Feeling Good Podcast | TEAM-CBT - The New Mood Therapy David Burns, MD

Ask David Unfairness Worthwhileness Erasing Depression with Lasers TEAM in the UK What's the Most Powerful Technique? We have lots of great questions today. The answers in the show notes were written prior to the podcast, and the answers in the live podcast as we discussed these questions may differ somewhat or amplify the written materials in these show notes.
We love your questions. Remember to send them to David@feelinggood.com.
Special Announcement Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information! Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field  Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend.
But there's some good news, too! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out!
Today’s Questions
Kiernan asks about “unfairness” and the connection between worthwhileness and achievement. Brittany asks: Can you “erase” feelings of sadness and depression by shining lasers in the patient’s eyes? James asks about the use of TEAM methods in the NHS in the UK Brian asks: Is positive reframing the most successful technique you have used with your patients? 1. Kieran asks (slightly edited for clarity): How would you talk back to negative thoughts like this one: “It's not fair that I can't afford quality food when there are millionaires that will have access to better food and a healthier lifestyle which has an effect on overall health and longevity'”? Or what if you feel like it’s unfair that you should have to pay a lot of money for an expensive dental treatment that you can’t afford? Kieran also asks (slightly edited by david): What if worthwhileness is not based on achievement but there are still things you would like to have and enjoy? They would buy and own things that they happen to like and not to impress others. Hi David and Ronda, and if Matt is on
I have been listening to your wonderful podcast for about the last 3 years as I drive to work. It has really opened my eyes about how your thoughts create your interpersonal reality. Loved the podcasts on jealousy addiction, perfectionism, achievement addiction and many more.
My questions would be: What about if someone wants to achieve more but it isn't based on worthwhileness? They would buy and own things that they happen to like and not to impress others.
Let's say they wanted to be able to afford a nice house, healthier higher quality food and water. As the quality does have an effect on health especially in the US as the regulations are not the greatest.
However, the fact that they couldn't afford to buy these upsets them? Thoughts: 'It's not fair that I can't afford quality food but there are millionaires that will have access to better food, lifestyle which has an effect on overall health and longevity'
Or if someone has to pay for unexpected expensive dental treatment.
Thoughts: 'It's not fair that I have to pay £14,000 for this treatment'. 'It should be more affordable to lower income households, as it is essential to have functional teeth'
I hope I have explained this well, I would love to hear your thoughts. Keep doing what you are doing and all the best.
Kieran
 
David’s response Sure Kieran, if you like I will make this an Ask David question for a podcast. LMK if that’s okay, and if it is okay to

Ask David Bipolar, the Dark Side, Changing Behavior We have lots of great questions today. The answers in the show notes were written prior to the podcast, and the answers in the live podcast as we discussed these questions may differ somewhat or amplify the written materials in these show notes.
We love your questions. Remember to send them to David@feelinggood.com.
Announcement: Our awesome summer intensive is returning after a long, five years due to the pandemic. It is typically the most outstanding and rewarding TEAM-CBT training of the year, and it will take place again and the wonderful South San Francisco Conference Center from August 8 – 11, 2025.
You can attend in person if you register soon, since in-person seating will be strictly limited and only a small number are still available. You can also attend the online, live-streamed version of this program at a substantial discount. The online experience and small group exercises will be similar for the in-person and online participants.
Check out the details, including early-bird discounts, at www.cbtintensive.com
www.cbtintensive.com
Hope to see you there!
Warmly, david
Today’s Questions
Alison asks: I have bipolar Disorder and I have had trouble challenging my negative thoughts. I’m suffering. What can I do NAME WITHHELD asks: Can or should a person really and truly accept their dark side? Trainor asks: In TEAM there is a strong emphasis on changing the way you think. But is it sometimes also important to change your behavior, or to make real changes in your life, or to help others who need help changing their circumstances==for example, people who are struggling in poverty.  
1. Alison asks: I have bipolar Disorder and I have had trouble challenging my negative thoughts. I’m suffering. What can I do? Hi David,
Many years ago I used your book to beat depressive thinking… in the last three years I’ve been diagnosed with Bipolar Disorder and have found my depressive thinking too difficult to budge with your book.
I’m really suffering; any ideas about what I could do?
Thank you for your service to humanity. I always recommend your book.
David’s response
Hi Alison,
A therapist could help. The new Feeling Great App could help. And tons of free resources at www.feelinggood.com.
In addition, can you please give me an example of the negative thoughts you can’t budge. Then we can point things out in the podcast and try to figure out why you’re getting stuck!
I have found that doing cognitive therapy / TEAM-CBT with individuals with Bipolar Disorder is exceptionally helpful during the depressed (not manic) phase, and works pretty much the same way as with anyone who’s feeling down.
Best, david
 
2. NAME WITHHELD asks: Can or should a person really and truly accept their dark side? Hello David,
My name is NAME WITHHELD and I am doing my PhD degree in Neuroimmunology in LOCATION WITHHELD. I had come across your book feeling good and your podcasts by one of my therapists - they have had an immense impact on my way of thinking.
I really love disarming and using “I feel” statements to connect! I had also realized that by finding some genuine truth in a person’s belief even if it sounds ridiculous, I would automatically develop certain level of respect for that person! I really love that! I feel really happy that I can respect a person even without accepting his/her beliefs!!
I am now working on my distortions. I really love working on my mind that way.
Anyway, I have wanted to ask you if a person CAN accept his/her dark side? I seemed to have loathed myself for quite a long time and couldn’t stand living alone without a partner or a person around. I hated myself for disrespecting my mother whilst growing up.
But, sometime during Dec last year, I had had an epiphany of why things happened the way they did and somehow, I learnt that the reason why I had disrespected my mother was because my father, after their separation,

#400! Yippee! Today, Rhonda has prepared a special celebration for our 400th podcast, and still going strong! She has invited a number of our favorite people and podcast guests to celebrate with us, starting with our beloved friend and frequent Ask David contributor, Matt May, MD, who officially joined us in early 2000.
Matt’s presence on the show had meant a great deal, personally and professionally, because I supervised Matt when he was a Stanford psychiatric resident, and had been missing our weekly chats! Our reunion via the Feeling Good Podcast has been special for that reason, but also because of Matt’s kindly but scholarly answers to the many questions all of you submit. Keep them coming, and send them directly to Rhonda or David. We love reading and answering them!
Next, we were joined by two more extraordinary psychiatrists and human beings, Drs. Heather Clague and Brandon Vance, who song their rendition (with guitar accompaniment) of “Help Dr. Burns!” (Based on Beetles’ Help, I need somebody!”
With their kind permission, here are the brilliant lyrics!
Help! I need a podcast!
Help! Not just any podcast!
Help! Pushing the Magic Button for ....
Help!
When I was younger, 8 years younger than today
I thought I could help everybody; help them in every way.
I got so grandiose; I was so self-assured.
I’d push my brilliant techniques, but my patients were never cured.
So, Help me not to Help oh Dr. Burns
Will they like me if they have to do the work?
If I set an ultimatum, am I a jerk?!
Won’t you please, please stop me?!
So many times, I tried to help, but then got stuck
I didn’t know but my patients were also thinking what the #?@!
Your podcast said to test at the start and after every session.
And then my eyes they opened wide
Boy, was that a lesson!
Oh Help me not to help, oh Dr. Burns!
Help me unlearn the bad habits I have learned
I’ll do homework when my urge to help returns
Won’t you please, please help me?!
Now I explore my patients’ reasons not to change.
I learned to sit with open hands if they choose to stay the same.
Only when they fight for change and want to do the work,
That’s when I offer tools, and know the changes will endure.
You’ve helped me not to help, oh Dr. Burns
‘Til my patients show me that they really yearn
To do the work and ask me really firmly
Won’t you please, please help me?
Your podcasts helped ME!
Oooooooh!
Much warmth to each of you!
Heather and Brendan
Our next guest was the brilliant and beloved Dr. Jill Levitt who joined my weekly Stanford training group when she and her husband, Brian, and two boys moved to the Bay Area from New York in 2007. Jill has moved up in the ranks and now co-leads the Tuesday group with me, and also joins me as co-therapists in a great many live sessions we have published as two consecutive podcasts.
The idea is to document exactly how TEAM-CBT works, and how we can nearly always get such blow-away results in a single, extended session. That was my dream as a young man, since the methods I was taught as a psychiatric resident almost never got rapid results, or even any noticeable changes in my patients. Now that dream has become a reality, and a great many people in our TEAM-CBT community have contributed to that evolution.
Next we were joined by our beloved Dr. Amy Huberman. Her riveting personal work on perfectionism was published recently on two consecutive Feeling Good Podcasts. Amy was glowing and filled with joy, which gave us great feelings of joy as well!
And then we were graced by a visit from Mina, who has starred in many Feeling Good Podcasts on a number of personal issues. I will be seeing Mina and her beloved husband in a few minutes for our Sunday morning hike and dim sum feast afterwards. It is always a highlight of my week!
Next was another Amy Berner who reported on her recent and wildly successful Intimate Connections Book Club with yet another psychiatrist, Dr. Leigh H

 FROZEN: Part 2 of 2 Featuring Personal Work with Cody Today, you will hear the exciting conclusion of the work that Jill and David did with Cody, a young man who sometimes freezes in social situations due to feelings of anxiety. He actually froze up when Jill and David were working with him in part 1 last week. What will they do?
Tune in today and you'll find out!
Before I describe Cody’s session, I want to remind you that I am bringing back my annual, four-day summer intensive at the South San Francisco Conference Center this year, for the first time in five years. We had to abandon it due to the pandemic, and this year we are bringing it back to life on August 8 to 11. It will cover TEAM-CBT for depression and anxiety, but with a few changes, hopefully innovations and further improvements.
For one thing, you can attend in person or online this year, and Dr. Levitt will be teaching with me. This will make the experience even better, since Jill is a brilliant psychotherapy teacher, certainly among the top in the world! The in-person seating will be strictly limited to 100, so register early if you are interested, at
Intensive Information / Registration The online version will be identical, with many skilled experts to guide you in the many interactive exercises, making both the in person and online versions identical. However, the online will be roughly half the cost, so that could be an appealing option if you are cost-conscious or if you live far away. No travel needed this year!
But perhaps most important, this annual intensive always proves to be the best training experience of the year, with chances to learn sophisticated and magnificent TEAM techniques to use with your patients. But you will also have the chance to do your own personal work. Many, many people have said that the intensives are absolutely magical, and I totally agree!
In fact, the summer intensive might be the training you always dreamed about, but never really received, in graduate school!. Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field  Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend.
Beginning of Part 2 with Cody You will hear some of the tools that seemed especially helpful, including
Self-Disclosure Positive Reframing, not only for his negative feelings but also for his freezing Identify and Explain the Distortions Externalization of Voices with Acceptance Paradox the Feared Fantasy the Experimental Technique And more. Whether you are a shrink or general citizen, I think there might be a lot for you to learn from Cody, not only about techniques to treat social anxiety and feelings of inadequacy, but also about enlightenment as well. ‘
That’s because the goals of a TEAM-CBT session are not just the reduction of negative feelings, but the complete obliteration of negative feelings, along with jumping on a psychic trampoline that catapults you into a state of profound self-acceptance and enlightenment.
At least, that’s my take on it!
Did it really happen?
Here's how Cody was feeling at the start of the session, along with his goals for each feeling at the end of Positive Reframing, and his feelings at the end of the session. As you can see, all of his negative feelings went to zero.
Emotions % Before
% Goal % After Sad, blue, depressed, down, unhappy 40
10 0 Anxious, worried, panicky, nervous, frightened 95 15 0 Guilty, remorseful, bad, ashamed 20 5 0 Inferior, worthless, inadequate, defective, incompetent 40 10 0 Lonely, unloved, unwanted, rejected, alone, abandoned 50 10 0 Embarrassed, foolish, humiliated, self-conscious 100 30 0

FROZEN: Part 1 of 2 Featuring Personal Work with Cody In today’s, and next week’s, podcasts. we present the next episode of live work with Cody. The first, which featured Rejection Practice for social anxiety, was published as Podcast #326 on January 9, 2023 at this LINK.
My co-therapist for this session was the wonderful Dr. Jill Levitt, the Director of Clinical Training at the Feeling Good Institute in Mt. View, California (LINK.).
Before I describe Cody’s session, I want to remind you that I am bringing back my annual, four-day summer intensive at the South San Francisco Conference Center this year, for the first time in five years. We had to abandon it due to the pandemic, and this year we are bringing it back to life on August 8 to 11. It will cover TEAM-CBT for depression and anxiety, but with a few changes, hopefully innovations and further improvements.
For one thing, you can attend in person or online this year, and Dr. Levitt will be teaching with me. This will make the experience even better, since Jill is a brilliant psychotherapy teacher, certainly among the top in the world! The in-person seating will be strictly limited to 100, so register early if you are interested, at
Intensive Information / Registration The online version will be identical, with many skilled experts to guide you in the many interactive exercises, making both the in person and online versions identical. However, the online will be roughly half the cost, so that could be an appealing option if you are cost-conscious or if you live far away. No travel needed this year!
But perhaps most important, this annual intensive always proves to be the best training experience of the year, with chances to learn sophisticated and magnificent TEAM techniques to use with your patients. But you will also have the chance to do your own personal work. Many, many people have said that the intensives are absolutely magical, and I totally agree!
In fact, the summer intensive might be the training you always dreamed about, but never really received, in graduate school!. Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field  Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend.
Now, back to the podcast, in which you’ll hear some additional TEAM-CBT magic. Cody asked for help with a problem that’s been bugging him for some time. He sometimes freezes up when asked to do a role play or answer a question during psychotherapy training sessions. This typically leads to an awkward silence, and feelings of intense anxiety, inadequacy, frustration, embarrassment and more.
Here's how he described it:
Upsetting event: I was doing a suicide screening role-play with our clinical supervisor and other therapists. After working through the first step of the role-play, I froze and did not say a word!
Here's how Cody was feeling.
Emotions
% Before % Goal % After Sad, blue, depressed, down, unhappy 40     Anxious, worried, panicky, nervous, frightened 95     Guilty, remorseful, bad, ashamed 20     Inferior, worthless, inadequate, defective, incompetent 40     Lonely, unloved, unwanted, rejected, alone, abandoned 50     Embarrassed, foolish, humiliated, self-conscious 100     Hopeless, discouraged, pessimistic, despairing 50     Frustrated, stuck, thwarted, defeated 50     Angry, mad, resentful, annoyed, irritated, upset, furious 30     Confused 60
     
As you can see and might imagine, the most intense feelings were anxiety and embarrassment, but several other feelings were fairly intense as well: such as feeling alone, discouraged, frustrated, a

Ask David, Rhonda and Matt Assertiveness, Suppressing your Feelings, and the "Miracle Cure" question Questions for today’s Ask David podcast. Chris asks if I have a book about assertiveness. Brian asks: Is there anything to the theory that "suppressing emotions" is harmful or is that just Freudian mumbo jumbo? Matt asks about the “Miracle Cure” question in the Assessment of Resistance portion of a TEAM therapy session. Rhonda began with a lovely endorsement and a cool reminder of the classic book, Robinson Crusoe, who created cognitive therapy (the double column technique) when he was stranded on a deserted island! I believe I wrote about it in one of my books, possibly Feeling Good. It’s pretty cool! You will hear Matt playing the role of the “evil” thoughts, like, “I am stranded alone on a deserted island,” and Rhonda will play the role of the “good” thoughts, like, “Yes, but my life was spared, and all of my shipmates died.”
Here's what it looks like in the novel:
Evil. Good. I am cast upon a horrible, desolate island, void of all hope of recovery.     But I am alive; and not drowned, as all my ship’s company were. I am singled out and separated, as it were, from all the world, to be miserable.     But I am singled out, too, from all the ship’s crew, to be spared from death; and He that miraculously saved me from death can deliver me from this condition. I am divided from mankind—a solitaire; one banished from human society.     But I am not starved, and perishing on a barren place, affording no sustenance. I have no clothes to cover me.     But I am in a hot climate, where, if I had clothes, I could hardly wear them. I am without any defence, or means to resist any violence of man or beast.     But I am cast on an island where I see no wild beasts to hurt me, as I saw on the coast of Africa; and what if I had been shipwrecked there? I have no soul to speak to or relieve me.     But God wonderfully sent the ship in near enough to the shore, that I have got out as many necessary things as will either supply my wants or enable me to supply myself, even as long as I live. I know this novel is a couple hundred years old, so it certainly deserves nomination of the earliest cognitive therapy!
Now, for the answers to today’s Ask David questions. Keep in mind that these answers were written BEFORE today’s recording, so the actual live answers will differ in some regards from the written answers below.
 
1. Chris asks if I have a book about assertiveness. Hi Dr. Burns,
I hope you're doing well. Do you have a book on assertiveness training?
I've used your books to help me with my hidden "should" statements, which has enabled me to be less angry or anxious whenever someone treats me less than satisfactorily.
While this has helped immensely, I realize it's still in my interest to reduce the behavior I disagree with. For example, my sibling scheduled an early morning shift after I had a long day of work. Because they can't drive, they expect me to take them to work, which means I'll only get about 5 hours of sleep; this in itself isn't a bad thing... except this is the 3rd time in a row they've done this.
After using your techniques, I'm less angry and anxious, but I still want to address the behavior to reduce the likelihood that they do something like this again, which is why I'm reaching out.
Thanks for your help.
Kind regards,
Chris
David’s Reply
Sure. I like my own book, Feeling Good Together, and have often recommended Manuel Smith’s When I Say NO I Feel Guilty.
There is a LOT to be said about assertiveness training, including the fact that it doesn’t always work! I can give a great personal account of that!
Sometimes, or always, skillful listening is also effective. Assertiveness without listening makes it sound like only your own feelings are important, which is obviously pretty self-centered.
One of the most helpfu