Final Reflections and Relapse Prevention

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 sometometimes 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 The way you feel and the way you live Let's get started A delightful hello Kevin And today we're gonna to do part two of the u fascinating and courageous work U with with Ruben who's struggling with u You call it performance anxiety was how AI conceptualizes it You can also say with the achievement addiction, perceived perfectionism, the approval addiction, perfectionism. he's got a lot of self defeating beliefs And we're going to be showing quite a different way of challenging self defeating beliefs this in this part too. So I think it will be very exciting to you. And also you're going to learn about something called the recovery circle, which I emphasized a lot in the early days of cognitive therapy. And and it was absolutely essential. And then we got away from it a little bit because the new techniques with positive reframing and the other new techniques directed at motivation and resistance And the more advanced empathy techniques became so powerful by the time we got to methods the first or second or third method usually usually worked. And so we kind kind of got lazy. And so in this workshop we're going to be showing, you know twenty or thirty methods for helping Rubin challenge one of his negative thoughts that's the She of the kingdom. Wonderful. And of course in the last episode, we had the first part of Ruben's life personal work with You and Jill and we heard the testing and the empathy phase. of therapy And and what people will be listening to in just a moment, we're going to be focusing on the assessment of resistance It's the A in team. And then the M is methods Of course he's in that Recovery circle and and being very thorough and effective with methods. And it's a beautiful example of recovery from this problem that we've been achieved with the two of you And at the end, we're going to retest him And see what happened to Yeah any intensely elevated negative feelings. Were we effective or was it just a lot of bullshit in the sky claims or is it the real McCoy? So I hope you love this work with Ruben and I hope you got a chance to do your own personal work if you haven't already Great. Well here we go And then and then if we work together together tonight and it was helpful to you and the end of the evening, we can't guarantee this, but you said, well, that That really blew my socks off You know, what might happen that would be helpful to you. If a miracle happens tonight, what miracle would you be hoping for? And I think being able to kind of be in those what feel like high stakes situations without such intense anxiety a little bit of anxiety would be good, but anxiety that kind of allows me to maintain my fluency of speech and allows me to maintain my presence and doesn't get me looping in these anxious thoughts And if we could make that happen, what would that be worth to you?, it would be worth a lot. It would be yeah, it would be huge for me They really So so Joel, can you take it from here? Sure. Yeah. So that was I was writing the chat box, the invitation step and the miracle C questions. so I'll move on to the next app, which is if we had a button right here, Rubin and we Press that button then you walked right out of here today and all these thoughts and feelings would go to zero. You'd feel kind of amazing, No longer anxious, worried, panicky, nervous, effective, inc competent, embarrassed. you know, all those things would go to zero wouldould you push that button? Maybe I wouldn't push it for it to all go completely to zero. Maybe I'd want to hang on to someome of those a little bit Beautiful. I'm glad you said that, right? So you're saying ye, maybe I thinkre you're Stepping right into the next step, which is like maybe there are some good reasons to hang onto some of these feelings, right? Maybe I don't want to feel anxious and inferior and embarrassed of a zero, I have some good reasons to hang ono them. So let's talk about that. This is called positive reframing, right? where we want to think about Maybe we can take some of these feelings. Maybe you could pick one or two and we can talk about what do these feelings show about you and your value system, what's important to you? what's beautiful about you and also how are these feelings maybe working for you, right? They're benefiting you in some way. So let' let's We can all write down on a piece of paper, you know positive values and benefits, and then we can take some of these feelings and even thoughts and maybe write some things down So we feeling or thought might you want to start with. And as a teaching point We've been leaning more in the direction of pulive reframing for thoughts that's equally powerful for thoughts or feelings But the thoughts cause the feelings and the thoughts are more individual to the patient. Yeah, I'm just looking at at my daily mood log here And I'm noticing there's a little bit of My tendency to say must pick the right thoughtact conversion. Yeah makeake sure you get the right one, Rubens. No pressure There's a lot of super juicy ones here Ruben Yeah Yeah, I think I'm going to go with inferior, inadequate, defective incompetential And that was at an eighty. So that's pretty strong, right? So like what we're going to think together about what are some benefits of feeling inadequate and effective and incompetent. and also what do they show about you? That's beautiful and awesome I mean, one benefit of feeling incompetent is that Well it helps me keeps me humble and keeps me working towards improving improving myself and improving my skills Let's write those down and you should write these down in a list you should have two things on your list written down some of the benefits of inadequate and comppetent that keeps me humble and keeps me Motivated. That wasn't your exact words, but I think that's what you were saying definitely keeps me humble and motivated. What are some other beautiful things about you that the feeling of inadequate andompetent show keeps It means I'm realistic to some extent that about my imperfections. Yeah. That that's that's number three that that seems Totally true. What are some other really great things about Ruben Ceiling In inadequate. You're here in a group with who W five. twenty five Ceags And maybe a few more feeling inadequate around these people It means I care about what other people think and I really admire you know, the people in this group Yeah, choose I hear what they think and that I admire the people. I think you might have had your hand up, James. I might have misread you. Yeah, no, Did. That's fine. You're doing great, Ruben No Can you keep this thing rolling here? Yeah. So you said I care about what other people think and admire the people in this group. Yeah, so can I mean, we can do more of an adadequate and incompetent, but why don't we move on to another one unless David, you had something you wanted to add there. Well everything this is like Yeah being a King touch to and during there are some beautiful golden Absolutely So what Rubin can we pick another feeling or thought and think about how that might be benefiting you? Let's do anxious, worried, panicky, nervous, frighten. Yeah. Let's do it how do you think that this feeling of anxiety and nervousness is working for you and or, right? What does it show about you? That's beautiful and awesome, the anxiety. It motivates me to prepare. or these kind of high stakes situations Yeah. it also shows that I'm human. Do tell us how that works? I don't know. I feel like you there are these super smooth characters that where everything kind of comes easy to them and and I feel like I'm kind of more it's easier for me to kind of relate to people who show a little bit of vulnerability and anxiety because they kind of feel more human and kind of more real to me in a way. Yeah. Yeah. And so I improves connections with others Yeah. I like that yeah, improves connections with others. I love that. I think it's so true that you know displaying some anxiety and of course, sharing that anxiety out loud helps you to be much more human and vulnerable and easier to connect with Ttally I Yeah. And again, I think I just was thinking that the it also shows that I feeling anxious about pleasing other people, for example, shows that I value those people feeling anxious about getting it right shows that I kind of value the audience, right? I want to do well by them Does that does that ring true for you Yeah, definitely and especially kind of feeling anxious about notot wasting other people's time, you know, shows that I care about care about their time and want to kind of contribute in a positive way Yeah. And maybe we could pick a thought. since that was a thought that actually seems really useful, right? Like Telling myself that I'm wasting other people's time is really a translation for I value other people's time. What about any other thought we can? look at here, um Yeah Maybe if I screw up, David will be disgusted and see I'm worthless selfish fraud That's a JC went. Rom and we're just looking for distorted valbs here So the thought is if I screw up David will be disappointed Is that right? I said in this one, I have David will be disgusted I't see that I'm a worthless Oh yeah, selfish wd Wow. So kind to yourself. Yeah, yeah, really. David will see that I am a worthless Selfish fraud Yeah Yeah, I don't know why I don't think I have that on the daily Mood bog Oh, sorry, I sent an up to add one to the groove. Yeah, sorry about that I didn't see it. That's okay Yeah That's a good one. What does that show about you that's positive an arsal How does that help you Yeah, I think a of a lot of similar things that I put here, it shows, well one that I haven't mentioned is it shows that I have high standards For myself Yeah, it shows that I again Like I said before, it shows that I want to do right by David and the group members and I value David's opinions Yeah and motivates me to again work harder and keeps me humble, which we've all we've written already. It keep you safe as well Because this David sounds like a pretty powerful ber And and so If you don't screw up, you can avoid this s This punishment, I guess. Yeah, yeah Okay I think it will keep me safe. Yeah, yeah, for sure. Is there anything else we should look at in terms of feelings or thoughts? I know we always you know, David, we can always do lots, but what else feels again, kind of juicy and important for us to maybe look at either a feeling we haven't looked at or a thought Especially one if the benefit of it eludes you, that's sometimes a helpful one too Okay, yeah, I'm talk another positive on the on the David one, it shows that I'm very aware of David's short comments Meaning You want to ribon, do you get that Or do you want an explanation of that? Do you believe Yeah may true? I think a little help with that one might be good. Well I think you're saying that teaching and feedback should be in a loving Oh go cstruct And David is too too harsh And the feedback he gives Okay. I can see. yeah, I think that is an advantage for for Ruben in this in this high state of anxiety. I think that's right. And David said what it shows also is that I'm aware of Davids shortcomings that David can be sometimes you know, abrasive or harsh or critical or something like that. Is that what you're saying, David? Yeah. So I'm going to be kind of keep my guard up and feel sort of anxious and guarded and And worid. The thought implies protect myself. Very dangerous St the box are r Do do, David because really bad things will happen to you Yeah. so it's yeah, it's similar to kind of keeps me safe. Yeah. yeah, definitely O. Let me just see looking down the list here. Yeah, so now we're returning to like anything else we should do Before we move on, anyone that you wanted to pick David? or we just see if Reubin had anything else he wanted to work on. If people don't like my contributions, I'll never make it as a therapist. Hm Yeah, that's a good one S they good m? Yeah, that would be great. Let's do that one So that was David, if people don't like my contributions, I'll never make it as a therapist Yeah. Okay. In other words, they won't send me referrals. againgain, that's the I have to impress peopleople in general to survive as a mental health professional Yeah. And what are some benefits of that, Ruben And what does it ye, and what does it show about you that's beautiful and awesome about what you value Yeah It shows that I want to be a good therapist And I really care about making contributions that people feel find valuable and and want to you know, contribute in a positive way towards towards people's recovery And again, I think likely mentioned before, it's also motivating to help keep me practicing the techniques and questioning my own competence so that I'm kind of staying on that growth edge and consistently checking myself so that I can be there for my patients. Is that true about you, Ruben? that you do want to always be a good therapist and make good contributions and keep on that growth edge so you can help your patients? Yeah, ye, that's true for sure. I'm glad you picked that one, David. That was really helpful. They're all juicy in different ways consent. And I'm just noticing the time, David and I' it's so's. Yeah, yeah. So I mean, first I would just ask you, Ruben, given all these benefits of your anxiety and inadequacy and shame and feelings of worthlessness, there are so many benefits. I know they sound terrible when I say them, but they're helping you in so many ways and showing truly beautiful things about you, wanting to be humble in caring about others wanting to be a phenomenal therapist, protecting yourself from embarrassment, motivating you. like why would you give these off? I mean these all sound pretty awesome. Why would you want to push that button? Have all these feelings show to zero minuteill because he said he definitely did not want to press that button. Yeah Could you revise it to Why would you want to work on that? You want to lower these feelings too. Oh Yeah, I was asking a different question, which was just simply why would you want to work on this and then we could go to the Yeah given all the benefits, yeah, why would you want to work on this Yeah U Yeah, no, it's true. These benefits are real and There are a lot of awesome things about these thoughts and feelings. at the same time, I think the extent to which these thoughts and feelings are present sometimes is overwhelming and paralyzing and ends up I end up kind of shooting myself in the foot rather than actually realizing the benefits underlying them. Great. ye Awesome. And so to David's point though, you did, I miss that and you did. I mean, or I forgot about it already that you did say you didn't want to make them go to zero, you wanted to dial them down. So let's look at that and David, I'm happy if you'd like to walk through the goal column on the Daily Mood loog with her Let's fly through that the goal column and all of you can take a look at your at Ruben's Daily mood loog. and the anxiety seventy was your estimate of what it frequently is And what be a nice amount of anxiety to have at the end of the group Yeah, maybe Maybe thirty would be a healthy amount. So let's write a thirty in the goal callum. and is that high enough? I think so. I think so. Yeah.. And then how ashamed do you want to feel? That's already a thirty. What would be an ideal amount of shame? Yeah, maybe twenty, twenty would be good Okay. And how inferior, inadequate, effective and incompetent you want to feel? was that was one of the that was the highest actually at eighty Yeah, yeah. I think there's a lot of good stuff in there. mayaybe thirty Thirty, okay. And then how rejected do you want to feel? That was forty Maybe twenty twentyw. Okay And then how embarrassed and foolish and self conscious, I was feeling that one. I misread you a moment ago, Jill. Oh. I'm sorry you felt that way But that's seventy. What would you like to feel? Let's do twenty for that one. twenty. Okay. And then frustrated and stuck has been thirty. What's amount good amount of frustration. Let's do pen for that one? Jereoa And then the resesentment and the upset. how that was thirty. What's a good am there? Let's go five on that one Oh okay, great So now let's let's dive in and we're going from Step three, which is the assessment of resistance to step four, which is is methods. And so if you'll choose a negative thought you'd like to work on first Jill will lead the charge and some of the many ways that we can challenge that thought because remember our hypothesis is that Those thoughts actually cause these negative feelings. And if we can reduce your belief in these negative thoughts we can reduce the intensity of these negative feels. Yeah Let's start with my speech is too slow and I sound foolish, ignorant and boring Okay, no number two. whyy don't you jump into that one? J'must gonna write it down. I have your daily melog digitally. So my speech is too slow. and can you finish it for me Hest my speech is current and boring Yeah u Yes. So could we first just do a quick identify and explain the distortions in that thought, Ribbin? So My speech is too slow and I sound foolish and ignorant and boring Can you take a look at the distortions and tell us what distortions do you see in that thought? Yeah, I would say it's all or nothing thinking in that It's basically saying either my speech has to be fast and interesting or completely slow and completely boring and ignorant which is, you know, not true. the gradations and Sometimes I speak faster and sometimes I speak slower So I think it' or nothing. it's over the generalization overver generalization for kind of the same reason mental filter, definitely dwelling on those pauses rather than the sort of moments of articulate speech that I have And again, discounting the positive for the same reason It's definitely mind reading. It's assuming that people will react negatively that they'll find it boring and that they think that I look foolish and ignorant. and fortune telling for similar reasons, basically all of these. And I even see a hidden should in here, right? Like I should always be I should always speak Y eloquencely or you know, in the perfect taste and I should always sound intelligent and exciting or something like that. Totally, totally. Yeah. definitely okay. I should lazling. I would ask you about I don't know if it's in there, but self blame is one of the tents. D defefinitely self blame. It's blaming myself for growreing up and and speaking slowly It's definitely also labeling calling myself boring and ignorant and bullish Totally that's a big one. notly Yeah. There is a lot in there. And then so and David, you know, feel free to jump in, our course correct at any time. Should we just ask Ruben? I mean, there's lots of ways we could there are lots of directions we could go in here. We could do the tried and true externalization of voices We could do the more aggressive feared fantasy We could try be specific, although we could also do that because I like be specific for labeling a lot of the times. but we could also kind of do be specific even within externalization of voices since it's an opportunity to use any method we want really in a role playay. Of course, we could also always do the more gentle, the most gentle double standard technique, right Should we ask Reuben, David, why he might like to try Yeah. and again, there's tons of other methods too, but Yeah, I think externalizivation of voices sounds like a good place to start for me Okay. There out David, do you want me to get us started? Either way. ye. you can jump in, you wantna lead it? Wh who would you like to attack you, Ruben Let's go with David. No The ogre Yes, R. Can I talk to you for a minute, Ruben Yeah, sure You know who I am Dar Rubens Negative rs. Yeah, that's right. and I know you're in this group to get all kind of lovely dvy cheered up. Oh you're so special. everyverybody loves you But it's just a fact that the universe that your speech is just too slow Then you sound foolish You canor out and boring. and I didn't want to hurt your feelings or anything, but I just wanted to tell you the truth. Yeah, I think Honestly, I think it is true that I speak very slowly sometimes and I have some long pauses which certainly feel awkward. And I imagine there are some people who might react negatively to that and lose interest. When that happens At the same time, people have also said that sometimes the pauses are helpful because it keeps them interested, which is counterintteruitative to me, but I think it's true that sometimes I sound ignorant and foolish and boring and the beauty of recognizing that is that I can work on those things and and work on my speech fluency and You know, it's not always going to be perfect and there are going to be times when people don't like it and I make a bad impression and that's part of life. So who won would you say? I won, I would say Big but not huge. Yeah, ye, big here. And remember that we've got four strategies We can use an externalization of voices. We've got the self defense paradigm We've got the acceptance paradox, We have the countertack technique, and then we have the category other, which is B specific or whatever other techniques one wants to use. Would you like to try to revise it by you weaving in some of those others or would you like to do a roll reversal I kind of be interested in a roll reversal if that's right And you want to do it with David or with Jill? Let's keep it with David for now and then next one we'll do with Jill. Okay. ye you have socket socket toain I. So now Ruben is going to play the role of his negative voice and David is going to play the role of positive Ruben Yeah Okay, Dave Ruben, can I talk to you for a minute Oh, you never stop talking to me. You're always there yapping in my ear. I'll never be alone. Great. Well, I wanted you to know that your speech is too slow and you sound foolish, ignorant and boring. I have a couple things to say about that My speech is what it is and it's Pretty awesome, actually I have a kind of a British type type accent that almost everyone finds charming And when I'm slow, you know, if if I if I sound Foolish or ignorant. Maybe I am feeling foolish or ignorant at that moment. O or maybe not. maybe people like it. But I have another problem much greater than my speech problem. What's that They're listening to your bullshut C constantly constantly putting me down I think I'm gonna to celebrate myself, slow speech and all And and teach you a little Buddhism, one hundred one. Yeah You know was. Did you want to think Buddhism No, you you can you can take your u your criticisms and stick them where the sun don't shine. Yeah Yeah, I think that was huge. Huge And how did I get to huge I think You use some of the techniques. I did, use some self acceptance. You also threw in some defense But I think the big thing was the counter attack Yeah R ye I have you know, I may have slow speech and that may be an issue, but it's not really the thing that's bringing me down. The thing that's bringing me down is you criticizing voice constantly writing on me for talking slow. Oh yeah, I love that. I love what you're saying. Let's see if you can do it. Are you ready? Ready? Yeah Rubin, I know David is trying to cheer you up with some of that love. Hippy stuff from the late nineteen sixties, but it's just it's just not gonna to c up becausecause it's a fact of the universe, Ruben. that as smart as you are and as handsome as you are and as impressive as you are your Fing speech is too slow And you sound foolish Iignnorant and bore it Bor Yeah. I mean, it's totally true that I sometimes have really long poses and that my speech is slower than I'd like it to be at times. And you know, maybe I lose people during those times and maybe there's some people that don't like it. but Honestly, I'm doing the best I can and I think my heart's in the right place. and I have a much bigger problem than Speaking too slow And that's your voice constantly nagging me in my head telling me how wless I am for speing so who won that one I did. That's not huge to me. Yeah, nice to go. I love that. Over to you, Jill. Well, I guess I would say, yeah. so now that you're at huge with that one, I feel like we could go in two directions. We could just pick another negative thought and just keep going with externalization of voices. Maybe that would make sense And or at least maybe we should do a little bit of that. And then we could always go to feared fantasy with that particular thought and be the audience telling you that your speech is too slow and that that you sound foolish and ignorant and boring and we could be the Group from hell, right? Two directions we could go in do you want to build on the momentum and do a few more externalization of voices thoughts or And the end to your fantasy Yeah, I think that would be my my temptation Right Yeah. Should we you want to pick another thought? and we'll hit you with that? Yeah, let me Let's do if I screw up, David will be disgusted and see I'm a worthless selfish fraud. Yeah Let me get the wastebket in case I have to bar M So if I scr up table, will be disgusted and think I am worthless Selfish fraud And we're using the first person J. I was reading it. That's his thought is if I screw up, David will think David will be disgusted andt think I'm a worthless selfish fraud. I was reading the thought. So yeah, Ruben, let's do another round of externalization of voices, right? So you are going to be who? I'm going to be Ruben positive Ruben. Exactly, and I'm going to be negative rubs Um, yeah, Reuben, you know If you screw up in this Tuesday group David is gonna be disgusted with you. and he's gonna think that you're a worthless, selfish fraud. Yeah, I froze for a second there. Could you hit me with it again Yeah, sure Ruben, if you screw up in the Tuesday group, As a small group leader, David is going to be disgusted He's going to think you're a worthless and selfish fraud. You know what? David and think whatever he wants to think and first of all Uncableuh, I'm choking on this one I think I feel like there's so many ways to go. Okay I'm choking. Mbe you want to do you want to pick one? I mean if you're choking because there's so many ways to go, then just try one way simplify or if you'd like to do a roll reversal, I'd be happy to do that too. Yeah. Okay. Can you helpit me with it one more time? Yeah. If you screw up, David's going to be disgusted with you and think that you're a worthless and selfish fraud. It's kind of amazing how much you admire David and want to in personon And it really shows how much you care about the Tuesday group and Steam CBT that you care so much about reallyally nailing this and not disappointing David At the same time telling yourself telling myself this, telling me this is not going to do anything to help me improve David is one of the warmest, kindest, most loving human beings that You know and has only been encouraging. So this notion that he's this horrible ogre is completely distorted and And yeah Okay. I think I think I won the sentiments. I was winning big. I think I I got a little anxious again and was kind of having trouble finding words. Yeah So you said, it's amazing how much I admire David and want to impress him and how much I care about the Tuesday group and Team CBT, justust how nailing this, not disappointing David, but telling me this is not going to help me improve So that was again, almost like a counter attack, but not a very spunky one, right? And But then you also said and basically you were like, this just isn't true. David is one of the warmest kindest most loving people you know. And so this notion of him as an over is completely distorted. So that was kind of like a defense, if you will, like this is not true Ltt Do you want to you know, invite two different things. Do you want to talk about what where you're feeling stuck right now? Is there something in here that It feels hard to challenge. you wanted to do a role reversal. I had some thoughts. feared fantasy that you were suggesting few Or a feared fantasy. Yeah. I think it would help like I'm having this sort of anxiety heat and So I think in a way, maybe what's coming up is the Yeah, maybe now that I'm doing externalization of voices There's a kind of a performative aspect to it as well And those A I doing it right Yeah, exactly. There are some of those thoughts like I need to do it right and I need to blow this thought away and impress people with my skill, kind of like that So maybe just voicing that is, yeah, I feeling that anxiety kind of Yeah, you got an externalization of voices and couldn't come up with a good response. And so you're telling yourself, I need to do it right and I'm not doing it right and I need to blow this thought away. and that causes you to feel kind of stuck and anxious and Yeah. Mhm Oh yeah and that that's helpful. That was such a nice example of going dropping back to empathy and I feel like I That's exactly what I felt like I needed in that moment. So thanks for that that doubt. I thought it was a beautiful example of self disclosure just realizing that for you, what here's what's coming up for me in this moment, I'm feeling really stuck and and telling myself that I need to be doing this just right. That feels like it's getting in away So do you to do you wna do one more round of it or do you w to do a roll reversal with me We we wish a feared fantasy too. Yeah, let's try a roller vessel. That's all right Andack You want to hit jail or David Sorry. I mean, in of we're going to be you're going to be the negative Reuben and I' be positive Ruben David will be positive Ruban Okay, I'll hit Joe Yeah Ruben, if you screw up, David will be disgusted and see that you're a worthless selfish fraud. Oh, I think I will screw up from time to time. I'm not going to do things perfectly as a small group leader. In fact, that's why I collect feedback. I expect that I'm going to make plenty of mistakes and I'm hoping to make them here and learearn and grow and yeah, learn how to do each and everything, even just a little bit better every time. And I mean, if David as the leader of this kind of beautiful consultation group is disgusted with me that says more about David than it does about me. So think David's going to be disgusted with me. It's not the kind of person he is. It's not the way he communicates But again, if someone that I were trying to do something you know, trying to put myself out there with, whether it was David or anything else, decided that they were disgusted with me and that I was worthless and selfish because I made errors, then I don't think they would be my guru anymore. And I think I want to be in an environment where people support making errors and mistakes and I want to support myself in making errors and mistakes too. Yeah. Yeah. those people who run that o And how did I win it? I really liked that you flipped it around to I hope I screw up. That's why why I collect feedback. the whole reason why I'm you know, a small group leader in training is so that I can learn exactly from my mistakes. Honestly, the more mistakes I make the better and no and that's also the mentality that David keeps enthusiastically putting forward is that we have to be comfortable with failure. and honestly, the more I fail in front of David, the better because he can then give me more specific feedback and the better of a therapist that I'll become. So yeah, the more I can fail, the better, the more I fail, the less The more vulnerable I am and the less I will appear a fraud, in fact. H I love that We kind of did a roll reversal without meaning to. I was just asking, how did I win? but then you kind of embodied it and made it even better. But I loved what you said. The more I fail in front of David, the better. 'cause the more I can learn, and then the more I fail in front of others, the more vulnerable I am. and that's Also a positive And also the less selfish I am Oh yeah, giving people opportunities to learn from my mistakes. That That's beautiful. Are you ready to jump into the group from helpll Yeah, let's do it And meet the David from hell FF thees This is the feared fantasy, just telling the audience You know And so What are you afraid that David's going to be thinking about you at the end of say this group or some group that I'm incompetent and worthless and should find another profession that I have no business being a small group leader You going too fast you're incompetent and worthless You should find U no profession, you should have not Be a small group leader And what else And you don't deserve to be here. Now, would you like to start out as the David from hell Or as Ruben. I think I can I'll start out as Reuben Yeah And you want me to be the David from hell Yeah Robin, you were said that you wanted my feedback, how you did in today's group Yes, please. Yeah. Well, and you want me to be real honest with your right Yeah, as honest as you can be, please Yeah. Well, I the most honest thing I can say is you' You're incompetent And you're a worthless human being those two things. those are just the starters Can you be a little bit more specific? Is there a cdertainen thing that I did that you didn't like that sort of displayed my incompetence and worthlessness You had a long pause at one point during the group. I think you were anxious Yeah, yeah. the pauses, I'm sure there are people who get exhausted with the pauses But I think If there are people who are that distraught by the pauses, then maybe I should be in a different group. Okay, who will I did L your small, big I think we're huge I think was huge. I think it was huge. How did it get to huge So I think be specific was really helpful because the sort of incompetence and worthlessness loses all meaning. And keeping in mind what we said before about how helpful it is to fail made me excited to hear the specifics And then when When the specifics was, you pause for too long, I just realiz the ridiculousness of that Yeah We're we're in a non pausing group here. We don't really want to in our in our group if you pause, you know? We have a a time limit actually on pauses. seeaail Ruben that the emperor has no clues Totally, totally. Yeah. Is that exciting for you to see It's really exciting. It's very cool. Yeah. yeah. feels like a feels like a weight has lifted for sure. Are you happy in a moment of enlightenment Yeah, definitely feel a lot a lot lou either. That is so so is there anything else here that Jill or I could hit you with any negative thought or any Sred fantasy thing that we could say to you that would be upsetting you We're looking to blow a system water completely and not just for the feeling a little less anxious or a little less inadequate or whatever Yeah, let's go with them I'm wasting people's time. I'll tell it And do you want me to be Ruben and and you can be the are youither Ruben from hell or what O be the group member from Hell. a group member from Hell So sunker to me. So David Why do you think you ment my name, Dava Ast Ruben, why do you even come here? You're just wasting people's time time with your poses Oh, okay. u Well, I'm coming here to learn and overcome my anxiety and my fears. And this kind of interaction is actually helpful to me because this is the kind of interaction I have I have feared the most, but yes, I have a lot of strengths And and many shortcomings and weaknesses as well. and And so I guess your problem here is just because I'm wasting your time Yeah, That's right. You're wasting my time and you're wasting everybody else's time Would you say? We're trying to learn. At this moment, we're talking about a conflict between the two of us. No, we're talking about conflicts is such a waste of time. talking about conflicts is a waste of time. You mentioned someone needs to find a new profession, but I don't think I'm the one than you. Yeah, nice, Beautiful. Yeah, Isn't that cool Yeah, that's very cool. Yeah, you won huge on that. Yeah. are there An others of these Could I also try a very different angle with the same w and even just around more be specific? Will you hit me with that one too, Ruben. You can be the group member from Hell. Yeah Yes. Ruben, you're just wasting people's time whenever you come to group Got it. you were looking for someone who talked faster? Was that the problem? or exactly yeah, share with me. what were you looking for in a small group leader? Why do you feel like I'm wasting your time? Yeah, small group leaders shouldn't always so much. They should have the answers ready at the drop of a hat They shouldn't waste our time with long winded slow responses How much time did you want me to take with my responses? Was there a precise number of minutes my responses should take? or do you lose interest when people talk for like more than ten seconds at a time or fifteen or twenty? You got me, ye Nice, I love that. was I was laughing because I was also thinking, Ruben, I just have to share. You know in this group, people nail me because I talk too fast So this whole this whole topic makes me laugh so hard because In the chat box, people would put like slow down, Jill or like can usually talk slower. So Anyway, it makes me laugh. like you know, so really exactly, how many minutes should we each take on our explanations, right would be a perfect hold any a sway over you or would you like to have the group members takeake a thought from your Daily moodlog and attack you with externalization of voices have several of them do that Yeah, that would be great. if people have the daily Goodog in front of them and want to chime in Yes, I. have the Ruben's Daily mood loog in front of you. Okay, Laura, will you start out? and then let's see, Sobon at the bottom there can go second and hit Ruben with one of his negative thoughts using the second person you All right, Ruben People will not love you and accept you as a flawed flawed and vulnerable human being, they just will not accept you Yeah. well what I'm what I'm learning is exactly the opposite that the more vulnerable and sored I can be, the more human I will appear to everybody and the more people accept me and love me and be able to relate to me. So I think Yeah, what you're saying just doesn't hold any water. L who w there How How did you in here Yeah Okay Aesome Your term, self defense Okay Thanks Llaura. But it was also self acceptance acceptance. Yeah. ye, totally. Ruben I think you shouldn't be so upset or angry. It's just plain ungrateful. Yeah. And is that one of those thoughts? Yeah,'s that's one of them one of them revised dating the dog. You know, there's a certain amount of ungratitude in feeling upset and angry, and yet I'm going to feel upset and angry from time to time. and that's perfectly fine There's nothing wrong with that. Ins fact I have a much bigger problem than feeling upset and angry some of the time and That's your nagging voice in my head tellelling me I'm worthless for having these feelings. Thanks, Sooban. I think that was a huge win on my part. you did some self acceptance and then you did some counter attack, right Yeah. Yeah, that was great And one quick thing we can do and then we've got a half an hour to kind of Hold this together, and we have another thing to briefly discuss with the group. but The you might want to you you're afraid that people will be critical of you And you might you've been very open and you've had some pauses tonight that I personally found just is fch bed Yeah. And do you want to ask people here by name and eventually, how do they feel about you, Ruben? Yeah, I would like that surve survey technique. I can't I guess I can see James. Sure, yeah. I was really surprised to hear all this Ruben. and you know I always really liked you. I think the accent is pretty cool and I thought the paes were just part of the accent, so never really noticed it really Thanks, James. We really appreciate that. I can't really see I can't see any other. G, we can There you go. If you guys raise your yellow hand, yeah, then Rriibbon can see you. Perfect. a mechanical hand. yeah Rub and H I love my gnd. It's wonderful all the time. I never get bored that one moment. I never think of that word at all. And than you you pause It just makes me feel that you're sensitive and you want to connect with us and I don't know, I just feel really close to you because of it. So I just wanted you to know that Thank you so much, Glen, that means the world to me. I guess Emma. Yeah Yeah, very similar to Gwen. I u have never once noticed a pause with you. and never once felt bored when you're speaking. So it's never crossed my mind But in actual fact, your style for me comes across as very considered Cm like intelligent, I find sometimes like less can be more And often the choice of wording is very thoughtful and deeply inspiring. So I actually find your style quite captivating in that sense. which is quite opposite to what the internal dialogue has Yeah Totally opposite. Yeah, thank you so much, Emma I appreciate that. You have a couple more here Nar Ja. Yeah. Ruben. first of all, I want to thank you for showing your vulnerability and going deep into your thoughts and feelings and even sharing with us about how you felt about your parents and how that internal dialogue was. In terms of how you appear in the group, I've always admired. your contribution. It's very thoughtful and Its it shows that you put in a lot of effort And I've never felt that you're winging it So it's just I sa Fraud is farthest from the truth that I would that you're feeling. so Thank you so much for sharing your personal journey and really appreciate it. And Laura, you're the last. Thank you It' about Hi We're on third base and we need you to get a hit So I I just I just wanted to share that I had the opportunity to be in a small group with you recently, and I was so impressed by your contributions and I really learned a lot from it and I haven't had the opportunity to be have you as a leader in a small group, but I would love that I think it's great that you care so much about making good contributions and wanting to do a good job. So thank you, and thank you for sharing all of this today Really Pressso Thank you so much, Flori. and thank you everybody. I really appreciate Now what I'd like to do is go through your end of session, negative feelings on the brief mood survey Starting with anxiety, that was seventy and your goal was thirty. How anxious are you right now?o Great And then how As shame. that was thirty and the goal was twenty. zero U And then they u Inferior and incompetent and all was eighty, the goal was thirty. What's that now? ten Jim And then the loneliness especially rejected had been forty and then twenty. what is it now Zero This Sarah And then embarrassed, foolish and self conscious, that started at seventy. What is it now Zero. I Sirl And then frustrated and stuck that had been thirty. What is it now Zzero zero and then the final was Resentful and upset. that started at thirty. What is it now alsoso zero zero And And then I have my two standard questions and then we'll turn it back to Jild for the general you know, little a discussion what a What did this all mean? and what are the teaching points But the first question is were these changes real or you just being nice? No, no, definitely. I feel very different. There's even the kind of residues of some anxiety in my body, but there's the kind of belief in in their reflection about sort of me as a person is completely gone That's great. And then the last question is, what was the healing element, would you say? because we did so many things. we did you know, measurement and we did empathy and we did posive reframing and we did, you know, a lot of techniques with externalization of voices and And you know the counter atttack and the acceptance paradox and we did a lot of things but you had moments of illumination when you suddenly saw something you hadn't seen before, and can you talk about what those might have been and what were the things that kind of opened your eyes. Yeah, I think Of course, it was a combination of things when thinking back to some of those moments now and I think one significant moment was really the sort of deep down recognition that part of What we're here to do in group is make mistakes and I think I had that understanding on intellectual level and I think it really kind of deeply sunk in today Yeah Yeah. and I think There's also David and I had a conversation before this, that was also very helpful. and kind of an how a moment there kind of carrying over to today that there really isn't a separation between me and the person I admire that in being so afraid of of that person, I kind of both make that person into a monster and and myself into a sort of nothing and both of those kind of views are equally distorted and we're all part of sort of a greater web that that there really isn't any separation and without that separation, a lot of these sort of thoughts and feelings kind of melt away Y I think that's where our fears Ager and hurt slimes when you when you get rid of that that artificial separation and we're just hanging out talking to each other And that's where the comes in. That's where the love love comes in. I don't know And it's not so corny to say it, but you know I ha sh it, it's profoundly true And And I think also that point though, I think, David, what you're saying and what Ruben, you're saying is also that when we are so self conscious and so anxious and so convinced that others are looking down on us. We're also thinking something pretty terrible about the other person, right? Like to think that David or Jill or someone else in the group would be so Essentially critical and harsh and judgmental. It doesn't make them look too very good either, right So in putting yourself down in your mind, you're also kind of putting the other person down too. kind of It hurts you. hurts it hurts us too Right I think is that right? David, am I capturing Absolutely. And that where life exists is far more humble and simple like R be specific. If you make a specific error, we can We can correct that specific error And we can learn from from each other, but this that this flashy version of life doesn't exist. Was there anything else Riben, you were talking about reflecting on like moments ofillus illumination? Yeah. Yeah, I think another big thing was sort of David and Jill's point that shame requires hiding something And so And the intention to come tonight and be vulnerable and open then and do that and be so lovingly and warmly received by David and Jill and everybody else in the group, I think it became clear that Same has no bearing in that context. and if I'm kind of laying it all bare, there's nothing to be ashamed of. And And that was really enlightenning as well because I think a big big fear was, oh, I'm a fraud. I'm like trying to stay cool. and that was kind of a big thing that was kind of perpetuating the anxiety. And in kind of opening up about that and being so well received, a lot of that anxiety just melted away Nicely stated Yeah No, I think it was I definitely saw a significant change when we did that role reversal about like the group, you know, I'm here to make mistakes. In fact, it's Great if I make mistakes and that's the way that I'm going to learn and grow. and that's also what the group is here for. It's what David values and sort of realizing that seemed freeing. Yeah, I'm trying to think anything else. Yeah. and lots of be specific was seemed helpful and I love David's counter attack. It's always so useful and you owned that in your role reversals as well. So I thought that was pretty cool. And the humor, like David's humor I always found find so powerful just highlighting the kind of ridiculousness of of the pausing. And I think Joe's also be specific of exactly how fast should I be speaking to please you Yes. How few pauses do I need to have this evening? Yeah someone I just wanted to say someone wrote in the chat something that's puzzling to me, can Rubin change one of the negative thoughts to a more positive thought I think that's what we were doing. I think the Yeah, it's Laura. No, I was just looking at the daily mood loog and I know a lot of them we were doing like, you know, like counter attacks and being really, really, you know, like fighting it. And you know sometimes yeah, we were doing that for a lot of them, yes But you know, like like justust sometimes it's I guess sometimes when We're not like in the positive thoughts column I guess I never just think of it as being like one of the devil's advocate, like one of those. I usually just just kind of changing it where it's just just different So maybe yeah, but I think essentially when we do I just think it's a good teaching point. When we do externalization of voices, that is what we are. We didn't stop and say, good, write that down. But essentially, what Ruben was coming up with in externalization of voices as the positive Ruben were in his positive thoughts. And I was writing them down on the daily the dog. and that is what I do when I'm working with patients too during externalization writing them down and then I'm asking him to write them down. Sorry, David I would say we would advise you, Ruben to do that when you listen to the wording of the session and then to write the positive thoughts down because that will actually help reprogram your brain circuits a little bit too, at least according to your father's friend, Mark Noble. And I think he's absolutely right on that But good it's a good point, Laura. I think Emma wrote it, Yeahah, that when we're working with patients, we will pause and then say let's write that down and make sure that they have a convincing positive thought. What we didn't do, David that we usually do, that might have been helpful is How much do you believe that thought? Okay, great. And now how much do you believe this initial negative thought? And we didn't do that. So that's true. And you can definitely slow down and do that. And then Davids saying, which I hundred percent agree with, that's your homework Rubens Listen to the recording or do it on your own and make sure you complete the whole daily mobog. You want to make sure every negative thought there has a positive thought that's totally believable and that crushes or kind of annihilates your belief. in the original negative thought. Yeah sounds I think that's great Yes. And also we did sorry, when we were reviewing all the methods, David, right? there were so many. And then also we ended with the survey technique, which can be a really powerful method. And Not everyone will have the group from hell that they can actually do a survey with, but you know, people who are feeling anxious and self conscious can do a survey with their friends, their family members, the people that they feel threatened by. Yeah. Yeah, we could have used thirty or forty additional techniques that I've thought about W one by one to challenge these negative thoughts, but When you have a good flow with somebody, and you've done your empathy and gotten your A pluses and then you do your Pitive reframing, you generally won't need thirty or forty techniques, generally, you know, five or six or seven or are usually more than enough S we take a few questions? Oh sorry, I was to take a few questions, A few questions for maybe five minutes or so and then yeah Gwen, you have a question, your hand with raised. Is it anticipated that Ruben will relapse Yes that one hundred percent of people will will relapse over and over again for the rest of your life. And the way Albert Ellis expressed it, it was just it's actually a physical impossibility to be happy all the time. and u You know, I totally I totally endorse that and so He should be prepared for relapse with relapse prevention training and part of that would be just a repeat of the externalization of voices we did tonight as well as to write down and challenge the distorted thoughts he'll have when he relapses the ones that everyone has, like this relapse proves that the therapy didn't work and it was just a band aid and we didn't go deep enough in all of those kinds of things And and that's what you need to really complete your treatment. And even that doesn't mean that Ruben will never have negative feelings again. but that he'll when those feelings come creeping back into his brain, he'll know exactly What to do? Okay, thank you. Yeah, was I was planning to as part of my homework, do a little bit of relapse prevention. as well. Yeah, that that big great Ruben It would be great. Yeah. Yeah, you can read about the last chapter of feeleeling great, Gwen, if you're interested. My other thought forree Rubin, just a tiny bit of homework, but that's more like ongoing homework is You did this tonight and I think you found it helpful is like if you find that you're anxious in a performative situation using self disclosure. can be really powerful, you know, and it kind of rem it's like the shame can't exist without secrecy. and Also, it removes the internal dialogue a little bit, makes it sort of external and it's a little bit freeing I told the story and maybe you've heard it before. David's probably bored of it, but David and I were presenting together down in Southern California. It was a really big room full of people. And I got really nervous right before we started My hands were shaking and my mouth was super dry. And so when I We were presenting on social anxiety. And when I got started, after I said a little bit of time, I shared that I was also struggling with some social anxiety in the moment. The trouble I was having was that my hand was shaking so much and my mouth was so dry I wanted to get a glass of I wanted to get a sip of water, but I was afraid I was gonna spill the water so I So not do either one So and then as soon as I said it and laughed at myself, I actually felt so much more relaxed. It was amazing. It's like a cheat code, but you're not doing it to cheat. You know, you're doing it to connect and to be human, but it's So freeing actually because in that moment, I think you just realize by sharing with people that you're not perfect, you almost like don't feel like you have to be perfect. And then shortcomings turn into advantages Yeah O Cismatic That's a speaker Yeah. I the try cool Yeah. Oh, I was just going to say group members look forward to a lot more self disclosure for means more. That's it for this week's episode of the Feeling Good podcast. For more information, head over to Dr. Burns's website at feelinggood. 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. therapist and clinical director of Fewing Good Institute Silicom Valley Thanks so much for listening, and we hope you'll join us next time for another episode of The Feeling Good podcast