Episode #188
Positive Reframing & TEAM CBT
ft. Dr Heather Clague & Dr Brandon Vance
Sometimes, without even realizing it, we can stand in our own way of making the changes we need to.
How can you determine if you’re struggling with this?
How can you identify the root cause?
How could TEAM CBT help take your recovery to the next level?
This episode is very unique. My special guests for this episode are Dr Brandon Vance & Dr Heather Clague. Dr Vance is a psychiatrist also specializing in TEAM CBT. Dr Clague is a TEAM CBT level 5 therapist respectively. Working together, they facilitate the Feeling Great Book Club, a special therapy-focused book club that has already helped hundreds of people go deeper with their treatment.
Join me for this episode, where Dr Vance & Dr Clague walk us through a fascinating and moving demonstration on how TEAM CBT can help take therapy recovery to the next level.
Click to listen now!
Full Episode Transcript
Dr Julie Osborn
Hi, welcome to my CBT podcast. I'm Dr. Julie. I'm a licensed clinical social worker and I have my doctorate in psychology, and I'm here to bring the power of CBT into your life. So today I'm super excited. I have two guests with me. You guys are going to love this podcast. First, I want to introduce Dr. Brandon Vance, and Brandon is a psychiatrist in Oakland, California who has studied CBT with Dr. David Burns since 2011. Other tools in his toolkit include ketamine therapy, hypnotherapy, EMDR, and ACT therapy. In his free time, he loves playing Latin music and being a father to his toddler. He and Heather run the Feeling Great Book Club, a professionally guided 12-week online self-help group they'll discuss later in the podcast. And we also have Dr. Heather Clegg, who is a psychiatrist and Level 5 Team CBT therapist, which is the highest level in Team CBT. Team CBT Therapy, we'll talk about as well, and a trainer with a practice in Oakland, California, whose life and practice was transformed by team therapy when she attended a workshop by Dr. David Burns in 2014. She co-leads the enthusiastically received Feeling Great book club and leads groups for deep practice into the Five Secrets of Effective Communication.
In addition to her work as a team therapist and trainer, Heather provides psychiatric consultation in the public hospital system in Alameda County. She's a mother of two young adults, enjoys singing, improv, and powerlifting, and was certified as a Level 2 cat lady in 2024. Can be very proud of. So welcome to my podcast. I'm so happy you guys are here. I'm going to kind of open it up for you to share anything else you'd like to with our listeners and go from there.
Dr Brandon Vance
It's really wonderful to be here. Thank you so much for having us. And I would say that Heather is a powerlifter in terms of psychotherapy and teaching as well. Pleasure to, to be partnering with her in various things that we do.
Dr Heather Clague
Yeah, I would say our, our big partnership is around the Feeling Great Book Club. Um, if we can plug that for a moment, it's, uh, 12 weeks that we read together Dr. David Burns's book Feeling Great. Um,. And we kind of gather in a large group to do a little bit of didactics and, you know, teaching and demos. And then the groups break into small breakout groups that are facilitated and stay consistent over the 12 weeks. So there's really a sense of community that builds as people read the book and do the exercises and learn together. And we've been doing that for like 5 years. Brandon started this during the pandemic. And I think there have been over 800 people who have attended the book club over the many iterations we've done it, formed a really lovely community. Now we have people come back who've done it in the past and they're facilitating the small groups.
Dr Julie Osborn
That's fantastic. That is fantastic. So Heather, can I start with you? Could you share with everybody what Team CBT is?
Dr Heather Clague
Yeah. Oh, just one last thing about the book club. Our next round is starting in September. And if folks want to find that, they can just Google Feeling Great Book Club and it has a sliding scale that goes to as low as anyone needs. So no one's turned away for lack of funds. So we hope folks will check that out. But yeah, to explain, TEAM CBT was invented by Dr. Burns, and it's an acronym. And T stands for testing, which is where we measure kind of symptoms before and after every session. And also the therapist gets feedback from the client after every session. So it's really evidence-based in a kind of micro, you know, session-to-session way. E stands for empathy, and Dr. Burns has developed the Five Secrets of Effective Communication, which is this kind of precision way to communicate that we warmly understand someone. And I know that when I first was introduced to Dr. Burns's work, I thought I was great at empathy. And then I started getting those feedback forms and realized actually I didn't really know what the patient was thinking. And by training in the 5 Secrets and getting humbling feedback from my patients, I've gotten much more skillful, and it's really changed my relationships, which is why I'm so excited about teaching the 5 Secrets, uh, practice groups.
It was actually Brandon came up with that as well. I kind of tagged on to him. He also leads these groups. Um, those are more intimate, kind of smaller groups to practice the communication skills. And then, uh, so that's T and E. A stands for either agenda setting or analysis of resistance. And this is this idea that we may come to therapy or, or self-help thinking we want to change, but actually some big part of us is pretty attached to the status quo. There's actually good reasons why we think the thoughts we think, why we have the feelings we have. And if we don't slow down and acknowledge that, even honor that, then we're going to hit resistance, and our system is going to snap back and it's going to resist any methods that we might have to change. So that's actually what we wanted to talk with you more about today, to sort of think about what's positive about what we think we might want to get rid of. Um, so that's T-E-A, and then M stands for methods, and that's the whole world of CBT methods or hypnosis or, or psychiatric medication. That's That's all the change agents.
But what Dr. Burns' brilliant insight was, if we set that up with kind of knowing where we're at with testing, really deep empathy of feeling warmly understood, and then really honoring what might keep us in the status quo, then we're really set up to change. And change at that point could happen very quickly.
Dr Julie Osborn
Yes. Yeah, that's great to know. And I want to say that when you're mentioning the Five Secrets of Effective Communication, I have at least two podcasts just on that because it's probably one of my number one favorite tools I learned from Dr. Burns back in the day. I mean, it's a game changer. I tell people it's just really powerful stuff. Right.
Dr Heather Clague
So folks should go back and listen to those podcasts if they haven't yet.
Dr Julie Osborn
Yes. And then, Brandon, can you talk a little bit? Like I said, I was so excited. I have two psychiatrists that actually do therapy as well as medication management and share with my listeners why you chose to do therapy as well, because it's just not common Most psychiatrists just focus on the medication and refer out to therapists.
Dr Brandon Vance
Yeah, I mean, I really want to do what works and what works sustainably. So helping people to learn tools to feel well and stay well is a way that they can then be empowered to feel well sustainably. Taking a medication can help and can help in the moment, but with a lot of the psychiatric medications, one has to keep taking them and then one can have side effects. There's also a large placebo effect, and I love the placebo effect. I mean, Whatever works works, and that's great. But there are some risks also to taking medications. And so, and then I've also found that actually psychotherapy for a lot of my patients is more effective than medications, and they don't need the medication. We can just get, we can resolve their depression, their anxiety without medication. And that's really ideal. A lot of times I also talk about diet and exercise and sleep, breathing well, things like that too. So we want to kind of look at the whole, the whole person.. But I found psychotherapy, and especially David Burns' team therapy, or even setting it up in this kind of a context where, like Heather's saying, we do testing, and so we can track how people are doing.
We can give feedback-informed therapy. So when they give us feedback, then we can adjust the therapy to that. We can tune into them with the 5 Secrets. And then this, these parts of, you know, looking at the, the resistance or looking at kind of aligning with, um, around what is the— as Heather says, like, what's the— what's actually good about the ways they are right now and honoring that, that we'll get into more today of the A and then the methods. And so I also think about methods like Heather was saying, we can use, we can use any of the different tools we have as methods. And if we set it up with that structure, then I can do hypnosis or ketamine therapy or even medications and be able to track how somebody is doing and also look at what's kind of causing them to kind of be stuck and then figure out ways to get unstuck. So I really, really love psychotherapy in all those ways.
Dr Julie Osborn
That's excellent. Yeah, no, it must be— it must feel good. I'm thinking as you're talking, being a psychiatrist, like, I'm not— I can— I only have pills for you, right? Instead of just kind of being in that narrow lane, to be like, yeah, you know, maybe, you know, some people definitely need medicine, true, but, you know, there's so much else I can offer you.
Dr Brandon Vance
Yeah.
Dr Julie Osborn
You know, and I find, you know, you always find some people that, I just give me a pill. I just want to feel better. I don't want to do the work. But, you know, I'm finding more people don't want to be on medicine. I am meeting more psychiatrists that are starting to titrate people off medicine more so than add and wanting to do more like referring for therapy. And, you know, and I think people are getting more educated also when they go for therapy and why they seek out cognitive behavioral therapy. Because they've gone to other therapists and they just kind of had some support and, you know, just supportive therapy. I'm like, well, did you learn any tools? And they're like, no. And, you know, they want— people want to get better. They don't want to be in therapy forever, you know. And that's what, you know, what Team CBT can offer— tools. And it's not going to take a long time if you're putting in the work. And people feel much more empowered, I find, um, and more committed to the therapy because of that.
Dr Brandon Vance
Yeah, yeah, I agree. And it's also a deeper relationship with my patients too when we can get into these very vulnerable areas and really see somebody's humanity. And sometimes if you're just prescribing medication, then there— it's— it can be both a shallow relationship and also the person's own relationship with themselves. If they're— when I, when I, when I do prescribe medicine, I, I like to ask people to, when they take the pill, actually remind themselves of why they're taking it and sort of say something kind of affirming to themselves about where they want to get to as they're from that medicine, so that they have more of a relationship to it. Because that's the other thing that we tend to be— we tend to be kind of like disembodied, and we're just popping a pill, and, you know, because the psychiatrist gave us prescription, and— but we're a little dissociated from it, the experience. And so wanting people to have that. But with psychotherapy, we can really delve in and really get to know somebody, um, and then work with them. And it's so fulfilling to see people change.
Dr Julie Osborn
It is, it is.
Dr Brandon Vance
Yes.
Dr Julie Osborn
Okay, great.
Dr Heather Clague
I love that.
Dr Julie Osborn
I'm going to remind my clients regarding that when they take their medication that it is true. They don't think about it. They just kind of take it and move on with the day.
Dr Brandon Vance
Yeah.
Dr Julie Osborn
And thinking what's the purpose in this?
Dr Brandon Vance
Yeah. The thing I was thinking about as Heather was mentioning TEAM and the acronym was that it can also be— it is an acronym. And also it can be about being on a team with our therapist and also on a team with ourselves. Like, are we fully aligned in what we're doing, whether it's taking medications, whether it's therapy, whether it's our process of kind of getting unstuck. And also, are we kind of at odds with our therapist? Are we like a little bit resistant? And we're like, oh, but, but wait, my anxiety is like motivating me to, to, to, you know, take care of myself, to be safe. I don't want to let go of that. And but the therapist is kind of pushing me to drop my anxiety because they have all these great tools. So how can we be on a, on a team with our patients, with our clients?
Dr Julie Osborn
Right. Okay, cool. Well, let's, let's go into that regarding if wherever you guys would like to start, you know, what we want to focus on today regarding the positive reframing.
Dr Heather Clague
Yeah. Yeah. So, um, so this gets to the T, the A of TEAM, um, which is, you know, kind of analysis of resistance. That sounds a little cold. Um, I think of it as actually a very warm intervention or warm process. And we thought Brandon and I might model that, um, sort of how that might go. And of course, this is something that adapts very well to self-help as well. We'll, we'll do it sort of as a dialogue, but you can do this with yourself, and, and our listeners could even kind of, you know, think about these questions we're going to ask as they listen along.
Dr Brandon Vance
And sometimes they even think about the A as alignment. I mean, there's different, different ways of using that, but like, how do we— how are we going to get aligned with, with the people and with, with the process?
Dr Julie Osborn
Yeah, that's good. I love that too. Okay, excellent. Okay. Yeah. If you guys want to maybe explain it a little bit or you want to get into the role play first, what would work best?
Dr Heather Clague
Yeah. Brandon, do you want to be the therapist or the client?
Dr Brandon Vance
Oh, I'll be the client. And I think anxiety is kind of a nice place to start because it's more clear, a little more simple.
Dr Julie Osborn
But yeah.
Dr Heather Clague
Yeah.
Dr Brandon Vance
How about—
Dr Julie Osborn
Yeah.
Dr Brandon Vance
So I'll be the client. Do you want to— Yeah.
Dr Heather Clague
Sure. So let's imagine that Brandon and I, we've met together maybe for a session or two. Usually this can come pretty quickly, and, you know, in, in a team, CBT therapies might come— it could even come in the first session. But let's imagine that Brandon has told me about what's going on with him. You know, we've, we've tested his symptoms, and we see that, for example, his anxiety scores are quite high, you know, in the moderate to severe range. Um, and Brandon, let's imagine for the sake of this, what kind of anxiety do you think you're suffering?
Dr Brandon Vance
Yeah, let's say, let's say I've just finished a podcast and I. And then I'm obsessing over it. I'm like, oh, I shouldn't have said that thing. And I feel it's like really a lot of anxiety in my gut. And I'm just like really tense. And I'm like, oh, I wish I hadn't have phrased things that certain way, because maybe people will think I'm, you know, not very smart, or maybe Julie might have not enjoyed working with me, or maybe I wasn't very clear. So I'm going over these thoughts kind of obsessively, and my gut is kind of wrenched, and I'm kind of walking around the rest of the day, and I can't sleep at night. And so I have a lot of anxiety about it.
Dr Heather Clague
Okay, great. And, and then let's imagine right now, what— how intense is that anxiety from 0 to 100?
Dr Brandon Vance
Uh, let's say, so let's say we're, we're, um, in the session and the anxiety is a 7.
Dr Heather Clague
7 out of 10?
Dr Brandon Vance
Oh, sorry, 70. Yeah, 70 out of 100.
Dr Julie Osborn
Okay, great.
Dr Heather Clague
And, and again, in a team CBT session, we probably would have written this out on a thought record. So we'd have all that data in front of us. We'd have the, the emotion scores and the specific thoughts that he wrote down. Um, and then I would, um, I would ask the magic button question. I'd say, you know, Brandon, we do have some powerful tools to change how you feel, but before we do that, I'd like to kind of do a little thought experiment for you. And just imagine there's this red button right here in between us, and if you push that button, all these challenging emotions are going to go away, all these difficult thoughts. You're not going to be obsessing. You're going to sleep like a baby. Um, would you press that button?
Dr Brandon Vance
Yeah, yeah, I would love to. I just— this anxiety is just too much. It's just yucky.
Dr Heather Clague
And that totally makes sense to me. Yeah, you'd want to be at peace. Yeah, 100% makes sense.
Dr Brandon Vance
Thank you.
Dr Heather Clague
How much you're suffering. Yeah. And before we do that, just— would anything get lost? Because once you press that button, you're just going to be euphoric on cloud nine, even though maybe you did kind of suck on that podcast a little bit, you know, like you're gonna— that's not gonna bother you at all, you're going to want to do the next podcast with zero anxiety. Would you, would you still push that button, or would there be any hesitation to make all the anxiety disappear?
Dr Brandon Vance
Oh, I know I'd love to just not have anxiety. Um, and yeah, the next podcast is don't have any anxiety, and sure, no, that'd be great. I would press it for sure.
Dr Julie Osborn
Yeah.
Dr Heather Clague
So you can't think of any way in which anxiety could actually be positive for you in your life?
Dr Brandon Vance
No, it's really yucky.
Dr Heather Clague
You just want to be someone who was always at zero for anxiety, 100% of the time?
Dr Brandon Vance
Well, I don't know, always at zero. I mean, it seems that would be a little weird. It would seem like I'm like in a TV show or something.
Dr Heather Clague
Yeah, yeah. What, what might go missing if you could never feel anxiety?
Dr Brandon Vance
Well, I mean, I feel a little sad as you're asking me that. I guess maybe it's because I think I might be disconnected from people a little bit, like, because they'd be feeling anxiety and I wouldn't be feeling anxiety, and I would just be like, everything's totally cool. And I don't know if I could relate to people as well.
Dr Heather Clague
So one way that you actually value anxiety is it helps you relate to other people when they might feel anxious?
Dr Brandon Vance
Yeah. And I think it's just being human. Relating to other people.
Dr Heather Clague
Yeah, yeah. And, and is there any way in which anxiety could actually be useful in, in your life?
Dr Brandon Vance
Uh, I mean, I guess it gets me to, like, you know, kind of, kind of gets me to get up in the morning sometimes and gets me to, to maybe prepare, like, prepare for a podcast or what— I mean, this example, but like in anything, like, just prepare for things, um, get my act together a bit.
Dr Heather Clague
Yeah, because I actually saw how much you were actually preparing for that podcast with Julie. You made sure that the sound was right and you had your kind of list of talking points. Um, it seems like the anxiety kind of motivated you to, to actually do a good job. Is that, is that right?
Dr Brandon Vance
Yeah, yeah, I think, I think it did.
Dr Heather Clague
If you had zero anxiety, you might have been a little— which, could you have been a little bit cavalier?
Dr Brandon Vance
Yeah, I don't think— right, I don't think I would do things quite as well. If I had no anxiety. I think I wouldn't— wouldn't— yeah, I think I'd be cavalier. I think I wouldn't really try as hard.
Dr Heather Clague
Yeah.
Dr Brandon Vance
Yeah.
Dr Heather Clague
And what does it say about you that you've had some anxiety about this podcast with Julie?
Dr Brandon Vance
I mean, it says that I, I, I really respect her and, and I respect you and, and, uh, that I want to also communicate the things that are important to the listeners Um, so all of that's important to me.
Dr Heather Clague
Your anxiety is actually a reflection of how much you care about doing a good job, is that right?
Dr Brandon Vance
Yeah, yeah, yeah.
Dr Heather Clague
Does it, does it show you have high standards?
Dr Brandon Vance
Yeah, that's— I mean, or at least whatever standards, but yeah, some, some kind of level of standards, like wanting to do better. Yeah, yeah.
Dr Heather Clague
I mean, are these things that we're mentioning, is this, is this real, or are you— I mean, are these actually important to you, these qualities of anxiety that we're mentioning? Is this—
Dr Brandon Vance
yeah, those are, those are important. Yeah, but I mean, I just would— I don't want to feel the anxiety. I mean, I'd love to like— yeah, I mean, those things are important. So if I can just have those and not feel the anxiety, that'd be cool.
Dr Heather Clague
Is that possible for you?
Dr Brandon Vance
I'm— that's what I'm coming to you for.
Dr Heather Clague
Oh, so, uh, you'd say you'd want to— you'd still want to be motivated to prepare and you'd want to really care about the podcast And you wanna, um, you'd want to get some feedback if, if there was some concern or danger, but you'd want to do that without any— with zero anxiety.
Dr Brandon Vance
Yeah, I mean, I do hear you're a miracle worker, so I'd like to like have that. Um, what's the point of a cake if you can't eat it too, right?
Dr Heather Clague
So like, I mean, it, it could be possible. I'm, I'm, I, I, I could be. I, I guess I know that for me in my life, anxiety has been kind of a friend. Help me anticipate dangers and help me anticipate, like, it does help me prepare. But maybe for you it's different.
Dr Brandon Vance
Well, um, never thought about it that way, be a friend. Um, I think I've had a relationship with anxiety that's been— I've been trying to kind of push it out of my life a lot. Um, and so I, uh, it kind of blows my mind. I'm not sure even what to think about that.
Dr Heather Clague
Yeah, well, I think when, when anxiety has been screaming at you so loud, right, if someone's just screaming at you, it's kind of normal to want to plug ears and make them go away. And what we're offering here is maybe something a little different, where instead of just trying to stop the anxiety and make it go away, can we actually listen to what it's trying to tell you? And can we, can we reflect on, on the positive qualities that it shows that you have? And I'm just curious, because you said you were up there at like 70 out of 100 anxiety, and, and as you start to kind of reflect on what why the anxiety is showing up and what it's trying to do for you. Just wondering how you're— yeah, kind of what level of anxiety you're having now as we're reflecting on what's positive about anxiety.
Dr Brandon Vance
It's, uh, I mean, it's actually, uh, it's going down mostly, um, although sometimes when you say some things it goes up a bit. I'm like, oh, am I gonna keep this? And then I start getting anxious about that. But, but overall it's actually going down a little bit. And as I'm kind wondering about, yeah, what is— I mean, if I could have a different relationship with it, in, in a way it would get a lot lower, I think, um, just, just because I'm listening to it somehow.
Dr Heather Clague
Yeah. I mean, you had a really particularly strong reaction of anxiety after this podcast, and I'm just again wondering, what, what does that show you care about? What is your anxiety connected to here in terms of your values?
Dr Brandon Vance
Yeah, I mean, it— I mean, it— I think it does show I care about, um, care about connecting with people.
Dr Heather Clague
Uh, yeah. Is that real?
Dr Brandon Vance
Yeah, that's real. Yeah, yeah. And shows I wanna— I wanna communicate some things that are really important to me that, you know, that, um, that I want to get across. And if I don't get those across clearly, that feels like a shame, like that's too bad to not be able to do that.
Dr Heather Clague
Well, I guess I'm wondering, you know, we don't actually have a magic button, but what if we imagine there was a magic dial?
Dr Brandon Vance
There's no magic button?
Dr Julie Osborn
What?
Dr Heather Clague
Well, what if, what if instead of eliminating anxiety altogether, we could help you turn it down so that you could keep what's really valuable about the anxiety, keep how it's helpful, keep the values it's connected to, but it wouldn't be shouting so loudly at you that you just wanted to close your ears over it.
Dr Brandon Vance
That'd be really nice. I mean, in a way, that would be even better than a magic button, because I mean, I think you've convinced me that like, they're like, if it'd be a little weird to be not anxious at all, and it might not motivate me, and it might not really show that I care.
Dr Heather Clague
Yeah.
Dr Brandon Vance
So that does make sense. So I'd rather have a magic dial, actually, if there's— but I mean, is that also not real? Can we, can we do that?
Dr Heather Clague
Well, we'll get there. We do have powerful tools. Um, but let's just, just stay with saying with the magic dial. Let's say you could dial the anxiety down.
Dr Julie Osborn
Right now you're at 70, and I agree that's It's pretty high.
Dr Heather Clague
You can't sleep, you're ruminating. But let's say we could dial it down to a place where it still could give you useful information, it reflects what you care about, but you wouldn't be kind of numb and walking around just euphoric all the time. What, what level would you dial it down to?
Dr Brandon Vance
I mean, I'd like it to be zero when I'm sleeping at night, and I'd like it to be maybe, um, yeah, I don't know, maybe 20%, um, when I'm— I mean, I guess I kind of like it to be a little higher before the podcast, so I'm preparing, and I'd like it to be lower after because there's really nothing I can do at that point. So I'd like to kind of accept how things are. Um, so I mean, but maybe average, like, yeah, I'd say 20-ish, but maybe, maybe a little higher before, a little lower after, and none at night so I can sleep well.
Dr Heather Clague
All right. And how— and just remind, how high is it right now?
Dr Brandon Vance
Well, it's about, it's about 55 right now. It's going to come down.
Dr Heather Clague
So it already came down.
Dr Brandon Vance
Yeah, it's weird.
Dr Heather Clague
Yeah. Well, that's why in the, in the, in Team now we have methods and we have very powerful methods. And it's true, there's no magic dial, but there are some very powerful methods that we can use. And just for the part of you that's anxious to know, we're not trying to get rid of it. We're not trying to turn it down to zero. We want it to show up when it's useful. And then we can let it take a break, for example, when you get to sleep.
Dr Brandon Vance
Yeah.
Dr Heather Clague
So let's pause there for a second. Coming out of the role play, hit the pause button.
Dr Brandon Vance
Discuss that a little bit.
Dr Heather Clague
Yeah.
Dr Julie Osborn
That was great. That was great. One of my thoughts when you were talking was reframing what it says about you, but also just reframing the word. Like, anxiety isn't always this bad thing. Feeling depressed isn't always— and all of your— I mean, all of our emotions are important because it makes us human, right? And that, you know, I always tease people like, you know, people that are happy all the time kind of annoy me.
Dr Brandon Vance
Right.
Dr Julie Osborn
I don't feel like they're real. They're not being vulnerable. Everything's just wonderful. So, you know, if you look, say, oh, this is all about me. And anxiety isn't just negative, right? So everybody's always like, don't feel anxious. Don't be depressed. Like, you know, I don't know what else, you know, where to go from there. But you're also just even almost reframing the word, you know, as you were doing this, you guys did a great job, you know, just Like anxiety isn't actually always bad.
Dr Brandon Vance
Yeah.
Dr Julie Osborn
It's kind of what I heard you saying also, if I was like a listener. Mm-hmm.
Dr Brandon Vance
Mm-hmm.
Dr Heather Clague
Yeah.
Dr Brandon Vance
I think that, that speaks to kind of the, my relationship with anxiety, which I think is really important, which the tradition, what you, we had mentioned ACT a bit before, Acceptance and Commitment Therapy, and that talks a lot about our relationship with our thoughts and feelings. And so we're changing that relationship a bit, even without trying to change the anxiety. We're changing my relationship with anxiety. And by doing that, then it becomes less of a problem. So even her, her questions to me just did, did kind of change my relationship with it.
Dr Julie Osborn
Yeah, it doesn't have to feel as scary. Yeah. And so it doesn't feel as good, right?
Dr Brandon Vance
Because it's not like anxiety is something I have to get rid of, but it's like, oh, okay, well, I mean, if you think about it, most of our—
Dr Heather Clague
I think our problems with emotions is when we have that emotion about the emotion.
Dr Julie Osborn
Right?
Dr Heather Clague
If we feel anxious about being anxious or sad about being sad or mad because we're mad, that's what escalates and amplifies things. But yeah, you know, when anxiety comes, they could say, "Oh yeah, okay, what is it trying to tell me?" Like, "Oh, I better prepare and I really cared about my performance." And right then it's like, I've heard the message. It doesn't, again, it doesn't have to shout so loud. And in my experience, it tends to kind of come through as a wave. And then, then I can move on to the next thing. But I'm grateful to it, and I don't— I'm not afraid of having those emotions.
Dr Brandon Vance
Yeah. So it's like staying dynamic, letting things go through. Emotions are human, but when they can come and go, that's one thing. But when they're stuck, and sometimes our thoughts about them and thoughts about things in the world, or what David calls our negative thoughts, those can keep that alive and keep us stuck in the swirling amplification loop.
Dr Heather Clague
Yeah.
Dr Julie Osborn
Right. So being able to reframe and say, yes, so what does my anxiety tell me? Like, I really want to do a good job. I want to help out with the podcast. I want to have everything in place. We're here to be of service to other people and teaching people these tools. So I'm glad that I had some anxiety this morning because it made sure I took care of everything before we got the podcast started. And I was able to communicate what I want. And then you're like, oh, OK. Like, oh, I'm glad I felt that way. And now I don't have to hold on to it anymore because now we're done.
Dr Heather Clague
Yeah.
Dr Julie Osborn
Doing that particular thing. Right.
Dr Heather Clague
So I think many people, I mean, I think folks who suffer from severe anxiety, it might take a little more work for them to appreciate how it can be positive because when you've been almost traumatized by extreme dysregulated emotion, it's totally natural to just want it to go away. And this is this idea of the dial is if we can bring anxiety back into a place where it is a useful signal again, you really see you don't have to be afraid of it. And I think most people who don't suffer from anxiety disorders kind of get that intuitively, right? Like, yeah, it's like you'd want to feel anxious if there's a danger, right? You'd want to have a signal that there's a problem that needs attention.
Dr Brandon Vance
Yeah, but if you've burned your hand on the stove, you're not going to want to go anywhere near that stove. And you just think of that burner as really evil, really horrible.. And but the idea of just getting a little warmth from it, right, is like, oh my God, you know. So yeah, that makes a lot of sense on what you're saying, Heather.
Dr Julie Osborn
Yeah, I'm glad you— and for Heather, I'm glad you brought up, like, you know, for people that might be listening that have been a lot of trauma and thinking, oh, my anxiety is like, you know, the worst thing in my life. What are you guys talking about? Right. You know, to be able to start, like, dial it down a little bit. And, you know, what part— of course I want to get rid of this intense anxiety that controls my life, but I always want to be mindful in my surroundings and things that I need to be— that I need to worry about or be mindful, you know, be aware of, I should say, you know, and kind of just give it a different perspective of looking at it just as a bad, bad thing.
Dr Heather Clague
Right. Exactly. That we're not saying that, yeah, PTSD-level severe panic trauma anxiety is a great thing and we want more of it. Yeah. We're saying it's actually connected to— it's an extreme and sort of dysregulated version of something that's really normal and healthy. And so that's where, you know, if, if someone does an anxiety disorder, there may be like— again, if someone doesn't have an anxiety disorder, sometimes just this positive reframing is enough. But if you do, then you might need to do methods like exposure work, right, where you sort of get to know with, with a supportive context, you get to know that anxiety in the extreme level, you know, and, and change your relationship with it so that it can settle down and it doesn't have to go to this kind of PTSD level.
Dr Julie Osborn
Yes. And then can you guys share, because when we started the explaining that you were saying you can do this with yourself, this exercise. So can you give, you know, the listeners some tools? Like, how could you do positive reframing if it's just, if you're just by yourself and not in front of a therapist?
Dr Brandon Vance
Yeah, I mean, one thing I wanted to mention, and it kind of leads into that, is that one of the things that in studies that seems to be helpful in terms of this process of psychotherapy, like, how does this work? And how does, how is like team CBT and CBT? Effective. And some of it has to do with disrupting expectation. And so setting this up in this way of like a magic button, which one can ask oneself that question and sort of do this as a thought experiment, like Heather was saying. So then that sets us up to kind of have an artificial all or nothing. Yeah, I would love to press that button. Let's take away all the anxiety. And then that next question of, well, wait, but could there be something helpful about the anxiety? Then that lets this kind of light bulb go off of, oh my gosh, wait, I've thought, I've seen this anxiety as a monster, and yet maybe there is something there. It lets me see it more as a, you know, see the vulnerability behind the monster. The monster has no teeth, like see, develop a different relationship.
And so then we can ask a few different questions. I would say when I would do it by myself or with somebody doing it by themselves, they could ask themselves, okay, well, if we had a magic button and we'd press it, it would take all the anxiety away, for example, and this is going to be anxiety. We can go one by one through the different kinds of feelings and do this with each feeling. But if it would take away, let's say, anxiety, it took it all away and I just feel perfectly calm, perfectly good, would I press that button?? And then I could write, you know, I could write the answer to that. And then I could say, well, could there be any reasons not to press it? And that's sort of a general question. And I would break it down into maybe 4 sub-questions. One would be, and the first I like to do would be around, what does this say about what, what's important to me? So what does the anxiety say about what's important to me, which Heather had asked me.. And then, how might the anxiety be trying to help me, actually?
What, what might, what might be helpful about it? That's another question. Another kind of offshoot that I like to ask that has to do a little bit more with ACT, this other kind of therapy we've been talking about, Acceptance and Commitment Therapy, is, is this feeling, and in this case anxiety, trying to help me do something, trying to get me to do something important?— again, get me to change something, actually act differently in my life. I mean, we can ask this with the different feelings. In this case, we could say the act— one of the advantages of the anxiety is that it's motivating. It may be— and then it's kind of very related to that to say, you know, maybe it gets me to like study more, like do more preparation or something in this example. But I like that about kind of like Should I— maybe, maybe it's really important to, to be there because it's trying to get me to do something differently in my life. And then the, the last question would be, if we're trying to change something, we want to honor it. And before we get rid of it, what would be lost if we get rid of the anxiety?
If we just drop all the anxiety, what would be lost? And that's, you know, in a sense, you know, kind of the opposite of, you know, How is it helpful? But it helps us think about it in a different way. And so, wow, if I didn't have any anxiety, what would that be? And for me, actually, I was surprised. The first thing that came up was maybe I couldn't relate to people as well because I would just be like, I don't feel any anxiety, but other people are having a normal human existence and I'm not feeling right. And I wasn't even expecting that to come up. But, but that's an important question too. So we can answer each of those questions. So what, what does this feeling say about what's important to me? What, um, what is it, uh, how might it be helpful to me? What is it trying to help me to do or to act differently in my life? How is it trying to kind of maybe get me to do something different? And without it, what would be lost? And then we can write the answers to each of those questions.
And then once we have that information, then we can circle back to the magic dial as Heather, and we can say, well, what, what level would I want to dial it back to? Um, sometimes there can be a little more nuance to that. Like I was saying, like, you know, I'd love to kind of compartmentalize it some or not have it at night or what, you know, but I think even just that global question and, and that question helps us think about it differently too. It's like, if I accept, maybe I really want some of it. Maybe I really want 20% of the anxiety. It's not just about trying to push it lower and lower and lower, but wait a second, some level might be too low. I don't want just 5% because I need more of a signal to be able to prepare, to really show that I really care, to be kind of present in this life and wanting to connect with people. So we can ask all those questions, do the magic dial, and that then sets us up for the methods later.
Dr Heather Clague
Yeah.
Dr Julie Osborn
So do you guys agree that when you ask someone with the magic dial, like, what percentage do you want? That then you're taking control over feeling anxious versus it happening to you.
Dr Brandon Vance
Yeah, I think that's such a, such a magical part of it because that also changes our relationship. We're not— it's not about fighting the anxiety, it's about like, hey, yeah, I want this amount, I want some, right?
Dr Julie Osborn
I've said before, some other podcasts, that, you know, it's like I used to, um, other things I like— worry. Like, I have kids, right? We all have kids here, you know, and I always say I'm never going to stop worrying about my kids because I love my kids, but I don't want it to keep me up at night. Right? So I'm not looking to get all my worry out of my life, right? Because that's just— it shows, like I said, I love my kids. I care about it. I hope they're safe. They're doing well, whatever. But I don't want it to be where it's affecting my life negatively.
Dr Brandon Vance
Right?
Dr Julie Osborn
So I just—
Dr Heather Clague
Follow on with what you said there, Julie, about, again, it's changing the relationship. Because if I feel like a victim of my anxiety, and I might spend all day fighting it off and trying not to feel it, When is it going to come? It's going to come at night when finally I'm too tired to keep fighting it. Whereas if I'm willing to treat my anxiety as a partner and take it seriously and let it be here with me during the day, I might even sit down and do— there's a method called worry time where I actually sit and really let it say everything it wants to tell me. Right? You could think of that as an exposure method, but I think of it as like a relationship-building method. Like, sure, like, you know, I'm going to invite you in when it's a good time for us to work together. And then chances are it's not going to feel the need to wake me up at night because it got Got to say it's peace.
Dr Julie Osborn
Exactly. No, that's why I mean, there's so many tools, right? Just as we start talking, it's like, oh, we have this, we have this. And that's what, you know, with seemTBT is it's so great because, yeah, if this one doesn't work, we have this other one. And, and there's lots of different tools. So, you know, as for the listeners, I, you know, you don't have to master every one, right? You want to figure out which ones work for me and do a little bit of this, do a little bit of that, and maybe hone in on specific ones. But, you know, all of them take some time to, to get, you know, to get good at and to master. And hopefully we're kind of planting the seed today for people because all, you know, all the time you guys probably hear this too, is when I first introduced like positive reframing, you know, most of my clients be like, I never thought about it that way.
Dr Brandon Vance
Yeah.
Dr Julie Osborn
You know, I thought you were going to say this or this or that. And they're like, they're kind of speechless a lot of times, you know, because they're like, like I, I never thought there was anything good about it.
Dr Heather Clague
Any—
Dr Julie Osborn
my, you know, my negative moods.
Dr Heather Clague
By the way, I wanted to just plug one more self-help option, which is our book club. I mean, the positive reframe is really— there are many examples of it in Dr. Burns's Feeling Great. And some people are really good, they can learn from a book and do the pen and paper exercises on their own. I know for me, I need a little bit more social support and accountability to do that kind of thing. And but it doesn't have to be with a therapist, right? We could— that's something that we do together in the book club.
Dr Julie Osborn
Yes, exactly.
Dr Heather Clague
We'll be starting in September if folks want to join us for that.
Dr Julie Osborn
And I think like any support group, right? Like, you guys are the leaders, but then when you're with other just, you know, people in the community, you don't feel alone. Like, there's all these— I mean, you guys have said 800 people have come through, which is incredible. Like, I'm not alone. I'm not different. There's lots of people that feel like me. So it's not just, oh, here's the therapist who's, you know, smart and is going to teach me something., you know, there's other people in my community that you can feel comfortable and walk through this with also.
Dr Brandon Vance
Yeah, I think that's huge. I think that's huge. Um, and so we have, yeah, like, like Heather was saying, we have, you know, maybe 60 people in the big group and then we'll do demos and then we break out into small groups of like 5 or 6 and that small group continues throughout the 12 weeks. And so people can get more and more vulnerable. And like you're saying, like, so it's, It's very powerful to hear something from somebody else who has gone through something like you have. And a lot of times therapists don't disclose a lot about themselves. And also that might be a way where we don't connect as well with our patients as, you know, somebody who's been through the same thing and, and reveals that they've been through the same thing. Um, sometimes David encourages us to disclose a little more and, you know, be just real people with our patients, but Right.
Dr Julie Osborn
But yeah, it's just like with anxiety, when we're saying all these other moods, it might be more difficult, but I think a lot of times like shame gets connected to it and being embarrassed and yeah.
Dr Brandon Vance
Right.
Dr Julie Osborn
All these. So then when you're in a group setting and people are like, you know, shaking their head, like, oh yeah, I know what that feels like.
Dr Brandon Vance
Right.
Dr Julie Osborn
Oh yeah. I've been there. You know, that shame can just kind of melt away because somebody else really knows how I'm feeling and thinking, and they're not going to judge me because they've gone through the same stuff or they're going through it right now.
Dr Brandon Vance
Yeah.
Dr Heather Clague
How are we doing on time? Because we were thinking it might be— because I think most people can relate to maybe anxiety being useful, but I think when we get to emotions like shame or hopelessness, people can feel like, well, how could that possibly be positive? Do we have time to think about that together?
Dr Julie Osborn
Yeah, you know what, we're together today. So yeah, let's do one more with that. That would be a great way to to show, like I said, more, you know, difficult emotions that seem to be, you know, hard to let go. Yeah. So if you guys want to role play that, that'd be great.
Dr Brandon Vance
Yeah, sure.
Dr Heather Clague
Yeah, should we switch roles?
Dr Brandon Vance
Yeah, let's switch roles. Yeah, yeah.
Dr Heather Clague
Um, okay, maybe we'll follow— let's just imagine that, you know, we've had the podcast and I'm feeling really, you know, embarrassed about how I, you know, showed up in the podcast. And again, I'm ruminating at night and I just I feel really kind of ashamed and I'm afraid that like, you know, any of my colleagues are going to listen to this. And yeah, I'm just feeling really inadequate and insecure and ashamed about how I performed in the podcast. And it really about what it says about me as a person that I would have performed that badly.
Dr Brandon Vance
Okay. Okay.
Dr Heather Clague
Telling myself that—
Dr Julie Osborn
go ahead.
Dr Brandon Vance
Tell yourself that.
Dr Heather Clague
Yeah, I'm telling myself that I'm kind of a loser and a jerk and Yeah, that I'm really kind of worthless.
Dr Brandon Vance
Okay, okay. And do we want to include a little bit of hopelessness in there too?
Dr Heather Clague
Sure. Yeah. And I'm—
Dr Julie Osborn
why not?
Dr Brandon Vance
Yeah, why not pile it on? Yes.
Dr Julie Osborn
Yeah, yeah.
Dr Brandon Vance
Okay. Yeah. So of course, first we would really empathize with Heather and, and how, how difficult that is to feel, you know, ashamed and afraid of how people think about you and inadequate. And you mentioned loser and jerk and some labels. And then we're sort of thinking about worthlessness and hopelessness. So we sort of really want to empathize and go through the TEA, well, the T testing and then the empathy first. And maybe as an aside, actually, while we're thinking about before we dive into the roleplay, Julie, you mentioned the Five Secrets, and as we're like empathizing, we're really— part of the Five Secrets is finding what's right in what the other person's saying. For example, if we're in conflict, we'd want to find, you know, the disarm would be finding what's right in what they're saying. And there's kind of an analogous thing that we're doing with emotions. We're finding kind of what's right in the emotions by doing this like process of saying, wait a second, is there something actually helpful about these feelings? So after after empathizing with Heather, maybe I'll jump in at that point and be like, Heather, gosh, you know, you've mentioned all of these feelings that we've talked about, and I wonder if we could do a thought experiment at this point.
And if we imagine that there's this magic button here between us, and what I mean by magic is if you press the button, all these feelings that are so painful that you've been describing would magically go away, you'd just be relieved of them. It would— they would just go away, and you'd actually be feeling good and good about yourself and good about how you did on the podcast and just feeling really comfortable in your own skin and, and just, just good. Um, would you press that button?
Dr Heather Clague
Yeah, yeah, please let me press it.
Dr Brandon Vance
Yeah, I mean, I— gosh, uh, you know, I can certainly relate to that and wanting just to, just to have it all go away. And yet in this kind of thought experiment, I'm wondering, could there be any reasons to even hesitate? I mean, you sound like you just press it right away. Is there any reason to hesitate? Is there anything that all these feelings might mean for you or be doing for you? Any reason you might not press it?
Dr Heather Clague
I mean, feeling something positive about feeling worthless and Yeah, yeah, yeah.
Dr Brandon Vance
Could there be— I know it's almost a strange question to ask, but could there be something actually positive about that? Um, maybe, and maybe to start, maybe something that it might— that those emotions might be kind of meaningful for you in this moment. So you've just done this podcast and you're kind of flooded with all these feelings, and what does that say about what's important to you, about your values, or what's really meaningful to what kind of person you are?
Dr Heather Clague
Yeah, um, well, I really wanted to do a good job.
Dr Brandon Vance
Yeah, yeah, yeah. And is that, is that important to you as a person, to do a good job?
Dr Heather Clague
Yeah, I mean, I think of being competent as like this gift that we give to people.
Dr Brandon Vance
Hmm, yeah. So it's, it's important to you as a person, and it's a gift that you give to people, being competent. Say a little more about that.
Dr Heather Clague
Well, I just want to be able to communicate well about this really cool stuff. And yeah, and, and yeah, so it feels kind of miserable to think that I did that badly and that people won't learn from, you know, the podcast. And, and so yeah, I really, um, yeah, I guess that, I guess that's funny, it really matters to me. And it's like I want to be able to show up as a good, competent person.
Dr Brandon Vance
Yeah. Yeah. I mean, I see how important that is to you, and that's a beautiful thing. And you mentioned shame like that. Yeah, that sounds like a really tough feeling. And specifically in terms of shame, if that were to go away completely, you would press that magic button, relieved of all of that. Anything good about that specifically?
Dr Julie Osborn
I don't know.
Dr Heather Clague
Can you help me out here? I'm struggling. Such a terrible feeling. I can't imagine what's positive about it.
Dr Brandon Vance
Yeah, I mean, might that say something about— I mean, you mentioned caring about other people and kind of communicating well to them. I mean, I'm wondering if shame might show that, uh, wanting to sort of— wanting to show up well to them, wanting to be accountable. Or wanting to have a strong kind of— it sounds like there's almost like a moral code to that, like you really want to have integrity and show up well and connect with them. I wonder if that might connect with the shame, like being really competent.
Dr Heather Clague
Interesting. I mean, the message of shame is that I'm bad, and I guess that shows that I want to be good. Uh-huh.
Dr Brandon Vance
Uh-huh. Yeah, you want to be good. Say more about what, what does good and bad mean there?
Dr Heather Clague
Um, yeah, it's so intense, it's a little hard to think about, but it's like, I mean, I want to be a good person, I want to be a worthy person, I want to belong. I want to—
Dr Brandon Vance
you said you want to belong?
Dr Heather Clague
Yeah, I want to contribute. I want to—
Dr Brandon Vance
yeah, yeah.
Dr Heather Clague
I don't—
Dr Brandon Vance
yeah. So does the shame kind of give you a compass for that? Does it help, or help some kind of guardrails?
Dr Heather Clague
Maybe if it didn't scream so loud. I mean, all I want to do is— when it comes on, all I want to do is hide.
Dr Brandon Vance
But yeah, right, of course, right, right. Yeah, I mean, yeah, let's just lean into that a little bit. Like, if it didn't scream so loud, what do you think the shame might be wanting to tell you? Like, if the shame was a friend to you instead of—
Dr Heather Clague
I'll tell you what just came to me was, like, I guess I wouldn't want to be someone who couldn't feel shame, because then what would you— then I would just be happy being a bad person.
Dr Brandon Vance
Okay, okay. Yeah, yeah.
Dr Heather Clague
Like, yeah, that's a funny way to think about it. I mean, it's, it's funny. It's like I see it as this sort of, like, terrible Gollum-like figure, but yeah.
Dr Brandon Vance
Yeah, right.
Dr Heather Clague
But actually, if it were just a little bit gentler, it would be like, yeah, kind of reminding me that like, yeah, that I want to belong and be a good person and show up as a good citizen, and I don't want to do things that are reckless or hurtful or—
Dr Brandon Vance
yeah, yeah, yeah, I love that. So, so this— I mean, we're talking about a podcast, but there's roots in here about being, being a good person, being a good citizen, that kind of drive this shame. And, and it shows that that's really important to you.
Dr Heather Clague
Yeah. Yeah, I haven't thought about it this way before. Um, yeah, and it's funny, it's weird that like just even thinking about this way, it's like I almost feel a little bit of relief. Like, actually, maybe I'm It's not like I am irredeemable. It's like I'm, I'm in a process. I'm like, yeah, like it's like it could be just gentle feedback instead of a crushing condemnation.
Dr Brandon Vance
Wow, that, that really touches me. Yeah, when you said condemnation and irredeemable, that, that— wow, that sounds so painful. And then, and then when it seems like feedback instead of that.
Dr Heather Clague
Yeah. Like, I think if it were just less loud, I could hear it better. Yeah.
Dr Brandon Vance
Yeah. Yeah.
Dr Heather Clague
Yeah.
Dr Brandon Vance
Isn't that interesting?
Dr Julie Osborn
Yeah.
Dr Brandon Vance
I noticed that with my toddler, actually. In fact, I talk about that with him a lot. When he's screaming, it's hard for me to really take his message in. If it's a little less loud, you can actually hear it better.
Dr Heather Clague
Yeah.
Dr Brandon Vance
Yeah. And it sounds like there's some all or nothing that kind of comes in with like, irredeemable. That's really weighty. But then, then you can hear it better if it's less loud. Um, beautiful. I wonder if there's, um, you mentioned hopelessness as well, and I, and I wondered if we could look at that a little bit, um, because that's, that's kind of a difficult one too. Yeah, if we could press that magic button and the hopelessness would completely go away, you'd be actually hopeful I mean, I do.
Dr Heather Clague
It's funny because I actually do feel a little hopeful now, but—
Dr Julie Osborn
Okay, okay.
Dr Heather Clague
Yeah, I think, I think the hopelessness is just trying to give me a break. It's like I get to give up.
Dr Brandon Vance
And is that— I mean, is that an important thing to, to be able to have a break, to take a break?
Dr Heather Clague
Sometimes.
Dr Brandon Vance
Uh-huh.
Dr Heather Clague
Not all the time, but like, uh-huh. Sometimes, like, I've been working hard all day and I just, I'm like, it's late and I just, I just feel like I have to give up and go to bed. Yeah. Maybe it's actually— that's actually kind of wise.
Dr Brandon Vance
Yeah.
Dr Heather Clague
I mean, that doesn't— you know, waking up in the morning with a sort of hopeless dread, that doesn't feel so useful. Um, but maybe it just— yeah, I've been so burdened by the shame, so maybe it's just kind of trying to protect me from that in a weird way. Because yeah, it's like permission to not have to keep struggling. Yeah.
Dr Brandon Vance
So, so it gives you a break and permission to not have to keep struggling.
Dr Heather Clague
And it is a funny kind of compassion, but like, yeah, yeah, yeah, yeah, yeah.
Dr Brandon Vance
That, that was, you know, somehow the word love came into mind. Like, is that actually a— you're mentioning a passion— is actually kind of a loving thing to give yourself a break?
Dr Heather Clague
I mean, it's a weird kind of love because it really feels terrible, hopeless.
Dr Brandon Vance
Yeah, right, right.
Dr Heather Clague
That is a weird But maybe it's the same idea, like if— I don't know if there's some other way to give myself a break other than to tell myself it's hopeless.
Dr Brandon Vance
Yeah, yeah, right, right. And, and we mentioned, you know, that, that one of the questions that I, I might ask is like, is it getting— trying to get you to do something differently? And it sounds like there might be some element of taking a break.
Dr Heather Clague
Mm-hmm.
Dr Brandon Vance
Huh. Yeah. What are you thinking of right now? It looks like—
Dr Heather Clague
well, I can just be pretty hard on myself, so— yeah, I mean, I, I'm, I'm kind of anxious to not be hard on myself, like that somehow I would like really become a bad person. But yeah, I don't know, this is interesting. Maybe in a weird way, if I was a little gentler, it might actually be easier to show up in the way I want to.
Dr Brandon Vance
Yeah. Yeah, that's beautiful.
Dr Heather Clague
Yeah.
Dr Brandon Vance
So, um, so if you didn't have the shame and the hopelessness, what, what would— yeah, say, say, sort of circle back to that. What would be lost there?
Dr Heather Clague
Well, I wouldn't want to not care about being a good person.
Dr Brandon Vance
Yeah. Yeah, yeah.
Dr Heather Clague
And I guess if I was doing something out of line, I would want to know that because I wouldn't want to be a jerk.
Dr Brandon Vance
Yeah, yeah.
Dr Heather Clague
Um, but maybe if I wasn't telling myself I'm a jerk so much, then I wouldn't have to, huh, give up completely.
Dr Brandon Vance
Interesting.
Dr Heather Clague
By being hopeless.
Dr Brandon Vance
Yeah, yeah. Yeah. So, so you've, you've mentioned that like, is if there was, you know, if it's shouting so loud, it's harder to hear, actually might be less effective in what it's trying to do for you. And I'd asked you, you know, this magic button question. If we had instead a magic dial and we could dial down the shame, we could dial down the hopelessness. What would that be like? And where would you like that to be? Let's say, you know, and I'm sorry, did I— I don't know that I'd asked you what level it was.
Dr Heather Clague
I'm sitting like 90% shame.
Dr Brandon Vance
90% shame? Yeah.
Dr Heather Clague
Can we do like 15%? Because shame feels really terrible.
Dr Julie Osborn
Yeah.
Dr Brandon Vance
Yeah. And would 15% be enough to kind of—
Dr Heather Clague
I think so. I think so. It's going to be plenty.
Dr Brandon Vance
It's going to be plenty.
Dr Heather Clague
Yeah. Okay.
Dr Brandon Vance
Great. What about the hopelessness? If we had a magic dial for that, what percent is the hopelessness now?
Dr Heather Clague
Well, it was like at night.
Dr Brandon Vance
I'm feeling actually— it was 90, you said it go down some.
Dr Heather Clague
And yeah, but I'm, I'm feeling quite a bit less now. But I guess, I don't know if it gets— hopeless is kind of extreme. Like, I just feel like there needs to be a message to slow down.
Dr Brandon Vance
Yeah, yeah.
Dr Heather Clague
Hopeless, like, yeah. Can I change the name of it instead?
Dr Brandon Vance
Yes, please. Well, hopeless is an all-or-nothing thing, right?
Dr Heather Clague
No.
Dr Brandon Vance
Yeah, yeah, it sounds like completely hopeless, right?
Dr Heather Clague
Maybe discouraged, like I could just use 30% discouraged.
Dr Brandon Vance
Yeah, I suppose literally hopeless. It's not necessarily all or nothing literally, but people think of it as completely hopeless, right? But discouraged, I love that. That's a— it's very nicely descriptive. So I love changing the name of it discouraged. And how much— what level of discouragement would you want to feel?
Dr Heather Clague
I don't know, like 30%.
Dr Brandon Vance
30%. Yeah, I love that.
Dr Heather Clague
Should be funny.
Dr Brandon Vance
Yeah, right, right. And I love that you didn't say like 2%. You're really acknowledging some of the— like, you really need to give yourself a break.
Dr Heather Clague
Um, yeah, I think I would ride over 2%.
Dr Brandon Vance
I'm sorry, what percent?
Dr Heather Clague
I think I would ride over 2%. I think I'm feeling— yeah, it would have to be at least 30.
Dr Brandon Vance
Yeah, yeah, I love that. So 30% hopelessness and 15% shame.
Dr Julie Osborn
Yeah.
Dr Brandon Vance
Okay. So let's stop here.
Dr Julie Osborn
That was great. Especially the hopelessness, I think, is one of the toughest emotions to find anything that you can take from it. So I'm really glad we're able to do that, to give our listeners— because I'm sure people are listening going, oh, well, yeah, for some moods this will work, but not for other moods. Right. So to be able to show this with some really painful, difficult moods that you can we can find something about them that shows us something about ourselves and maybe how they can benefit on some level and on some that we need to let go. And like I said, we can rename our moods because they're our moods. We get to rename them whatever we want. Right.
Dr Heather Clague
It's interesting. I mean, this example also shows how sometimes one extreme emotion triggers another extreme emotion. Because you're sort of trying to protect yourself from kind of— and I know in, um, I do some internal family systems, we talk about polarization. These sort of different aspects of ourselves drive each other into these extreme roles. So like, you know, when one, when one emotion calms down, then the other one doesn't have to shout so loud, right?
Dr Julie Osborn
Right. Yeah. Yeah. Oh, sorry.
Dr Brandon Vance
We all had thoughts at the same time.
Dr Julie Osborn
Yeah, I just want to share this with shame. You know, what else would it do for someone is maybe, you know, like, oh, I want to get too, you know, uppity or think I'm the greatest thing and person in the world, smart, you know, come across, you know, that way. So my shame keeps, you know, you might tell yourself, yeah, you know, that it keeps me like in line.
Dr Heather Clague
Humble.
Dr Julie Osborn
Yeah. Yeah.
Dr Brandon Vance
Right.
Dr Julie Osborn
Right. So yeah. Yeah. So there, you know, that might kind of keep you from doing other things. So anyway, I mean, there's so much to explore and it's all individual, but this is, you know, gave a great taste at least of like, oh, okay, this is how these tools can help.
Dr Heather Clague
Thanks for saying that, because I, again, I think we could, we could keep going. Like, there's— if this resonated for people, I would say there are other dimensions. Like, I don't think— like, these emotions evolved. Like, there's a reason why humans have these emotions. They have some adaptive function. So if we haven't, in our— in this dialogue, haven't hit something that resonates and someone still feels stuck, I would like encourage them to— like, there's more. We can always find something.
Dr Julie Osborn
Yes. Yeah. Excellent.
Dr Brandon Vance
I also think the sequence can be helpful in the sense that if we go through emotion by emotion, it breaks it down to be a lot easier for the person, especially if you're working on it just yourself. So if you go— and I often like to go first with anxiety. I think it's a little easier to understand some of the positive reframe about for people. Depends on the person, though. Like Heather's saying, some people have really intense trauma. Dropping the anxiety just a little might seem really threatening. But once we go with some of the other feelings, then we get to shame, which is usually a difficult one, and hopelessness, which is maybe the most difficult for a lot of people. But if we do the others, then when people start to get it, they start to get, okay, well, wait a second, there, there must be something helpful about this in some way, or that it reflects about me, you know, something important to me. So then that gives them a little more resources to be able to engage in this way. And for Heather, even working on the shame even dropped her hopelessness.
Dr Brandon Vance
So that was even helpful to loosen the hopelessness a little bit to then— Yeah.
Dr Julie Osborn
Almost like little building blocks or I have people do fear ladders. Maybe you could ask yourself, what's the first emotion be comfortable to least work on? And then you might just start knocking them down as you go along. Yeah, exactly. Yeah. That's a great point. So if someone's feeling overwhelmed, another feeling, just listening to us, It's like, just start with an easy emotion that you don't feel too overwhelmed addressing.
Dr Brandon Vance
Yeah.
Dr Julie Osborn
And then be able to build on that. Yeah.
Dr Brandon Vance
Also, a lot of times people talk about them as negative emotions, but I like to kind of reframe that too and just call them uncomfortable emotions because I think even calling them negative emotions sets us up to be kind of against them. Right. And so it sets a certain relationship. The other thing that occurs to me is that in the book Feeling Great, David goes through— yeah, I think he has a page of kind of common, both values and helpful things. So commonly, how is this feeling, you know, perhaps advantageous for me to feel and what it might mean about the kind of person that I am and what's important to me. So if somebody's really stuck, they can look through that list. And then that's another power of our book club in the sense that you can brainstorm as a small group like, well, gosh, I'm really stuck here. I can't imagine how hopelessness might be helpful or what it even— what it might say about me that's important. What do you all think? Like, you know, and, and, and then after a number of weeks of being with the same group of people, people might feel enough sense of safety within that group to be able to bring up that question.
Dr Brandon Vance
Because in the beginning it might be hard to bring up also.
Dr Heather Clague
Yeah.
Dr Julie Osborn
No, great, great. Well, let's circle it back. We'll talk a little bit more about what you guys are offering to finish up the podcast. But this was, you know, I'm grateful, you know, for your time and your expertise and being able to just explain things even a little different way than I do already, you know, on the podcast. And I want people to know how to be able to, you know, reach out to you guys. And I'll have this on with this podcast, all the information to you guys if you want to reach out to Brandon or Heather as well. But if you guys can share anything else you want to share about, again, how to, you know, reach you, your practices, and then what you guys are offering and the dates with the book club and any other groups.
Dr Heather Clague
Sure.
Dr Brandon Vance
Yeah.
Dr Heather Clague
Yeah. So we're gonna, um, we'll have a, uh, we'll start in on September on Mondays for 12 Mondays starting September 21st from 4 to 5:20 PM Pacific time. And the cost for that is $240, but for all, all 12 sessions. But we have a sliding scale, so you can just email me or Brandon if you need a discount, and we'll go as low as whatever you need. And then we'll have an abridged book club on Wednesday mornings. So that'll just be 3 weeks from October 7th to 21st, from 8 AM to 10 AM. And the cost for that is $89.
Dr Julie Osborn
Um, and what do you do in the bridge one? What do you talk about there?
Dr Heather Clague
We're gonna— we won't go through every chapter. It'll be a little bit more high speed. Um, so we'll have 3 2-hour sessions and we'll kind of get right down into teaching the tools and practicing them. So it's kind of high-speed book club.
Dr Julie Osborn
It's—
Dr Heather Clague
the advantage is it's shorter. Disadvantage is maybe a little bit less time with your small group and community, but, um, we have some great small group leaders, so, um, I think that'll be a great experience too. And the morning time is a little easier to access for folks who are living around the world than the afternoon time.
Dr Brandon Vance
Exactly.
Dr Julie Osborn
Okay, great. And Heather, for yourself too, regarding— can you share about your practice a little bit?
Dr Heather Clague
Oh yeah. So I have a private practice in Oakland. Um, yeah, I see folks with depression, anxiety. I do TEAM. I also do ACT, as you were saying, Acceptance and Commitment Therapy, and some Internal Family Systems work, which all feel very aligned in terms of this positive relationship with emotions, um, and then judicious use of medications.
Dr Julie Osborn
Um, and you see people in person and online if someone wanted to reach out to you?
Dr Heather Clague
Okay. Yeah. And then Um, we— I've got to put the next one up, but I also, as does Brandon, we do these, um, Five Secrets practice groups where we get together a group of 8 people and we just practice, practice, practice the Five Secrets, do role plays, get feedback. Um, that's been really a joy, and I think I've seen people really transform their relationships in that.
Dr Julie Osborn
And when you're offering those, my next one probably won't be till January. Okay.
Dr Heather Clague
And then we also do an ACT group, a book club on the book by Russ Harris, When Life Hits Hard. Which is a book about grief, but the, the tools around Acceptance and Commitment Therapy are applicable to a wide range of experiences. And we'll probably do our next— that book club in the new year as well.
Dr Julie Osborn
Excellent. Okay.
Dr Brandon Vance
And so, Brandon, yeah, so, so if people— as Heather was saying, if you, if you Google or whatever search engine you use for Feeling Great Book Club, that will bring you to a page for the book club and it can tell you all about it. Part of what we want to do with that is make it really accessible to people, so that's why we have a sliding scale down as low as you can afford. And also, we want to make it accessible across the world. Until this year, we've always had two full groups on Wednesday mornings and Monday afternoons, or at least a morning and afternoon, to kind of spread it around the world. And here, because of various reasons, we're doing the abridged one on Wednesday mornings, but still to give people an opportunity to do that. And then on that same website, so that will take you to the Feeling Great Therapy Center, which Heather and I are part of, and then to the book club part of that website. But on that same website are— when you go to the About, About the Therapists on that, Heather and I are both there.
Dr Brandon Vance
So that and the links there can lead you to our own information.
Dr Julie Osborn
Perfect. Okay.
Dr Brandon Vance
And then I also have a private practice in Oakland and work with people around psychotherapy. I use a a team CBT kind of structure. And then I do these different kinds of things, hypnotherapy and some EMDR and ketamine therapy. And so, and work with actually an ear acupuncture protocol for insomnia and addiction. And so I love to do, you know, sort of have a bunch of different tools to work with people in the methods section of things.
Dr Julie Osborn
That's great. That's great. And do you see some people online as well or just?
Dr Brandon Vance
Yes. So I see people online and in person. So I have an office in person 2 days a week and then online 3 days a week.
Dr Julie Osborn
Okay, great.
Dr Brandon Vance
And only within California, so I'm only licensed in California.
Dr Julie Osborn
Okay, me too.
Dr Brandon Vance
Yeah.
Dr Julie Osborn
Okay, good.
Dr Heather Clague
But the book club can be—
Dr Brandon Vance
the book club is for anybody over the whole world.
Dr Julie Osborn
Yeah. Yeah. And I was thinking with the book club too, I thought maybe somebody that went through your book club already doing the Bridge might be just another, like, you know, um, just to acclimate— not acclimate, but, you know, just to go over the main tools, I guess, instead of going through the book club again. It can be like, I— or, you know, just coming back. I call them like booster sessions. You know, I'll have clients that there's like, I just need to come in for one or two sessions, so it's like I need a refresher. Yeah, for that as well, huh?
Dr Brandon Vance
Right. Yeah, I think that's great for that, right? It's really nice to have read the whole book before the abridged one, I would think.
Dr Julie Osborn
Right, right. Okay, excellent. Any last thoughts you guys want to share?
Dr Brandon Vance
Just really a pleasure to be on this podcast. I love your podcast and love that you work with people around, you know, helping people learn more about CBT and helping them to use the tools themselves. And that's what we're also trying to kind of be kind of in between the therapy world and just the individual self-help world with the book club. But I love that idea of self-help and sustainability and sort of empowering people with these tools. Really appreciative to be here talking to you.
Dr Julie Osborn
Yes. Okay, great.
Dr Heather Clague
Yeah.
Dr Julie Osborn
Yeah. Anything else you wanna share, Heather?
Dr Heather Clague
No, that just, yeah, so much respect and admiration for you for doing this wonderful podcast. And thank you so much for having us.
Dr Julie Osborn
Thank you. No, thanks for, yeah, being here for all everyone listening. I hope you found this helpful. I found it even more helpful. I mean, we're never done learning, right? Training, training, training, and using it in our own lives as well and sharing it with with others. So I'm grateful we had this time together. And for those following me, you can find me on Instagram under my CBT podcast. My website is mycognitivebehavioraltherapy.com. You can find me on Facebook under Dr. Julie Osborne, YouTube, same, Dr. Julie Osborne. And share this with anyone that you might find helpful. And remember to always make decisions based on what's best for you, not how you feel.