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    Health

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

    This podcast features David D. Burns MD, author of “Feeling Good, The New Mood Therapy,” describing powerful new techniques to overcome depression and anxiety and develop greater joy and self-esteem. For therapists and the general public alike!

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    Copyright: Copyright © 2017 by David D. Burns, M.D.

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    Latest Episodes:
    449: Stories from My Hippy Days, Part 2 May 19, 2025
    Show notes

    Stories from My Hippy Days, Part 2 Featuring David and Rhonda A year or more ago we did a Part 1 podcast on stories from my days as a Stanford Medical student in the late 1960s. This was the Hippy Era and the famous "Summer of Love." A young man, Clyde, recently asked if we'd do Part 2, since we didn't get to all the stories the first time around. As an aside, there are more stories, so if you like them, we'd be happy to do a Part 3 as well. 1. Husain Chung and the crazy teen from LA: When a stallion wants to run, you run with the stallion!" 2. A frightening encounter with Vic Lovell: And a mentor's advice on how to handle it. 3. Bar next to the Free University Coffee House: Outrageous works, even with the Hell's Angels. 4. The bearded man on the quad near the Stanford Student Union—Telling me to "sit with open hands" 5. Ken Kesey and his merry pranksters walked into the Stanford Student Union—they were dressed in pajamas or clown outfits and Neil Cassady was juggling hammers. 6. The tape recorder experiment: Bizarre week, unexpected conclusion. 7. Encounter at the Medical School: "Psychiatry and Psychotherapy—Are they Relevant or Obsolete?" Featuring Hussain Chung 8. Missing the medical school graduation ceremony: Didn't pick up my diploma until years later. 9. Homeless in Carmel Valley: Saved by Ramadan, Subud and Bapak. Thanks for tuning in today! And keep your requests, questions, and feedback coming. Your satisfaction and happiness are our top goals! Rhonda and David


    448: Ask David, featuring Adam Holman May 12, 2025
    Show notes

    448: Ask David, featuring Adam Hollman Relationship woes--what should I do? How can animals have feelings if they can't think? How often should I fill out the Daily Mood Log? Why can't husbands express their feelings? Today we are joined by Adam Holman, LCSW. Adam has recently left his full time clinical practice in Arizona to join our Feeling Great app team here in San Francisco. I think you'll be delighted by his warmth and wisdom. Although he works with us full-time, he still practices one day per week and specializes in X depression, anxiety, and screen addiction(e.g. video game addiction and more.) He has appeared on two previous Feeling Good Podcasts, # X and # Y. We are delighted to have Adam as the honored guest on today's Ask David podcast! Here are the questions for today's Ask David. They were all written before the podcast. If you listen to the podcast, you will get much more information and perspective. The Questions Hello Dr Burns. I hope you are doing well. I participated in the webinar held on 18th of April. It was a good experience for me and I would like to thank you and your team in arranging for that.

    1. Far asks: if You have a relationship problem, but also feel inadequate. Should you use the Daily Mood Log for the internal problem of inadequacy and the Relationship Journal for the actual dialogue?
    2. Moritz points out that animals, who don't think in words, still have intense emotional reactions, including fear and anger. For example, when a deer spots a predator, like a cayote, it feels terror and instantly runs to get away. Doesn't this prove that terrifying events can cause feelings directly? In other words, that makes it seem like thoughts or cognitions are NOT necessary to feel emotions. What do you think?
    3. Rob asks: How often do you fill out your own daily mood journals? Do you do one every day? Would you be willing to share recent examples of your own journals with podcast listeners?
    4. Brittany asks: Why won't my husband share his feelings? (Or, we could ask, why can't men express their feelings?)
    The Answers 1. Far asks: If you have a relationship problem, but also feel inadequate. Should you use the Daily Mood Log for the internal problem of inadequacy and the Relationship Journal for the actual dialogue? Hello Dr Burns. I hope you are doing well. I participated in the webinar held on 18th of April. It was a good experience for me, and I would like to thank you and your team for arranging it. May I ask a question? When there is a relationship problem it should be addressed by the relationship journal and interpersonal downward arrow and not by the cognitive method as far as I know. What about when there is a relationship problem together with strong feelings of depression and frustration as a result of an internal dialogue of being inadequate and defective. Should this component be addressed by the cognitive method and straightforward technique? Thanks a lot. Far Kom David's Reply This one just came in, so we'll answer it live. 2. Moritz: Are thoughts REALLY necessary to have emotional reactions to events? Hi David, first of all, thank you for the podcast, and in particular for answering my question about how you help people with schizophrenia or bipolar disorder, which came out a few weeks or months ago. I just finished listening to episode 430, where you stated that that negative thoughts can cause negative emotions (this part I'm totally on board with), but also hypothesized that probably only negative thoughts cause negative emotions. Did I understand that correctly? (If not, please ignore the rest of this email, it won't make any sense). I'm kinda confused about this claim. This is totally not my area of expertise, but I'm under the impression that fear is much older and more "primitive" than (at least conscious) thought, from an evolutionary point of view. It would seem unlikely that an old evolutionary feature in the brain would only be triggered from a newer feature. My other source of confusion comes from my own comparison with animals. It is my impression that basically all mammals show some kind of fear response, but we don't attribute thoughts to all of them, never mind full-blown self-reflective, conscious thoughts. So at least in the mammals with simpler brains, it seems likely that fear (and other negative emotions) could be triggered pretty directly without going through negative thoughts first, and it would also be quite surprising if we didn't all contain the same mechanisms, since we share most of our neural architecture with all mammals. Do you think these considerations are valid, and if yes, are they compatible with your approach? After listening to your podcast, my own mental model of negative emotions is something like this:
    • stimuli can cause negative emotions directly; this happens in all mammals
    • when the stimulus goes away, negative emotions also ebb and go away after a certain time, unless something keeps them alive
    • in humans (and likely in at least some mammals), thoughts also can trigger emotions, and so they can disable the natural dampening of negative emotions.
    This mental model might explain satisfy both the evolutionary considerations, and explain the data you've gathered from the Feeling Great app. I admit I feel a bit silly writing you this, because you spend so much more mental energy on these topics, so it seems unlikely I have anything to contribute that you and your team didn't think of. So, sorry for the long rambling, and I hope you still find something interesting in it, or maybe you can clear up some of my confusion about your model. Best regards, Moritz David's reply Thank you for your thoughtful comments. I think they are awesome, and definitely not "silly." Here's my take on it, for what it's worth, and I just speculate, too. All animals, including human animals, have perceptions. When a dear spots a cayote, the "stimulus" is a perception of a dangerous predator. This "cognition" triggers the emotion. People think cognition means sentences involving words, but my understanding is quite different. The idea is that any kind of conscious perception can trigger emotions, including sudden fear or anxiety. The perception might simply be an image, which is also a type of cognition or perception, that can suddenly trigger great fear. When I see a rock climber on TV, this "picture" or "perception" stimulates a powerful physiological fear reaction. That's because I "see" the picture as being incredibly dangerous and imagine falling. Thanks, david Might use as an ask David follow up, if that's okay! Moritz replies Ok, "simple" cognition without explicit thought can be enough to trigger emotion, got it. Feel free to use that as an Ask David if you want. Regards, Moritz David's final reply Thanks, yes, it is the perception of danger that triggers the fear. Terrific! As another example, you could argue that when the airplanes flex into the World Trade Center in New York on 9/11, everyone felt terrified, horrified, and devastated, and it was the event that caused these feelings. Doesn't this prove that thoughts, or cognitions, are not required to have powerful feelings? It would seem like you didn't have to put a thought in your mind to feel fearful when watching the horrifying images on TV. What do you think, Moritz? Well, here's my answer. It is not true that everyone had the same feelings watching that horrifying scene. We all had our own unique reactions, depending on how we were thinking about it. And of course, some people felt joy, glee, and more, and did NOT have negative feelings. That's because they thought about the event quite differently. For example, Osama Bin Lauden and his followers when watching were delighted, and like thinking, "Those Americans finally got what they deserved!" Same event—radically different emotional reactions. All of your emotions result from your thoughts. The positive and negative events of our lives do not, and cannot, affect us directly. We have to interpret the event first and give it meaning. Thanks! David 3. Rob asks: How often should you do Daily Mood Logs? Do YOU fill out your own Daily Mood Logs? Hello Rhonda and David: I hope you're both doing well. I'm a long-time listener to your podcast, and I shared an endorsement that you included in podcast episode 333 about two years ago. While listening to an episode recently, some questions occurred to me that I wanted to share with you. How often do you fill out your own daily mood journals? Do you do one every day? Would you be willing to share recent examples of your own journals with podcast listeners? I can understand how you might not want to do this and certainly respect your right to privacy, but I thought also it might be interesting for listeners to hear. I would be honored if you would share your thoughts with me when you have a moment. Rob Robinson All the replies to this excellent question will be spontaneous and live on the podcast. 4. Brittany asks: Why can't my husband express his feelings? Hi Dr. Burns, I have a question. This is something that frequently comes up in arguments with my husband. Here is an example from yesterday: Me after finding out he was upset the night before I said: "Why did you tell me everything was fine and it's all in my head if you were upset?" Husband: I shouldn't have to tell you. You should be better at reading me. I feel annoyed because when I did ask him if he was upset the night before, he denied it then put the blame on me the next day that I should be able to read his mind. That doesn't seem fair. I don't suppose I could put that in my five secrets response though as it wouldn't make the problem better. What do you think? I guess I should probably do the relationship journal. -Brittany David's reply Hi Brittany, Here's my quick assessment. Your first statement to him when he said he'd been upset sounded a bit blaming. In other words, he was trying to express his feelings openly and told you he'd actually been feeling upset. And you immediately punished him. Can you see that? In other words, you said: "Why did you tell me everything was fine and it's all in my head if you were upset?" Can you see that when he confided that he had been feeling upset, you blamed him for not telling you the night before. He might have felt scolded, put down. What do you think about that? And could that be why he has trouble expressing his feelings? Can I use this on an Ask David, with your first name or with a fake name? And yes, you can use the Relationship Journal on situations like this! For sure! Go for it! Sorry if this sounds harsh or direct. You know, I hope, that I have tremendous regard for you! David Other ideas include:
    1. When we blame others, we are nearly always CAUSING the very problem we are complaining about.
    2. Our anger and frustration nearly always results from "Should Statements." In other words, he "should" have expressed his feelings sooner, and better, etc. This sounds like you expect him to be some ideal husband, rather than a real husband. I sometimes also have trouble expressing my feelings, or even knowing clearly what or who I'm upset with, or why. And I always appreciate a little bit of help at figuring that out!

    447: Perfectionism Update, Featuring Adam Holman May 05, 2025
    Show notes

    Perfectionism Update Featuring Adam Holman Today we are joined by Adam Holman, LCSW. Adam has recently left his full time clinical practice in Arizona to join our Feeling Great app team here in San Francisco. I think you'll be delighted by his warmth and wisdom. Although he works with us full-time, he still practices one day per week and specializes in X depression, anxiety, and screen addiction(e.g. video game addiction and more.) He has appeared on two previous Feeling Good Podcasts, # X and # Y. We are delighted to have Adam as the honored guest on today's Ask David podcast! Today's questions come all the way from North Macedonia! Dear Dr. Burns, Thank you so much for your kind response. I'd be truly honored if my questions could be considered for a future episode of your Ask David podcast. Your work has been a key influence in my research on perfectionism and its cognitive-behavioral aspects. Here are a few brief questions I'm currently exploring:

    1. How has your view of perfectionism evolved since Feeling Good?
    2. What strategies have you found most effective for challenging perfectionistic thinking in therapy?
    3. Is perfectionism often rooted in a fear of not being "good enough"?
    4. How does it typically manifest in academic or professional environments?
    If you happen to include any of these in a future episode, I'd be grateful if you could let me know so I can tune in. Thank you again for your time and for the lasting impact of your work. Warm regards, Mitko Toshev Doctoral Student Faculty of Pedagogy University "St. Kliment Ohridski" – Bitola North Macedonia David's Reply Yes, this will make for an excellent podcast with a refresher on perfectionism, featuring questions from Mitko and a spirited discussion with Adam, Rhonda and yours truly! We had an in depth discussion of all the latest bells and whistles in the treatment of perfectionism with TEAM CBT. This included the two very different but complementary approaches to treating depression or any of the 23 common Self-Defeating Beliefs. So, if you've ever struggle with the thought that you're not good enough, or that you SHOULDN'T have made this or that mistake, this podcast will be right up your alley! Thanks, Mitko! david

    446 Gender-Affirming, Life-Saving Medical Care, featuring Stanford's Dr. Rachel Sewell Apr 28, 2025
    Show notes

    446 Who am I? Medical Help that Saves Children's Lives Featuring Dr. Rachel Sewall: "I want to shout from the mountain tops!" Today we hear from Rachel Sewell, M.D., a Stanford pediatric endocrinologist who provides medically necessary care for transgender and gender diverse young people. She shares how in a time when there is a lot of inaccurate information being spread about this vulnerable population she will continue to advocate for them by providing education and accurate information, including by being a guest on this podcast. She says: When I was a medical student, I wasn't initially sure what type of medical practice I would pursue. However, I always knew I'd be an advocate for LGBTQ+ patients . As a first-year medical student, I trained and worked in the emergency room. I quickly realized, as did my mentors, that I enjoyed and was excellent at working with children, so I focused on pediatrics. That summer I had the chance to do research in endocrinology which is the study of all hormones. Think of hormones as messages that travel throughout our bodies delivering important information. Hormones are responsible for so many important functions including keeping our bones healthy, helping us grow, using the energy from our food, and causing kid bodies to change into adult bodies. My work with transgender and gender diverse children and teens involves providing evidence-based holistic care with a skilled team of clinicians. More than anything, my patients want to be respected, heard, and allowed to thrive. . In providing them care,I bear witness to intense conversations, emotional highs and lows, as well as the purest examples of joy. Throughout it all, it is my privilege and pleasure to provide them gender affirming care. During this episode we reviewed definitions of gender identity vs the sex assigned to someone at birth. We review the common times when young folks share their gender identity with the people in their lives as well as what it means to be cisgender vs transgender. We discuss sexual orientation and gender identity and how these are complicated and independent aspects of everyone's sense of self. Rachel continued, Medically necessary care for transgender and gender diverse patients is life-saving. Imagine, you know you are male but your body has a period every month. This can be profoundly distressing and results in gender dysphoria. Gender dysphoria is the intense discomfort that results from your identity not aligning with your body and negatively impacts people's everyday lives. Now imagine being told that there are safe and effective ways to avoid experiencing that distress. I have had numerous patients say that the care they receive has saved their life. When people hear gender affirming care it often leads them to think of care provided to transgender and gender diverse people but everyone deserves access to gender affirming care. Because it is simply a model of care that recognizes the importance of and validates people's identities and experiences. Other examples of gender affirming care include being able to take a medicine to help prevent hair loss on your head or undergoing a breast reconstruction surgery after having breast tissue removed in the fight against cancer. When discussing possible ways to support a patient's identity I tell families that there is no one size fits all. Everyone's journey is completely unique. For some patients, having their legal documents align with their chosen name is the most important thing. For others, they alter their gender expression, aka the way they present themselves to and interact with the world around them with things like hair changes, makeup, clothes etc. to align with their identity. For some folks it is important to pursue hormone therapy. And for some they will end up pursuing surgical interventions when they are adults. I also discuss that the timing of sharing your gender identity if it does not align with your sex assigned at birth varies tremendously. But regardless of age, gender-affirming medical care always makes a tremendous difference in peoples' lives! Rhonda and I are deeply grateful to Rachel for giving us this wonderfully patient and clear education in a field that was not even covered, to the best of my knowledge, when I was a medical student at Stanford. We hope your voice today, Rachel, will be heard by many, and will hep to bring greater peace, acceptance, love and understanding to our many podcast fans. Thanks! Rachel, Rhonda, and David


    #445 Awesome Interviewing Secrets featuring Dr. Kyle Jones Apr 21, 2025
    Show notes

    Secrets of Superb Interviewing-- How to Be Everyone's Number 1 Choice! Today we feature our beloved Kyle Jones, Ph.D, a clinical psychologist who suggested we might do a really cool podcast on the interviewing skills featured in Chapter 16 of my Feeling Good Handbook. Rhonda and I are absolutely delighted to welcome Kyle for his third appearance on to the Feeling Good Podcast. (Rhonda had to excuse herself after introducing this episode because she was not feeling well) In that chapter on interviewing skills, I listed the five basic principles of successfully interviewing for a job, for admissions to a school, or really almost any type of interview at all. I have to warn you that these ideas may be unfamiliar, and will definitely be quite different from what you've been taught about winning interviews. #1: Be personable and friendly. Don't try to impress the person who's interviewing you! #2 Make them sell themselves to you. #3 Be honest, but present yourself in a positive light. #4 Don't get defensive. #5 Punt when you don't know the answer to the question. To illustrate the first idea, I told a story from Dale Carnegie's book on How to Win Friends and Influence People, in which he describes his interview with a wealth and powerful man in the hopes of soliciting a donation for the Boy Scouts of America. This was back in the era many years ago when the Scouts were still very popular. The receptionist who made the appointment warned Dale Carnegie that he would have only 15 minutes, and emphasized that her boss was 100% meticulous about time. He started exactly on time, and ended exactly on time, whether or not you were done, so he better talk fast once the interview started. When the time came, and Dale Carnegie entered the office, the receptionist again reminded him that he'd be kicked out after 15 minutes no matter what! As he walked in, Dale Carnegie spotted a trophy fish proudly displayed on the wall above the rich man's desk, and asked, if the wealthy man he'd caught it. himself, The rich man said he had caught it in lake so and so. Dale Carnegie got excited and said, "I fish there too. Where, exactly, were you fishing on the lake when you caught this fish?" The man told him where his favorite fishing hole was, and they become engrossed in a vibrant conversation about the joys of fishing. Suddenly, the office door opened, and the receptionist appeared and said the time was up. On the way out, the wealthy man said, "Oh, I forgot to ask you what the purpose of the interview was." Dale Carnegie said, "Oh, I'm sorry, I forgot to mention that I am trying to raise money to support the Boy Scouts of America." The man replied, "You'll receive a check in the mail tomorrow for a million dollars." And those were the days when that was an enormous amount of money. What's the moral of the story? Relate to the person who's interviewing you as a person, and show an interest in them, instead of pitching your talking points and trying to impress them. People usually make decisions influenced greatly by how much they like the person they are talking to. Don't try to be impressive. Aim for friendly, real and human. How do you do this? Well, let's say that you have an interview with a law firm, hoping to get hired, and you're just out of law school. I used to be the shrink for the University of Pennsylvania Law School, and at the time there were too many law school graduates looking for too few job openings, and almost no one was hiring. They referred despondent and panicky students to me who'd had a string of rejections. At the time, the top firms had at least 50 to 100 top notch candidates for every position. Was there any hope of starting their careers? I told them to do some research on the person who was going to interview them, or on their firm. Find something interesting about them. Then, at the start of the interview you can say something like this: "I'm so excited to meet you because I've been following your work for some time. I was amazed and blown away by your strategy in the X, Y, and Z case, and I was wondering if you're still using that approach in litigation and how it's been working out? I'd love to hear more about your work, and how you came up with the approach you're using, and what you like the best about this firm." This will get them to talking about themselves. DON'T try to impress them with how great you are . That will just bore them, or turn them off, and it will certainly put you under pressure to perform. This pressure will probably make you anxious, and your anxiety and insecurity will show. Instead, impress them with how great THEY are. They'll love you! I trained the students in this doing role-playing of imaginary job interviews. Every student I trained in this approach became the #1 choice at every firm they interviewed at! This approach is not just for law students, it's for every type of job, as well as interviews for college, graduate school, and more. Here's the underlying idea. People don't really care much about you. They care about themselves. This is true of all of us. So, use this to your advantage, and you'll suddenly be super happy and glad you were OTHER centered and not SELF centered! Does this mean you should hide your own skills and accomplishments? Of course now. You can answer questions about what you offer with humility and integrity. But that alone will rarely be enough. #2 Make them sell themselves to you. Let's say you're applying for graduate school, and it's very competitive. Again, they have 100 brilliant candidates for every position. Suppose the interview says something challenging, like "As you know, all the top candidates in the Unites States apply to us here at Harvard. Most of them were #1 in the their college classes and several have already been nominated for Nobel Prizes. Why should we be interested in you?" This, of course, is absurd, but I'm taking the worst imaginable question in an interview. Yikes! This sounds impossible, right? How in the world could you respond? Actually, it's easy. You can just say, "Gosh, I don't know if I'd be a good fit here. That's what I'm hoping to learn today. Maybe you can tell me what you're looking for in a top notch candidate. What kinds of candidates have gone on to be stars, and what types have been disappointments? Then I can give you a better answer on whether or not I might be a good fit. Although I love your company, and I'm so impressed with your own career, I wouldn't want to accept a job unless I was convinced I could really contribute to your firm." Is this realistic, or just some David fantasy? During my senior year in college, I was planning to go to graduate school in clinical psychology, since I'd majored in philosophy and psychology seemed like a way more practical career. However, my college adviser said that medical school would be a far better choice because medications were becoming more and more important in treating mental illnesses, and only psychiatrists could prescribe drugs. I told him that I'd never had any interest in being a medical doctor, and wasn't even a premed student, so there was no way I could get into medical school. I hadn't even had a single biology class in college. He said "That won't be a problem I don't think. You've got the gift of gab, and they probably won't even notice." So, I applied to a number of medical schools and landed an interview at Stanford, and several others. My interview was with someone in the Anatomy Department which was located in the basement of the museum on campus. I went down the stairs and into a room where I met the man who was interviewing me. I said, "It's a bit dark down here. Is this where the medical students dissect their cadavers?" He said, "Absolutely. But it's actually pretty awesome down here. In fact, my laboratory his just down the hall. I said, "Oh, could I see your laboratory? I'd love to take a look and find out what kind of research you do." He seemed excited and as we walked into his lab I noticed all kinds of fancy equipment and read the name on one of them, so kind of photometer or something. I had no idea what it was, but said, "Oh, I see you have an X, Y Z photometer. (or whatever it was). Do you use this in your research?" He said, "Oh, absolutely, it's extremely important in my research." I asked him about the research he did. He excitedly started explaining it, and for the most part I had no idea what he was talking about, but kept expressing interest and asking him for more and more information. I was terrified that he'd ask me questions about my undergraduate work and my research, which of course did not exist. I'd never done any research! Just philosophy classes and such. Well, we had quite the conversation, but after a while he suddenly looked at his watch and said, "Oh, my goodness. We were only supposed to talk for 15 minutes, and we've been talking for nearly two hours. I have to rush over to the medical school quad for an important meeting I'm almost late for. Why don't we walk over in that direction together?" As we were walking out of the basement, he said, "Oh, my goodness, I forgot to ask you who you are and where you're from." I said, "Oh, I'm David Burns from Amherst College." He said, "Well, David Burns, I want you to know that you're the kind of young man we need at the Stanford Medical School.!" I said, "It's really kind of you to say that, but I'm afraid I won't be able to come to the Stanford for medical school." He said, "That's nonsense? Of course you can come! Do you think Harvard is going to make you a better offer? We'll top anything they offer." I said, "Oh no, sir, that's not it. You see, my father is a minister, and we don't have much money, and I've heard that attending medical school would cost more than one hundred thousand dollars. And he believes that borrowing money is a sin." He said, "David Burns, I'm the head of the admissions committee, and that's where I'm headed right now. And I'm going to tell them that you're the #1 choice for admission this year. And you won't have to pay a thing. We'll pay for tuition, room, board, books, expenses, everything. It won't cost you one cent to go to Sanford medical school." I said, "Oh, thank you so much! That's an offer I can't refuse!" I got my acceptance letter two days later and the rest, as they say, is history. But to spell it out. Why was I accepted to a top-flight, highly competitive program when I had absolutely NO credentials? Because I expressed an interest in him, and I was friendly, and I believe that meant a great deal to him. And I'll always be grateful for his help. My wife and I returned to Stanford almost 30 years ago, where I've served on the voluntary (unpaid) faculty at the medical school, teaching and doing research and continuing to develop TEAM CBT. I turned out to be a terrible medical student, and dropped out for a full year on two different times because I just wasn't the "medical" type. I had very little aptitude or interest in medicine. But I did end up as a psychiatrist, and came to love medicine and healing people who were suffering, and doing research. And my voluntary work is my way of trying to repay my tremendous debt to Stanford! And I'll never forget the kind gentleman who interviewed me. Kyle and I jammed on all five examples, including many additional stories to bring these ideas to life. Kyle used this strategy when interview for his internship in psychology, and it worked like a charm. I would say that I've taught many people how to use these ideas, including family members, students, and colleagues. The impact has been nothing short of incredible. That probably sounds over the top, and I "get it." But the stories are true, and the ideas can change your life. Remember what the Buddha said, 2500 years ago: "Selling yourself sucks! So, Stop it, and do what works!" Warmly, Rhonda, Kyle, and David

    Contact information

    Kyle is a superb TEAM CBT therapist who practices virtually throughout California. Here's his contact information: Dr. Kyle Jones

    444: I'm angry! Live Work with Sunny, Part 2 Apr 14, 2025
    Show notes

    I'm angry! A Once-UndocumentedImmigrant Speaks from the Heart-- Live Work with Sunny, Part 2 Last week you heard Part 1 of the Live work with Sunny, who's struggling with radically conflicting emotions. On the one hand, he has finally achieved his dream of an incredibly happy and fulfilling life, but he is frequently plunged into profound despair, fear, and anger because of the increasingly adverse political climate for people who are "different"—in gender identity, sexual orientation, nationality, political beliefs, skin color, and more. And he is shocked, fearful, and angered by the mean-spirited treatment so many are receiving—and which Sunny has endured throughout much of his life as well. Today, you will hear about how we set the A = agenda for our session with Sunny, along with the M = Methods we used. You can find Sunny's goals for each negative feeling at the end of the Positive Reframing, and at the end of M = Methods, if you Click here His scores on the Empathy and Helpfulness Scales in the Evaluation of Therapy Session were perfect. Here are some of the take-home lessons from this session with Sunny. 1. Unhealthy negative feelings result from distorted negative thoughts, like "I'll be miserable forever." Healthy negative feelings, in contrast, result from thoughts that are realistic and, for the most part, undistorted. Healthy negative feelings do not usually require any kind of "treatment," but skillful empathic listening and support will nearly always be appreciated. 2. Empathy can be very powerful, and it is absolutely necessary for a meaningful therapeutic relationship, but empathy alone is not enough to change the way someone feels. 3. Finding compassion for someone who has harmed you, while extremely challenging, can also bring you peace. 4. Emotions such as anger, sadness, and anxiety are important protective instincts. And one can feel these emotions and be compassionate and loving at the same time. 5. As a therapist it can be tempting to either assume that you can't help a patient because their feelings are "normal," or to try to cheerlead or problem-solve for a patient to cheer them up, but the TEAM-CBT model allows us to collaborate with the patient, understand when and how they want to change, honor their resistance to change, and offer them the tools they need to change in a way that honors their values. Thank you so much for listening and joining us. Rhonda, Jill and I are deeply indebted to you, Sunny, for your courage and vulnerability last week and today, letting us into your world on such a personal level. We love you and will always be grateful to have you in our lives, both professionally and personally! Sunny, Rhonda, Jill, and David


    443: I'm angry! Live Work with Sunny, Part 1 Apr 07, 2025
    Show notes

    I'm angry! A Once-UndocumentedImmigrant Speaks from the Heart-- Live Work with Sunny, Part 1 Sunny Choi is a beloved member of the TEAM community. He grew up in Hong Kong before emigrating with his family to the United States when he was 11 years old. He graduated from UCLA with a major in engineering, completed a master's degree in Engineering Management at Stanford, and developed a successful career in high tech Silicon Valley companies. However, he left his work to pursue additional graduate training in clinical social work because he discovered that his strongest call was to help individuals who were being marginalized by American culture and suffering. He then obtained an MSW degree with a specialty in Community Mental Health from California State University. We were fortunate when Sunny discovered and joined our free Stanford TEAM CBT training group, and blossomed into an expert TEAM therapist and beloved colleague and friend. Today, Dr. Jill Levitt and I worked with Sunny because he requested a session to work on his own troubled feelings concerning the recent political developments. He emphasized that he wanted to do personal work, rather than focusing too heavily on the current political controversies and battles. You can find the Daily Mood Log (DML) that Sunny prepared just prior to his session if you click here As you can see, at the top of his DML, he described the upsetting event as tearing up when he was teaching a class and discussing a case of a transgender Mexican American man, and he began reflecting on his own memories of growing up as a gay male and undocumented immigrant. Sadness and anger were the two strongest negative feelings (rated 70 and 80, respectively on a scale from 0 to 100), although he was also moderately anxious, guilty, rejected, hopeless, and frustrated. You can also see the ten negative thoughts he recorded on his DML, and how strongly he believed each one, on a scale from 0 (not at all) to 1000 (completely.). During the session he added three more thoughts: 11. I (shouldn't be) living such a happy and pleasurable life when others are suffering. 70% 12. I should be helping others more. 80% 13. I have to figure out the correct way to be thinking and feeling. 50% At the start of the session, he said that he felt vulnerable and nervous discussing such personal feelings, memories, and thoughts. He also said that after doing much personal and professional work, he was generally happy and loving, but felt profoundly disturbed when he thought about so many people who are suffering. He said, "Many of my clients are being deported. And those who are gay are worried that they'll lose access to their medications." These were the kinds of thoughts that triggered his feelings of guilt. During the empathy phase, Jill mentioned that she felt honored to be talking to Sunny today and proud to be a member of a community where you can reach out when you're suffering. She added that she felt torn, as I did, because it seemed to us that many of his negative thoughts were realistic, and not distorted, and that it makes sense to feel sad, anxious, worried, and angry. For example, his first negative thought on his DML was, "The world is much more unstable and dangerous now." Sunny emphasized that most of the time he does feel happy, especially when involved with friends and family, and doing the things he loves. But then he gets confused and guilty, wondering if it is right to feel happy when things are looking so dark for so many people. It certainly makes sense to feel unhappy when, as Sunny said, some of his clients and friends have lost their jobs and people in the LGBTQ+ community are afraid they'll get deported. And we're all afraid to speak up and talk about diversity, which has become a dirty word that can get you into trouble. And when Sunny thinks about this, he feels profound sadness and compassion. But as previously noted, this has caused confusion for Sunny, and he struggles with feelings of guilt about the fact that he is truly happy so much of the time. He's happy about his beautiful life, his marriage, and more—this, in fact, is his happiest he's ever been. Here's how he puts it: "I used to be undocumented. The experience and the hostility and bias I confronted traumatized me. And when I heard Trump talk about all the 'murders and rapists' invading our country from Mexico, I became tearful. I feel angry—they don't think we're human. "I want people to be more compassionate. . . . To say we're rapists and criminals, it's not okay. . . it's mean, and it's very harmful to mental health. . . . It's like repeatedly poking at someone who is recovering from a terrible wound, and it hurts." Jill was touched, and found Sunny's vulnerability heart-warming, beautiful, and refreshing. Rhonda reminded us that unless we are Indigenous Native Americans, all Americans are descended from immigrants. In my own case, all my ancestors came from Sweden in the late 1800s during the potato famine. Sunny pointed out the European immigrants have not been discriminated against in the same way as the Africans, Asians, Latinos, Islamic, and dark-skinned individuals: "Let's be open. It's racism. I felt it right from the start." Sunny gave us an A+ on empathy, and then we worked to set the agenda for the session. What did Sunny hope to get from the session? What did he want help with? What changes was he hoping for? He said: "Maybe my feelings are appropriate, but some may be too intense. My goal is to find peace; to have hope, and to try to do something to help. . . I want to feel proud of who I am and what I stand for. I want to try to be loving and compassionate, even to people who don't have the same beliefs and values. . . . Although that can be incredibly challenging!" When you listen to today's podcast, you will hear the T = Testing and E = Empathy portions of the session. Next week, you will hear the A = Paradoxical Agenda Setting and M = Methods portions along with the conclusion, including the final T = Testing to evaluate his end of session scores on the Brief Mood Survey and Evaluation of Therapy Session. Thank you for joining us. Rhonda, Jill, Sunny, and I appreciate all of you!


    442: Eliminate Anxiety Fast: The Awesome Hidden Emotion Technique Mar 31, 2025
    Show notes

    Ask David: The Awesome Hidden Emotion Technique Featuring Matthew May, MD with Rhonda and David The following answers to Ask David questions were written prior to the live podcast where Matt, David, Rhonda, and others discuss the questions in real time. Their answers may differ from Dr. Burns responses listed below. 1. Michael asks: How did you invent the Hidden Emotion Technique? It's been incredibly helpful to me! Hello, Dr. Burns, Your lifelong work continues to be invaluable to me and so many others, and I apologize if this question was answered on a previous podcast. To my knowledge, it hasn't been. I was wondering how you discovered or created the hidden emotion model? I recently struggled with inexplicable death anxiety that came on every night since college started back up, and I was at a loss, until I remembered the hidden emotion model and wondered if there was something I wasn't acknowledging? Sure enough, I discovered I was actually quite resentful of my new schedule not allowing me to easily fit the gym into my schedule unless I wanted to forgo valuable sleep. Once I had addressed this resentment, the death anxiety vanished. I would love to know how this wonderful technique became part of your phenomenal practice! -Sincerely, Michael Polus. David's reply You can read all about it in When Panic Attacks, when I learned about it accidentally based on an interaction with a patient who was stuck. Perhaps we can answer it on a podcast. Thanks! david 2. Janie asks: How can I help a patient who ruminates? My client ruminates, that is she experiences repetitive thoughts about conversations and gets stuck in the negative feelings that come from dwelling on those thoughts and conversations. She has referred to it as repetitive thinking about conversations that were distressing in some way. She replays the conversation in her head, and evaluates and re-evaluates her responses. She then plays the conversation using possible different responses she COULD have used and worries whether these would have been better responses. The first individual is a friend where the friendship is very challenging and interwoven into many parts of my patient's life. My patient ruminates about conversations and wonders over and over if she said the right thing or wonders how the friend took what was said. It is a loop that my patient often gets stuck in for long periods of the day. The second individual is my patient's husband. With him, she ruminates about how to say things to him so she can motivate him to be involved in the ways she wants him to be. We will work on these relationships using the 5 secrets eventually, but first she'd like to work on the rumination because it takes up so much of her time. How can I help her? David's Reply I would recommend

      1. TEAM CBT in a step-by-step manner. I do not, in general, like to throw techniques at people based on a description of a problem.
      2. Motivational techniques to reduce resistance and bring resistance to conscious awareness.
      3. Paradoxical Cost-Benefit Analysis
      4. Dangling the Carrot / Gentle Ultimatum / Sitting with Open Hands
      5. The Hidden Emotion Technique
      6. What If / Downward Arrow Technique
      7. ERP (Exposure plus response prevention)
      8. Many other techniques inspired by methods a and b above (TEAM CBT)
      9. Feared Fantasy: confronting her worst fear
      10. Five Secrets of Effective Communication
      11. Work on acceptance: she is perfectionistic and self-critical
      12. Hidden Emotion: anger

    Thanks for listening (and reading the show notes),

    David, Rhonda and Matt


    441: David, Rhonda and Matt Answer Your Questions about Relationships, Dating, and Religion Mar 24, 2025
    Show notes

    Ask David My friend won't say thank you! Dating Anxiety Religion vs. Psychotherapy We want to remind you about an awesome virtual workshop on habits and addictions that Dr. Jill Levitt and David will be presenting on March 28, 2025 We will feature powerful new paradoxical techniques that will blow your socks off. It will be from 8:30 to 4:30 and you will earn 7 CE credits while having fun and learning how to heal yourself AND you patients. Check it out! It's less than two weeks away, some check it out while you still have time! You'' LOVE it and LEARN a LOT! Registration and More Information Here! As is so often the case, the answers to these questions that appear in the show notes were email replies to the person before the show. To get the full discussion, make sure you listen to the actual podcast, as the answers often evolve in unexpected ways when the "experts" hash it out! Today's episode is chock full of personal stories (some racy), expert Five Secrets advice and demonstration, philosophical / spiritual discussion, and secrets of successful (and racy) dating. 1. Brittany asks: What can I do say to a friend who does not say "thank you" when I pay for our meal or drive a long distance just to see them? 2. Jaydipe asks: How can I get over my anxiety around attractive women? 3. Ali asks: Can religious beliefs cause or intensify feelings of anxiety? (David will talk about the synergies between TEAM CBT and spirituality in all religions. He will also mention the potential antagonisms.)

    1. Brittany asks: What can I do say to a friend who does not say "thank you" when I pay for our meal or drive a long distance just to see them. Hello David and Rhonda, I have a friend who typically does not say thank you to me when I pay for a meal out or drive us a long distance. I am someone who always says thank you even if the other person just bought us $10 worth of fast food or gave a short ride. I find myself feeling resentful towards my friend for not saying anything when I pay and drive us around all day. It makes me feel like they don't appreciate it. At the same time, talking about it and sharing my feelings would then feel like I'm asking them to say it, and then it would not feel authentic. I have said something about it in the past, and they were like I'm sorry, thank you. But it didn't mean much at that point. Is this one of those annoying traits I just learn to accept? Thank you, Brittany David's reply Well, you could just use a gentle I Feel statement, which might be paradoxically stronger, but combined with Stroking. Like this, "Jennie, you know I think the world of you, and greatly enjoy our times together, but when I pay for lunch, or drive a distance to hang out with you, you rarely ever say "thank you," and then I feel hurt and unappreciated." Something like that combines Stroking with I Feel and might be effective. But I always rate myself on what I do, or say, and not so much on how the other person reacts. You could, perhaps, also ask if they are upset with you about something that they've had trouble expressing to you. Best, david 2. Jaydipe asks: How can I get over my anxiety around attractive women? Hi David Many thanks for the podcast I'm struggling with social anxiety and talking to attractive women and I've watched all the podcasts relating to it. I think deep down I have a shame around finding women attractive, so I find it difficult to express interest in them. I find that I can talk to them easily during activities like climbing or co workers, but even on dates with women I can't seem to take things forwards playfully like you'd expect on a date. I'm too serious and I think that turns people off. I feel like I'm under the spotlight and I have to impress them otherwise they won't like me. I know this isn't true and I've been trying to get myself to do exposure therapy by asking girls for their numbers and being rejected so it helps with that. Also, I struggle with societal expectations, I hear women say that they don't want to be approached or talked to or anything so I just end up avoiding them because I don't want to annoy them, but it holds me back from getting the sex and relationships I want Any help much appreciated Thanks, Jaydipe David's Reply I have included your excellent question on an upcoming Ask David. In the meantime, have you read my book on dating, Intimate Connections? Best, david PS Should I use your first name, or a fake first name? 3. Ali asks: Can religious beliefs cause or intensify feelings of anxiety? Dear Dr. Burns, After reading your books, I've started to recognize that many of my anxious beliefs seem to have a religious background. For example, in the Bible, there's a verse from John 5:14: "Later Jesus found him at the temple and said to him, 'See, you are well again. Stop sinning or something worse may happen to you.'" Here's where I struggle: I want to live my life freely, which includes things like being with different girls before marriage (something I already do). But according to religion, this is considered adultery and a sin. Another verse that weighs heavily on me is from Matthew 5:27-29: "You have heard that it was said, 'You shall not commit adultery.' But I tell you that anyone who looks at a woman lustfully has already committed adultery with her in his heart. If your right eye causes you to stumble, gouge it out and throw it away. It is better for you to lose one part of your body than for your whole body to be thrown into hell." I often find myself looking at beautiful women on the street, which Christianity teaches is sinful, and this sometimes leads to feelings of guilt. I wonder: do I need to leave religion altogether to break free from these negative, self-critical thoughts? I also have other related thoughts that seem to link my faith with the good things happening in my life. For instance: My life is going well right now. My parents are alive, my brother is getting married, I'm healthy, and I've been fortunate in many ways. I've had incredible experiences, like participating in two Erasmus+ exchange programs in Poland and Lithuania during university, volunteering in Latvia for a year, and even having my New Zealand visa approved in a highly competitive process (only 100 spots for 85 million people, and the application closed in 5 minutes!). I often think that these blessings are because I believe in Jesus, follow the Bible, and try to live as a good person who avoids sin and doesn't deceive others. But then these anxious thoughts arise:
    • I should always be thankful or pray, or else my life will fall apart.
    • If I leave religion, something bad might happen—my parents could fall ill or pass away, and it would all feel like my fault for turning away from Jesus.
    • Without faith, I'd lose my good fortune(luck), my appearance, and my opportunities.
    • Wherever I apply to would be rejected, then I would understand that it was Jesus in the first place doing all of these things in my life, not me or vice versa!
    • I'd find a terrible job, terrible working environment, terrible mutual relationships.
    Then everything would be my fault and I'd tell myself I should have believed in him in the first place but now I deserve everything that happens to me! These thoughts are overwhelming, and I'd love to hear your perspective on how to approach and challenge them. Thank you so much for your time and the invaluable insights you share in your work. Warm regards, Ali David's reply Hi Ali, Sorry you are struggling with so many restrictions, judgments, and inhibitions! I can imagine it triggers anxiety, guilt, inadequacy, resentment, discouragement, and more. You can let me know! If you want, I can include this as an Ask David question on a podcast, with your first name, or a fake first name. Let me know if this works for you. Also, what religion are you? I know that many religions around the world can be very fundamentalistic and super strict in their teachings. My own religious upbringing had a touch of rigidity, too. Best, david Ali's response to David Hello again, Actually, my family comes from the Christian (Orthodox-Armenian) minority in Turkey, where I was born and raised. So, I am an Orthodox Christian. You're absolutely right that I struggle with many restrictions and judgments. I'd love for you to include this as an "Ask David" question on a podcast since I haven't seen any episode (and I've listened to most of your recent podcasts, including number 408: Do You Believe in God? Does God Exist?) that addresses this topic. By the way, I already use an alias, so "Ali" is a fake name, but you're welcome to use it in your podcast! Here's a quick DML (Daily Mood Log) to clarify what I'm dealing with: The Upsetting Event: Doing my daily half-hour Bible reading before bed and coming across certain verses. Emotions:
    • Sad: 60%
    • Anxious/Worried: 70%
    • Inadequate: 60%
    • Guilty/Bad: 90%
    • Abandoned: 70%
    • Pessimistic/Discouraged: 80%
    • Stuck: 75%
    • Angry/Resentful: 75%
    • Tricked/Duped: 80%
    Although I don't consider myself a devout Christian, over the past few years, I've started reading the Bible—the Old and New Testaments. Initially, I read them in my native language, but now I read in English to fully understand the content. Growing up in the church, I believed everything the priest taught. However, encountering some events and stories that seem illogical to me has made me question my beliefs. I often feel tricked and wonder if I've truly believed in all this. At the same time, I feel anxious and worried, as if questioning or criticizing my religion is a betrayal of God. Please let me know if you need any additional information. Ali David's reply Thanks, Ali, this is super. I was also raised in a somewhat strict Christian (Lutheran) home, and as a child had plans to become a minister, like my dad. In college, I learned critical thinking, and began to question some of what I was taught when I was growing up. For example, there seemed to be a bit of a bias against Jews, and my dad said they had to convert to Christianity to be "saved" and, I guess, avoid going to hell after they died. That didn't sound right at all, not loving, as Christ taught, who was himself a Jew, but hostile and judgmental. And I had good friends who were Jewish, so it felt offensive. Same with people who were gay. A strong bias that this was somehow "bad" and sinful, or something like that. Christianity, in the sense of the Catholic church, was really created by people a couple hundred years after Christ died, and they were reflecting their own human biases when they wrote the new testament and translated the old testaments. For better or worse, I am personally not afraid to disagree with much of what is in the Bible, and interpret it, not literally, but as a series of stories trying to communicate important spiritual truths, but these truths get quite distorted when people began focusing on literal truths, rather than "seeing" the message. Literal translations of religion risk missing the spiritual meaning and truth. This is especially true of the orthodox movement within any religion. This tendency toward being literal, rigid, and judgmental may be a partially inherited, genetic trait. Regardless, to me, it is offensive and ugly, and definitely not religious, but quite the opposite. In the early days, lots of religious cults emerged, and they all had their own special leaders. If your leader couldn't walk on water, that guru was considered inferior. So, it was fashionable to say that your spiritual guru could "walk on water." What does that really mean? To me, it means that this person is pretty special, and much kinder and more loving than most others, and can perhaps convey some spiritual truths to us. But actual walking on water is a magic trick best left to television and stage magicians. This is my thinking only, and I do not wish to impose my thinking and beliefs on you or on anybody! I had tremendous respect and admiration for a Catholic nun, Sister Shela Flynn, who worked at my clinic in Philadelphia because she wanted to learn how to do CBT. She was humble and wonderful, and once shared with me that she also thought the stories in the bible were primarily metaphors, just stories trying to convey this or that idea about love, humility, and so forth. Not literally true stories you "had to" believe to be a "good Christian." An, in addition, using my philosophy and CBT training, there is really no such "thing" as a "good Christian." Positive and negative labels can be useful but can also be hurtful and destructive. Will stop babbling, and feel free to reject or ignore some or everything I am saying! But on an emotional level, I feel hurt, and angry about the literal "rules-based" versions of religion. Because I see, all over the world, atrocities being committed to a massive degree in the name of this or that "religion." I am most comfortable with Buddhism, but even then, many people take it literally, make up rules, and so forth, just like other religions or spiritual "paths." For some reason, people love to make up rules and then try to force others to conform to their beliefs and rules. This is due, in large part, to arrogance, and the desire to feel "special" and "superior" to others. These are not, to my way of thinking, spiritual qualities, but quite the opposite. Finally, I do not mention religion in my therapy, which is 100% secular, and based on research and on scientific research on how people actually change. But at the moment of recovery, which often happens in a flash, rather suddenly, the patient often "sees" something of a spiritual nature which they had not seen or grasped before. I have never seen anyone lose their religious beliefs because of effective therapy, but quite the opposite. In fact, what we might call "recovery from depression" (or some other problem) sometimes looks an awful lot like what the religious mystics from all religions have called "enlightenment." So, that's the sermon my dad would have perhaps wanted me to preach from a pulpit! I guess this is my pulpit, and you are in my congregation! And this Sunday morning here in Los Altos, so that's the end of today's sermon! Best, david Contact information You can sign up for the David and Jill workshop on healthier habits here: cbt-workshop.com

    440: Who is the REAL David? Mar 17, 2025
    Show notes

    Getting to Know David David Answers Personal Questions! We all know David Burns as the creator of TEAM-CBT, but not many people get to know David, the person. It is fun to know David the person, because he is just like all of us. He is a real person (not a robot), full of life and love. I want everyone in our audience to be able to relate to David on a deeper level, to feel a sense of connection with him, and hopefully for all of us to build our sense of community with each other. Thanks so much to Stan Dickens, TEAM UK, for submitting these questions and sparking this discussion. The complete list of questions was much longer, but I (Rhonda) have selected the ones listed below. I hope you like listening to this podcast, Rhonda The questions are not necessarily in the order listed below, but all are answered on this podcast. David's answers are all 100% spontaneous, and you will hear them on the podcast! Music & Entertainment 1. Which band do you like most, the Beatles or the Rolling Stones? (David, please say The Beatles!) 2. Following on from that, what kind of music do you listen to? Can you tell us about some of your favorite musicians, bands, or composers? Here are some links to just a few of a great many favorite songs of mine. David

    • Tom Waits Never Let Go (of your hand) https://www.youtube.com/watch?v=pROjyuj2P8k&list=RDpROjyuj2P8k&start_radio=1&rv=fGe2igm7Ieo
    • Rickey Nelson It's Up to You https://www.youtube.com/watch?v=vsBP5P0Xe2c&list=RDvsBP5P0Xe2c&start_radio=1
    • James Brown Please Please Please https://www.youtube.com/watch?v=vruy2GRUsV8
    • Mick Jagger and Muddy Waters Please Don't Go! https://www.youtube.com/watch?v=Mbao_laqF8E
    • Jim Croce I'll have to say I love you in a song https://www.youtube.com/watch?v=WB6FQBp-YwU
    • Last Train Home Pat Metheny https://www.youtube.com/watch?v=goXJTv_U-PM
    • Lucy Thomas "Hallelujah" https://www.youtube.com/watch?v=dLk9pzmaFHY
    3. If your life were turned into a film, who would play you? 4. Can you speak with an English accent? Would you be brave enough to give it a try right now? Career & Professional Reflections 5. If you hadn't dedicated your life to cognitive behavioral therapy and mental health or authored Feeling Good, what might you have done instead? 6. Is there a common misconception about you or your work that you'd like to clear up? Personal Insights & Philosophy 7. If you could have dinner with three historical or modern figures, dead or alive, who would it be and why? 8. If you could give your younger self just one piece of advice, what would it be? 9. How did you meet Melanie, and what do you love most about her?

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