Techniques for Overcoming Social Anxiety

Welcome to the Feeling Good podcast Have you ever wondered why you keep feeling the same way? Even when you're trying to change Anxiety, habits, relationship struggles Sometimes it can feel like nothing really sticks I'm therapist Kevin Cornelius, and each week I sit down with Dr. David Burns one of the world's greatest authorities on cognitive behavioral therapy and the creator of Team CBT This podcast is all about practical tools that actually work Clear techniques you can use to overcome anxiety and depression Iprove your relationships and build real confidence No fluff. No vague advice just effective tools that can help you change the way you think It' the way you feel. and the way you live Let's get started Today I am excited for episode five two, which is an Ask David episode where we get to answer questions that all of you have sent in It's a wonderful way for us all to learn We've got the good fortune of having Dr. Rhonda Borovsky with us. Hello Rhonda Hi Kevin, Hi David. Oh And of course, Dr. David Barnes, as always is here for the Feeling goodood podcast. Hi, David Hello, hello. It's wonderful to be here. and let's jump right in and take a look at what people have been asking so that we can answer their questions and learn from them Sound good Yeah, that sounds great. We got two juicy questions for today. Wonderful So the first question actually comes through The feeling great at And the Feeling Great app is a wonderful tool People can find that, by the way at isitfuingg. com Yeah and have a fine sand? Yeah and that's a tool. David has developed with a wonderful team fantastic for people to use to help yourself with feeling better and also improving relationships There's a section of the app where taught some important things to understand about negative feelings and how we change our feelings. And there's a beautiful example of a patient that you worked with David named Elise person overcame tremendous trauma And then a question by somebody who read that story was Well, wasn't this just a quick fix What about deeper trauma And I think maybe in order to answer that question, we might need to know the story of Elise and the work that you did with her.. Would you be okay with telling us that? To frame this question in a general context, the goal of my life is to produce high speed change Be when I was a psychiatric resident, I almost never saw people change after weeks or many months of general talk psycho analytic supervision and it're just kind of the frustrated b to use polite language And and then over the course of my career, I have figured out how to cause Yeah At least in the in the patients I've seen, I'm talking about the last thirty years of patience that I've treated everyone in one single session a two hour session, and I can usually bring about a complete elimination of symptoms And sometimes we might have to schedule a thirty minute follow up session as I'm doing tomorrow. with someone I recently treated and we got a fantastic result in a two hour session, Hiral from India. We're gonna do her relapse prevention training But for the most part, that's about it And when people hear this Uh they're skeptical Pople always want to put down what I've developed because it sounds so impossible And and one thing they think is that if David is seeing a complete elimination of symptoms And then by that, I mean symptoms like depression going from ninety to zero anxiety going from one hundred to five, you know, just dramatic huge changes. that's just some kind of a quick fix that doesn't count And there has to be some deeper issue that hasn't been dealt with. And this was a woman who escaped from Nazi territories in World War two Her husband and all of her relatives died in the concentration camps But she managed to escape with her two little boys and make it to New York And she found a job there cleaning people's houses so that they could have, you know, a small apartment with, you know, bed to sleep on and a roof and and and food food to eat And she had been doing that, you know, her entire life. And then she she came to me from the intensive care unit of our hospital at University of Pennsylvania School of Medicine where she had attempted suicide And that was the time I was just learning about cognitive therapy. And I thought, well, maybe I could try it on her and some other really difficult patients. because I didn't think it would work I didn't believe that thoughts caused oppression And that the moment you stopp believing your negative thoughts, the depression would lift. That just sounded like silly Psychology to me And And so I consulted weekly at Beck's Clinic and asked him, you know, how to treat her. And I won't go into all the details, but she had this thought I've never accomplished anything worthwhile or meaningful in my life And that was the thought she had at just the moment before she attempted suicide And so my job with her was to help her find a way to challenge that that thought. And I was new at cognitive therapy and I didn't have many tools But but we found after some failures a tool that just happened to work like a charm and she suddenly stopped believing that thought and saw what rubbish it was And at that very moment her depression cleared. And then people then challenge me and say, well wasn't that just a quick fix? How about the deeper issues that have to be? Do don't with And I've been hit with this my entire life, not by everyone, but by you know a significant percentage of people and they always think they've got something so clever that I've never thought of How about these deeper issues And I can remember once I was treating a Pen student who had just come to me for depression And I was telling him, I was, you know, learning all this new cognitive therapy and change your thoughts in the here and now And he said, Well, how about the deeper issues? Arenn't we going take some time to talk about my childhood and find the patterns there that will explain my depression And I told them you know, I was taken aback because I had spent my residency doing that with patients and I never once saw it help anybody at all And I was measuring things even in those early days. So I could tell when depression was improving and when it wasn't And I was looking for something that would make depression. disappear And and I didn't want to get bogged down with him in, you know, weeks or months of Anal's talk about his past. because In my hands, it was a worthless thing to do I I mean, that's that's the fact. That's how I saw it And so what I told him, I said, I'll tell you what, Jim U, If you'll let me take three or four questions sessions and cure your depression, they willll do that first and then at that point, if you want to take several months or as long as you want talking about your past. I'd love to do that. I'm just struggling to build up my practice. I like you. You're a full fe patient. It would help stabilize my by my uncome and so forth But but he agreed to this arrangement and he was right responded, you know in four or five sessions and this depression entirely disappeared. And I don't remember what his issues were but they were fairly easy to turn around. And then they said, okay, now the great news is can we can work on Y past, and we can start scheduling weekly sessions to a week if you like to explore your past And he says, o, I don't need to do that anymore And and that was it. I never saw him again after that And I've made that offer to so many patients over the years. and I've never once had wanted to explore their P us And recently Ive stumbled across some research that I published last week in Psychology Today Magazine. and I have a more formal version of the of the research that Hello, I'm have prepared for submission to an academic peer reviewed journal The bottom line is I was looking at data from our feeling Bade app And the feeling grade app asks at the intake evaluation how you're feeling in seven negative feelings between zero and one hundred at the start And it also asks how have you felt over the past two years on those feelelines And we had a pretty symptomatic population. This was our first formal data test of that was the version of the app we had in twenty twenty three two hundred and ninety people. And they were, you know, moderately depressed on average, but it went all the way from not depressed at all to the most severe depression you could see on an inpatient psychiatric unit And then over the previous two years, they estimated their depression and negative feelings at about, you know in the fifties, which is really, really high. This was a symptomatic group that had struggled with severe chronic depression. And then the app works by changing negative thoughts in the here and now, exactly as I did with Elise And and we did a three a beta test in a four week follow up, but it's the basic training to just teach the basics of cognitive therapy. It was even before we had AI. And we saw dramatically dramatic changes in those three days and we were able to prove that it was caused by changes in negative thoughts. and it was the first proof in two thousand years depression actually is caused by negative thoughts That's another one that we're going to be submitting to a scientific journal, but I've published it and psychology today What was really interesting is I said How much of this change and negative feelings that occurred in three days and persisted for next four weeks till the end of the beta test, is this dramatic improvement How was that influenced by previous depression over the past two years And because I imagined people with, you know, severe previous depression would be relapsing more and more, you know, improving less and that type of thing. And I was astounded But I use something called structural equation modeling, which is the most sophisticated form of statistical modeling. You can do It's very highly conservative. computer Sand David, I've got some news for you the once you've taken into account how the patient feels today. all the The feelings in the previous two years add zero everything to understanding of change, to improvement. They don't even belong in I don't even want them in the model because it's just a waste of waste of space And this has never been been shown before. and the psychology todayoday article is called the Ment You're R in. is vastly more important than the one you remember Oh And and that's consistent with my experience in the past fifty years. I've treated everyone how you're feeling in the here and now. On rare occasions, if I had a patient having flashbacks who hadd been abused by her babysitter and then I did memory rescripting kind of with the memories of the trauma and rescripted them for her. But for the most part and I have a forty consecutive trauma patients in my book Feeling Great that I treated all of them just with one two hour therapy session and they all had a complete bl away of their symptoms I'm so That's my answer. is that I don't have any scientific evidence that it's necessary to be ing into the past and analyzing the past and reworking your past, whatever that even means in order to change how you think and feel and to have a perfectly wonderful life The reason for that is because the past is em embedded in the current moment You see when I'm looking at a current moment when you're upset It's the same pattern as you were having in the past And so when we change the present, we We ch we change the past And so that's my answer. And my only comment is that's a scientific approach. We need to do more research on this because it's brand new find it's going to shock I think the world of therapists if they pay attention to what my findings are, that lot of them aren't going to like it And I like that fact. to tell you the truth because they're they're always saying, Oody knows the scar, you know. You know, you've got all these things are stored in your body and you have to work them out with eye jiggling or deep massage or whatever these these things are. and my data simply just does not support that But in addition, you see, we're not working with science, we're working with religion And the schoolchs of Thraapy function is cults. And and they get cult leaders. and the cult leaders are primarily narcissistic sick puppies who are trying to promote themselves And they all have some powerful theory about the causes and cures for depression and anxiety and relationship problems But most of them are very disturbed themselves and not good. goodood scientists followers, they all people want to have some kind of a Jesus type figure to look up to tove to believe in And and so people When they talk about, oh, you're not dealing with these deeper causes. I've been in psychoanalysis for fifteen years and I'm dealing with deep causes. Well, you've got a conflict of interest, my friend, because you've invested a lot of money and you can keep doing that if you want. But that's my answer to that question. And it's harsh and intentionally harsh Yeah Well, there's so many important things that you just said, David. and I want to kind of highlight a couple of them for the person who's hearing this for the first time. Is that okay? Yeah, absolutely So that's a big box, Kuffin. Yeah, that's right The story of Elise Elise, the patient that you worked with and she was an early patient of yours. who was a Holocaust survivor is what I was hearing you say And she had attempted suicide. So she' extremely depressed. And she's coming to you for treatment And you helped her look at one moment in her life when the depression was really bad for her. It was right before she made her suicide attempt And in that one moment that you worked on with her, you were able to find what needed to be done to help her create total recovery from her depression Right. I think that's really important for people who are listening to hear that You can help yourself Overcome somethingomething as horrible as deep deression by just looking in that one moment when it's really bothering you, all the answers are right there and using a tool like the Daily Mood log where you're looking at that specific moment, what were you feeling thoughts cause those feelings. Like Elise, what she was telling herself was, I've never accomplished anything in my life that was meaningful or important. Yeah, right Yeah And you tried some methods with her until she was able to see that's not true at all. And she didn't believe that anymore. And in that instant when she didn't believe that thought anymore She totally recovered from her depression. It can happen that quickly R heal somets in my experience. Yeah people don't believe it and they right It' a fraud. And I really wish I was a fraud. I've been taking fraud lessons Because I'll make a lot more money. I'll be like Tony Robas and othero gurus who who got got rich Turn no U you know, people love things that are fraudulent because they want to believe, you know, what they're told. they, you know No Well, I think it's important to acknowledge that you're not just telling us this. This isn't something that you just made up and you're trying to sell something to people here, but rather you've got real data to back this up, right? Oh us with some of what happened in your app. And And your work with thousands of patients where you've seen it happen over and over again and just one moment, the person made all the change that they needed to make. I measure things at the start and end of every single therapy session and that's what I urge all team therapists to do. But all these other schools of therapy, they don't do that at all. I ask that Stephen Hayes and he is a beautiful answer, I might say, if you like U you know, like What if they call it on TV where they you like on music TV, they'll have these, you know wild dancers and stuff like that. he's the psychiatric equivalent of that But if you look at his science I've asked him over and over, do you measure things with your so called A therapy And he doesn't. He gets very evasive But he thinks everyone should have their own scales that they make up and you don't put things and analyze them statistically Well, how Stephen Hayes quote the Budda Are you going aim you've got some wonderful school of therapy when you're not measuring anything. That just worse to the extreme. that That's what Jesus said on the sermon on the Mount And David, yes. and I u I think that I want to againhip just went down to twenty percent of. Okay. I've been introduced to White.re you're telling us right now many times. and I've seen it work with the clients that I work with and I understand where you're coming from. And I'm wondering for that person who happened to click play today because they're trying to find a way to end their own suffering And they want to get better so desperately. And they're listening to this because you're such a great expert. What should that person be doing right now that could help Thank you for great, great question. They say follow the money and you mentioned, you know, what what's David selling? What are these gurus selling? there they're always, you know trying to make trying to make money, but our feeling r out is free. It's totally free. It's not a free trial. It's a free subscription. And just go to feelingg. com and check it out and give it an hour and a half of your time And if you don't have an hour and a half to commit to your life, well then This isn't I'm not the guy for you. You know, when I see people, I see them for two hours And if somebody says, Oh I don't want a two hour session. I want a fifteen minute session. I say, Well, I don't know how to do that. But if you give the app an hour and a half, most people experience dramatic changes The first time they sit down with the app in an hour and a half And that's something that you can do. And if you like it, then you can continue using it and learn more and more about these approaches. I love that, David, because it gives somebody something specific that they could do right now to help themselves. Yeah. And Rhonda, I want to take advantage of All of your Wonderful knowledge here. and I'm wondering if there's something that you wanted to say about this question. Isn't it a quick fix when somebody like Elise changes her belief and a negative thought and feels better So you know I think I had said when we were off camera. When I put on a different hat and I I try to do a different type of therapy besides Team CBT. I usually fail. And u You know, I too, I love this story, David. I wish and I've said this too on this podcast and to people. I wish every human being on Earth, but of course, it's impossible But maybe with the app, it's less possible I mean, more possible. I wish everyone in the earth on Earth could have the opportunity to have a session with you or to speak to you or to work with you in some way. because You know, your empathy towards others, your compassion, your knowledge, your gifts are so You know Life's changing And I say that too having experienced you as a you know, the last six years on this podcast, but also you've done personal work with me at least three times. probablyably more when we if we include the Tuesday group that have absolutely changed my life and And Like I just said, I've done personal work with you at least four times. So Each of those times, I was dealing with some other specific situations So you know, one time on the podcast, My own insecurities about public speaking and being here, and we worked on that And then another time you know, when I had the cancer diagnosis and my fear about that and we worked on that. So you know, Um you did some family issues too. Yes. when we were in the Absolutely, I didn't want to bring that up in the specifics. But when we were in the Tuesday group You know, you're I just so remember being in the room with you in a small group and Alex Clark was across the room Werner I can actually see Mark Mark Noble was visiting And you asked me a question. That was just such a simple question And I just remember looking at you and seeing the love and compassion and empathy in your eyes and and spoke about things that I I had never spoken about before. I'm going to start crying. becausecause you generate that Tust and safety. And um I wish I had in my I wish I had the amount of skill that you have in your fingernail. Um, And it's, you know, we've talked about skill is getting got pretty darn high Well, we talked about this before with Math Team therapy is really hard to learn. The five secrets were really hard to learn It takes a lot of practice I've been doing this thirteen years. and the last episode I just talked about, you know, pretty big failures You know, it And um You know, we talk about I know, I' kind of babling. we talk about learning by failing Um And so I think there's a lot of pressure from therapists learning team CBT to fix somebody or to have them reach a level of enlightenment and happiness and joy in two hours and and When we can't do that You know, we all then now need to deal with our negative thoughts about You know, we're a failure and o, I'm not David Burns and And that's a challenge too with people learning Team CBT and Um You' one hundred percent I have a friend who does those kinds of who does the kind of therapy where she'll say to me, Wh do you feel that if I say, Ohh, I'm really upset about let's say my something I don't know what? Michael did She's like, whereere do you feel that in your body? And I think, I don't know What does that mean It coms under the left scapula and it's turquoise in color with the blinking red lights on it Right And I find that really annoying And there's so much power in Team CBT. I wish it was taught in every single graduate school that has anything to do about training therapists You I And can I tell you what I think's gonna happen? Okay they u the you know, I've a few, you know, you, Rhonda have learned a lot. You Kevin have have learned a lot U, Matt M has learned a lot and become Jill Levitt has learned a lot and become the terrific therapist But there aren't any of you around. I've attempted to train fifty thousand therapists attended by intensives or two trainings in the U S. and Canada. I've gone all over the place pouring my heart out trying to convince therapists that this is the way and they should measure things. And here are some new techniques that really work And I've been very unsuccessful of's just a dozen or so of you who are really gotten good at it And that's why I've created the app because the app will do what I say But I think the punishment for therapists Yeah Yeah yeah I'll get my revenge probably long after'm I'm dead But I think that the app I've created already is vastly more effective than therapists on average and and, you know, I've tried to get you to collaborate and to ask your patients to use the app for free. and it'll increase your therapeutic efficacy. And most people don don't listen. You're just full of horssehit and wrong ideas Yeah, you're like Catholics time of the Copernican Revolution and you're believing The Eth revolves around the sun. And and that you're the center of the universe. and I'm telling you it ain't that way And I believe that good money drives out bad money. and And And so you can continue to, you know, stubbornly pursue your rebirthing therapy or whatever bullshit school of therapy you you've committed yourself to Or you can hop on the train into the twenty first century And and but but say science has has arrived and data has arrived and Things are going to be changing pretty rapidly now And and, you know, in my opinion, youre you're going to be left left behind And and as the Buddhist so often said, good riddens to bad, what is it therapy ye. That's right. Now I'm wondering if now is an okay time for us to look at another question today or if we have time for that still. Yeah. let's do this one. we can do a quick one. Okay I'll read you the question Dina was asking I struggle with anxiety and sometimes I'm overwhelmed by anxious what if type thoughts I'm a college student Last week, I was supposed to visit a professor during her office hours to get some help with an assignment I was anxious and stressed all morning, thinking, what if she's mad at me What if I come across this stupid Maybe I'm gonna waste her time Maybe I'll never grasp this course material And there's a good chance I'll get overwhelmed and have to drop out if I don't catch up on missed assignments Maybe I won't be able to finish college Now, I can sit down and work on a mood log and address these types of thoughts, yet they come back and they freak me out What's the best way for me to handle this in the moment Should I argue back with the thoughts Should I carry a completed mood log around with me to read when I can't stop thinking this way Or is there a better way for me to handle these thoughts And then we have aog We review the daily mood loog, Kevin, and we canlude it in the show notes Howudina wrote was that the upsetting event was last week around one PM sitting on a bench outside biology class by myself. trying to get myself to visit my professor during office hours In that moment, Dina was feeling down and unhappy at seventy five percent Anxious, worried, panicky, nervous, and frightened at ninety percent Guilty, remorseful, bad and ashamed at seventy five Inferior, worthless, inadequate, defective and incompetent at seventy five emmbarrassed, foolish, humiliated and self conscious at seventy Hfpless, discouraged Pessimistic and despairing at seventy and frustrated, stuck, thwarted and defeated at ninety percent and then There are some thoughts that causeed those feelings. She believed them all one hundred percent, thingsings like I'm incapable of facing my fears and just going in to talk to her. professor is mad at me If I try to talk to my professor, I will look stupid I'm just gonna waste her time if I go to her office I'm never going to grasp this course material I'm never going to catch up on missed assignments I'm going to have to drop out of college again I'm a lousy student. I shouldn't have so much trouble with anxiety My professor must think I'm an idiot when you see in the show notes person Dina was able to use methods and come up with positive thoughts that she believed one hundred percent that totally crushed her belief in these thoughts. in that moment and her symptoms went Almost all the way down for for each of those categories of feelings And then she's saying that in the moment when other times when she's supposed to approach her professor or when she's really worried about falling behind in school She'll have the same types of kind of unwanted, intrusive thoughts that come up and overwhelm her. And she's wondering, what do I do about that when that happens And and then just to make a long story short, she was able to blow away all of these negative thoughts U, totally u And so I'm incapable of facing my fears and just going to talk to her. It's not true that I'm totally incapable of visiting a teacher at office hours. I've done it before. one hundred percent, believe Telling myself I'm capable just makes things worse and stops me from reaching my goal one hundred percent Now how much do you believe the negative thought went from one hundred to zero and she had found two, four, six, eight distortions, all or nothing thinking over genereralization No. She didn't put emotional reasoning, but that would be one metal filter discounting the positive fortune telling, you know, there's some self blame and there shoulds too I she there was even more. , you know, than what she found, but she did great. And so the general question is let's say you have anxiety and you can blow it away using cognitive techniques, which is important. Remember, cognitive techniques is one of four Gals for tools I use with every patient But I use all four, not just one And that's one of my My my prereaching points is stop doing one fucking thing and thinking that's gonna do it for all of your patients U if you we have many many ways of helping people And those four tools are the motivational method, the cognitive which we've seen here the exposure method and the head and emotion method. So we still have tons of tools to explore And to give you a simple example U, so I I've I And I'll make real quick the story. But let's say you have a fear of heights or a fear of elevators Well, you can write down all the negative thoughts that you have about elevators. The walls will close and the oxygen and the room will disappear and then you could Pve those on the daily mood log. And and u u, you know, and your your fear will temporarily disappear. That's the armchair work and that's incredibly important to do I've talked about this woman Well, I've treated many women with and as well with elevator phobias. And and then the armchair work is not enough you've done sooner or later, you've got to get out of that chair at end of the elevator and test your fears in real time. and you can call that exposure work or cognitive exposure work call it whatever you want And that's what Dina has to do And and so I would I would suggest for for interventions for Dina, although there is probably fifteen or twenty that would be helpful at least that I could come up with. and this is just a quick thing because our time is a little bit limited. But one important thing with all social anxiety is self disclosure And it's it's it's the u And I noticed she had seventy five percent feelings of guilt and shame And and that comes from hiding the symptoms And and so Id want you, Dina, to find some way to share with with your teacher and people in general to tell everyone that you sometimes struggle with severe social anxiety and that you're ashamed of that And you've decided to stop being ashamed and to start and to start telling people And that's I've often thought of anxiety and especially social anxiety kind of like What are those bats called that come and suck your blood out. vampires. Yeah That shame is kind of like a vampire. It can't stand the light of day. In other words, it instantly perishes under the light of day So so whenever I'm I'm feeling anxious, I always try to find a kind of a polite and friendly way of sharing that with whoever whoever I'm with And that's been so incredibly helpful to me because I've had intense social anxiety but myself. And I've used that technique during public speaking anxiety, that was intense And I f that when I hear how I'm feeling, the audiences laugh and year and send so much work in my direction and I work up I use it with individuals And I ask my patients to do it as well just go around and be telling people that you have a tendency to be socially, socially anxious. so that's one one intervention The before we go on because I don't want to hog this too much, but I do want to keep it moving rapidly. Any thoughts on that Kevin and what and Rondan, what might she say to her teacher to bring this out into the open U she would just say exactly what she wrote. in in her letter Um, to you David just to go up to her and say You know, there's a good chance I'm going to be overwhelmed by the work and I feel like U I'm really I'm anxious and I'm stressed andm I'm worried that you're mad at me and I'm worried I'm coming across as stupid and I'm wondering Um You know, I also have social anxiety and I'm struggling with that and I just wanted to share this with you and You know, I don't really need anything back from you. It just feels like really important for me that this is something to share Yeah, that would be one one way of getting it out into the open. What what what would be your idea, Kevin As far as using self disclosure, you mean Yeah, I wonder if also it would be helpful to talk to other students and share what her experiences have been. Right, what would she say to them Sometimes I fall really behind in school And it's hard for me to catch up and I feel ess and discouraged and afraid that Good enough And then I'm afraid to talk to other people and let them know what's going on with me and I've 've been hiding that and feeling really bad about myself. and I decided that I don't want to hide anymore, that I'm going to about it instead of feeling ashamed and that's why I'm talking to you about it right now Oh, that's beautiful, Kevin. That's got the magic touch to my way of thinking that's hitting it hitting it out of the park And if she just does that, you know, all the time with with everyone I had a fellow come in from Chicago for an intensive And he was really afraid of rejection And so he came on on the Sunday hike My son was there too And then after that we went in downtown Mountain View And I just had him go up to person after person and say that he's shy and socially anxious and fearful of rejection And that he he just wanted to tell people and that he's not going to hide it anymore because because he's kind of a Princeton. feellllow, you know, like real good looking and real Ivy leeagy And so this is kind of like out of out of character for him And I had him do it like probably thirty five to fifty times in a single day. We even stopped cars and he knocked on windows and then rolled it down told them, you know I just want you to know that I've been shy my whole life and I'm embarrassed about it and I've been hiding it in shame, but I'm not going to hide it anymore And and he got, you know, all overwhelmingly positive reactions from from people. He got only one negative in that park you remember where the lake is Oh, Rhonda Yes and there's a bench behind there And then there was some fellow near us. We were sitting on that bench and the fellow appeared to be This psychotic And, you know, he said do the And my patient asked him, you know, I'm I'm really shy and anxious and insecure. Do you reject me? And he said,, yes, I do The fellow went on a rant. was was angry at the world and it was so ridiculous that it didn't bother the patient at all Jam. Uh, the, uh, But anyway, that that that would be And that's part that was the But there's also other things that they could do. like they could do exposure, I'm sorry, they could do relapse prevention where they're asking themselves You know, they could do another daily mood log on the fears of the therapy not working they're working with a therapist, even on their own, when they're doing other various methods. I'm guessing they've done double standard technique or externisational of voices or some of the other role plays or any method. They could record it in their voicemail when they're feeling really successful and strong and when they've defeated their thoughts one hundred percent really and believe theyre positive thoughts equally strongly I mean and their negative thoughts have gone down to zero. they can, you know, listen to that recording H Yeah, I love that. As a reinforcement I had some other ideas I wanted to run by you and get your response to, Is that okay Yeah. I think that sometimes when people' struggle with anxiety and these uncertainty type thoughts that just kind of hit them over and over again. like what was happening with Dina They start to think There's something wrong with me that I'm having all these thoughts I shouldn't have Al negative thoughts and it's bad for me that I'm feeling the way that I am when I have like repetitive thoughts that I can't stop and my anxiety goes up and up and up And sometimes it's important for a person to understand that brain actually throws all kinds of thoughts at us all the time We can't control what thoughts come up for us. If we tried to stop our thoughts, we would probably be unsuccessful and we would probably make things worse. And if we're giving ourselves this message, there's something wrong with me because I have negative thoughts We're just adding to our problem and making it worse for ourselves. And so sometimes it's helpful to just notice, wow I'm really, really having a lot of Uncertain, unanswerable questions cross my mind right now You know, when I'm when I'm telling myself, maybe she's going to judge me. Maybe she thinks I'm stupid. Maybe I'll flunk this semester. you know, all of those are those are unanswerable. And if we try to answer them, We're just going to get stuck and make it worse. So sometimes it might be helpful to just say, oh, wow, look at my thinking it's almost like a form of acceptance paradox And If you really like to do the acceptance paradox, the way to do it is with third fantasy or externalization of voices. Oh yeah. ye. So let's demonstrate externalization of voices. and I'll be her positive self and you can be her negative self or vice versa Sure. How about if I'm the negative voice? Okay S it to me And you're Dina, Hey, Dina, I just want to tell you that you're probably gonna to flunk out of school this year and you're never going to get caught up You know, that that's kind of bull bullshit to tell you the truth. If you look at my daily mood log, it's beautifully done. I reduced all my negative thoughts to zero. I'm really small a smart Okay But I do have a lot of really, really severe failings But my negative thoughts are not the worst of them at all. Who just won? Well we're not done yet. Aren't you going to ask me, you know, what are what are your What are your worst qualities? Yeahah, other than your neg And listening to your bullshit. beating me up all the time all day long every day. That's the problem. It's not my negative thoughts. It's your relentless punishment Yeah But let's try a roll reversal Okay But Dina, I'm the negative Dina. Isn't it true that you have tons of negative thoughts? and isn't that pretty pretty neurotic? Doesn't that mean that there's something wrong with you Well, there actually are many things wrong with me. I do have some flaws for sure. You make that sound like I'm a special case because I have flaws or them particularly flawed or something. And actually, I'm a person just like anybody else and I also have strengths too. U And so I'm just going to accept myself as human and know that I've got my good moments and my bad moments and not harm myself the way that you're trying to do right now. You You know, who who won? I think I did Biger or small I think that that was a huge win actually. Huge win. How'd you get to H? Yeah Well, because I stopped requiring myself to be perfect in order to feel better Yeah I accepted I do have flaws and had a sense of humor about it You know Right? Oh you know, the u I want to come back to you here Rhonda. Do you want to chime in Do you want to show me that? Do you want to say that thoughtought to me Oh yeah, yeah. you know. I mean you guys did a beautiful job, but I could try it too Deina, I'll be the negative, Dina, you'll be the positive And negative you know, positive dana, could I talk to you for a minute I notice you have all of these insecure thoughts. your professor' going to hate you and you're going to screw up when you're in her office and You know, and then you have all of this social anxiety and in my book, that just proves there's something something wrong with you. And you shouldn't be like that Gsh, I just want to say Um negative Dina that those are all really mean thoughts and As a matter of fact I I probably will screw up a couple of times, maybe even more than a couple times and I learn best by failure. Soc I welcome my screw ups And it is true that I have social anxiety But I also know that my social anxiety says really great things about me And I embrace them like Like relationships are really important to me and Um You know, with the help of my incredible therapist and the feeling great up and all of the books I'm reading, I'm learning to overcome all these negative thoughts and that's making me a stronger Um you know person in the universe and I'm kind of loving myself through all of it. Yeah, beautiful. who won I won thick or small. Big or huge Huge Huge o. let's try another another technique is is the The what if technique followed by feared fantasy And and and and she's afraid that her professor would get mad at her because of her social anxiety or something of that nature. Is that true, Kevin? M And so would you like I'll be Dina if you'd like to be the professor from hell Sure, I'll be the professor from hell Yeah And, um, and, uh Professor, could I speak with you for a moment Yeah, I guess so. sure. Oh sure. the I'm sure you have a lot of students come to your office And u you know, I I hold you in such enormous high regard as as you know for your Brilliant Son' fantastic Teaching But one thing that I've never told you is I often get anxious in your office in front of you because you're kind of an authority figure and I've always struggled with social anxiety So so I'm kind of kind of afraid that you're going dislike me or, you know, think I'm I'm really stupid or that there's wrong with me Um do you ever have thoughts like that M Yeah, and I'm going to respond as the professor from hell, by the way.. Well, no, of course I've never had thoughts like that because I'm way better than you And when I hear you say but that's the way that you've been thinking and feeling, I just want you to know that I judge you. And and I actually see you as inferior to me Oh, well, I'm inferior in a lot of ways. so there's plenty, plenty here to judge Um, T I can imagine that you have a lot of students who are insecure around you And do do you judge all of them I'm certainly better than my students. I definitely think that. But I would actually say that probably you're the one that's the worst Oh, okay And you're the one that I judge the most. Yeah. what aboutouty makes you particularly up upset Well, because you're so afraid of me You make mistakes in front of me And I don't think that students should ever make mistakes. They should be perfect and then just have me confirm that they're perfect. That such a great model. And you know, I used to believe that myself until I got to thinking about it And then I realized that making mistakes and learning from really smart people like you is the greatest form of learning. And you've never had students in the past who made mistakes and who didn't know the stuff initially Certainly that some have made mistakes, but I judge them too, just like I judge you. Oh okay.. And does that make your life pretty unhappy or do you enjoy judging people It's one of my favorite pastimes. No kidding. What are some other things you judge people for? Do you judge them for religion or skin color or, you know, gender identity or or sexual orientation. what are what are your favorite things to judge people for? All of the above. In fact, you know, somebody recently asked me, what are your hobbies? and what do you really enjoy judging Have you thought of writing a book, judging all the people I hate and why? that sounds great. It'd be a bestseller. G it. Yeah. Yeah Yeah, how much How much weent I can I can represent if you give me ten percent of your of your royalties So anyway, who won Well, I definitely think that you did. You know, why? And how because it just highlighted how absurd person who judges so harshly it would be if that was actually how they would look at someone. If I were this person, Dina, if I was the client and I saw the way that professor from Hell was behaving, I would probably notice, well, that's not what my professor is actually like Yeah, right. And yeah, that's what I'm afraid of. I'm behaving as if that's Yeah they're likeike. But the reality is they're a person and a teacher and you know That's right There was something humor. Yeah that really that really is helpful, I think, right And then she could do shame attacking exercises too. J go to the mall and shout out. I get really nervous in front of my professors or in the school, you know Well, I think that sometimes it's helpful for me if I make sure I heard things right that you shared today about like what Dina could do. herself in this problem. One of them was is that exposure is really necessary Yeahnive She had a lot of success with cognitive techniques, but she really needs to also do some Cosure Yeah to truly overcome this problem And that if she did, I would imagine that you could really find relief from these return ins. Absolutely. And I will show you how to do the exposure in my opinion, but also the hidden emotion model. Yeah. what might be a h hidden emotion here Well, there might be some anger toward who Gosh, I don't know. both professor Mbe parents Um I don't know specifically enough to I't know the answer to that, but But she's trying to please everybody and she could very well be unhappy about certain things that she's not talking about But here's how I would do the exposure and Let's say the professor' Elizabeth, Professor Elizabeth Professor Elizabeth, could I talk to you for a moment I appreciate the chance to consult with you today and I have several questions about your recent lecture that I thought was fantastic. I'd like to clarify a few things that weren't entirely clear to me I don't know if you've noticed this, but I know that a lot of the students just have tremendous high regard for you because you're one of our you know, finest teachers here in our in our faculty, really. And by the same token, some of us me in particular have a feeling have a tendency to feel intimidated by authority figures And and so I'm often hiding a lot of shyness and anxiety when I'm with you thinking, Oh she must hate me or this that or the other thing And and then hiding these feelings makes it really hard for me to to come and talk to you. And and so I want to tell you that, you don't have to do anything that I've just decided to stop hiding my feelings and and open up and become a little bit more real. So u And I just want to thank you for being such a fantastic teacher and mentor H, who's up Well, that was beautiful. Not only was that an exposure abusing self disclosure, it also sounded like you were really Uutilizing five secrets of effective communication too. Yeah And I maybe using some stroking Yeah Right Right? Absolutely So there's a really great list of things that a person in Dina's position could be doing to help themselves here, right about self disclosure Yeah using five secrets, effective communication to address a hidden emotion problem. Yeah. Right. There was also a feared fantasy seeen what it's like to face that that monstrous person and what is comeck? they if just afraid Yeah Yeah, well, thank you It can also be teacher for specific negative and positive feedback Oh yeah, like what we do in our te chain. You know,'s. What did you like the least? What would you like what about my work? Do you like the best? What do you like the least? Where do I need to? to focus And then that would bring reality into the dialogue. See she's very self centered, isn't she? so focused on imagining what teacher is judging her for So if she asked for some specific feedback of my weaknesses and strengths, then she would have reality to face rather than imagined nightmare. You know, I love that. And she wouldn't have a dialogue between two people Right now, she's the center of everybody's attention Yeah, it's negative attention. and then you can also do the interpersonal downward arrow What role does she see the teacher in? and what role does she see herself in How can you and does that same pattern pervade her other relationships L What is the pattern, Kevin What is the pattern that's going on between Dina and this teacher No characteristics What adjectives does she imagine the teacher has Oh, well harsh judge. Yeah and accepting Yeah, Yeah disliking Yeah, ye. Eactly.. And then what role does she see that she's in? What does describe that role Oh week. incapable Mhm o. incomet see Pb unimportant. Yeahll Uhuh. And then how does it feel for weak, unimportant her be interacting with angry, mean, harsh, critical, judgmental Professor Well terrifying Uh, ye, Uhuh And then what are the rules that connect these roles? What rules does she have to follow to survive in the world that she's created for herself I must avoid speaking to this teacher M think And when I'm speaking with this teacher, what are the rules I must obey can't show her how I actually feel. with you Because you would judge me have I have to be a phony to survive I also can't look stupid. I can't ever make a mistake in front of this teacher. have to be perfect. Yeah And I can't ever disagree Mhm. I can't ever have a point of view So there's just a goldmine to work with with this with this patient What was what was your assessment, Rondae, you mentor and teacher and evaluator Well, it was really wonderful Um to hear all of the details of specifics, how you would manage how you would manage each of these really challenging. patience and the beautiful job of helping them to achieve You se and Elightenment in their lives and move forward without being encumbered by negative thoughts Thank you, what was your assessment to our first two solo flights here, Kevin I just really enjoy Having my mind to open up to learn more and more and questions that people are asking are so helpful Oh yeah to give us a chance to bring these concepts to w for the listener. and ye And I like imagining what does a person listening to this who's not a therapist take away from this. What could they learn from what we're doing. And I think we brought that to life for them today. Yeah I hope so, and we hope we love all of you and appreciate your questions. and them keep them coming, but but I agree with you. I think there this kind of dialogue about how do we really patients who have real problems has such a deep aspect to it and so much becomes understandable And I just think it's it's not only rewarding tremendously. Yeah illuminate in. And So welcome on board and No until until next week, I guess. Yes, thank you, goodbye Goodbye, everybody Love you all Love you David, loveo you Kevin ana Thank you, David That's it for this week's episode of the Feeling Good podcast For more information, head over to Dr. Burns's website at feeling goodood. com where you'll find show notes on the podcast page Plus past episodes and lots of helpful resources for therapists and non therapists alike We'd love to hear from you Send us your comments or questions anytime. And if you enjoyed the show, please share it with someone who might benefit You can also support us by leaving a five star rating on iTunes I'm your host, Kevin Cornelius thepist and clinical director of Fuming Good Institute Silicong Valley. Thanks so much for listening, and we hope you'll join us next time for another episode of the Feeling Good podcast