improvement, or feeling less depressed, but magic, and enlightenment.

Jill summarized her new 11-hour home study course in TEAM-CBT with video and audio illustrating and teaching the four components of TEAM-CBT, Testing, Empathy, Assessment of Resistance, and Methods. This class sells for $187 and is suitable for therapists as well as the general public, and offers continuing education credit as well as certification credits in TEAM-CBT. I (David) believe that Jill is one of the truly great psychotherapy teachers, and urge you to check it out if you'd like to hear more!

Rhonda, Jill, Jillian, and David

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    263: OCD in Kids, Featuring Dr. Taylor Chesney

    1:14:56

    Photo features Taylor and her husband, Gregg, who is an ER / ICU physician in NYC. 263:  OCD in Kids, Featuring Dr. Taylor Chesney Rhonda starts this podcast by reading two incredible endorsements from fans like you. Thanks so much for the many kind and thoughtful emails we receive daily! Today’s podcast features Dr. Taylor Chesney, the founder and director of the Feeling Good Institute of New York City. Taylor was a member of my Tuesday training group at Stanford for several years during her doctoral training in psychology. Then she and her husband, Gregg, who is an ICU / intensive care unit doctor, returned home to NYC where she opened her clinical practice. We have featured Taylor on a number of two previous podcasts: Corona Cast 4 (published 4-09-202) and Corona Cast 6 (published 4-30-2020). We always benefit greatly from Taylor’s wisdom, warmth, and superb teaching. 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    262: A Country Doctor, Part 2 of 2: "Nothing I do makes a difference!"

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    A Country Doctor, Part 2 of 2 A = Assessment of Resistance At the end of the moving and tearful empathy phase, we asked Jillian about her goals for the session, which included the ability to enjoy my work to give away all of my certificates set limits with my patients feel happy with what I do not have to fear my work anymore! After Jillian said she would be willing to press the Magic Button to achieve all these goals instantly if we had one, we suggested Positive Reframing first. to see what might be lost of she suddenly achieved all these goals. You can creview the Positive Reframing that we did together. Here’s Jillian’s Emotions table at the end of Positive Reframing, showing her goals for each emotion when we used the Magic Dial. The idea is to dial each feeling down to a lower level that would reduce your suffering while still allowing you to preserve all the awesome things about you!   Emotions % Now % Goal % After Emotions % Now % Goal % After Sad, blue, down, unhappy 80 15   Embarrassed, foolish, humiliated, self-conscious 50 10   Anxious, nervous 90 20   Hopeless, discouraged, pessimistic, despairing 100 0   Bad 70 0   Frustrated, stuck, thwarted, defeated 90 5   Inferior, inadequate, incompetent 95 5   Angry, mad, resentful, annoyed, irritated, upset, furious 100 10     Jillian said that the Positive Reframing really opened her up, especially when we read the list of positives out loud. It kind of shocked her in a good way so see that her negative feelings were not really problems, defects, or symptoms of one or more “mental disorders,” but the expression of what was most beautiful and awesome about her as a human being, and as a physician. This Positive Reframing is one of the unique aspects of TEAM-CBT. Although we are encouraging the patient to keep the symptoms, rather than pressing the Magic Button that makes them disappear, it paradoxically eliminates or drastically reduces the resistance to change, and opens the door to the possibility of ultra-rapid recovery. M = Methods We asked Jillian what Negative Thought she wanted to work on first, and she chose #9: “I’m not having a big enough impact.” She believed this thought 100%. First, we asked Jillian to identify and explain the cognitive distortions in this thought, and she focused on these: Should Statement; Self-Blame, All-or-Nothing Thinking, Mental Filtering, and Discounting the Positive. In retrospect, I think I spotted two additional distortions: Emotional Reading (I feel I’m not having a positive impact, so I must not be having a positive impact) and Mind-Reading (my patients expect me to have the answers to all their problems and judge me when I don’t have all the answers.) Then we challenged the Negative Thought, and Jillian she was able, with a little help and a role reversal, to crush it, as you can see here. Usually, crushing one Negative Thought is about all you really have to do, because once the patient blows one Negative Thought out of the water, there is usually a kind of “cognitive click,” and the brain suddenly changes, and all the positive circuits suddenly get fired up. It’s amazing to behold, and you will hear it for yourself! The damn did suddenly break, and Jillian could clobber the rest of her Negative Thoughts fairly easily, using a combination of Self-Defense, Self-Acceptance, and a lot of the CAT technique. She suddenly appeared to be a radically and delightfully different person during the Externalization of Voices. You can see her final Daily Mood Log here. You can see her feelings on the Emotions table at the end of the session. Emotions % Now % Goal % After Emotions % Now % Goal % After Sad, blue, down, unhappy 80 15 0 Embarrassed, foolish, humiliated, self-conscious 50 10 0 Anxious, nervous 90 20 0 Hopeless, discouraged, pessimistic, despairing 100 0 0 Bad 70 0 0 Frustrated, stuck, thwarted, defeated 90 5 0 Inferior, inadequate, incompetent 95 5 0 Angry, mad, resentful, annoyed, irritated, upset, furious 100 10 0 Jillian’s scores on my Happiness Test on the Brief Mood Survey also soared to 100% and her ratings of Jill and David on Empathy and Helpfulness tests were also perfect. After the workshop, Jillian sent this email. Hi Jill and David, As I drove home tonight from my office, I actually felt like my heart had been opened. My chest didn't feel as tight and locked-up like it normally does. It felt so relaxed. I put my baseball cap on, rolled the windows down, and listened to 90's country music (my favorite) on my drive and sang loudly. I have spent the last hour checking my new superpowers. There have been negative thoughts, but telling them to "shut the heck up. I am not listening to you" has been quite liberating. I even was greeted by my 4 year old when I got out of the car. I knelt down and hugged her without the worry of being a rotten mom, but rather one of feeling like I am the perfect mom for her, flaws and all. Thank you for this opportunity. I took a chance to email you in the first place after listening to a podcast weeks ago. I thought there would be no chance in heck that I would be selected. I am glad I had this remarkable opportunity and grateful to have worked with both of you. Much love and admiration, Jillian I hope you enjoy it as much as we did. Again, a big hug and thanks to the star or our podcast, Dr. Jillian Scherer who gave us all an incredible gift today! Thanks for listening. I hope you learned a ton and were moved emotionally. Write and let us know what you think! Jillian and Jill joined Rhonda and me for a two plus month follow-up at the end of the recording of part 2. She is still glowing and doing great, and emphasized the three main experiences that led to her amazing breakthrough: 1. When we did the Downward Arrow, she discovered that she had an underlying belief that she "should" or "must" make some kind of enormous, amazing contribution through her clinical work. Letting go of that internal demand was an enormous relief. I (David) think of this as one of the four "Great Deaths" of the "self," or "ego." 2. Learning to talk back to the relentless inner chatter that is always saying, "you're not good enough," using the CAT (Counter Attack Technique.) 3. Reframing the negative thoughts and feelings, and seeing the inner beauty in her suffering. David again emphasized that TEAM-CBT is not just about improvement, or feeling less depressed, but magic, and enlightenment. Jill summarized her new 11-hour home study course in TEAM-CBT with video and audio illustrating and teaching the four components of TEAM-CBT, Testing, Empathy, Assessment of Resistance, and Methods. This class sells for $187 and is suitable for therapists as well as the general public, and offers continuing education credit as well as certification credits in TEAM-CBT. I (David) believe that Jill is one of the truly great psychotherapy teachers, and urge you to check it out if you'd like to hear more! Rhonda, Jill, Jillian, and David
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    261: A Country Doctor, Part 1 of 2: "Nothing I do makes a difference!"

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But this gives all of you the chance to hear what you missed, and I think you will NOT be disappointed! When Jill and I asked for volunteers for the live demonstrations in the workshop, Jillian was the first to respond with an offer to volunteer. This was her email, describing her situation.. Hi Dr. Burns, I am writing to you offering to be a volunteer for the live demonstrations in the workshop on 5/16, if you need one. I am learning TEAM CBT, and have been enjoying it personally as well as trying to do more of it professionally. I am a family medicine physician, but I have my own direct primary care clinic. This means that I can spend 1-2 hours with a patient if needed. I have been slowly offering this to patients who want to do the work to improve their mood or anxiety. As for why I am writing, my anxiety and need to please people is huge and disruptive to my enjoyment of life. I keep striving and achieving things likely to get the attention of others. I fear not knowing the answer and making a mistake with my patients. This had caused me to develop anxiety and insomnia at my last job. I sought counseling and physician coaching, but ultimately I wound up leaving that job, moving to another state [due to intense stress and demands of that job], and starting my own practice. My current practice is going well, but I am annoyed when patients come in or call with questions I don't know the answer to. I constantly worry that I will not be able to figure something out by myself and that the patients will leave me. In addition, I continually strive for [yet another] training certificate. As you know, I did medical school, residency, and fellowship, but I also have a lactation consultant certificate, training in lifestyle medicine, and now a Level 1 TEAM-CBT certificate with enough hours for Level 2, and most recently I started a 3-year program to become a pastor for our church. And I realize that I will not have the time to sustain all of these. It is as if I love the journey of getting the certificates, but I am not great at implementing them, so I move on to something else. As for the rest of life, I have a great life, but I am melancholy most of the time. My husband is terrific, sensitive, understanding, loving, and yet, I am constantly reading marriage books because I think it could be better. My 2 children, aged 8 and 4, are smart and funny, but I live constantly thinking I am going to screw them up and so I read even more parenting books. My family medicine practice is thriving and offers me part-time work at great pay with autonomy, yet I dread Monday mornings. Overall, my life should be an A+ and enjoyable, but somehow I make it seem like everything is going wrong all the time. I have sought counseling and even TEAM-CBT earlier this year via teletherapy from FGI. I continue to do a Daily Mood Log about 3-4 times a week. I feel like we got so far, but not to complete recovery. My FGI therapist was the eighth therapist I have been to, but the others were mainly talk therapists. I just thought I would reach out in the hope that maybe you need a volunteer, and maybe I would have the opportunity to work with you live. It would be nice if my anxiety and faulty core beliefs didn't steal my joy. Sincerely, Jillian As you can see, Jillian is an incredibly dedicated physician, but feels like she is never doing enough for her patients. At the start of her session, she described her incredibly stressful previous job, when she was often on call for 72 hours at a time, often going long hours without sleep. She said, “I used to walk to work, hoping I’d get hit by a car.” Although, as you saw in her email, she finally quit, and set up her own practice in another state, she continued to struggle with depression and the belief that she wasn’t doing enough. Her constant self-criticisms robbed her of happiness, in spite of the fact that she had a fabulous practice, superb medical and human skills, and a wonderful husband and children. Her unhappiness confirms what Epictetus taught us nearly 2,000 years ago: we are upset, not by things, or events, but by our views of them. In this case, the facts of Jillian’s life are all stellar. In fact, she rates her life and practice as A+. And yet, she was still lacking in the most important dimension: happiness and self-esteem. Because of her constant and intense feelings of insecurity, Jillian heroically pursued more and more specialty trainings and certifications, thinking that eventually she would develop feelings of competence, confidence, and happiness. She even enrolled in a three-year training program to become a minister, in addition to enrolling in the certification and training program for TEAM-CBT, and more. But nothing was ever enough. That’s because, as the sages have taught through the ages, the answer is within. No amount of expertise or accomplishments will ever solve Jillian’s problem. Jillian’s life was perhaps like trying to get the elusive brass ring on the Merry Go Round, except her ride was far from merry. She told us that she sometimes had fantasies of escaping to a remote tropical island. Perhaps you, too, have sometimes felt like you’re not good enough, or that you or your accomplishments are just not good enough. Let us know what you think about the answer that Jillian found in front of a live audience that day, and whether it might apply to you as well. In today’s podcast, you will hear the first portion of her session (T = Testing and E = Empathy), and next week you will hear the fantastic conclusion (A = Assessment of Resistance) and M = Methods.) T = Testing To get started, take a look at the Daily Mood Log that Jillian shared with us at the start of her session. As you can see, Jillian’s negative feelings were all intense. You would not have known how powerful her suffering was if you had met her in her daily life. In person, she comes across as you might expect from her email: exceptionally warm, thoughtful, human, conscientious and likeable. That’s one of the really important reasons for Testing. You can see exactly what you’re dealing with, in terms of the type and severity of negative feelings. In addition, we’ll ask Jillian to rate her feelings again at the end of the session. That way, we’ll know how effective—or ineffective—the session was. This information can sometimes be humbling, but it is always illuminating. Neither Jill nor I could conceive of doing therapy without the Testing! At the end, we’ll also ask her to rate us on Empathy, Helpfulness and other dimensions using exceptionally sensitive scales that can highlight even the smallest therapeutic errors that the therapist would not otherwise be aware of. E = Empathy During the empathy phase of the session, Jill and I empathized while Jillian described her struggles with negative feelings and a lack of happiness and self-confidence. During the empathy portion, I did the downward arrow technique to learn more about Jillian’s fears and Self-Defeating Beliefs. The goal was not to change Jillian, but simply to understand the root of her suffering at a deeper level. We started with the thought, “I should know how to fix people who come to me with a problem like depression, anxiety, headaches, or headaches, or even the lack of money to pay for the medications I prescribe.” Here’s how the Downward Arrow dialogue evolved: David: And if you sometimes do not have the solution for your patients, what does that mean to you? Why is that upsetting to you? Jillian: Then people will be disappointed and leave me. David: And then what? What are you the most afraid of? Jillian: My practice will deteriorate. David: And then? Jillian: My patients will think I’m a failure. David: What would happen then? What are you the most afraid of? Jillian: Then the whole town will think I’m a failure. David: Of course, no one would want something like that to happen, but we might all experience it differently? What would that mean to you if the whole town thought you were a failure? Why would that be upsetting to you? Jillian: That would mean I’m a loser. David: And if that were true, what would that mean to you? Jillian: That would mean that I don’t mean anything to anybody. David: And then? What would happen if you didn’t mean anything to anybody? Jillian: Then there’d be no point in life. That was pretty much the bottom of the barrel. The purpose of the Downward Arrow Technique is to uncover the Self-Defeating Beliefs at the root of your suffering. Once you’ve generated your Downward Arrow list, all you have to do is review it, and then look at my list of 23 Common Self-Defeating Beliefs and circle all the ones that seem to fit. As an exercise, you might want to take a look at the list and see how many you can find before you see the ones that Jillian found! Here’s Jillian’s list: Perfectionism Perceived Perfectionism Achievement Addiction Approval Addiction Fear of Rejection Pleasing Others (Submissiveness) Worthlessness Spotlight Fallacy Brushfire Fallacy Superwoman A Country Doctor, Part 2 of 2 A = Assessment of Resistance At the end of the moving and tearful empathy phase, we asked Jillian about her goals for the session, which included the ability to enjoy my work to give away all of my certificates set limits with my patients feel happy with what I do not have to fear my work anymore! After Jillian said she would be willing to press the Magic Button to achieve all these goals instantly if we had one, we suggested Positive Reframing first. to see what might be lost of she suddenly achieved all these goals. You can creview the Positive Reframing that we did together. Here’s Jillian’s Emotions table at the end of Positive Reframing, showing her goals for each emotion when we used the Magic Dial. The idea is to dial each feeling down to a lower level that would reduce your suffering while still allowing you to preserve all the awesome things about you!   Emotions % Now % Goal % After Emotions % Now % Goal % After Sad, blue, down, unhappy 80 15   Embarrassed, foolish, humiliated, self-conscious 50 10   Anxious, nervous 90 20   Hopeless, discouraged, pessimistic, despairing 100 0   Bad 70 0   Frustrated, stuck, thwarted, defeated 90 5   Inferior, inadequate, incompetent 95 5   Angry, mad, resentful, annoyed, irritated, upset, furious 100 10     Jillian said that the Positive Reframing really opened her up, especially when we read the list of positives out loud. It kind of shocked her in a good way so see that her negative feelings were not really problems, defects, or symptoms of one or more “mental disorders,” but the expression of what was most beautiful and awesome about her as a human being, and as a physician. This Positive Reframing is one of the unique aspects of TEAM-CBT. Although we are encouraging the patient to keep the symptoms, rather than pressing the Magic Button that makes them disappear, it paradoxically eliminates or drastically reduces the resistance to change, and opens the door to the possibility of ultra-rapid recovery. M = Methods We asked Jillian what Negative Thought she wanted to work on first, and she chose #9: “I’m not having a big enough impact.” She believed this thought 100%. First, we asked Jillian to identify and explain the cognitive distortions in this thought, and she focused on these: Should Statement; Self-Blame, All-or-Nothing Thinking, Mental Filtering, and Discounting the Positive. In retrospect, I think I spotted two additional distortions: Emotional Reading (I feel I’m not having a positive impact, so I must not be having a positive impact) and Mind-Reading (my patients expect me to have the answers to all their problems and judge me when I don’t have all the answers.) Then we challenged the Negative Thought, and Jillian she was able, with a little help and a role reversal, to crush it, as you can see here. Usually, crushing one Negative Thought is about all you really have to do, because once the patient blows one Negative Thought out of the water, there is usually a kind of “cognitive click,” and the brain suddenly changes, and all the positive circuits suddenly get fired up. It’s amazing to behold, and you will hear it for yourself! The dam did suddenly break, and Jillian could clobber the rest of her Negative Thoughts fairly easily, using a combination of Self-Defense, Self-Acceptance, and a lot of the CAT technique. She suddenly appeared to be a radically and delightfully different person during the Externalization of Voices. You can see her feelings on the Emotions table at the end of the session. Emotions % Now % Goal % After Emotions % Now % Goal % After Sad, blue, down, unhappy 80 15 0 Embarrassed, foolish, humiliated, self-conscious 50 10 0 Anxious, nervous 90 20 0 Hopeless, discouraged, pessimistic, despairing 100 0 0 Bad 70 0 0 Frustrated, stuck, thwarted, defeated 90 5 0 Inferior, inadequate, incompetent 95 5 0 Angry, mad, resentful, annoyed, irritated, upset, furious 100 10 0 Jillian’s scores on my Happiness Test on the Brief Mood Survey also soared to 100% and her ratings of Jill and David on Empathy and Helpfulness tests were also perfect. After the workshop, Jillian sent this email. Hi Jill and David, As I drove home tonight from my office, I actually felt like my heart had been opened. My chest didn't feel as tight and locked-up like it normally does. It felt so relaxed. I put my baseball cap on, rolled the windows down, and listened to 90's country music (my favorite) on my drive and sang loudly. I have spent the last hour checking my new superpowers. There have been negative thoughts, but telling them to "shut the heck up. I am not listening to you" has been quite liberating. I even was greeted by my 4 year old when I got out of the car. I knelt down and hugged her without the worry of being a rotten mom, but rather one of feeling like I am the perfect mom for her, flaws and all. Thank you for this opportunity. I took a chance to email you in the first place after listening to a podcast weeks ago. I thought there would be no chance in heck that I would be selected. I am glad I had this remarkable opportunity and grateful to have worked with both of you. Much love and admiration, Jillian I hope you enjoy it as much as we did. Again, a big hug and thanks to the star or our podcast, Dr. Jillian Scherer who gave us all an incredible gift today! Thanks for listening. I hope you learned a ton and were moved emotionally. Write and let us know what you think! Rhonda, Jill, Jillian, and David
  • Feeling Good Podcast | TEAM-CBT - The New Mood Therapy podcast

    260: TEAM-CBT Games, featuring Amy, Heather, and Brandon

    1:03:21

    Podcast 260 TEAM-CBT Games, featuring Amy, Heather, and Brandon In today’s podcast, three of our most creative TEAM therapists describe a number of innovative games they’ve created to facilitate learning key TEAM-CBT techniques in group settings. Our guests are: Amy Specter: Amy is a Level 3 certified TEAM therapist, licensed marriage and family therapist and credentialed school counselor. She works with at-risk youth in schools and has an online private practice specializing in shyness and breakup recovery. She can be reached at amy@amyspecter.com. For a free copy of Flirty Dice or to purchase Tune In, Tune Up head over to https://www.feelinggreattherapycenter.com/   Amy Spector Brandon Vance, MD: Brandon is a Level 4 certified TEAM trainer and therapist for individuals, couples and groups.  His most recent TEAM related project is an international book club to support people in reading Feeling Great. He can be reached at: brandonvance@gmail.com Brandon Vance, MD Heather Clague, MD Heather Clague, MD is a Level 4 certified TEAM therapist and psychiatrist who works in private practice and at Highland General Hospital in Oakland.  In addition to teaching and writing about TEAM CBT, she runs Berkeley Improv that holds in-person and online improv classes for all levels. You can reach Heather at: heatherclaguemd.com Tune In / Tune Up, a card game which features spontaneous speaking situations using the Five Secrets of Effective Communication.  Heather, Brandon, and Amy guided us while we played and explained each of the following games during the podcast: Love Feast, where you make fake, over the top introductions of other people in the group Flirty Dice, where you have to flirt with some using a specified facial expression, a specified type of question, and a specific affect. Future Projection, where you talk back to a Negative Thought from the perspective of your wiser, happier self from the future. The group also discussed how these types of games can help individuals with social anxiety develop greater courage, spontaneity, and interpersonal skills. We also did a group Shame Attacking exercise and briefly described the use of this tool in the treatment of social anxiety. You can also reach Heather, Brandon, and Amy at the Feeling Great Therapy Center, where you’ll find links to Tune In / Tune Up, Flirty Dice and more Improv Games. Thanks! Rhonda and David
  • Feeling Good Podcast | TEAM-CBT - The New Mood Therapy podcast

    259: TEAM-CBT for Eating Disorders, featuring Donna Fish, LCSW

    1:11:55

    Podcast 259 TEAM-CBT for Eating Disorders, featuring Donna Fish In today’s podcast, Rhonda and David are delighted to welcome Donna Fish, LCSW, a New York mental health professional who’s doing pioneering work applying TEAM-CBT to eating disorders such as overeating / obesity, binging and vomiting (bulimia), and anorexia nervosa (starving oneself in combination with excessive exercising). These problems appear to be more prevalent in modern society, perhaps because of the emphasis on physical beauty as well as the availability of fattening foods and the financial resources to purchase them. Donna is an LCSW and Level 4 TEAM-CBT therapist. She is a guest lecturer on eating disorders at Columbia University and Harvard University, and author of Take the Fight Out of Food. She has been a popular guest on many radio and television shows, writes for Psychology Today magazine, and more. Donna began the interview on a personal note, reflecting on one of Dr. Burns’ workshops in 2014. She volunteered for a role-play with David illustrating the Externalization of Voices, a powerful cognitive therapy technique David developed during the mid-1970s. That experience pointed Donna in the direction of learning more TEAM-CBT. Here’s how she described her experience at the workshop: It blew my mind! I don’t easily follow any one particular ‘school of therapy, but I joined a TEAM-CBT training group that Dr. Taylor Chesney had just begun in NYC and then continued my online training until this day! I am thrilled to combine my eating disorder training and experience with the TEAM approach, and have been training therapists at Elise Munoz’s Feeling Good Center in NYC, so that they can use TEAM with the common problem of Binge/Restricting. Donna started her career as a professional dancer, and struggled with her own eating and body image issues. She saw these problems in her many peers and colleagues working as performers as well. She said: I was always on a diet, and saw foods as “good” or “bad.” I would restrict (fasting) during the week and then binge on all the “bad” foods on weekends. My life was a yo-yo of binging and restricting. Later, I taught myself how to eat in a healthy way, and how to say, “Yes, I can have that food and I can have it right now if I want it (which I do). But do I really need it right now?” This simple change in how I talked to myself freed me and cured me! When I became more accepting and less rigid in my “eating rules,” I paradoxically began to feel happier and more in control. I saw so many actors and dancers who used up tremendous amounts of emotional energy struggling with body image issues and problems with eating. That’s why I did a 3-year training program in working with eating disorders. When some of my patients who had recovered became pregnant, they worried about giving their own children an eating disorder. That’s why I wrote my book incorporating the methods that had been so helpful to them. This included a 4 Step Program to help them to give their kids a healthier relationship for life. These are the four steps: Step One: Talk To Your Kids About Nutrition Step Two: Reboot the Connection Between the Belly and the Head Step Three: Separate Hunger and Fullness from Other Feelings Step Four: Teach Your Child Skills and Develop Confidence in Decision Making I incorporated many of the ideas and techniques in TEAM-CBT, including Dr. Burns’ Decision-Making Tool, as well as his “Addiction and Habit Log.” (link to the free chapters on these tools available on the home page of my website). Donna emphasized the role of restricting in the maintenance of eating disorders. She explained that restricting and fasting actually cause and perpetuate the problem because the cognitions become ‘Tempting Thoughts’ to binge such as: “I will definitely re start my diet tomorrow, and I won’t eat that cake that I shouldn’t have had, so I may as well eat more now since I’ve already blown it.” She explained: If you commit to having a piece of that cake tomorrow as well, and in fact every single day, you are less vulnerable to the Tempting Thought of “I won’t have that ‘bad food’ tomorrow’ which tempts you to eat the cake, and then every other food that you ‘won’t eat tomorrow or again’, since you’ve already had a piece. In fact, learning how to eat a piece of cake, or whatever food you deem ‘bad,’ is imperative to learning how to eat well and balanced in order to modulate your weight. The Tempting Thought that you will Restrict Tomorrow, seduces you to binge. The Focus needs to be on Reducing the Tempting Thoughts to Restrict!  A Method like ‘Examine the Evidence’ can be used to see if Thoughts like:  “I won’t eat tomorrow or have that food again,” evolve into Tempting Thoughts that promote the ’binge’ in that moment of temptation, and it becomes a circular game of ‘Restrict/Binge’. Donna described some of the dangerous medical consequences of restricting and severe weight loss that you see in young people with anorexia, including brain shrinkage. She said that parents are sometimes ambivalent about treating their children who have anorexia for a variety of reasons, including the fact that anorexic teenagers are typically perfectionistic high achievers. But when the parents learn about the medical consequences, it sometimes changes their thinking. David adds that two parents will frequently be in conflict about the best way to deal with any problem in a child, and this conflict is nearly always the cause of the “stuckness.” When, and if, the parents decide to work together as a team, the problem nearly always improves significantly. This, in fact, is the whole idea behind the fairly successful “coercive treatment” for anorexia nervosa pioneered at the Maudsley in England. This program involves both parents sitting on the two sides of the child, and forcing him or her to eat, and not giving in to the child’s attempt to manipulate and insist that she or he cannot, or will not, eat. Although the program sounds crude, and most parents initially resist, this type of forceful intervention is effective for roughly 50% of the children with anorexia nervosa, and can be life-saving. This is critical since a significant proportion of these children ultimately die from anorexia nervosa if they don’t have effective treatment. Donna described additional medical consequences of various eating disorders, as well as the cycle of binging and vomiting, which leads to dehydration and actually causes the patient to feel bloated. One of the key cognitions in patients with bulimia and anorexia is the fear of losing control and gaining a great deal of weight, so they engage in many ritualistic activities in an attempt to gain control. However, most of these efforts actually trigger a loss of control. One of the main goals of Donna’s treatment is to change this rigid mind set which is the actual cause of the eating disorder. Donna emphasize the importance of the TEAM-Therapist’s mind set as well: I don’t need any of my patients to change. . . The use of paradox in TEAM is powerful. I work with my patient to list the many GOOD reasons for overeating. Donna described how she integrates the tools and strategies of TEAM into her brilliant work with patients with eating disorders, including David’s Triple Paradox technique. David described the Triple Paradox, which is one of the latest tools he has developed for any habit or addiction, including the eating disorders. If you'd like two never-published chapters on these tools, you will find a free offer for them on the very bottom of my home page at feelinggood.com! These two chapters were originally intended for my book, Feeling Great, but removed due to length. They are intended for therapists and the general public alike. Donna also uses the Brief Mood Survey, testing patient’s moods at the start and end of every therapy session, along with the Assessment of Resistance, the Miracle Cure question, Dangling the Carrot, and more. She also emphasized the vitally important “fractal” concept, focusing on one specific moment when the patient wants help. The idea is that all the patient’s suffering will be encapsulated in one brief moment when the patient was struggling, and the solution in that brief moment will often be the solution to all of the patient’s suffering. If you would like to contact Donna, you can email her at Donna@DonnaFish.com, or visit her website, www:DonnaFish.com. Thanks for listening today! And thank you, Donna, for illuminating how we can use TEAM-CBT in our work with individuals who are struggling with eating and body image problems. I was personally impressed with Donna, not only for her obvious and impressive mastery of the treatment of eating disorders, but also for her warmth, grace, and vulnerability, which will definitely inspire trust and positive expectations in her many patients! Rhonda and David Dr. Rhonda Barovsky practices in Walnut Creek, California. She sees clients mostly via Zoom, and in her office.  She can be reached at rhonda@feelinggreattherapycenter.com. She is a Level 4 Certified TEAM-CBT therapist and trainer and specializes in the treatment of trauma, anxiety, depression, and relationship problems. Check out her new website: www.feelinggreattherapycenter.com. You can reach Dr. Burns at david@feelinggood.com.
  • Feeling Good Podcast | TEAM-CBT - The New Mood Therapy podcast

    258: Doctor, I know you’re secretly sexually attracted to me!

    59:29

    Podcast 258: Doctor, I know you’re secretly sexually attracted to me! / How to Agree with Criticisms that are Just Plain Wrong! Today’s podcast features the incredibly brilliant and kindly Dr. Matthew May, who has become a semi-regular on the Feeling Good Podcast. Our show was the result of an email from Ana Teresa Silva, who is running a new and totally free weekly practice group for the Five Secrets of Effective Communication. If you want to learn those invaluable techniques, contact her immediately before they fill up at ana silva ateresasilva6@gmail.com. Her question had to do with the incredibly important Disarming Technique, which means finding the truth in a criticism, even when the criticism seems absolutely incorrect. I’ve posted her letter and my response at the end of these show notes. Today we tackled two kinds of incredibly difficult attacks, with lots of role-playing and (hopefully) useful feedback and teaching. One was the one listed in Ana’s email, where you are accused of stealing money, but you didn’t actually steal any money. So how can you agree with that? The other was perhaps even harder—what do you do when a patient accuses you of being sexually and secretly attracted to him / her? Matt, Rhonda and David illustrate a variety of strategies for responding with the Disarming Technique as well as the rest of the Five Secrets. The role-playing is challenging and immensely interesting! David emphasizes that if you want to learn the Five Secrets, three things are mandatory: An intense desire to learn. Humility. Tons of practice. David also emphasized the intense resistance nearly all humans have to all three components of EAR: E = Empathy A = Assertiveness R = Respect. I have attached a document listening 12  GOOD Reasons NOT to Listen, Not to Share Your Feelings, and NOT to treat the other person with respect. If you want to master the Five Secrets, my book, Feeling Good Together, will be an invaluable resource. If you read it, you MUST do the written exercises while reading to get any deep understanding of this approach. Simply reading will not “do it!” I want to thank Dr. May once again for hanging out with us today. In our next podcast with Dr. May, he will describe his work with a young professional woman who loved fly fishing but had an intense fear of leeches. Make sure you tune in, it will be extremely interesting, and his patient will join us, too! If you want to contact Dr. May, you can reach him at: Here’s Ana’s email: Hi, David. Hope you are recovering well!! I got stuck with the Disarming Technique. Last week, in the Five Secret Practice Group meeting, something came up and I didn`t know how to answer. How do we “disarm” someone who blames us for a very specific behaviour that is not true? For example: “Why did you steal my money from the drawer?” I thought we could try to find some truth in the attack noticing some reasons why the person could be mad at us or doesn`t trust us, or maybe we could ask if we did something to offend or upset her, but, at some point, we have to say that we didn't steal the money, right? And we`ll be defending ourselves. Can you help me with this? Thank you! I appreciate it. ana silva Ana Here’s my response: Hi Ana, We’ll do some practice on this on today’s show. You might say, “I’m afraid I’ll have to plead guilty to your criticism. Although I didn’t and would never steal money from you, I clearly have done a terrible job of winning your trust and providing genuine warmth and support. “It’s painful for me to hear how I’ve failed, and I feel ashamed, especially since I like you so much and value our friendship. I wouldn’t be surprised if you’re feeling angry, frustrated, and disappointed, and perhaps alone, too, and perhaps even anxious. “Can you tell me more about what happened, and how you feel, and all the ways I’ve let you down and come across as untrustworthy?” This is just a try, and the details will be different depending on who the person is and what the situation is. Hope this helps! Also, Podcast 161 might also be helpful. It’s all about “hearing the music behind the words” (https://feelinggood.com/2019/10/07/161-listening-to-a-different-kind-of-music/) david Rhonda, Matt, and David (without Dr. Rutherford Knows) Rhonda and I are convinced that Dr. May is one of the greatest therapists on the planet earth. If you have a question or would like to contact Dr. May, please check out his website at: (www.matthewmaymd.com) Dr. Rhonda Barovsky practices in Walnut Creek, California, but due to Covid-19 restrictions is working via Zoom, and can be reached at rhonda@feelinggreattherapycenter.com. She is a Level 4 Certified TEAM-CBT therapist and trainer and specializes in the treatment of trauma, anxiety, depression, and relationship problems. Check out her new website: www.feelinggreattherapycenter.com. You can reach Dr. Burns at david@feelinggood.com.
  • Feeling Good Podcast | TEAM-CBT - The New Mood Therapy podcast

    257: What's an "Intensive?"

    53:18

    Podcast 257: What's an Intensive? Today’s podcast features Dr. Lorraine Wong and Richard Lam who describe the intensive TEAM-CBT treatment program at the Feeling Good Institute in Mountain View, California. Dr. Wong is a board certified clinical psychologist and the Clinical Director of The Feeling Good Institute in Mountain View. Richard Lam is TEAM Certified Therapist, Trainer and Certification Program Manager at the Feeling Good Institute. An intensive is a departure from the conventional weekly 50-minute session and compresses an entire course of therapy into a brief period of time. David describes how he created this treatment approach accidentally at his hospital in Philadelphia when one of the world’s most famous and beloved actors, a man who was a great fan of Dr. Burns first book, Feeling Good: The New Mood Therapy, contacted him and asked for treatment. However, there was a catch. He only had two days available, and asked if he could fly from Hollywood to Philadelphia and book all of my sessions for two days. I was delighted to do that, and scheduled 17 back-to-back 45-minute sessions on a Thursday and Friday. He came in a disguise, and explained that fans and the paparazzi were constantly hounding him, and that he felt like a hunted animal. I asked if the disguise was effective, and he said it wasn’t working at all. People still hounded him and asked why he was wearing the disguise and asked for autographs. Because he was a powerful actor, the roleplaying techniques I have developed, like Externalization of Voices, were tremendously effective, and he actually made a complete recovery within a couple hours. Later on, I developed an intensive program for the patients in our inner-city neighborhood, with the help of the president of our hospital, and it was also incredibly effective for our patients who had few resources. However, they loved cognitive therapy! Richard and Lorraine explain how they are implementing the intensive concept at the FGI, working with people from around the United States and the world who come to Mountain View for several days for the treatment. They describe their work with a severely and chronically depressed man who came from Europe who seemed incredibly challenging at first. He was super skeptical and said that that he’d had tons of failed therapy but nothing and no one had ever helped him. He was telling himself things like this: Life isn’t worth living. I’m a special case and no one will be able to help me. Life shouldn’t be so hard. I should be able to enjoy life more. However, once they blew away his resistance using Paradoxical Agenda Setting, Richard explains that “it was a breeze to blow all of his negative thoughts out of the water.” The treatment is costly in the short-term, but can be extremely cost-effective in reality because recovery often happens rapidly. It is my impression, too, that in the hands of a skillful therapist, extended sessions and intensive treatment with TEAM-CBT can often be amazingly effective. If you would like to contact them, you can go to the FGI website (www.feelinggoodinstitute.com) or email them: Richard@feelinggoodinstitute.com or Lorraine@feelinggoodinstitute.com. Thanks for listening, and thanks to Richard and Lorraine for being especially fun and gracious guests on today’s podcast! Rhonda and David Dr. Rhonda Barovsky practices in Walnut Creek, California. She sees clients via Zoom, and in her office.  She can be reached at rhonda@feelinggreattherapycenter.com. She is a Level 4 Certified TEAM-CBT therapist and trainer and specializes in the treatment of trauma, anxiety, depression, and relationship problems. Check out her new website: www.feelinggreattherapycenter.com. You can reach Dr. Burns at david@feelinggood.com.
  • Feeling Good Podcast | TEAM-CBT - The New Mood Therapy podcast

    256: Intense Performance / Public Speaking Anxiety, Part 2 of 2

    1:39:23

    Intense Performance / Public Speaking Anxiety, Part 2 of 2 Last week we presented the first half of the session with Michelle Wharton at the Live Therapy workshop on May 16, 2021. Michelle had been struggling with years of intense public speaking anxiety, especially in professional settings. So far, we’ve commented on the T = Testing and E = Empathy portions of the session. Today, we present the exciting and inspiring conclusion of that session. A = Assessment of Resistance At the end of the moving and tearful empathy phase, we asked Michelle about her goals for the session, which included Not to have to feel this terror at full volume. Not to be stopped from volunteering for things that require public speaking and teaching, and to be able to feel some excitement in my career! After Michelle said she would be willing to press the Magic Button to achieve all these goals instantly, with no effort, we suggested a round of Positive Reframing so we could see what might be lost of she suddenly achieved all these goals. You can click here  to review the Positive Reframing that we did together, as well as Michelle’s Emotions table at the end of the Positive Reframing. You can see her goals for each emotion when we used the Magic Dial. The idea is to dial each feeling down to a lower level that would reduce your suffering, while still allowing you to preserve all the awesome things about you! The Positive Reframing is one of the unique aspects of TEAM-CBT. Although we are encouraging the patient to keep the symptoms, the Positive Reframing typically eliminates or drastically reduces the patient’s resistance to change, and opens the door to the possibility of rapid recovery. This will be true even if the patient has been struggling with a problem unsuccessfully for years or even decades, as was the case with Michelle. M = Methods We asked Michelle what Negative Thought she wanted to work on first, and she chose #5: “People will think you are selfish and self-preoccupied.” She believed this thought 100%. First, we asked Michelle to identify and explain the cognitive distortions in this thought. As you can see on her Daily Mood Log (LINK), she found all ten distortions. Of course, the most prominent distortion in this thought is Mind-Reading. That’s because Michelle thinks she knows how other people will be thinking and feeling about her when they find out about her intense public speaking anxiety. This distortion is nearly always present in any form of social anxiety. I know this from my clinical work and personal experience, since I have personally suffered from at least five forms of social anxiety, including extremely public speaking anxiety, when I was young. You feel absolutely certain that you’re flawed and that people will judge you! Then we challenged the Negative Thought, and Michele she was able, with a little help and a couple of role reversal, to crush it. Take a look. (LINK) Here were Michelle’s reflections on that portion of the session. First we used the Double Standard and I think that’s when I said this to the imaginary friend with the exact same problem: “I think you’re being kind of brave.” Then it evolved into Externalization of Voices. Both David and Jill played the negative Michelle and I had a little difficulty talking back to my Negative Self. I connected on a logical level, but didn’t yet have the ammunition or determination I need to blow my Negative Thoughts out of the water. David spotted my ambivalence immediately, and suggested that maybe it wasn’t something we should work on. Before he made that comment, I didn’t even realize that I had mixed feelings about giving up my intensely self-critical thoughts. At that point, I found myself making the decision to fight back and felt myself getting stronger. The next time David (as the Negative Michelle) asked if he could talk to me for a minute I told him he had only 30 seconds to make his point because it was time to back off. I had some hesitation about only using the Counter Attack to defeat the thought but David said he liked the feisty response. Then David and Jill both told me of all the positive feedback that was coming through the chat, and I was given the opportunity to use the Survey Method with a couple of audience members. I think I asked two or three people if they thought I was using up valuable time, since that was one of my painful Negative Thoughts. The both commented that they found the session incredibly helpful and that they could relate to these feelings of anxiety and shame, and that they weren’t judging me harshly at all! Here you can see how Michelle challenged thought #9. As you can see, her belief in this thought fell from 100 to 50, and then to 0. Negative Thoughts % Now % After Distortions Positive Thoughts % Belief 5. people will think that you’re selfish and self-preoccupied. 100 50 0 AON OG MF DP MAG/MIN ER LABE SS SB In fact, I’m being kind of brave!! 100         My anxiety is very real, and it’s good to ask for help. 100         My fear of public speaking is a common and exceptionally worthy problem! 100 You can see Michelle’s Emotions table at the end of the session, after she had crushed all of her Negative Thoughts. Emotions % Now % Goal % After Emotions % Now % Goal % After Down 40 5-10 5 Embarrassed, foolish, self-conscious 100 5 0 Anxious, panicky 100 20-30 0 Discouraged 70 0 0 Inferior, inadequate, incompetent 90 25 5 Frustrated, stuck 80 10 0 Lonely 80 0 0 Angry, mad, resentful, annoyed, irritated, upset, furious 60 0 0 After the workshop, Michelle sent us this email. HI David and Jill, I was going to write to you and tell that I would probably be happy to go ahead with the podcast but that I wanted to do a DML on some concerns about judgements as well as concerns about crossing of professional boundaries (worrying that I’m ‘oversharing’ with clients). Then, I just so happened to have supervision scheduled with Robyn Blake-Mortimer (another Level 4 therapist in Adelaide - I think she was Robyn Fowler when working in New York) this morning and she suggested we do some TEAM personal work on it. It was incredibly helpful and I’ve decided that I’d be happy for you to share the podcast, if Jill and Maor give permission. Robyn helped me to see that there was probably (intentional distortion!) a large impact on my life from the fact that my family survived Cycle Tracy (Christmas 1974) despite our house being 99% destroyed. Our lives were hugely affected and I (now) see a strong connection between this and the bed wetting. Which is not to say it changes the ‘ok-ness’ of the issue, rather that it helped me to see the amount of cognitive distortions that were in my worries about broadcasting the podcast (that ‘my problems should all be fixed by now’). Another liberating moment for me, thanks again to TEAM. Here’s what was left of our house after the Cyclone - just the bathroom where we were. Thank you again. M. This was my response to Michelle: Wow, Michelle, that’s fantastic, kudos, I really like the way you’ve caught the pass and you’re running for a touchdown, like a speedy wide receiver (if you follow football.) I really like all of your thinking and plans! Also, something both of you might want to consider is if we might consider turning each session into two consecutive podcasts. People love and are helped the most by live work podcasts. This is not required, and is just a thought. So proud of both of you! Warmly, david Michelle’s scores on all the scales on the Brief Mood Survey at the end of the session were zero, and her scores on the Happiness Test soared to 100%. Her ratings of Jill and David on the Empathy and Helpfulness tests were perfect as you can see at this link. Here’s what she wrote on the question on “what did you like the least about your session?” "Absolutely nothing!! This was such a gift and I feel so fortunate and incredibly grateful." Here’s what she wrote on the question on “what did you like the best about your session?” "Addressing the ambivalence, the Positive Reframing, the warmth from you both, and how it helped me to soften into and accept these feelings." On the audio, you will also hear the amazing follow-up interview we had with Michelle many weeks after this session. Thanks for listening. I hope you learned a ton and were moved emotionally and inspired. Write and let us know what you think! And thanks, too, to Michelle for giving all of us a gift that’s worth far more than gold! Rhonda, Jill, Michelle, and David

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