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

264: How to Get Laid! (With a Little Help from the Five Secrets of Effective Communication)

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How to Get Laid! (With a Little Help from the Five Secrets of Effective Communication)

One of our top TEAM-CBT teachers and therapists, Thai-An Truong, LPC, LADC from Oklahoma City, is featured in today’s podcast. Thai-An is the owner of Lasting Change Therapy, LLC, a TEAM-CBT group practice in Oklahoma that focuses on using TEAM-CBT to help women overcome depression, anxiety, and relationship problems, so they can live happier lives and have more satisfying relationships. She is passionate about working with postpartum women after overcoming her own personal struggles with postpartum depression and anxiety. She is also passionate about spreading TEAM-CBT and training therapists in this awesome treatment approach.

Thai-An suggested a podcast on how one could use the Five Secrets of Effective Communication to deal with critical comments from your spouse or partner during marital conflicts. She submitted specific examples from several troubled couples she has worked with, and Rhonda submitted an example as well.

  1. Wife continues to bring up things that needs to be addressed, e.g., baby's medical needs, how he needs to set boundaries with his mom, precautions to take because of the pandemic.

Husband says: "All you do is talk about stressful things. You don't even care about being romantic anymore."

Wife’s typical response: "How can I be romantic with you when you aren't doing what you need to for our family?"

  1. Sex often comes up with every couple, and the criticism is typically from the husband, as in the first couple and this second couple as well.

Husband says: "You never want to have sex. It's like we're roommates instead of husband and wife."

Wife’s typical response: "I'm tired, and I can't just get in the mood when you haven't been nice to me all day."

  1. This couple had been trying unsuccessfully to have a baby.

The wife was very critical of her husband and said: “If it wasn’t for you, I’d have a baby. I should have married someone else."

Husband’s response: He said nothing and walked away.

  1. Infidelity: In this couple, the wife had an affair three years ago and the husband continues to bring it up when they get into arguments.

Husband says: "Oh, you say I'm so bad because I did x. How about you cheating on me? You're the one who did the worst possible thing, and I can never trust you again."

Her typical response: "It's been 3 years, why can't you just let it go so we can move on with our lives? I'm tired of you throwing this shit in my face all the time."

During the podcast, we critiqued the responses to the criticisms in these four cases, using the EAR algorithm. It was easy to point out that the responses of the partner who was criticized typically failed in all three categories:

  • No effective E = Empathy.
  • No effective A = Assertiveness.
  • No effective R = Respect.

We also spelled out the consequences of these responses to criticism, and showed how the respondents were actually forcing their spouses to treat them in exactly the way they were complaining about.

Then we used the “Intimacy Exercise” to practice more effective responses, based on the Five Secrets. This is, by far, the best way to learn the Five Secrets.

Your Turn to Practice

Now, here’s another example that Thai-An provided, and you, the listener, can practice with it. This wife was talking about how her friend had hurt her feelings. The husband typically goes into the advice-giving and problem-solving mode.

Her criticism: "You suck at listening. I don't need you to fix it."

His typical response: "I'm just trying to help."

First, see if you can explain why the husband’s response was ineffective, using the EAR acronym.

Ask yourself:

  1. Did he use E = Empathy and acknowledge how she was thinking and feeling?
  2. Did he use A = Assertiveness and express how he was feeling at that moment?
  3. Did he use R = Respect to convey some warmth, respect, or love during the heat of battle?

Next, ask yourself about the consequences of his response. What will his wife think? What will she conclude? How will she feel? How will she likely respond to his defensiveness?

Finally, put yourself in his shoes and see if you can write out a more effective response, using the Five Secrets of Effective Communication

Thanks!

Rhonda, Thai-An, and David

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There are tons of free resources on my website, plus my books, like Feeling Good, and others, can be invaluable, including on the topic of suicide. You can get used copies inexpensively on Amazon, too! All the best, david * * * After Hearing Podcast 14 on the Five Secrets Megan asks: Hi David, I was wondering what your thoughts are about using the five secrets when in communication with someone who may not be coming from a place of love or respect, or someone who might weaponize your vulnerability, such as someone with narcissistic tendencies? Thank you, I appreciate you and all you do to make the world a kinder and gentler place. David’s Response Hi Megan, Please provide a specific example. What did the other person say, and what, exactly, did you say next. One exchange is enough. Then we can do something amazing, and not just BS on an abstract level that will be useless. You see yourself, based on your note, as the sweet innocent victim of the other person's "badness." Once we have a specific example of an interaction that did not go well, and you focus on your own role, things will suddenly fall into a shockingly different perspective. david Will include this in an Ask David. * * * Telia asks: Hi David, Thank you so much for your free information and podcast #155 on emotional eating. Could you please do another episode on compulsive emotional eating? I have suffered with this my whole life. I listened to episode 155 but I need more help like actual questions to ask myself or tools to use in the moment. I have suffered with this my entire life, and I know with your help I can be free from it. Thank you Telia from Australia David’s Response Hi Telia, Check out the free chapter(s) offer on bottom of my website home page. Full instructions are right there. Feel free to contact me if any questions after following the guidelines there, and doing the exercises on paper. d * * * Daniele asks: What “upsetting event” should I put at the top of my Daily Mood Log? Does it have to be the event that triggered your depression? Hello Dr. Burns, i am reading your second book, Feeling Great. The first one, the new mood couldn’t help me or i couldn’t get it done right. And now i am trying Feeling Great. I like the book and your thoughts. I have struggled with anxiety and depression since 2014 - on and off. Lately more on.... My biggest problem with the exercise is that you have to put an event that make you depressed. I don’t know exactly why it started and i so it’s difficult to find an event. What can I do? I feel depressed and don’t know why. These days the fact that i couldn’t get rid of the depression for so long is the main reason why i am depressed. Thanks for your help, Daniele from Italy David’s Response Hi Daniele, You just have to focus on one specific moment when you were upset and want help. It can even be the moment when you are working with the Daily Mood Log. d Thank you, Dr. Burns! Daniele * * * Anca asks: Do I have to complete a Daily Mood Log every day? Hello Dr Burns, Thank you so much for the podcast and all the wonderful resources you are gifting to the world! I've been listening for the last 3 months, and I can say that your discussions with your colleagues and patients have improved my mindset and my perspective on life. They helped me to identify feelings of self-blame and other-blame that I didn't even know I had. I also didn't realize how toxic they were. I've bought the Feeling Great Book and completed 2 Daily Mood Journals. I am still in the beginning and try to improve my skills for challenging the negative thoughts. I am just wondering if I am approaching this correctly - sorry if I missed this from the book - Do I need to complete the Daily Mood Log every day? I am asking this because on the days I do feel down and do have a negative event and thoughts, it takes me a lot of time to complete the log, around 2 hours. On other days I feel ok, and don't have upsetting distorted thoughts. Should I record one negative event every day, with all the negative emotions and thoughts that come with it, or work on the same upsetting event every day, taking on one or 2 thoughts at a time? Thank you for your support and your generosity. With Gratitude, Anca David’s Response Hi Anca, Will make this an Ask David. The short question is that you can work on the DML a little bit every day. I would aim for 15 to 20 minutes a day, like meditation. On some days, you will want to put in more time, which is fine, but you get 100% credit after 15 – 20 minutes. You can work on a DML over several days. This is just one idea, and ultimately you are in charge! Congrats on the fantastic work you are doing! david David * * * Oliver asks: Dear Dr. Burns, How much time do you require your patients to spend on their daily psychotherapy homework (Daily Mood Journal)?  And how much time did they actually spend on a mood journal? From my experience, I seldom complete them in 2 hours, the time you set up for one session. A daily mood journal with 5 negative thoughts would often cost me 4 to 6 hours. I am wondering how much time your patients usually spend on one daily mood journal? Besides, when I was filling out one daily mood log, more upsetting events would float in my head. To avoid being distracted, I recorded the second upsetting event on another Daily Mood Journal. But I found I never had the chance to work on it because I seldom completed the first event. I am now unemployed, so I have enough time to work on an upsetting event, even if it cost me far more than 2 hours. However, I doubt if full-time employed people have enough time to do this homework, without sacrificing the time to be spent on families, sleeping, sports, and other activities. That is somewhat upsetting. Do you require your patients to finish a Daily Mood Journal in one day? I believe the guidance on this topic is not only important for me, but also for all of your readers and patients. And another question that confuses me is that what is overkill when doing Positive Reframing? And when to decide it will be overkill or not? Thanks. Oliver Smith David’s Response Thanks, Oliver. You can do a DML over several days, no need to complete it all at once. 15 to 30 minutes per day would be excellent. ON Positive Reframing, I wait until we “get a feel for it,” and we generally have listed a dozen or even 20 or so positives. I have an app I’m working on that will help with these questions. Will read your question on an Ask David, perhaps. Thanks! * * * Sarah asks: Hi Doctor Burns! Your podcasts have been so helpful! I want to know what you would have said to the husband, in this episode, if he were the one that came to you, first, about the marriage. If we all cause the very relationship problems that we are complaining about, what is it that the husband is doing to cause Sarah not to listen to him and explode in anger? I see that Sarah is not able to listen and empathize, however, It seems like the husband is able to listen and empathize. What would his next step be? Thanks! Sara David’s Response Thanks, Sara. This is an interesting but abstract question, and I never find that answering them is productive, as 100% of the learning is in the specific example. If he were asking for help, I would ask him to write down one thing that his wife said, as well as what, exactly, he said next, thinking of an exchange that didn't go well, and an example he wanted help with. Then we’d use the EAR technique to analyze his communication errors and show how he’s causing the exact problem he’s complaining about, followed by a revised response using the Five Secrets. You could do that for yourself, and we'll see what YOU might be able to learn! For example, what is something someone said to you, and what, exactly did you say next? Or, you could make up an example for me to comment on. * * * That's it for today! Rhonda, Matt, and David
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She described a terrifying experience while exploring in a jungle in Sumatra, where the leeches not only invade the water, but can also drop onto you from trees. After hiking through the beautiful, lush landscape for some time, Danielle began screaming and sobbing in terror when she noticed that her foot was bleeding because of a leech that had just detached itself. This was understandably embarrassing, and she realized that she needed to overcome this fear before going on another jungle adventure. In today’s therapy session live leeches will be placed on Danielle’s skin, and she will be encouraged to surrender to the anxiety and make it as intense as possible, rather than running away or trying to control or avoid it. This is an extreme form of exposure called “flooding.” It  can be incredibly effective, and often works quickly, but requires great courage on the part of the patient and therapist, as well as a high degree of therapist skill. To prepare for today’s exposure session, Danielle obtained four live leeches, which she kept at her apartment. She said that even looking at the leeches slithering around in the water and thinking about them biting her made her fear instantly jump to 9.5 on a scale from 0 (not at all) to 10 (the most intense anxiety). She asked Matt if he’d be willing to do the leech exposure first. Matt agreed, since we never ask our patients to do anything that we wouldn’t do, ourselves. This modeling by a trusted friend or therapist can be a useful tool in the treatment of anxiety. Danielle carefully removed one of the leeches with a spoon and placed it on Matt’s forearm. After crawling around for a minute or so, the leech attached itself and begin to engorge itself on Matt’s blood. Danielle watched in fascination and fear, and then it was her turn. She bravely placed a second leech on her forearm. She was afraid it was going to be extremely painful, but was surprised when it was just a mild feeling of sandpaper on her skin. Over a period of about ten or fifteen minutes, with episodes of nausea and profuse sweating, Danielle’s anxiety gradually dropped from 9.5 at the start all the way to 1, and she felt triumphant. You can see some photos and videos of the session here, including our lunch prior to the session at the Phoa Cabin in downtown Los Altos. It is a favorite local spot that features tremendously tasty Vietnamese food.  (LINK) Teaching points in today's TEAM-CBT session include the following: Avoidance is one of the major causes of all forms of anxiety. When you avoid or try to escape from your fears, they will always intensify. Exposure is a powerful treatment tool for anxiety, but is not a treatment per se, and there are many additional tools with powerful anti-anxiety effects. I (David) use at least 40 tools in the treatment of anxiety, but exposure must always be included in the mix. It is probably impossible to cure any form of anxiety without exposure. All patients and most therapists resist and fear exposure. Patients fear exposure because of the intense anxiety they must endure and their belief that something terrible will happen if they don’t avoid their fear, and most therapists are also afraid that the patient is too fragile, or the procedure is too extreme, and something terrible will happen. However, I (David) have never had a bad outcome when using exposure. I am convinced that poor therapy skills, and not exposure, cause negative outcomes in the treatment of anxiety. Excellent empathy is extremely important in treatment of Anxiety. Danielle mentioned the importance of her trust in Matt, and in his modeling of the exposure in the treatment. I (David) strongly agree with this, as I have had to use exposure in the treatment of my own fears and phobias and have also benefitted from doing exposure with someone I trust and admire. Once you’ve beaten a phobia, and no longer fear the thing that once caused terror, fears have a way of creeping back in, especially if you do not continue to face the thing our feared. To prevent this, ongoing exposure is needed. Although Dr. May treated Danielle for this problem successfully in the past, Danielle’s intense fear of leeches had returned during the COVID pandemic. While some form of relapse is almost always inevitable, the good news is that facing your fear frequently can massively reduce the frequency and intensity of relapses. Danielle seemed pleased with her session and agreed to do ongoing exposure on her own every day with the leeches as homework. The next day, we received this email from Danielle. Hello! I had a fantastic time yesterday with you and I am so grateful for all of your support and guidance. Thank you so much for taking the time to help me overcome my fear and help others do the same! It was so wonderful and special seeing you all again in person. Here are some awesome photos from the session as well as our lunch at the Phoa Cabin, and this link contains two videos. Rhonda, Danielle, Matt, and David
  • Feeling Good Podcast | TEAM-CBT - The New Mood Therapy podcast

    264: How to Get Laid! (With a Little Help from the Five Secrets of Effective Communication)

    1:09:13

      How to Get Laid! (With a Little Help from the Five Secrets of Effective Communication) One of our top TEAM-CBT teachers and therapists, Thai-An Truong, LPC, LADC from Oklahoma City, is featured in today’s podcast. Thai-An is the owner of Lasting Change Therapy, LLC, a TEAM-CBT group practice in Oklahoma that focuses on using TEAM-CBT to help women overcome depression, anxiety, and relationship problems, so they can live happier lives and have more satisfying relationships. She is passionate about working with postpartum women after overcoming her own personal struggles with postpartum depression and anxiety. She is also passionate about spreading TEAM-CBT and training therapists in this awesome treatment approach. Thai-An suggested a podcast on how one could use the Five Secrets of Effective Communication to deal with critical comments from your spouse or partner during marital conflicts. She submitted specific examples from several troubled couples she has worked with, and Rhonda submitted an example as well. Wife continues to bring up things that needs to be addressed, e.g., baby's medical needs, how he needs to set boundaries with his mom, precautions to take because of the pandemic. Husband says: "All you do is talk about stressful things. You don't even care about being romantic anymore." Wife’s typical response: "How can I be romantic with you when you aren't doing what you need to for our family?" Sex often comes up with every couple, and the criticism is typically from the husband, as in the first couple and this second couple as well. Husband says: "You never want to have sex. It's like we're roommates instead of husband and wife." Wife’s typical response: "I'm tired, and I can't just get in the mood when you haven't been nice to me all day." This couple had been trying unsuccessfully to have a baby. The wife was very critical of her husband and said: “If it wasn’t for you, I’d have a baby. I should have married someone else." Husband’s response: He said nothing and walked away. Infidelity: In this couple, the wife had an affair three years ago and the husband continues to bring it up when they get into arguments. Husband says: "Oh, you say I'm so bad because I did x. How about you cheating on me? You're the one who did the worst possible thing, and I can never trust you again." Her typical response: "It's been 3 years, why can't you just let it go so we can move on with our lives? I'm tired of you throwing this shit in my face all the time." During the podcast, we critiqued the responses to the criticisms in these four cases, using the EAR algorithm. It was easy to point out that the responses of the partner who was criticized typically failed in all three categories: No effective E = Empathy. No effective A = Assertiveness. No effective R = Respect. We also spelled out the consequences of these responses to criticism, and showed how the respondents were actually forcing their spouses to treat them in exactly the way they were complaining about. Then we used the “Intimacy Exercise” to practice more effective responses, based on the Five Secrets. This is, by far, the best way to learn the Five Secrets. Your Turn to Practice Now, here’s another example that Thai-An provided, and you, the listener, can practice with it. This wife was talking about how her friend had hurt her feelings. The husband typically goes into the advice-giving and problem-solving mode. Her criticism: "You suck at listening. I don't need you to fix it." His typical response: "I'm just trying to help." First, see if you can explain why the husband’s response was ineffective, using the EAR acronym. Ask yourself: Did he use E = Empathy and acknowledge how she was thinking and feeling? Did he use A = Assertiveness and express how he was feeling at that moment? Did he use R = Respect to convey some warmth, respect, or love during the heat of battle? Next, ask yourself about the consequences of his response. What will his wife think? What will she conclude? How will she feel? How will she likely respond to his defensiveness? Finally, put yourself in his shoes and see if you can write out a more effective response, using the Five Secrets of Effective Communication Thanks! Rhonda, Thai-An, and David
  • Feeling Good Podcast | TEAM-CBT - The New Mood Therapy podcast

    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. Taylor specializes in TEAM-CBT for children and teens, and tells us today about the upsurge in OCD (Obsessive-Compulsive Disorder) in young people, and how she approaches this problem using TEAM-CBT along with some family therapy. Taylor describes OCD as a pattern of intrusive thoughts, fears, and images that trigger feelings of anxiety. In addition, the patient engages in a series of repetitious, supposititious behaviors in an effort to avoid the fear. Sometimes the parents may get caught up in the child’s fears as well and engage in the compulsive rituals as well. The fears Taylor sees in children are similar to the fears reported by adults with OCD, such as the fear of contamination, and the compulsive habit of repeated handwashing, and more. But especially common in kids are fears that loved ones, like parents, won’t come home or will be hurt. Common OCD rituals in children include wanting things to be a certain way; for example, organizing your desk meticulously, arranging your pencils, and so forth. The patient often feels that he or she can’t stop or something terrible will happen. Another common fear is getting sick, and needing repeated reassurance that the food the child is eating is safe. David asked about the Hidden Emotion Model that is common and often helpful in adults with OCD, or any anxiety disorder. For example, if a child fears that a parent will be hurt, might this suggest that the child has repressed angry feelings toward the parent? Taylor confirmed that this dynamic was, in fact, common in children as well as adults with OCD. She emphasized the need for an alliance with the parents as a part of the treatment team. This might include urging the child to express his or her anger, wants, and so forth. Taylor speculated that the increase she’s seen in OCD may be the result of the COVID pandemic, and the uncertainty we all feel. Children have a great need for love, empathy, structure, and certainty, and OCD is just one pattern that the increase in anxiety can take. At the start of treatment, Taylor does an initial intake session with the parents, followed by two sessions with the child, and in both cases attempts to empathize and form an alliance via the Five Secrets of Effective Communication. She also wants to find out who the “patient” really is. Who is asking for help? Is it the child? Or the parents? She also wants to know who will do the work of the therapy. If the child doesn’t see the OCD symptoms as a problem, she will work with the parents. Sometimes there’s a mismatch as to what the problem is. The parents might want the child to get help with procrastination on schoolwork or household chores, but the child might want help with shyness and relationships with other kids. She describes how she uses TEAM to show the child that his or her symptoms reflect his or her core values, but that they can turn down the intensity of the fears using the Magic Dial. She emphasized a role for psychoeducation in the treatment as well, explaining the evolutionary and protective role of anxiety. It’s just that sometimes the volume gets turned up to unnecessary levels. She said that the parents are a huge part of the treatment, since the problem “lives in the house,” and the parents may fear what might happen if the child does not engage in the rituals. And, of course, Exposure and Response Prevention are important keys to successful treatment, just as they are in adults. Taylor described a compelling example of a teenager with an intense fear of vomiting in the middle of the night, who had resorted to a variety of rituals including avoiding dinner, secretly sleeping in his bathroom just in case. and more. Together, she guided him in the creation of a hierarchy of exposures as well as Positive Reframing of his symptoms. He successfully completed his treated in just six sessions. Taylor offers a 12-week introductory course on TEAM-CBT with children and adolescents, and is a superb and highly esteemed teacher. For more information, you can contact [email protected] or look for her on the website of the www,FeelingGoodInstitute.com Rhonda and David
  • Feeling Good Podcast | TEAM-CBT - The New Mood Therapy podcast

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

    1:51:33

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

    261: A Country Doctor, Part 1 of 2: "Nothing I do makes a difference!"

    45:47

    A Country Doctor, Part 1 of 2: "Nothing I do makes a difference!" This is the first of two podcasts on one of the live therapy demonstrations that Dr. Jill Levitt and I did at our psychotherapy workshop on Sunday, May 16th, 2021. I think you will find the session interesting and incredibly inspiring! Our patient is a physician in a small town in the mid-west. I want to thank Dr. Scherer for her tremendous courage in sharing this very personal experience with all of us. Dr. Levitt practices at the Feeling Good Institute in Mountain View, California, where she also serves as Director of Clinical Training. She also teaches at our weekly TEAM-CBT training group as Stanford. I am thrilled to share the audio of Jillian’s live session as a two-part podcast, since only mental health professionals are allowed to attend the workshops sponsored by the Feeling Good Institute. Many non-therapists were eager to attend, and disappointed when they learned that only shrinks could attend. 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 [email protected] 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: [email protected] 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

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