Sadness as Celebration, Part 1 Feeling Good Podcast | TEAM-CBT - The New Mood Therapy

#252: Sadness as Celebration, Part 1 In today’s podcast, Rhonda and David present Part 1 of their work with a young woman named Rose. Rose is a 38-year-old mother of two boys aged 2 and 5. She works as a Therapist at an outpatient clinic, the East Bay Center for Anxiety Relief, and is a member of our Tuesday training group at Stanford.
Rose sought help because of her profound grief after talking to her mother about her father’s recent visit to his oncologist. Her father has had many severe health problems in the past several years. He’s been a survivor, but suddenly the outlook seems bleak, and Rose feels tremendous sadness and fear, because of her deep love for her father.
In most cases, grief does not need treatment. Clearly, grieving is healthy and even necessary when you lose someone you love. However, it can be helpful to distinguish healthy from unhealthy grief.
From a cognitive therapy perspective, all feelings, including grief over the loss or impending loss of someone you love, result from your thoughts. Healthy grief results from negative thoughts that are not distorted. For example, if a loved one dies, you may think of all the things you loved about that person and the experiences you will no longer be able to share. Your sadness is actually an expression of your love.
Healthy grief, in contrast, results from distorted thoughts. For example, in my book, Feeling Good, I described a young physician who became suicidal when her brother committed suicide because she told herself; “I should have known he was suicidal that day. His death was my fault, and so I, too, deserve to die.”
This thought triggered intense guilt, and it contains many of the familiar cognitive distortions, including Self-Blame, Emotional Reasoning, Should Statements, and Discounting the Positive, and Fortune-Telling, to name just a few. With my help, she was able to challenge and crush her distorted thoughts, and her depression disappeared.
Then she was then able to grieve his tragic death. Paradoxically, the distorted thoughts that triggered the unhealthy grief had actually prevented her from grieving in a healthy way. Today’s podcast is illuminating because Rose is experiencing a combination of healthy and unhealthy grief resulting from a mix of undistorted and distorted thoughts.
The work that Rose did is incredibly inspiring, and sad. Today we will publish the first half of the session, including T = Testing and E = Empathy.
Next week, we will publish the second half of the session, starting with the question, “What do we have to offer our patients once we’ve empathized?” Then you will hear the A = Assessment of Resistance and M = Methods portion of our work with Rose.
T = Testing
Take a look at the Daily Mood Log (LINK) that Rose shared with us at the start of her session. You will see that she had very elevated scores in 8 different categories of negative feelings, suggesting she was in pretty intense distress. We will ask her to rate these feelings again at the end of the session so we can see if she experienced any changes during the session.
I’m a firm believer that all therapists should use testing at every session, and many are now doing this, but lots of therapists still refuse for a variety of reasons. I was going to say “bogus reasons,” but didn’t want to sound harsh or dogmatic!
To me, the refusal of psychotherapists or psychiatrists to measure symptoms at every session is the “unforgiveable sin!” I don’t believe it is possible to do good therapy, much less world class therapy, without Testing, for a wide variety of reasons:
Therapists perceptions of how patients feel, and patients feel about them, are not accurate. Measuring suicidal urges at the start and end of every session can save lives. Seeing how effective. or ineffective, you were at every session allows you to fine tune the therapy and abandon strategies and methods that aren’t working in favor of better techniques. This t