Summer Special!

TEAM CBT ft. Dr David Burns

Episode #163

I can’t wait to share this episode with you, where I got to interview an absolute icon of Cognitive-Behavioral Therapy, Dr David Burns.

Dr. David Burns is an Adjunct Clinical Professor Emeritus of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine. He's an award-winning researcher, teacher, and best-selling author of self help books including Feeling Good, with more than 10 million copies sold worldwide, and he’s the host of Feeling Good podcast, which has received over 9 million downloads. Dr. Burns was a pioneer in the development of Cognitive-Behavioral Therapy and is the creator of TEAM CBT, which makes rapid recovery from depression and anxiety possible. His Feeling Great app triggers 60 to 70% reductions in feelings of depression and anxiety in less than one day, which is what we're all looking for!

Join me, Dr Julie, and my special guest, Dr David Burns, as we break down the fascinating TEAM approach to CBT, and how you can use that new understanding to help you understand & challenge your hot thoughts.

Click to listen now!

 
 

Full Episode Transcript

Hi, it's Dr. Julie. Welcome to My CBT Podcast. I'm a Doctor of Psychology and a Licensed Clinical Social Worker specializing in Cognitive Behavioral Therapy. I'm here to help you bring the power of CBT into your own life.

So today I have an incredible guest. Super excited. Dr. David Burns has joined me on my podcast. We can talk more about Team CBT and he's going to educate us more and give us more great tools. So I want to give a little intro, so. Dr. David Burns is an adjunct clinical professor emeritus of psychiatry and behavioral sciences at the Stanford University School of Medicine. He's award winning researcher and teacher and best selling author of self help books including Feeling Good with more than 10 million copies sold worldwide, and the host of Feeling Good podcast which has received over 9 million downloads. Dr. Burns was a pioneer in the development of cognitive therapy and is the creator of Team cbt, which makes rapid recovery from depression and anxiety possible. His Feeling great app triggers 60 to 70% reductions in feelings of depression and anxiety in less than one day, which is what we're all looking for. So thank you for being here.

Dr David Burns

Well, thank you for having me on your show. Your show is highly praised and highly rated and it's just a real honor to meet you and to know shoot the breeze a little bit.

Dr Julie Osborn

Thank you. So I wanted to share with our listeners how I got to get introduced to you in the first place. So I was going to conferences to get my continuing education units like everybody, but I was leaving with feeling kind of empty, not learning any tools. You know, everybody was just kind of talking about themselves and selling their books. And I'm like, I don't have anything to take back to my clients. So I'm like, I'm not going to do that anymore. So I did some research and I realized that you did workshops. So it was 10 years ago and I went to your rapid recovery workshop. And the thing that stood out to me, I wanted to share with everyone was at the end of each day, you had us fill out, you know, what did you like, what you didn't like. And then the next day we came back and you were standing up there reading all the things people didn't like or they wish you did different. And to this day I was like, who is this man so humble? I mean, you're a personally, you're a guru in the field and you're acknowledging what you could have done better. And then I was sold.

Dr David Burns

Yeah. Yeah. It's funny how that works that way. And I didn't learn that until quite A ways into my life, but it's sure a good thing to know. And when you try to impress people, you just turn them off. And when you're humble and real and respect even people's criticisms, they really like it.

Dr Julie Osborn

Yes. Yeah. And it's really helped me in my practice when I've had moments of messing up, knowing with your training how to just be present and empathize, and if I need to apologize and repair that with, you know, with the client. So that's been very helpful. And then just let, you know, a group of us that met there, we still meet once a month, and it's been 10 years now.

Dr David Burns

Oh, wow.

Dr Julie Osborn

All trained in the team CBT, and we meet months a month to practice tools and give each other support in our practices. So you've been a huge factor in my life and my practice, so I thank you for that.

Dr David Burns

Well, I'm grateful to learn that. Thanks a lot. That's very cool.

Dr Julie Osborn

So could you share with us first about what team CBT is, just so everybody can.

Dr David Burns

Yeah. You know, when I first learned CBT from going to Beck's weekly seminar, it was good, but it didn't work for everyone. And the research studies kind of showed that as well. Like, a lot of people, maybe half of people would recover really quickly. But, you know, some of them, they were, yes, budding you and kind of fighting with a therapist. And that's not unique to cbt. If you look at the outcome studies for depression for every form of psychotherapy is really, really not impressive. They're all better than placebo, but not by a huge margin. And so I. And I saw that was the truth in my own practice. So I did a lot of research just based on collecting data from my practice and analyzing for articles for, like, Journal of Consulting Clinical Psychology and some of the other research journals. And then asking myself, how might I modify the original cognitive therapy to make it more powerful and to have impact on a greater a net to catch more fish in, you know, to appeal to more. More people. And that then. So T E A M kind of emerged, especially after I moved back here to California from Philadelphia. And the main features of it, you know, the T stands for testing. And I've developed, you know, Beck had his, you know, excellent 1964 when he developed it, his Back Depression Inventory. And it was a tremendous thing in its day because it was the first test that measured depression. People didn't even know if that was possible when he developed it. And all of a sudden, yes, you can get a precise measurement of Depression. So I started using it in my practice. But it was a good test, but not a great test. And so I developed other tests that were very short that people could complete in maybe 15 seconds, and that had exceptionally high reliability and accuracy. And I wanted to measure not, how have you been feeling over the last three weeks? Which is how the last two weeks the Beck test is set up, I wanted, how are you feeling right now at the start of the session and again at the end of the session, so I could see how much impact I was making within a session. And that was one of the real keys that led to Team cbt, because I discovered that a lot of things that I thought were just great, people thought were very sucky. And some things when I thought I was screwing up, patients gave me, you know, oh, this is the best session ever. So my patients taught me a lot over the years. And then we also measure empathy at the end of the session and helpfulness and things like that, as you know. So that's the testing part. And that was a great departure, to be honest, and really pave the road for fast acceleration and evolution of the techniques. And then the empathy was. All therapists claim to have good empathy, but I developed a real sensitive empathy scale and discovered that most therapists fail in empathy with most patients all the time, but they don't know it because they're not testing. And when you use the empathy scale, you can see if patients give you a perfect score or not. Like a 20. It goes from zero to 20. And we say that anything less than a 20 is a failing grade. And we want to make it easy for therapists to fail, because when you fail and process that with humility, like you were mentioning that before the podcast, you can really deepen the therapeutic relationship. So that's a little bit of a different emphasis, I think. But the big thing was developing ways of dealing with resistance. That's the A is assessment of resistance, or you can call it paradoxical agenda setting. And that's. I found that the reason therapy fails, not just cognitive therapy, but all kinds of therapy, psychopharmacology and everything, is because the therapist sees your role as pushing helpful things on the patient. And what it's your. It's either your school of therapy or your new antidepressant or whatever. And that kind of sets a lot of people up to push back. And so I spent a lot of time figuring out why people resist and then coming up with a system for understanding resistance, for depression, for anxiety, for relationship problems, and for habits and addictions. As well as how to antidote resistance. And that's the thing that ushered in ultra high speed recovery for me and some of my students. Not everyone is able to pick it up, but a few of them have. And. And then finally M is methods. And I've developed, I think back when he started out, had like five or six methods, examine the evidence, do an experiment, things of that nature that were pretty good, but a little on the dry side. And so I wanted to be using something more dramatic. I'm going to unplug my phone here, which is ringing. Sorry. And so I began to develop role play techniques that had a lot more zip. And now I've developed close to 150 techniques for challenging different kinds of negative thoughts, because everyone responds to something a little bit different. But that's kind of an overview of what team is testing empathy, agenda setting and methods. And I go through that process with every patient, but it's different for each patient because the problem will be different, the empathy will be different, the resistance will be different, and the methods that work will be different. But those are like the four ingredients, I think, of effective therapy.

Dr Julie Osborn

Yeah. And what I found is the therapist using them. Like, especially with having so many methods. Right. For me, it's helpful because I know it's, if this doesn't work, I have something else to go to. But also, I always tell my clients, you know, not every tool is going to work for you and for them not to feel like, oh, no, this isn't working. I'm doomed. Right. It's like, oh, no, there's all these other tools I can use that, you know, continues the hope for them that they can get better.

Dr David Burns

Yeah, that's right. Yeah. I think patients really love that. I call that philosophy of failing as fast as you can. And that's also one important difference, is that most therapists think your goal is to succeed. My phone line just fell on my foot, weighs practically nothing. So my foot is intact. But the philosophy, I tell my patients, my philosophy is to fail with you as fast as we can, because I don't know which technique is going to work for you. You're telling yourself that you're a loser, that you're a hopeless case, that you're worthless, that you should be better than you are, and things that really cause tremendous distress. And I don't know which technique is going to work for you, but if we go through them, you know, one at a time, and we maybe can fail every five minutes, and then we'll get to the technique that works for you fairly, fairly rapidly. And so that, that's another unique feature I think of team.

Dr Julie Osborn

Oh, for sure. Yeah. I mean people have a very different concept. Right. I'm coming into therapy, you're going to fix me. You know exactly what I need.

Dr David Burns

Yeah, right. Yeah, right.

Dr Julie Osborn

And then there comes, I guess that, you know, that's where the resistance comes in. Like why aren't I getting better? Why aren't you helping me? Why aren't you fixing me?

Dr David Burns

Right.

Dr Julie Osborn

But it might be really their resistance. Is that right?

Dr David Burns

Yeah, absolutely. Yep, you've got it.

Dr Julie Osborn

So can you explain a little to our listeners more like what does that mean the process and the outcome resistance?

Dr David Burns

Yeah, that was a big breakthrough coming up with the idea of outcome and process resistance. I was at Stanford, I'm on the voluntary faculty at Stanford, the adjunct faculty. So I just donate teaching time in exchange for my title, I guess is the way it works. And they had a meeting of several on the voluntary faculty. And I don't know how I, I don't usually go to meetings. I'm not a meeting person. But except this, like this is a great meeting, meeting you and shooting the breeze. But was, I don't know even know what we were supposed to be talking about, but the idea of the word resistance came up and I said, you know, I've been hearing about resistance ever since I was a psychiatric resident and no one ever told me what it was to find it and no one ever told me what techniques we could use to, to combat it. And, and I bet the residents don't know. And why don't we get together, we could exchange emails and, and put different ideas of what resistance is and list them for the residents, psychiatric residents in the training. And, and then we could also, you could listen techniques that you use to overcome resistance. And so I thought everyone would be very excited about this. And I waited six months and not a single email came. And I would write and say, does anyone have any ideas on, on resistance? They wouldn't even answer my email. And I guess they thought it was a stupid or dorky thing to do. I don't, I don't know why. And then I had a dream in the middle of the night. I'd gotten very frustrated and I woke up in the middle of the night and I saw that there forms of resistance. And if you like, I'll tell you what they are because they're really cool. But that really shaped the evolution of team cbt. And we can start with depression. And now for each target there's four Targets, depression, anxiety, relationship conflict, or a habit or addiction. And those are just the four most common things that most of us see. And each has what I call outcome resistance and process resistance. And what do those words mean? Well, they're very simple. Outcome resistance means the patient doesn't want a good outcome. So if you're depressed, a good outcome would be to eliminate the depression and achieve happiness within today's actual session. And outcome resistance means that the patient will fight against that goal. They might say, I'd really like to overcome my depression, but inwardly, for some reason, and I think we've kind of figured out what it is actually, but they will fight you. And that should be obvious to all of the people listening to the podcast, that if you try to cheer someone up who's depressed, not only is it never, ever effective, it's always, always irritating. It pisses the person off, because people don't like people to try to cheer them up when they're not feeling cheerful. But that's the outcome resistance for depression, and you have to learn how to bring that to conscious awareness and melt it away. The process resistance for depression, or for anything, means the patient may or may not want to get better, but there's a process that they'll have to engage in that they're going to fight against. And for depression, that process is psychotherapy homework. And I've done research in the journal that I published years back in the journal JCCP Journal of Consulting and Clinical Psychology, one of the top research journals. And I documented. I did a study of patients who did homework and didn't do homework at my clinic in Philadelphia and found that there was a massive causal effect of homework compliance on recovery from depression. And it wasn't a big effect. It was an enormous effect. And so I had to then focus on, well, how can I get patients who were depressed doing their psychotherapy homework and developed a way of coping with that? That worked out really well also. But those are without the solutions. Those are the two kinds for depression. Should I mention the two kinds for anxiety?

Dr Julie Osborn

Sure. Yes. So many people have anxiety. That'd be great.

Dr David Burns

With anxiety, there's outcome and process resistance, but they're different, totally different than for depression. In anxiety, people are always worrying, worrying, worrying, and so to be cured, that means in today's session, your anxiety would disappear and you'd be cured. You'd be joyous. And outcome resistance means that the anxious patient won't permit that, will fight against that. And that's true of every anxious patient because they have something called magical Thinking that you think that your anxiety is going to help you or protect you in some way. For example, one of my early patients asked for help with OCD because she was washing her hands 50 times a day, and her hands were all covered with, you know, scabs and flaking skin and red and looked kind of inflamed and irritated. And so she wanted treatment for that. But to find out what was the root cause of her anxiety, I said, like, well, what are you the most afraid of if you didn't wash your hands? And she said, oh, well, then they'd get contaminated. I said, okay, and write that down. I did a downward arrow technique, which you probably use. And then I said, and then what are you afraid of if your hands get contaminated? She said, well, then I'll touch my children. Okay, well, put that down. And then what are you the most afraid of if you touch your children with your contaminated hands? And she said, well, then they'll get contaminated. So I said, then write that down and put another downward arrow under that statement. And what would happen if your children get contaminated? She said, oh, they'll get leukemia, and that one will happen. Then she said, then they'll die. And she started sobbing. Now, this was an intelligent woman. She was a psychologist herself and a very lovely woman, but she had that belief system. So if you say to her, here's a magic button and you press it and you'll be cured of ocd, will you press that button? She said, oh, no, no, I don't to want. Want to do that. Do you see? Because she's struggling, but at the same time, she subconsciously believes she's protecting her children. And also, if you want to bring in a psychodynamic dimension, which I always do with anxiety, in addition to the many other techniques, since she's constantly obsessing, that her hands are going to kill her children. Right. That's what I have to protect against. Well, does she have some emotion toward her children that she's not acknowledging? I call this the hidden emotion technique. And in fact, she, like most anxious patients, is overly nice. And so she gets pissed off at her children when they misbehave, but she tries to discipline them with niceness, which doesn't work, and then they keep misbehaving and she suppresses her anger, and then it comes out as ocd. So that's called hidden emotion. To come to terms with the fact that it's pretty normal to be angry with your children, and maybe that's something that you would want to deal with. In a different way, yes. But anyway, that's the outcome resistance. And then of course the process resistance for anxiety is you're going to have to use exposure techniques to confront your fear. I had another patient, Sarah Shane was her name. She was on one of, one of my podcasts. She was in my Tuesday group at Stanford. I have a free weekly training for therapists around the world every Tuesday night at Stanford, a two hour training group. And she'd been coming to it for years. But then she confided to me once, sometimes we do personal work and she, she said could, could you treat my OCD in the class? And, and she explained that she also had a, you know, fear of germs and she would take two hour showers and she was afraid even to come into the Stanford building where we have had our group in those days. Now it's all virtual, but we used to meet in the behavioral sciences and she would bring towels and things so she wouldn't have to touch door handles because everyone's touching the door handles and this is freaking her out. And so I agreed to do it. And we went through the T, the A, te and the A, and then it was time for the methods. And I said, well, Sarah, now are you ready? Because you know you're going to have to have a death and rebirth experience and you're going to have to confront your worst fear now. So I said, let's go out. And the group followed us. We had about 30 students and we went into the women's bathroom and I put the toilet seat up, said, do you have to touch the inside of this toilet? She said, oh, no, I couldn't do that. She said, I'd like to see you do it. So I said okay, I'll go ahead and do it. And then she said, oh, I'll do it too. And then she started doing that. And then, and it was weird. We were all crammed 30 kids into this little bathroom at this Stanford might have looked weird to anyone who's watching. And then I said, how anxious are you? Between zero and 100? She said, oh, it just went up to 120. And I said, well that's not good enough, let's walk out of the building. But I want you to touch all the door handles on the way out. And so she's touching them out and freaking out. And then we finally went out in front of the building. There was just this big garbage can. It was empty, but there was about a, maybe a millimeter of slime, black slime inside of it. And I said, now I want you to put your hands in here and then rub them all over your face. And she said, no, no, I couldn't possibly do that. I said, oh, you can do that. You have two arms and your hands are attached, and you can put. Put them in there and do it. And she says, well, if I do that, I'll vomit. I'll vomit. And I'll say, that's even better. Just put your hands in there, get all upset and vomit all over your hands too, and then rub them all over your face. And he said, oh, you do it if you think it's so easy. So he said, sure. So I put my hands in and got them all black and rubbed the black all over my face. And then I said, it's your turn. By the way, there's a little humming in the background. I don't know if you can hear it sounds like a stream or water or something. Oh, okay, good. Maybe it's just my hand. But at any rate, she forced herself to put her hands in. She didn't vomit, but she put them and started rubbing on her face. And all the 30 students who were watching started sharing. And then we went back up in the seminar room and sat down, and I said, how are you doing, Sarah? And I noticed she was crying. And I said, what are you crying about? She says, Dr. Burns, I was just cured. I'm not afraid of dirt or germs anymore. And that was so neat. And that was years ago. And she's come to workshops and rubbed on the floor in front of everybody and rubbed her hands on her face. But that's the exposure, and it's like the death of the self. And that's the process, resistance for anxiety. And you have to negotiate that ahead of time with the patient and see what's it worth to the anxious patient to be. To be cured. And patients fear anxiety, therapists fear anxiety, and everyone thinks, oh, something terrible is going to happen if I use exposure. But if you fall for that trap and let your patient off the hook, then cure becomes impossible. You know, if exposure is not the only treatment for anxiety. I have 40, at least 40 techniques I use. But exposure has to be a part of the package if the patient wants. Wants treatment, because it doesn't even mean anything to cure anxiety without exposure. It's a nonsensical concept. How would you overcome the fear of heights without going onto heights?

Dr Julie Osborn

Right, right.

Dr David Burns

You know, it doesn't even mean anything. So that's that. That's it. And. And so we've Covered depression and anxiety. Maybe that's enough. We can do relationship problems and habits because they're very fascinating as well.

Dr Julie Osborn

So let me. I love that. I would love to do that one. It's one question before we move on from anxiety. It's a couple thoughts that came to mind for me. So with the exposure, I've had some clients that sometimes they don't even plan it, but they're at some, you know, like, I had someone that went to his brother's wedding, and we didn't even plan this, but he says, oh, after the wedding, the next day we all went to the bar to watch, like a sporting event. He goes, I hardly knew anybody. He goes, and I didn't even have any anxiety. I was like, I was. It was great. And I said, oh, my God, that's wonderful. You end up having this exposure, you know, opportunity that really worked for you. What happens? So that was good. But it wasn't enough to, like, cure him, right? Yeah, something like that is that, you know, continue to create exposure experiments with him because, you know, they'll have like, oh, yeah, that worked. But the next time it's not going to. I find that a lot with my anxious clients. You know, it's just this one moment was good. Like, I don't know if it was luck or. But the next one, and it doesn't, like, you know, continue forward for them.

Dr David Burns

Well, exposure isn't accidental exposure. That just happens in your everyday life. It's something you do intentionally to maximize. Maximize the anxiety. And once you've done it, you have to understand with anything that you're cured from. Relapse is 100%. It's impossible to feel happy all the time. Albert Ellis said that. The Buddha said that 2,500 years ago. And so you just prepare the patient for relapse. But with anxiety, the key to relapse, for interventions. I see. I used to have a. Oh, I've had like 17 phobias and forms of anxiety myself. And since I was a little boy, I had an intense fear of. Of cameras. I couldn't smile in front of a camera. Tremendous performance anxiety. But now, see, I. Hi, I'm smiling. I like to smile. I've overcome it, but I have to keep it up all the time. In other words, I do public speaking all the time. My first public speaking was at Oxford University, and I imagined it would be a horrible nightmare. And it was exactly the way I imagined. It was the most humiliating experience of my life. But you do have to keep. After both depression will come Back, you have to know the technique when those negative thoughts, I'm no good, come back. They're guaranteed to come back. But if you know the technique that works for you, then it doesn't have to be such a. Such a thing to be feared. But if you don't prepare patients with relapse prevention training, then it's a serious mistake, I think, because when they relapse, they get terribly upset and you lose your credibility if you haven't prepared them and they say, oh, my, the treatment was superficial. It was just a band aid. I have deep problems and things like that. And so you want to hit those concerns ahead of time, right?

Dr Julie Osborn

No, that's a great point because I think most people think, oh, good, I'm cured one and done. Right. I don't have to worry about this again. And then when it comes back, yeah, that how it failed and their failure and. And, you know, even hard to get them back. So being able to find ways. I talk to my clients when, you know, we finish therapy, we need to create a system for them to keep practicing, like, oh, yeah, cool, you, like, every day. Because we're always working with people. Right. And as a client, you know, it takes some discipline, you know, and some kind of structure to be. Remember to let me sit down and do like a daily mood log or, you know, what are the things that I need do to keep. Well, because, you know, it's like, you know, it's out of sight, out of mind when you finish therapy sometimes for people.

Dr David Burns

Yeah. And it's so interesting how people will resist picking up a daily mood log and writing down their negative thoughts when the depression returns because they fight against it, even though you've demonstrated to them you can absolutely cause 100% elimination of your depression by writing down your thoughts, identifying the distress distortions, and use the blah, blah, blah technique, double standard externalization of voices, whatever, to blow them out of the water. But there's something so weird about human nature that we cling to the negativity, and that's what makes our work so fascinating. A lot of things make our work fascinating.

Dr Julie Osborn

Yes, yes. Yeah. They're even surprised that when I say, I use this stuff every day, you guys, right? I mean, I practice what I preach, you know, and they're like, you do, like, they just think, oh, I'm well and I'm stable and I'm. And so I don't use anything. I'm like, you know, we all have thoughts all day, every day. Our brain never shuts down. We all have too Many of them. Right. And we need to be working through that on a daily. Just like I say, you know, working out. Right. You don't go to the gym and reach your goal and say, I'm done. Right. You keep going. And I think maintenance sometimes is the hardest part.

Dr David Burns

Yeah, Yeah. I love what you're saying, and it is so, so true. Well, should we jump over to the most difficult topic of all?

Dr Julie Osborn

Sure.

Dr David Burns

Well, there's two relationship problems and habits and addictions. I think relationship problems may be the toughest, but again, we always go with outcome resistance and process resistance. Now, the context that I'm working with people is typically they've come for an individual mood problem, but then suddenly, at a certain point, they'll start talking about their spouse, their partner, or a sister who they're pissed off at, and they've got all these complaints about their husband, their whatever, and it's all blame, blame, blame. And, you know, I've tried everything with my sister, but nothing works. Ever since we've been little, my sister's been telling me that I think I'm better than her. And now she tells me, because I have a PhD and all she has is junior college, that I'm looking down on her, and over and over I've told her that's not true, that's not true. And she keeps saying the same thing over and over again, and nothing could help. And so if you want to help that person, which is pretty easy to show how to overcome something like that. But the first hurdle is outcome resistance. And that's what would it be worth to you if I could show you how to have a loving relationship with your sister? And, you know, what are you just telling me about your sister and how awful it's been? Or were you actually asking for some help? Because it sounds like you're kind of fed up with her and you've tried a lot of things that haven't worked. And so I'm not sure I'm hearing you asking for help, which is totally cool. We don't have to be close to everyone in our life. So let me know. Did you just want to talk about your sister, or did you want to roll up your sleeves and learn some pretty cool techniques? And I'm assuming you don't, but just let me know. And that would be dealing with outcome resistance. And you look at the world today and you see that there's a lot of outcome resistance to having loving relationships, even on the political side, that it's like we're divided heavily and the hatred for our opponents, whether the opponents are the Republicans or the wokie Democrats or whatever, there's this kind of intense internal pressure to look down on the other, on the other people. And then, of course, that anger and division leads to hostility and hatred and murder and warfare, killing. And these are intensely desired by human beings. And so that's the outcome. Resistance for relationship problems is huge because, you know, some naive therapists assume that people want loving relationships. Humans are basically good and want loving relationships. And nothing could be further from the truth. Ever since we evolved, we've been, you know, killing each other and trying to exploit one another. So that's the first bridge to it has to be crossed in a relationship problem. And then the process resistance is, you know, you ask the person, who do you think is more to blame for this problem in your marriage? You or the other person? Who do you think needs to do the changing? You or the other person? And 90% of the time, at least, I say, oh, it's the other person, my wife's fault type of thing. Then I say, well, gosh, then, you know, I don't think I could help you because she's not here. And did you want me to call her up and straighten her out for you or what? And if you want me to help you, I've got some tremendous techniques to show you how to have a more loving relationship. But the downside is that I use this tool called the relationship journal, and all I need is one thing your spouse said and exactly what you said. Next. We'll write those things down, and then I'll be able to show you that the problem that you're complaining about is actually your fault, that you're causing the very problem that you're complaining about. And you might not want to see that. It might be too painful for you to see that. And if so, I could totally, totally understand. But on the other hand, if you had the courage to experience that death of the self, the death of that blaming, angry self, I could show you how to turn this into a loving relationship. And that's the process resistance issue there.

Dr Julie Osborn

That's wonderful. Yeah, that's great. Yeah. No, I hope all our listeners are, like, going, what is such a different way of thinking? Which is what we need, right? Yeah, yeah, we know how to do everything, but it's not working.

Dr David Burns

Yeah. When I was younger and I developed the five secrets of effective communication, I used to stupidly think and naively think that people with troubled relationships just need to learn how to communicate differently. But then I realized, no, they're experts at communication already. They know how to communicate in a hostile way and hurt the other person, and that's 100% what they're looking for.

Dr Julie Osborn

Yeah, that you're. The five secrets of communication. My favorite tool for communicating. It's. I want, you know, people to look it up. And I think I did a podcast talking about it. It's so powerful. Just the disarming.

Dr David Burns

Yeah.

Dr Julie Osborn

So powerful. I just love it.

Dr David Burns

We did that in our Tuesday group, and we're going to have to do several weeks on it because it's even difficult for therapists to learn to find the truth and a hostile criticism. And some people are tone deaf. They can't hear the music behind the words. And some of these really sublime techniques are fairly deep in what you have to understand in order to make them work. I'm so happy you'll love the disarming technique.

Dr Julie Osborn

Oh, yeah. So years ago, when I first learned that from you, my youngest daughter, she was upset about something, and she was ready to go upstairs. And I think a lot of kids always think, I know what my mom's gonna say. And I just said, you know, you're right. And she literally stopped and looked at me and then just walked upstairs.

Dr David Burns

Yeah.

Dr Julie Osborn

Once I agreed with her, the argument stopped and she couldn't agree with me. Right.

Dr David Burns

It's a huge discovery when my. I have a very loving relationship with my daughter, but she was dead set on, I'm never going to get married. I'm never going to have children. And so. Okay, that's cool. And then she found a guy, and they lived together for 13 years and decided to get married. And then all of a sudden, she wanted to get pregnant and had a beautiful little baby who's now 16 years old. But I remember after he was born for a while, she would say things like, dad, you know, now I've had this baby, and I'm going to be trapped for 18 years until he's 18, and I can't go to my aikido anymore. I can't do any of the things I love to do. And so I just remember the disarming technique. And I would say to her senior, you know, I love you so much, and what you're saying is so right, and it's unfair, all the burden on women and, you know, having to be a wife and maybe some are working and raising the kids is like 300% work, and it's totally overwhelmed. And you are trapped for the next 18 years, and your little boy is just lucky to have such a Devoted mother. And then she said, oh, dad, actually, I love him and I'm so happy to have him. See, by agreeing with her, she would immediately change her mind. The same as what you're saying. But it's such a discovery, and it's hard for people to learn.

Dr Julie Osborn

It is. And then can you share with us regarding the habits?

Dr David Burns

Yeah. And it's not what we see in politics today either. It's kind of like, defend yourself, put other people down. I think Elon Musk said that empathy is the greatest weakness of Western civilization or something like that. And it's pretty stark, you know, and one reason I love therapy, or what we call team CBT or cbt, is it goes down to your value systems at some level.

Dr Julie Osborn

Yes. That's. I have clients come in just for the political. And I say that's the issue. Exactly. Our values are not aligning, and that's this discomfort there. Exactly. Yeah. It's tough. It's tough.

Dr David Burns

Well, should we do habits and addictions?

Dr Julie Osborn

Yes, please.

Dr David Burns

Okay. Well, thank you. I just love this topic and so much fun to talk to you and somebody who kind of is on the wavelength that's so refreshing. But in habits and addictions, this would be fairly obvious. But, you know, when. Sometimes when I'm doing a workshop and people and we're gonna do cover habits and addictions in. In part or to a large extent, I. I say, you know, one of the biggest habits and addictions is, you know, binge eating or. Or overeating. And tell me, how many of you here in the group would like to lose a little weight? Put your hands up and, you know, 80% of the hands go up. And I say, you just made a mistake. You told me that you want to lose a little weight, but there's no one in. In the world at this time who wants to lose weight. And a human being has never wanted to lose weight. Except for people with anorexia nervosa.

Dr Julie Osborn

Yes.

Dr David Burns

But everyone else do, you see, because losing weight sucks.

Dr Julie Osborn

That's true.

Dr David Burns

It means discipline and deprivation, and you're just fooling yourself when you say, you know, I want to lose some weight. You don't want to lose weight. I don't want to lose weight. We want to eat gooey, sticky, tasty food and watch TV and take it easy. We don't want to get out when it's raining and jog and you've got a back pain and that type of thing. So that's the. The outcome. Resistance is that for all habits and addictions, the Outcome resistance means giving up the greatest, what you probably think is the greatest and only source of joy in your life. You know, maybe it's drinking every night after a long hard day. And that's the relaxation, the joy I give myself or you know, I love to overeat or whatever. And you have to, and this is hard for therapists to recognize that people with addictions have addictions because we want that addiction, we want that habit. And unless you address that, you're going to have a very poor, especially long term outcome with habits and addictions. And so the way that I deal with that is I have a new technique that I had on one of my Sunday hikes. On Sundays, my students can meet at the front door at 8:30 and we go out for a hike for a couple of hours and then we go out for brunch and we do personal healing along the way. And on one of the hikes, a very super talented cognitive therapist, she started many treatment centers and a lovely person, but she's a little overweight. And, and, and she said, you know, can you, can you help me lose weight? And, and I, and I said, well, before we do that, let, let's see if you really want to lose some weight because this idea that people want to lose weight is kind of an illusion. And I said, and I do. Now I do it on a piece of paper with three vertical columns. And the first column is good reasons to continue eating whatever I want, whenever I want, you know, but the good reasons for to continue my habit or addiction. And so we walked and came and she dictated the reasons into her cell phone so she'd have them as a list. But we came up with 11 or 12 really great reasons to overeat. You know, it comforts her and she loves certain foods and blah, blah, blah, all these tremendous, it shows that she is going to do what she wants to do. And she's kind of a rebel and she doesn't have to, you know, be skinny like you're supposed to be, and, and all of that. And so we got all of these listed. And now I'm not fighting any of this. I'm just agreeing with her on everything. Then I said, now we're going to do the middle column on this triple paradox. Now let's list all the really awful things about dieting and losing weight. It's not the awful things about being overweight, it's the awful things about losing weight, dieting and exercising. And then she, you know, well, for one thing she said, I've never liked Athletics and I don't enjoy jogging. And, and, and. And I would have to discipline myself and give up this food and that food and the other food and fighting off craving all the time. So we came up with a list of about 10 or 12 really good awful things about dieting and losing weight. And then. And I said, now, the third column on this, you know, triple paradox is what is the fact that you're overweight and eating whatever you want, whenever you want and not disciplining yourself. What does that show about you and your core values as a human being? That's really beautiful, positive, and awesome. And that's, again, one that people have never thought about. You know, how could my overeating show good things about me? And all of a sudden she said, well, for one, you know, it shows that I'm very independent because there's all this pressure from society, and you have to be a certain way and you have to look a certain way. And I'm saying, no, God damn it, you're going to love me the way I am. I don't have to conform to some, you know, image of what a beautiful woman is supposed to look like. And, and, and then it shows I can be a rebel. And she came up with, you know, at least six or eight or ten things about what it showed about her and her core values that's positive or awesome. And so I said, now we've just come up with 30 really, really good reasons not to lose weight. So I'm confused about why you wanted me to help you lose weight. And she said, it doesn't make any sense right now. This is all the reasons why I haven't been willing to diet or exercise or lose weight. So I said, okay, great. So what do you think now? She says, I think I know what's going to happen, and I don't need any more help. I said, well, what's your decision? She says, I'm going to start losing weight, and you won't even have to help me because I'm an expert. I know exactly what to do. But just going through that exercise was a paradox because I was trying to motivate her not to diet or exercise. See, three powerful reasons not to change. But when I did that, I became her subconscious mind. Do you see? So all of a sudden, we were externalizing her resistance and making it permissible. And the odd thing is, when you see your resistance as something positive and beautiful, it tends to go away. And so that's the main resistance for habits and addictions.

Dr Julie Osborn

Yeah, that's Great. I mean, what did. I don't think anyone thinks about it in that way at all.

Dr David Burns

No, no. That's because therapists are addicted to helping. That's their habit in addiction.

Dr Julie Osborn

That's true.

Dr David Burns

And that's why a lot of people can't learn Team cbt, because it means the death of your codependent helping self as a therapist.

Dr Julie Osborn

Yeah.

Dr David Burns

And it's not that we don't want to help, but the team means working through the patient's subconscious resistance and not trying to help relate to any phase in the therapy. And that's the whole key to the kind of revolution of Team cbt, as opposed to the original cbt. And then the m of methods of team is just, you know, I have way, way more methods than. Than in the early days. And. And. And we really create new methods in my Tuesday group. And when I'm treating people almost definitely on a weekly basis, we'll come up with a new. A new method.

Dr Julie Osborn

Yeah. That's great. That's great. And I find that my experience, too, with clients is people are getting more educated and coming and saying, I've been in therapy. It was like, talk, supportive. It didn't really, you know, work. I. I really. I want cbt, you know, and that they're coming. I'm finding that. That, you know, they don't want just this, like, what you call, you know, this cheerleading. It sounds nice at first, but then they're like, I leave, and I still don't know what to do when my panic attack comes or when I'm angry with somebody because I have no tools.

Dr David Burns

Yeah, right. Right.

Dr Julie Osborn

So people are much more open to it and wanting. And they don't want to be in therapy forever either.

Dr David Burns

Right, Right.

Dr Julie Osborn

Yeah. Because I can. I can. Even after all these. I've been doing CBT since 1997, and, you know, I still get surprised sometimes how quickly people get well when they really use that. I'll be like, are you sure? Oh, yeah, I'm good. I'm like. Like, when they really work it every day, like you have always said, it can work so quickly.

Dr David Burns

Yeah, yeah. But a lot of people get angry about that if they haven't experienced it or seen it. And I get a lot of flack. I get a lot of positive feedback. I've been posting videos on our Feeling Great channel. Just free videos and stuff, but, you know, over 90% of people just love them. But every now and then, you know, when I'm talking about how recovery generally comes as a flash and that when I'm working with people. I rarely see anyone for more than a single two hour therapy session. And to some people, it just seems so impossible because they've been trained to think that depression takes, you know, months or years of therapy. But it's just great to have tools that can work really, really rapidly. It's been the dream of my life. I had the dream when I was a psychiatric resident. I used to remember once jogging, thinking, I wonder if it's possible to actually have techniques that you could teach people and that they could use them and get better really quickly. And then I said, if that was true, then therapy would, like, be an art that you could train people in. And I had that idea, but I didn't know the details of it. It certainly wasn't the way I was taught. I would just sit with my patients and then I'd go and sit down with the psychoanalytic supervisor. And the supervisor would say, what happened in the session? I would say, well, the patient just came and complained and cried and got angry and just vented the entire session. And the supervisor would say, oh, you're doing great work. That's wonderful, David. And they're getting all their repressed anger out. And then I would say, well, okay, that's good. But does a time come when they suddenly say, I'm feeling joy now. And if so, approximately how long does that take? Because I haven't seen that with any of my patients so far. And they always evaded that question. They never once answered that question.

Dr Julie Osborn

Wow. Well, look at this is, you know what. And look what you've created for all of us. We're all grateful. All the tools and.

Dr David Burns

Thank you. Yeah.

Dr Julie Osborn

Pushing it, pushing it. Because I know, because you are a trained psychiatrist, but you went more in with the psychology. Right. And, you know, teaching people ways to get, you know, it's empowering to teach people, you can do this. Right? I can teach you this, and then you can do this for the rest of your life. And, and I tell people too, especially like, say, with the Five Secrets of Effective Communication, I said, once you get this, you'll see how you can communicate better with people.

Dr David Burns

Oh, yeah, right. So it can just in every situation of life, it's not just with your patients, but with your family and with your colleagues.

Dr Julie Osborn

Yes.

Dr David Burns

I have to use it all the time because I'm so outspoken. I piss people off all the time. Then they get mad at me and then I have to disarm them.

Dr Julie Osborn

Look, I use my. Well, let me. I want to give you an opportunity also before I finish here is, you know, to share about. You just recently put out your Feeling Great app for free, which I've been around. And just to share a quick story because I just sent it to my family and the other night my husband had a situation with someone. He says, I'm going to get on that app you sent me. And so he's sitting on the couch and he's walking through and, you know, he said this is the most impressive with the AI and the tool. Like, it really helped him get to that place he could understand and deal with the client that he was dealing with. I just wanted to share. That was just the first time. And he was like, wow, this is really good. And it really made him stop and think and, you know, the distortions and all of that. So it's a great tool. So if you could just share. Thank you, listeners about that.

Dr David Burns

Yeah, well, sure. They. I've trained a lot of therapists. If you count all the people who've come to my workshops over the years, there's tens of thousands of them. But I've noticed that it's you. You were able to learn these things and some therapists can. Can, but a lot of therapists can't. It's, you know, that's been my experience for what it's worth. And, and I'm not entirely sure why, but it's just that the. And it's such a radically different form of therapy that I've developed. And so I thought, well, although I've failed with most therapists, maybe I could succeed with a computer, teach a computer. It'll do what you tell it to do. And so I've had some really great close colleagues who've been helping me develop the Feeling Great app. And as you say, it's gotten pretty powerful now. And we're working on the V3, the third iteration. It's going to be quite different from the current. But at any rate, the current version works very rapidly with most people to create healing. And it does kind of the kinds of things I do in therapy sessions. Goes through T E A M. So we're giving it away for the, for the summer. So if you just. The website for the app is feelinggreat.com I believe, and you can sign up and download and use the Feeling Great app. And then there's a lot of free stuff on my website too, which is feelinggood.com and there's all of. I have a podcast, as you know, the Feeling Good podcast. And there's free classes and things on the website almost Everything on my website is free, and everything on both websites now is free. So there's a lot of free resources for people. So if you're hurting and you want to try out some of the ideas, we've been talking about that. That would be the way to do it, but move fast. And, you know, I don't know if we'll be able to keep making it for free beyond the summer. We haven't decided that yet. But, you know, if you, if you use it or you can also go and watch the videos. A lot of people are getting better by watching the Feeling Great. These are little free videos on. On various topics. I think I've published about 50 or 70 of them, and people seem to really, really like them. So that there's just tons of research resources for you if you're. If you're hurting and you'd like to try some of these new ideas and techniques. You know, I'd be just delighted to have you check them out. Or you could even get the book Feeling Great and read that even that is helpful to some people.

Dr Julie Osborn

And so if you go on my website, which is mycognitive behavioral therapy.com and I have a story tab because I have some merchandise with my podcast. But you go to the bottom of the page, your book is on there, and they just click on it and it'll take them straight to Amazon. So anybody, way to look up. But all the free stuff you give in. My cat. My. Yeah, my podcast is free, too. And, you know, I started just because I really believe that the world would be a better place if people had these tools. Right. Because, you know, we all are reacting off our emotions, which get us nowhere, and we have to figure out what we're thinking and having those tools. And I was really naive. I got to tell you, when I started my podcast, I'm like, okay, like, you know, the United States. I didn't really think much and just like you because I listened to all your stuff. The, you know, the feedback from people literally all over the world, you know, is so humbling. I mean, I've. I get these emails sometimes. I've. I mean, I've definitely. I've cried over some people said, you know, I can't afford therapy. This is real. Like, I'm. I'm not anxious anymore. Like, I. It's just been unbelievable the. How much we can reach people by being able to give and be of service. I look at it as, you know, to put it out there. Yeah, yeah. Because people was, oh, you're making money off pie. I said, no, it's just, you know, I've been blessed with, you know, with my practice and everything. I've been able to do that. I said, I just want to. You know, I think we all need to be of service in some way. You are extremely. With all your free stuff, too, and just putting it out there, it really makes a difference. And your videos, I listen all the time, and now I start sharing them with my clients.

Dr David Burns

Oh, thank you. Thank you. I really appreciate that.

Dr Julie Osborn

Yeah, I think the videos are great, too, because some people are just. They want something quick. You know, sometimes they're like 10, maybe 15 minutes. You know, it's like, oh, I can listen to that and move on, you know, instead of like, oh, I got to read a chapter I got to do, you know, if they're not willing. But it's a quick way to start learning, you know, the tool that I know your newest ones are on the five secrets of communication. Right? That just came out.

Dr David Burns

Yeah. Yeah. People want quick. That's been the curse of my life, because I'm not quick. But, you know, like, if you give me two hours, I can, you know, probably cure you of depression. I'm not allowed to use that word, cure. So I didn't say that, but if I had said it, I would have said it. But, but, but. But, you know, it's not like simplistic things, but they're like profound things that can change your life, and they take a little time and effort to get them, but once you get it, boy, oh, boy, it's a tremendous reward. But I try to have short videos, but I published, you know, Wittgenstein was one of my heroes, and I published just. I guess, just published maybe a week ago. We publish one or two of these every week. It was on Wittgenstein, and he was a philosopher, and I've never been able to explain him, but he's really. His philosophy kind of led to the philosophy of CBT and Team cbt. And so I kind of explained it, and I think I got tearful on the video, but it was a long, long video, so we thought this one probably won't be very popular, but that one has gone over the top and. And ratings, the number of views and what people are saying about it.

Dr Julie Osborn

Yes.

Dr David Burns

And I think people are hungry, and people were saying, you mentioned that this is a long video, and you apologize, but keep sending long videos because a lot of us really want something substantial. But it is great to be able to communicate with so many people through YouTube. But you know, we haven't gone viral yet, so we're still kind of in the. In the junior your leagues, I guess.

Dr Julie Osborn

And. But, you know, whoever. Whoever we touch makes it, you know, just takes one person.

Dr David Burns

Oh, yeah, right. Absolutely.

Dr Julie Osborn

Yeah. Well, I would like. I mean, just reading your introduction. I'm hoping to get to your 9 million downloads as well. But I'm beyond grateful, David, for your time. It's been an honor. I can't, you know, to be honest. It's to share my anxiety. I'm like, I'm not telling anyone until I get the interview done. I wanted to stay calm. It's, you know, it's just. I mean, I just respect you and like I said, you're, you know, just learning from you and. And. Oh, and the other training, which I. I was the one in the first group, actually, that Jill Levitt did, that was over a year.

Dr David Burns

Boy, she's a master. She's the dumb.

Dr Julie Osborn

So that's where I really got deep into your training, that I wasn't like that first group. I don't even know how many years ago it was. It was for a whole year and we'd meet like once a week. So, you know, I just love.

Dr David Burns

For a year with Jill in a group.

Dr Julie Osborn

Yeah.

Dr David Burns

Oh, wow.

Dr Julie Osborn

Yeah, it was the first one that they offered because I know they do a lot now and we were all like, just getting, you know, just, you know, level one and there's.

Dr David Burns

Oh, yeah, right.

Dr Julie Osborn

Teaches. So cool.

Dr David Burns

Is that. Yeah, I get to teach with her every Tuesday in my group.

Dr Julie Osborn

That's great.

Dr David Burns

And if any of you who are listening are shrinks or coaches and you want some training, you know, just send me an email, let me know and then you can sign up for the group. And there's no charge for the group, but you have to come consistently. There are some requirements.

Dr Julie Osborn

That's great to know. Yeah. So many resources. So once again, can you give them your website one more time? Because they can get to all these.

Dr David Burns

Yeah, yeah. My website is feelinggood.com, and that's for me, David, and my Feeling Good book and all my books, and there's free classes there, and there's over 400 free podcasts, and there's just tons of stuff there. And then the one for the app is almost the same, but it's Feeling great dot com.

Dr Julie Osborn

Okay.

Dr David Burns

Instead of Feeling good dot com, Feeling great dot com.

Dr Julie Osborn

Okay. And anyone can Google you. Google you. And you'll be all over the place as well, I'm sure. So, yeah, that should work. They can find you.

Dr David Burns

So, anyway, have a great weekend, and thank you so much. It was just. I was very humbled and honored and grateful to be on your show. And congrats to all you've created and achieved. And you deserve just all kinds of appreciation and kudos.

Dr Julie Osborn

I appreciate that. Thank you for being with me. Have a great day.

Dr David Burns

Yeah, you too. Bye. Bye.

Dr Julie Osborn

Bye.