Stanford Psychiatrist Reveals How Cognitive Therapy Can Cure Your Depression and Anxiety

Hello everyone, welcome to another episode of Impact Theory. I'm here with someone who is a total legend to me. This is David Burns. MD David. Welcome to the program. Thanks for inviting me. I'm excited. I am very excited. I came across

your

book. I've been feeling good for 18 months and since then I've been desperate to get you on the show. I think it's one of the most profound books if someone is struggling with

anxiety

,

depression

, any type of mood disorder, so when you release the new book, you'll feel. Great, it was a perfect opportunity to communicate.

I think the two books together are really the most, without a doubt, the most effective thing that I have found. I think

cognitive

behavioral

therapy

in general is beyond extraordinary. If I do my job. Well, because I know you have the information, if I do my job right at the end of this, someone who is struggling with a mood disorder, I think they will make a lot of progress, if you don't mind, let's start with the basics, what is

cognitive

-behavioral

therapy

? And why do you think it works so fast? Yeah, and after that we can add the new thing and feel great because there's a whole new dimension.

It's like a step up from cognitive behavioral therapy, but all the cognitive stuff is still there. pure gold and goes back to the teachings of Epictetus, the Greek Stoic philosopher who said approximately 2,000 years ago that people are not disturbed by things, nor by progress, nor by what happens to us, but by our view of them, and that idea is very simple. and basic that most people can't understand what it means we'll come back to that in a minute now the second idea is that when you're depressed and anxious again it's not the events in

your

life that are What's bothering you it's the messages what you give to yourself, the way you interpret events and when you're depressed you give yourself messages like I'm not as good as I should be and there are a lot of people listening right now. who's thinking that and uh or if you're shy you might be thinking you know why I'm so shy I'm really screwed there must be something wrong with me depressed people often feel discouraged or hopeless and then you tell yourself things will never change This is the real me I really am a loser I will be like this forever and now and the really surprising thing is that what I just said has been known for more or less 2000 years, but what is really new and amazing is that the thoughts that trigger

depression

and

anxiety

are not valid thoughts.

Depression and anxiety is the oldest scam in the world and you are fooling yourself but you don't realize it and then the final message of Cognitive Behavioral Therapy is the very moment you change your way of thinking, in other words , the moment you can, you suddenly see that those distorted thoughts are not true and you stop believing them, in that instant you can change and that was revolutionary and when Feeling Good came out in 1980, that was the first book that really introduced these ideas to the world and at that time there were only about 12 cognitive therapists in the world and all of us were considered charlatans because no one said it was a chemical imbalance in the brain.

I have been working on research on that defunct and fraudulent theory at the university of pennsylvania and we saw that it really wasn't a true theory and then like so many young

psychiatrist

s I was trained in this endless Talk, just come and talk, talk, talk, and that didn't seem to do anything for my patients. I gave them tons of pills that didn't seem to do anything for most of them and then this new drug-free idea came up and The first time I heard about this I also thought it was quackery, but then I started going to a weekly seminar taught by Dr.

Beck at Penn. He was creating cognitive therapy. I said, "I'll try this with some of my patients to prove to myself that it is." It is not true and lo and behold, they began to recover like popcorn. I said, man, there must be something to this and I resigned from my tenure-track academic position at the medical school to go into private practice and help develop it because it was so exciting. but that's the cognitive part and then what happened I started writing. I wrote this book feeling good only because I was so excited. I want people to know what was happening to my patients.

I could hardly believe it myself. People who had suddenly become suicidal. Getting it back was very exciting and then feel good finally caught on and sold over three million copies, the sequel to the feel good manual sold another two million and cognitive therapy has become the most popular form of psychotherapy in the history of humanity, is practiced throughout the world and is the most researched form of psychotherapy in human history. Well, that was the magic in 1980 and the cool thing was that researchers found that if they just handed out my feel-good book, people who would go to a medical center to get treatment for severe or moderate depression and just say, "Well, it'll be four weeks before you can see your Frank," but meanwhile, reading this book, they found out that two-thirds of them recovered without pills, without therapy, in four weeks and no.

Not even water needs therapy and it is so good that you point out that if someone had told you how far you have come now in terms of how quickly these disorders can be altered, you yourself would have said that you know this guy is a Healer, they're a scammer yeah and that's true what I'm getting at so going back to the first notion you talked about that nothing is good or bad but thinking makes it so right the shakes are right yeah and honestly , when I first heard that I knew I played a role like that it seemed pretty obvious to me, but as a student of the brain, I assumed this was going to be a balancing act where maybe you started a process with thinking, but at the end In the end it became a programmed neurochemical process and that was where the real problem was, but in feeling good you go through a story that I think is so deep that it's worth talking about here because that's probably how people would be, but... what's happening? postpartum depression that's obviously hormonal obviously neurochemical um yeah and honestly when you started the story in the book I thought actually yeah how is that not hormonal and neurochemical?

Yeah, well, all your feelings result from your thoughts and um, us. I don't know how the brain creates depression and anxiety and these theories like the chemical imbalance ones were just rubbish from the beginning, there was never any reason from a scientific point of view to link depression with a brain serotonin deficiency that was a theory: this It's a neurotransmitter, serotonin, and it's too low in depression, so if you increase serotonin, people will recover and we found out that theory was bullshit when I was doing my research in medical school because we had an award. for the depressed veterans at the VA and and we did research studies there and we increased their serotonin levels, yes, we gave them, half of the veterans got shakes, they all got shakes every day, but half of them had at least 20 grams of l-tryptophan, which is 20 times the amount you generally get in your diet and which is what goes directly from the stomach to the blood, diffuses to the brain and is converted into serotonin, so we cause massive increases in serotonin in the brain. half of the veterans and we kept them on this program for four or five weeks we continued to measure their moods throughout the process, no, it was double blind, no one knew who was receiving this massive increase in brain serotonin and then we cracked the code to see how the two groups were doing. and there was absolutely no difference in the groups and neither group improved at all, so we published that in the world's leading psychiatry journal, the archives of general psychiatry and everyone ignored it until about 15 years ago because they clearly ignored it Well, there is money that drives. stuff um and yeah big pharma yeah they're making billions of dollars off this theory that's part of it because pharmaceutical companies can create a drug that has some effect on the serotonin system and then they can get approval of food and medicines. administration to market it as an antidepressant, but now all the new research indicates that chemicals called antidepressants are actually not antidepressants, they're just placebos, they're just chemicals with side effects, so they don't outperform placebos, so we don't know. the cause of depression, but the good thing is that there is a chapter in the new book by Mark Noble, a neuroscientist, and his thought is that the new team therapy, which is like cognitive therapy on steroids, you could say that in reality selectively activates people.

They're not going to understand that you're going to read team in lower case when it's actually an acronym, just break it down real quick so CBT cognitive behavioral therapy team is a test. We test patients at the beginning and end of each therapy session and the readers of the new book will also take these tests to track changes in their mood while reading the book. Empathy will probably never

cure

anyone of anything, but you should have it if you are doing therapy and I also try to create empathy in the book by showing warmth and compassion for the readers and many of the readers of my first book, feeling good, have probably written to me 50,000 and I've been told that you're the only one who understands me, so I think sometimes you can get more empathy from a book than from a person and then an assessment of resistance and that's the new dimension that I've created in the last 10 or 15 years of my work at Stanford that is different from cognitive therapy.

Therapy is in the book and it's still as good as gold, but we've also developed new techniques to eliminate what I guess mental health professionals call resistance, which may not make much sense to the general public, but It seems that when it comes to change we are all ambivalent we want to change and yet we have a shot put in the water one foot on the shore and you can see it clearly probably take an example when I do workshops say how many of you would do it do you like to lose some weight and you know all the hands go up and I say you just made a mistake which is not true you want to lose some weight you definitely don't want to lose weight there are only two things you can do to lose weight and they both suck one of them is you start to eat carrots instead of that delicious cinnamon that you love and everyone else you go out and exercise when it's like it is now and the air is horrible or it might be raining or snowing.

You want to be thin and attractive but you don't want to lose weight, you see and that shows resilience, I mean, and it's huge, and it's also true in depression, people are depressed, it's the worst form of suffering in the world and they say. oh yeah, I would give anything to get better and then I tell them and this is in the new book, well let's say there's a magic button here, you press this magic button and you'll instantly go into a state of effortless euphoria you'll press that button and everyone says oh yeah, I'll set it up, press it and then say, well, we don't have a magic button, but I have some magic techniques and I suspect that by the end of today's session we can probably do it.

All your negativity, all your depression, anxiety, shame and guilt, hopelessness and anger, they all disappear, so let's get back to the post, we will definitely get to that very counterintuitive punchline, but I want to, I want to say it. in what I consider to be possibly the most difficult example for people to overcome postpartum depression, obviously hormonal, well yeah how come it's just your thoughts, yeah well it's not just your thoughts but your motivation for being depressed, but what she was telling herself is that it's me. I'm a failure as a mother, she was having problems with breastfeeding and I and I shouldn't have mixed feelings about having a baby because she wasn't even sure she wanted to have a baby and then she told herself she did. the wrong emotions I should be better off breastfeeding I'm failing as a mother She was beating herself up and it's those thoughts not a supposed hormonal imbalance that's causing her depression Now I can hear the people at home screaming right now that you're blaming the mother for her postpartum depression well, how do you respond to that?

It is never to blame anyone. Guilt is the cause of depression. It's not a

cure

for depression, but it's actually very liberating to discover that your depression is the result of messages you received. you are giving yourself things that are cruel and false and in today's session I can show you how to crush those thoughts and get rid of this depression so that you can enter a state of joy not only feeling less depressed but also feeling euphoric but uh the goal It is never to blame someone, in fact, discovering that you are wrong when you are depressed, that you are giving yourself incorrect and unfair messages is the greatest discovery a human being can make.

I can give you a personal example or us. I can continue with the woman withpostpartum depression because she also has a person, for example, does it have something to do with trains, trains, trains, that was the double whammy because when I first heard you say that I thought it was okay. Wait a second, if this is true then you should be able to take someone who was clinically depressed from two to nine and if they had amnesia their depression would disappear instantly and that's probably why electroconvulsive therapy works temporarily. It's actually not a very good treatment, but you lose your memory, so you forget your thoughts for a few hours.

This is super interesting, I think it would be if you told the story of the train tracks. It was quite enlightening. Oh, that's great. Yeah, after I wrote feeling good, this young man wrote to me and said, "Oh, I read your book feeling good and I love it, but I can't believe that a thought you have to have a thought to have an emotion," he said, and Yeah? you were stuck on a railway track with a train approaching you would be terrified and you wouldn't have to put a thought in your mind and I had read that letter when I was coming home from the airport in a taxi and I put it in my briefcase and I was reading this letter and I thought, my God, I must be a fraud, this makes sense, how do you know, obviously, that if something terrible happens, you're going to be terrified and you don't have to put a thought in your head and, interestingly, as we were turning a corner about a mile from my house, there's a railroad track and there was a car on the railroad track driving on the railroad track and I saw there was a freight train about a mile and a half away, about 60 miles down the road. hour on that track and they don't stop so I told the taxi driver to stop I gotta see if I can get that guy off the train track otherwise he'll get crushed so I ran and you know it was gravel you know , on the edge of the tracks, you know it was a little high off the ground and I went up and I knocked on the window and the car stopped, it was only going three miles an hour or something, he rolled down the window and said oh um uh, can you Tell me the way to City Lion Avenue?

He was an older gentleman and I told him City Line Avenue. To be a joke, it's eight miles in the other direction, but you're on a railroad track and a train is coming. You have to back up to get off the road because I wanted to back up onto the road. so he could turn his car around and then leave before the train hit him and then he started backing up and I took him onto the road now the train is about 30 seconds away and they started honking like they wanted to get out of the way . off the damn track and he was right perpendicular to the train, so I got in front of him and waved my hand, I said back up, now back up, you just have to back up three or four feet and the train will miss you and the guy started. moving slowly and then the train blew its whistle without stopping, braked but skidded and crashed sideways at about 60 miles per hour and the car broke in half and the front half moved about 15 feet or So from where it had been from the impact and I ran to the driver's window again and all the windows were broken and I expected to see a bloody headless corpse, but the train hit just an inch behind his head and it was going so fast it was like when you pull a uh uh like If there was a glass on a table and there was a cloth underneath, you pulled the cloth very quickly, the glass didn't fall and it was something like that and it looked perfectly normal, but there was glass everywhere and he said which direction did you say for the evidence of the city line and I said you just got hit by a train and uh and he said no, he said that's ridiculous, I said oh no, why where?

Do you think all this glass came from where? He says you are right. Looks like someone broke all the windows in my car. I suddenly said where is your back seat? and he turned around and saw that half the car was missing and then he looked at me and said: where is this train? I told him it's right there, it's 15 feet from here and the engineers are running here right now and he says this is wonderful and I say wonderful, what's so wonderful about it, he says, well, maybe me. I can sue and then the engineers came, the police came, the ambulance came, I told my story to the police and I went home and I couldn't understand what had happened, and the next day I was running six miles. and I saw this man looking through the rubble, a younger guy and I stopped and said oh yeah, what are you doing?

And he says, well, you know my father almost died yesterday. He was hit by a train, but someone saved him. his life and I said well that could have been me because I was here and I was trying to get him off the train tracks and I didn't understand why he was driving on the train tracks and I was asking how to do it. I got to City Line Avenue and then the guy said, Well, my dad's had dementia for quite a few years and that's the way it is. He lost his driver's license five years ago, but he forgot it and after dinner he decided to take the family car for a drive and he ran away and went driving and that explains what had happened, but here you have the same situation and I thought , Oh my God, this guy is going to be killed, you see, I felt intense panic.

He had the thought, oh, this is it. great, I'm going to make a lot of money from a lawsuit, so he was happy, same situation, different thoughts, radically different feelings, yeah, look, when you told that story, I actually thought the punchline was going to be good, look um I'm actually doing this but you know it illustrates a point and then hearing that it was actually real um and then there's a it's interesting because it's actually a two way street so you have the thought that it triggers something biological in the brain. , so they did a study where they removed the amygdala from a group of chimpanzees and released them back into the wild due to the inability to feel fear, so within about 48 hours they were all dead because they wouldn't have avoided a predator they would not avoid. limbs that were too small and then if you can interrupt that communication, because if you think something negatively you will get a physiological response and nothing, yeah, you're not trying to say that, yeah, to me it's super interesting.

So, going back to our woman with postpartum depression, she has these thoughts. They're giving him a neurochemical cascade where he has a physiological response to this. Confuse the physiological response with what is actually causing this. How then does it begin to regress? From that, how she, what the process is, keeping a diary of her mood and all that will help her do well. There are two phases. Now, when I wrote feeling good, it was simply how to squash negative thoughts, but. Now I think it's worth explaining that to us, I think people understand the essence of the 10 cognitive distortions.

Well, sure, let's do it and maybe later we can talk about this amazing new thing that speeds up recovery so much. Do you know what she is saying to herself? Well, she's telling herself that it's my fault the baby isn't breastfeeding. I'm a failure as a mother and I shouldn't have mixed feelings about having a child either. Mothers are supposed to just love. your children and uh and those thoughts have all the classic cognitive distortions, for example, uh, should, shouldn't statements having mixed feelings, um, I blame myself too, it's my fault the baby is having trouble, uh, breastfeeding, that one. kind of and she had about eight thoughts and they all had multiple distortions, you know, all or nothing, thinking, looking at things in black or white categories, emotional reasoning is huge, a lot of people are listening right now, it feels depressed and desperate, so he feels like a loser.

They say I must be a loser I feel like a loser I must be desperate I feel desperate hope She is also involved in mind reading thinking oh other mothers don't have mixed feelings other mothers do you know these ideal ideal mothers and that's the The first step is recognize that what you are telling yourself is not true, it is distorted. The second thing is to realize that what you are doing to yourself is mean and I used a series of techniques with her. They were all pretty effective, but a very simple one is called the double standard technique like, uh, I don't remember what I called it, I always disguise people's names and then I can't remember God, I know his real name, but whatever his name. in the book I said, imagine if you were, I was a dear friend of yours and I look a lot like you and I went to the same schools, I got the same grades and I also have a new baby here and I'm not you, I'm a dear friend of yours. and then uh and she and I said could we do a little role play like this?

She said oh sure and then I said, let's give her a name, let's call her Martha and me. I'm Susan and I said, uh, Martha, could I talk to you for a minute? for years and our pregnancy didn't happen and we almost gave up and then suddenly the pregnancy came, now we have this beautiful boy but he is having trouble breastfeeding and I tell myself this is my fault and I am a failure as a mother, that seems pretty valid and then my patient, who was playing the role of herself talking to a dear friend, said, oh my gosh, that doesn't mean do you make any sense?

You know that many mothers and babies have this problem and you know that it is certainly not your fault if your little one has problems with breastfeeding and that certainly does not make you a bad mother and I said. Well, that's cheering me up a little, huh, but I want to make sure that's totally true. Is it 100 true? Or are you just bothering me? You're just trying to cheer me up and she says no. What I'm saying is totally true. right, so I said it, if it's 100 true for me and I'm like a clone of you, then that would be 100 true for you too, that's right, she says yes, so I said write that, we're doing all this in writing and I told her how much do you believe in what you wrote in the positive thoughts column she says 100 and now how much do you believe in the negative thought that this is my fault and she said zero percent and that's how it works but then I wanted to go further there and I said, "Okay, could you help me with that?" but I have another negative thought and I want to see what you think.

I'm not always excited about being a mother and I'll tell you the truth. I've had mixed feelings about pregnancy all the time and sometimes I'm really excited about being a mother and other times I look forward to my job and my career and I feel a little overwhelmed and even a little resentful and surely that makes me a failure as a mother, right? I mean, a mother is only supposed to have loving felines, she isn't and she says that's ridiculous, you know, all mothers have mixed feelings about everything, no one has pure feelings and yes you have mixed feelings. that makes you human, it doesn't make you a failure and I said, that's right, you mean I have a right to have mixed feelings, even resentment about being a mother, I said, she said, absolutely, that's human, all mothers feel that way. sometimes I said this you're lying to me you're just blowing smoke in my face and she says no that's one hundred percent true and I said write it down and then how much do you believe this negative thought?

I'm a failure as a mother because you haven't always known the excited feelings of being a mother and she said zero and that's the kind of thing that's learning to treat yourself with compassion and kindness and realism instead of intimidating yourself with these negative thoughts. distorted and that's really the essence of cognitive therapy and then there's this other great discovery from my weekly training group at Stanford. I have a Tuesday night training group that is free for community therapists because most of them are unhappy and know they are not getting better. results so they can come to Stanford every Tuesday and get free, unlimited psychotherapy training and free, unlimited personal therapy for themselves if they want, and out of that group has come another huge idea that I think is just as big and important as cognitive therapy, that is, it changed. the world of psychotherapy in the 1980s and I think this will cause another massive revolution in the way psychotherapy is done because we have discovered that I still use all of those amazing cognitive therapy techniques, but we have discovered a technique. that makes them work even faster and that than cognitive therapy because you see, in the old days when we only got cognitive therapy, I would think that if I treated someone with severe depression better in 6 8 10 12 sessions, that would be fantastic and it was and that is what is needed now with the new techniques when I work with people, generally I would say 90 95 percent of the time I see a complete elimination of symptoms the first time I sit with them, now that has to be a 90 minute session or a two hour session, I can't do it in an hour, but I can do it in two hours and then it's usually one and done, you know it's a full course of psychotherapy and then I do relapse prevention training and, for the most part, the person is ready to go.

The key idea was that people resist, that they talk about two different types of resistance. This to me is kind of a no. The "you know, look, this is working,but it could still be better" and recognizing that people put obstacles in the road and that you found a way around them is so powerful, yes, yes, it has been mind-blowing because I have never had so much. It is very fun to do psychotherapy because almost everyone They recover. True, the first time I meet them when they get high, I get high, but the essence of it is that Freud called this resistance and people talk about resistance.

Why do people want to be depressed? Why do they want to be depressed? Why do they resist recovery? Because half of the people have a pretty strong resistance half of the people don't, but about half of the people do, but the therapist seems to struggle with effective treatment and we used to think we were trained to think that, oh something, this is their identity, they see themselves as a negative person. so they are afraid to give up their identity or they get secondary gains, they like the attention they get from being depressed and things like that or they like that people feel sorry for themselves and these interpretations of resistance are like uh you put down the patient and I don't think they are true in most cases and they definitely never helped anyone, but what we have found is that noticing something negative about yourself it will not help you, yes, yes, yes, if the therapist convinces you. you just feel sorry for yourself you will feel angrier and more hurt it won't help you in any way sometimes there is a little bit of truth in it sometimes i get angry i want to feel sorry for myself for a little while but it's not the most important thing what keeps people stuck in depression and what we have discovered, let's take the postpartum woman we talked about, one of her core problems is perfectionism, she has had great achievements her entire life and Part of her success is that she always She criticizes herself when she falls short and so when she beats herself up and says I'm a failure as a mother and this is my fault, it shows how loving a mother she really is and it shows that she has high standards. and you want to do what's best for your little one and I don't want to put this back into the context of something that you said at the beginning and I said, It comes to us and I want people to know that we're in this now, which is the notion of the magic button. and getting people to positively reframe, I think that's the term you've given, yeah, where you're going. something that you would perceive as negative and you realize that there is actually something good, so if you can go back to knowing that you present this to people, they feel absolutely horrible and the most powerful example that I think you have of this is the mother of the girl who was shot in the face with a pellet gun and one of her teeth or several of her teeth exploded and multiple surgeries and the mother had let her go out to play and then it's like, oh man, she's hitting herself to herself.

I should never have let her out of it. I am a terrible mother. You know my daughter is suffering. How could I allow myself to be happy again? How did you help her realize that pressing the magic button and doing everything? that anxiety and all that, you know, shame and guilt, like how the hell did you make him see that guilt and shame and anxiety are actually positive? Well that's the really funny and funny thing you see, she had been suffering for nine years since your daughter had been shot at the age of 12 and she blamed herself because she said she shouldn't have let her go out to play that night .

So I'm a bad mother and nine horrible, centaur years. We empathize. I was. treating her in front of a live audience and I said now if there is a magic button here I said well first of all what do you want from this session if a miracle happens what miracle would you want she said well I feel better I'm so tired of feeling 100 guilty, 100 anxious and 100 embarrassed, 100 depressed, desperate and angry, and I said well, let's imagine there is a magic button here and if you press it you will instantly heal yourself effortlessly and enter a state of euphoria, could you press that button?

I would absolutely press it in a heartbeat. Everyone says that. I say, well, we don't have a magic button, but I have some amazing techniques, but I don't think it's like that. It's a good idea to use those techniques and I just said well, why not? You know this is what I need. I have been trying for nine years to overcome my depression. I said well, before we use those techniques, let's see what all your negatives are. Thoughts and feelings show something positive about you and now let's also say your sadness and depression. For starters, you've been terribly depressed because your 12-year-old daughter has had surgeries and failed treatment for PTSD for nine years. and she has been feeling quite miserable so if you press the magic button you will be cheerful and happy so you are saying that you want to be cheerful and happy about the fact that your daughters are suffering for nine years she said oh no, that's not like that.

Sounds good, so I said: what does your sadness show about you? That is positive and incredible. She says she shows how much I love my daughter. She so she leaves that. It's so real. It's so powerful. It's that important. You're telling yourself that the people here in the audience are judging you, that was another one of her negative thoughts. They think you're a bad mother. You think you're a bad mother. What does that thought show about you that is positive and amazing? fact that you're worried that people here in the audience might judge you, she says, I guess that shows that I want a positive loving relationship with them and it's true, she says absolutely, I said, it's so important, she says absolutely, so put that. down shows that I want loving relationships with people here in the group and then you are very self-critical, you constantly beat yourself up I'm a bad mother, I'm a failure, I shouldn't have done this Do you know I should have done that?

What is that program about you that is positive and amazing? She says, well, maybe I have high standards, I said absolutely, that's right, she says yes and I said, have your high standards helped you? He says oh yeah, I do everything I can to help my daughter and I got a PhD in clinical psychology. I've accomplished a lot and I said, is it that important? and she says absolutely, I said, what else does all this self-criticism show about you? That's positive and amazing and she says well, maybe humility, I'm not one to brag about myself, I said, is that humility important, she says yes, I'm a very religious person, it's a spiritual principle to leave humility aside. and then and you're anxious all the time if you press the magic button your anxiety will go away, but what are some of the good things about your anxiety?

Since it keeps me alert to protect my daughter. The last time I let my guard down, he got shot. face so I guess you are saying your anxiety is your love for your daughter she says absolutely so she brushes it aside and then you are angry is that valid? What are some of the beautiful things about your anger? She says, well, the parents. of those children they should never have been let out to play with other children with a loaded rifle uh and then what does your anger show about you karen that's incredible she said well I'm like an angry mother bear I'm going to protect my Daughter, I'm not going to let Let those parents get away with it and I said: Is it that important?

She says absolutely, so we made a list of about 25 beautiful things about her depression, anxiety, shame, guilt, anger and hopelessness, even hopelessness is even a good thing because it keeps her from getting disappointed and angry like it's pointless. that you could sit with dr. burns during a session and cure you, that's like a snake oil salesman, so your hopelessness shows that you are a critical thinker and that prevents you from getting horrible hopes and then being disappointed at the end of the night, she said absolutely like that, so I said, well, look given all these beautiful things about you that we've listed. 25 beautiful things about yourself that are all expressions that you know of these negative feelings that you have these negative feelings because of these beautiful things about yourself and if you press that magic button, they will all go down the drain along with your Negative feelings are that what Do you want she says no, I don't want to suffer but I don't want to give up all these positive core values ​​that I have and then we said well maybe we can make a little compromise here, maybe instead of pressing that magic button we will have a magic dial and you can lower them to a lower level but not to zero, so how sad would you like to be at the end of the night?

Right now it's a hundred, he said oh, ten percent. It's enough, they said, are you sure it's enough? Could I sell you the 20? Now I'm in the position of trying to persuade her to get more upset, you see, instead of trying to sell her something that would only provoke resistance and So she marked them to zero, she felt shame, she didn't need any shame and one of them she just needed the two percent and some I wanted 10 and that kind of thing and now I have made a deal with their subconscious. Count on her resistance that will reduce them to these levels but no more and then I told her now, Karen, that I have to advise you on one thing: the techniques that we are going to use are so powerful that you could surpass your goals such as your depression.

It can go from 100 to zero instead of 10, but don't worry because if you get too happy, I'll try to help you work your depression down to 10 before the end of the night and Then she started laughing and at that moment I knew I had her. and then it was easy, then it took her about 15 minutes to respond to the negative thoughts the same way we played before, using a double standard, she identified the distortions and she didn't. He only reached zero on everything, he actually went beyond zero and entered a kind of state of euphoria and the good thing is that I have all this on video and I am going to show it in a couple of presentations for therapists and there will be one coming soon too. for the general public, so people have to be able to see these little snippets, but that's how it works and I want to go a little deeper into the resistance that you talked about in the book about how there are two types, you have resistance to the results , you know, process resistance, oh yeah, a little bit about that and then I'd also like to better understand whether people are subconsciously identifying that these are actually good traits or is it that. they don't want to confront something negative about themselves no, it's okay um no no uh confront something negative about yourself that wouldn't be true in depression and anxiety it might actually be true when people are angry and vengeful uh that was with the habits and addictions, but in depression and anxiety resistance always results from there being really good and beautiful things in you, but this resistance to results and process is driving me crazy because you actually received the new book, which it's kind of exciting to me, but yeah, there are eight types of resistance there are outcomes and process resistance for four goals depression anxiety relationship issues and habits and addictions outcome resistance is what we just worked on with karen who was depressed about her daughter means that subconsciously you don't want a good result from the therapy and in this case because all her negative thoughts were due to the most loving and beautiful thing about her, but that is the resistance to the result, the resistance to the result for anxiety, it is a little different, uh, what all anxious patients or people feel. like my anxiety was protecting me from something terrible and if it cured me you know horrible things would happen, so for example I treated a woman with obsessive-compulsive disorder who washed her hands 100 times a day thinking she was going to get contaminated and she wants treatment for it and then I said well, I guess I press this magic button and you will be cured.

Would you do that? She says absolutely, I don't want to see you. I said okay, so now you're cured. and then you're not going to wash your hands 100 times a day what's going to happen she says my hands are going to get contaminated and then I said what's going to happen she said well that's going to happen to my children. okay and then what's going to happen and then they're going to get contaminated and that's what's going to happen well then they're going to die of leukemia they're going to get leukemia and they're going to die and then she started sobbing I told her do you still want to press that magic button she said oh no , no, I don't want to pressure him and that's the result.

Endurance. You will see. She thought her anxiety was protecting her and her children. Now the processed resist is a little different process. Resistance means there is something you are doing. having to do that you're not going to want to do it to improve look it's once you've decided I want to improve that's half you're halfway there but now, what is this that you're going to have to do well? What the press patient will have to do is psychotherapy homework and practice writing down negative thoughts, doing the exercises in my books and feeling good and then feeling good and then feeling great.

The crucial thing is to do these exercises because that is where you reprogram yourself. your brain that's where the change really happens and that's why when I work with people I say this is a soft ultimatum if you want to work with me you have to agree to do the exercises if not I'm not the therapist you're looking for because the only thing I can specialize in is and It's fast and irreversible, I care if you want to keep talking endlessly to someone without you knowing. change your life then I'm not the person you areseeking and I lay down the law but in a loving way and then most people want to continue with therapy and they do the homework and 100 of the patients who do the homework between sessions recover 100 of the patients who refuse to do the homework task they do not improve or recover, so it is really important in anxiety, the resistance to the process is exposure, the anxious patient will have to face their fear, their worst fear, and when it happens, it will be terrifying and if you want it to cure your anxiety you will have to face your fears now in most cases I will be there with you I will go with you to face your fears but you must do it by simply talking about your anxiety is not good, it is not going to cure you and I know how important it is because I myself , when I wrote my book, when panic attacks were the focus of all anxiety disorders, I discovered that I had had 11 anxiety disorders when I was writing it I didn't realize this and then in the six months after it was published, I thought of six more, so I had 17 anxiety disorders, I was afraid of bees, blood horses, dogs, I used to have incredible anxiety when speaking in public. something like this would have scared me, how do you do it by talking?

Because if you are going to expose yourself to speak, the audience is not unconscious, you are there, you are exposed, it is a self-narrative, um, how do you do it? How do you do more than just motivation? It is important. I use many techniques, but I can tell you how I overcame mine. If you have time for another story. Yes please, when I was doing my research on brain chemistry. I was invited to go to a prestigious conference in England at the University of Oxford sponsored by NATO and it was called the Institute for Advanced Studies for Metabolic Compartmentalization in the Brain and I was doing computer simulation work on serotonin metabolism in the brain and I was invited to the 80s. the best scientists in the world, brain scientists, and then two younger people who were just starting out and I was happy to receive one of those two invitations and I was terrified because the work I was doing challenged the work that was emerging. from the national institute of mental health the preclinical psychopharmacology laboratory and I could see that their research was not being done correctly they were not analyzing the mathematics that they were using was not correct and they did not have good data, they were losing half of it, they were injecting radioactivity into rat brains and then they were losing half of them so I decided to redo those experiments properly and I came to the opposite conclusion and this was the first research study I had done but I heard that the head of that lab likes to humiliate people in the conferences and that he was going to be at this conference and my talk was the last one at the conference after four long days of listening to these brilliant people and I felt so overwhelmed and and finally it was my turn and the night before I was so anxious that I couldn't I couldn't sleep and I wandered around the Oxford campus and the owls hooted at me mockingly, I was in a panic and I had a fantasy that I was going to The podium he got scared reading and mumbling my talk and that he sat right in front of the podium and at the end he jumped in the air and he started yelling at me and I absolutely believed that that would happen and all day I waited for my turn and it was like death and saying I wish I wasn't here why I came to this conference finally they introduced me and I went up to the podium with my papers and there he was right in front of me sitting in the front row he looked at me exactly like I had fantasized and I got so scared I read and mumbled my talk and then at the end there was silence and the moderator said does anyone have any questions for the young man doctor? and this guy jumped out of his chair and started yelling at me telling me that my work was stupid and that I didn't know what I was talking about and that it was incredibly humiliating and then he sat down and the moderator said: Does anyone else have any questions for the young doctor ?

Nobody said a word, they said this concludes our conference, now we're going to walk two blocks to the restaurant blah, blah, blah, for our celebration, you know, a banquet or something and when I walked there I felt shorter than a piece of land and no one would do it. He walked next to me and when we got there no one sat next to me and it was the most humiliating experience of my life and then when I flew back to the United States halfway across the Atlantic Ocean I finally calmed down enough to to think about what his criticisms were and I had to think that this guy doesn't know what the hell he's talking about, that it was a lot of nonsense he was throwing at me and I and I went to talk to my collaborators who had been helping me and and one One of them was a colleague of Pan, a physiologist named Martin Prang and I had heard that he was one of the two best mathematicians in the United States and he was helping me with the mathematics behind which we were doing a computer simulation of serotonin metabolism in brain.

What we were doing was pretty innovative and I said, I don't think this guy knows what he's talking about and he says David, you're absolutely right. His criticisms just don't make sense, so we did some more simulations and I wrote. I wrote my article and sent it to a magazine and then I got a call. This is a bit of a long story but it has a good conclusion. I got a call in about three weeks from the editor of the magazine and I thought, Oh my God, why are they remembering? They usually don't write rejection letters, they call him and tell him how horrible his article was and he called and said, listen, dr. burns, we received the article from him and something unusual, none of the reviewers had any suggestions to change anything in it and they have unanimously agreed that it should be published, it will be in our next issue, but I wonder if we could submit it to the ae bennett contest.

This is an annual competition for researchers under 35 years of age. about brain research and it's the most important word in the world and you'll be competing with uh nimh, the group you're criticizing, and scientists around the world. Could we send your item? I told you I'm sure not. idea and then he called three weeks later and said you're the first unanimous inventive winner and uh I just couldn't believe my ears and he said can you give a talk to a thousand

psychiatrist

s in New York next month? who were at our meeting to receive the award I said, "I bet I absolutely can and then every night before I went to bed I started fantasizing about, you know, ruining it in front of a thousand psychiatrists, then I forced myself to change the image and in Instead, imagine just talking without notes and telling people how lucky I was to work with martin prang and dave brunswick and how great howell herring and jack jack london are as people on my research team and how fantastic the people were. discoveries we made and how grateful I was and what a fantastic experience it was and I told them I wouldn't accept the award unless they gave my other co-authors the same recipients, which they said they wouldn't do and then I said I want that.

I won't accept the prize and they told me: "Okay, we'll do it" and so they came and I just forced them and I imagine that at the end of my talk everyone would rush to congratulate and the opposite. I tried and I didn't believe it, but I kept trying to think that way and then when the day came, I went up to that podium, my wife came with me to New York from Philadelphia, there were a thousand, you know, researchers in the audience and then I told them about the research and I talked to them about how excited that I was, how grateful I was to have incredibly brilliant people on my research team, and what the implications were of the research and the methods we had developed to do this.

This investigation and at the end everyone ran to the podium and you know, it was exactly how I had fantasized, so that's how I overcame another fear and then the strange thing was, two or three weeks later. This Sloan Kettering group in New York is called He said, Can we come meet you and Martin Prank in Philadelphia because we have an idea and we want to see if you think it's ridiculous or theoretically possible because you see we've been using math. uh and some information to find out what's going on inside the brain and they said they wanted to create something called a cat scanner that could take pictures of the inside of the human brain using electromagnetic material and we thought?

Their math was valid and they thought this was possible. Did we think this was possible? and he didn't have much to say because he didn't have martin's mathematical power but martin looked and he says yeah he said this this is definitely I'm going to work and then they went and developed the world's first cap scanner so anyway that was my uh, my experience with public speaking anxiety and you know, and then you know, once you've had that experience, uh, I, I've had very little public speaking anxiety since then and that's how to know you to me, it's like a big moment that says you know I'm old and I'm turning 78 in a week and everything I have, thank you.

All I have is the experience. Do you know what I mean? What an experience it is to be with you and share these stories that can touch people and change their lives. David, I mean it when I say I'm so grateful for your work and you know what you've managed to put together in those two books alone let alone the rest of your work, feeling good and feeling great is transformative and was originally given to me by one of my employees who had been struggling. with anxiety and he had found this and he knew that I had struggled with anxiety so he gave me a copy oh yeah, as I was reading it I thought oh my gosh, it's so step by step it's so usable it's something you can implement immediately and The more you interact with it, the more evident it becomes how powerful it is and that last example you gave of when you imagine something you're creating that bodily response to what you're thinking and I said you know a lot of people rehearse failure and very few people rehearse failure. success and because you've rehearsed failure you're starting to associate this negative response with something that would otherwise be neutral, so it's no surprise that you then go and act exactly the way you thought. you were going to act, so it's a really rudimentary thing that I think no one has explained as clearly and simply as you and given the ways to relax and I think feeling great really is as revolutionary as you think in terms of dealing with it. resilience and understanding that as part of the process of overcoming whatever mood disorder you're struggling with, so again thank you so much for coming on the show.

I'm looking forward to seeing people embrace the new material, I'm sure they will. It will be as transformative as the last one, so thank you, thank you very much, this has been the best interview I have ever had because of all the effort you put into it. I couldn't believe how good you are and you do it uh it's a great gift for the person you're interviewing and it takes a lot of work and I'm very grateful it's very kind it's the least I can do to show my appreciation for what you've done . given the world um it's amazing okay everyone trust me when I say every word I've said is absolutely true it's amazing his books will change your life if you use them and talking about things you can use if you haven't already made. make sure to subscribe and until next time my friends are legendary, take care buddy, say something out loud, it's 10 times more powerful than if you think about it and then when we start studying the data, particularly the data that you just be reinforced by Christine Porath of Georgetown and Harvard that negativity is a multiple of four to seven times more powerful than positivity.