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

#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

Incredible Voices from the Past! Plus: David's Amazing Summer Intensive Returns August 8 - 11, 2024 Today, David and Rhonda are joined by Dr. Jill Levitt, the Director of Clinical Training at the Feeling Good Institute in Mountain View, California, and two incredible voices from the past: Dr. Karen Radella, a clinical psychologist who volunteered to do personal work at the 2013 summer intensive at the South San Francisco Conference Center, and Jacqueline Ong, LCSW, who volunteered to do personal work at the 2019 summer intensive. That was the last summer intensive, due primarily to the Covid pandemic.

Karen Radella, PhD
But here’s some fantastic news. The intensive returns again this summer, from August 8 to 11, 2024, at the same location. And Karen and Jacqueline give testimonial today, along with Rhonda, to the magic of the intensive, by describing the phenomenal impact of the personal work they did years ago, and the tremendous impact that work has had on their personal and professional lives.
Both Karen and Jacqueline had been suffering from the devastating emotional impact of severe personal trauma for many years. Nine years earlier, when Karen’s daughter was 12, she asked Karen if she could go out to play after dinner. She’d done this for years, but Karen had the thought that it was late and cold outside, but gave in and let her daughter go out to play.
Minutes later, some neighborhood boys snuck up on her and shot her in the mouth with a high-powered pellet rifle that blew out one of her teeth and did considerable damage to her mouth which triggered PTSD and required many dental surgeries to correct. Both Karen and her daughter had been suffering emotionally for the nine years since that incident.
Karen was telling herself that she was a bad mom, that she “shouldn’t have” let her go out to play on that particular night, and that her daughter’s horrific trauma was her fault. She was also convinced that other people, including the 100+ in the audience that evening, would be judging her as harshly as she was judging herself, and her feelings of fear and despair were palpable at the start of her live work.
Karen described the techniques that were so helpful to her in her fantastic recovery that evening during her two hour session with Jill and David, including the Survey Technique, which she said was the “coolest experience of my entire life.” She was also helped by other techniques, including Explain the Distortions, the Double Standard Technique, and the Externalization of Voices.
Jacqueline had suffered a different but equally severe traumatic event of a personal nature, but also disclosed it and worked it through with great courage in front of an audience of the same size in 2019. Like Karen, she experienced a complete elimination of her symptoms in the 2 hour session with Jill and David. She describe the keys to her suffering and recovery involved perfectionism (the need to be flawless) and perceived perfectionism (a term David coined that refers to the belief that others expect us to be perfect in order to be loved and respected.)
Jacqueline emphasized that “failing as fast as you can” is one of the keys to the rapid recovery we so often see in TEAM. Instead of meeting once a week for an hour, which sets you up for very slow progress with relapses between sessions, you use technique after technique in one session until you find the one that works.
Of course, following “recovery,” your negative thoughts will return over and over throughout your life, because no one is entitled to be—or would even want to be—happy all the time. But once you’ve experienced your own enlightenment, you know the tools that work for you, so you get better and better at heading off the relapses at the pass.
Jacqueline and Karen both said they’d heard that the personal work at an intensive can be life-changing, but they “wouldn’t have believed it” until they experienced it. Rhonda said,

Ask David, Rhonda and Matt More on Insomnia; Porn Addiction Guilt; Rage Questions for today James asks for help with insomnia. Arjun Asks: How can I stop blaming myself for my porn addiction as a teen? Stephan asks: How do you treat feelings of rage? And what if you are simply very angry, but you don’t have any thoughts?  
James asks for help with insomnia, Hi Dr. Burns,
I enjoy your newsletter and have experienced moments of clarity with your book. However, my current struggle is that I have developed terrible sleep anxiety. I feel nervous tension in my stomach and trembling limbs as nighttime approaches. Some nights I can put these feelings aside and dose off and others I just cannot stop dwelling on the negative body sensations and it does not allow me to sleep. I wonder if you can offer some advice on how to get over this fear and accompanying sensations.
Best,
James
David’s reply
Thanks, James. Sorry you’re struggling with trouble sleeping.
Yes, a Daily Mood Log can help, to find out what you are telling yourself that makes you so anxious about not sleeping.
Also, the Hidden Emotion Technique may be important to find out if there’s a problem in your life that’s bugging you.
There are also the typical sleep hygiene tips that can be useful for some folks, too! You can find these with an internet search.
Can I use this as an Ask David question for a podcast, with your first name or a fake name?
Best, david
 
Arjun Asks: How can I stop blaming myself for my porn addiction as a teen? Hi Rhonda,
I Really appreciate the work that you guys do and I listen to most of the feeling good podcasts. I'm 27 and have struggled with depression and anxiety since my teens. I'm currently in therapy with a TEAM certified professional from India, but I'm still grappling with feelings of being stuck in my past.
During my pre-teen years, I battled a porn addiction for about a year, which has left me with ongoing feelings of anxiety, guilt, and depression. Despite trying various therapies, I haven't found relief.
I keep fixating on the thought: "I shouldn't have indulged in porn addiction in the past. It's led me to develop anxiety and depression."
How do I debunk this thought, reduce its hold on me, and cope with the regret it brings? It feels like I'm trapped in my past. and constantly blaming myself for that one mistake. because that indulgence in porn really did change my life. I wasn't the same as before. and never could go back to being who I was.
How do I put the lie to this thought? Any methods you'd recommend putting in the recovery circle?
Your insights would be invaluable in helping me move forward.
Thank you,
Arjun
David’s reply: The key concept is that the problem is perfectionism, plus the beating up on yourself in the here and now, and not the behavior or misbehavior in your past. In the live podcast, we can discuss the importance of T = Testing (with DML), E = Empathy and A = Assessment of Resistance, and M = Methods, like explain the distortions, Perfectionism / Self-Blame CBA, D. Standard, EOR, EOV, etc. etc.
The issue, as I see it, is that you are looking for a technique to help you accept yourself, but in reality, it is a decision for you to make. The choice is to accept yourself with compassion or continue to beat up on yourself.
There are many really GOOD reasons to beat up on yourself, and we can perhaps outline some on the podcast. You would then have to explain why you’d really want to accept yourself, given all the good reasons to keep beating up on yourself, and given all the positive things your self-criticisms show about you.
Also, I will try to remember to tell one of my favorite Buddhist stories that relates to this problem.
 
Stephan asks: How do treat feelings of rage? And what if you are simply very angry, but you don’t have any thoughts? Hello Mr. Burns, I hope this email finds you in good spirits.
I’ve just begun your book “Feeling Good