Feeling Good Podcast | TEAM-CBT - The New Mood Therapy

A lively chat about a paradoxical approach to beating procrastination. They tease ten practical TEAM CBT tools that promise rapid change. Techniques mentioned include the triple paradox, stubborn refusal, and a playful TikTok method. Listeners are invited to a free live webinar with dynamic, upbeat teaching and registration details.

(featured photo shows David, his wife Yvonne, and son, Joey, when young) Meet the Incredible Dr. David Antonuccio, Part 2 of 2 Shrink, Songwriter, and Hero Today we continue our conversation with my dear friend and esteemed colleague, Dr. David Antonuccio, a true scholar, clinician, researcher, musician, and champion of scientific transparency. The Nicotine Patch Study David revisited his landmark research on the nicotine patch, a costly trial involving roughly 600 participants who were randomly assigned to receive either a real nicotine patch or a sham patch. The goals were to assess safety and efficacy. The safety data looked reassuring. However, the efficacy findings were unexpected: the placebo patch worked just as well as the active nicotine patch in reducing smoking. The sponsoring company published the safety data but refused to publish—and refused David access to—the efficacy findings, which showed no advantage for the nicotine patch. You can check the link to the NEJM article here. David writes: "Notice the 48 week follow-up data were excluded in this paper despite the fact that they were available. That really annoyed me. I also now believe that the original version of the paper was ghostwritten and ghost analyzed by the industry folks.in other words. I'm not sure that the authors ever had access to the "raw" data before they were analyzed." This was important because there was a decrease in smoking DURING the study among those wearing the patch, and getting their "fix" of nicotine that way. . . but what happened AFTER the study? David writes: "Here is the link to the follow up paper that emphasized efficacy and included the 48 week follow-up data." Notice that this paper was not published until three years later, when the Nicotine Patch had already been heavily advertised and sold on the market. This early experience in his career revealed the tension between marketing interests which focus on sales, and scientific interests which focus on truth and transparency—a daunting and frustrating pattern that would emerge again and again in his career. Expert Testimony in a Tragic Criminal Case David then described expert testimony he provided in a deeply troubling legal case. A 72-year-old woman, happily married for 50 years and a respected kindergarten teacher, had recently been prescribed Paxil, along with Ambien and Ativan. She abruptly, and without memory, woke up in the middle of the night and stabbed her husband 200 times and was subsequently arrested for homicide. There was no jury trial; instead, a plea bargain was used to determine sentencing. Dr. David Antonuccio was called as an expert witness in her defense. He described Dr. David Healy's research documenting a significant increase in both suicidal and violent urges among some patients taking SSRIs, especially Paxil. He argued that this woman's bizarre behavior was consistent with a drug-induced dissociative or fugue state. Based in part on David's testimony, the charge was reduced to manslaughter, and the judge sentenced her to time served, allowing her to return home to her children. For more on this topic: David Healy's Research on SSRIs and Homicidal Urge SSRIs Called on Carpet Over Violence Claims Black Box Warnings and Patient Rights David also emphasized the urgent need to revise Black Box warnings to reflect the full range of possible toxic or dissociative effects of psychiatric medications—not just suicidality. He has long advocated for a Patient Bill of Rights to ensure scientific transparency and informed consent. A Surprising Conversation with Dr. John Nash David shared a fascinating personal story about calling Dr. John Nash, whose life inspired the award-winning film A Beautiful Mind. In the movie, Nash's recovery from schizophrenia is portrayed as medication-dependent. However, Nash told David directly that this was not true—the medication narrative was added to the script, possibly out of concern that portraying his recovery without meds might discourage viewers from taking prescribed medications. Nash said: "What saved me was the support of family and friends." Music, Truth, and "Buzz" David is also a talented songwriter. One of his songs, "Buzz," addresses the emotional and ethical issues surrounding electroconvulsive therapy (ECT). The inspiration came from a man in the Midwest who was legally ordered to undergo ECT against his will. A widespread public outcry ultimately convinced the judge to rescind the order. Forgiveness and "In the Air Tonight" One of David's favorite songs is Phil Collins' "In the Air Tonight," which he sees as a deeply spiritual musical meditation on forgiveness—a theme David considers one of the most powerful psychological forces we possess. David explains that the Phil Collin's song is about forgiveness, but more indirectly and specifically about the songwriter's inability to forgive. And yes—David sang it live for us on the podcast! You might be interested in this chapter that David coauthored on the science of forgiveness Thank you for joining us today. And heartfelt thanks to you, Dr. David Antonuccio, for your gifts of enlightened skepticism, ethical courage, incisive scientific thinking, and soulful musical talent. David, Rhonda, and David

Stories from a Giant and Gadfly Discover the Protest Music of RainFall!-- like "The Antidepressant Blues!" Today, we are delighted to spend some time with a dear friend and highly esteemed colleague, Dr. David Antonuccio. David is a retired Clinical Psychologist and Professor Emeritus in the Dept. of Psychiatry and Behavioral Sciences at the University of Nevada, Reno, School of Medicine. In addition to his academic work, David had his own clinical practice for 40 years. He has published over 100 academic articles and multiple books, primarily on the treatment of depression, anxiety, or smoking cessation. Since his retirement from practice in 2020, he has been making music as part of a duo called RainFall, with his musical partner Michael Pierce. Their music can be found on Spotify, Apple music, and Soundcloud, among other streaming services. I first became familiar with David when a colleague recommended his article entitled: "Psychotherapy versus medication for depression: challenging the conventional wisdom with data," which was published in Professional Psychology: Research and Practice way back in 1995. The article blew my socks off. In the first place, he had come to the many of the same conclusions I had come to, that antidepressants had few "real" effects above and beyond their placebo effects. However, he also had incredible insights into some of the problems and loopholes with drug company research studies on antidepressants, so I tried to get as many colleagues and students as possible to read that article. Here is the article link Although I had never met David, he became my hero. One day, while I was giving one of my two-day CBT workshops in Nevada, I was singing his praises and urging participants to read that classic article, but, unexpectedly, some people started chuckling. At a break, I asked someone why people had been laughing. They said, "Didn't you know that David Antonuccio is here attending this workshop? He was out visiting the bathroom when you were singing his praises, so he didn't hear you!" And that's how we met! I couldn't believe my good fortune in meeting this brilliant and humble man in person. And to my good fortune, we became good friends right off the bat and eventually did a lot of fun professional work together, like our exciting conference challenging the chemical imbalance theory of depression which we called the Rumble in Reno. I was also proud to be included as a co-author in a popular article with David and William Danton reviewing the brilliant work of Irving Kirsch. Kirsch had re-analyzed all the data on antidepressants in the FDA archives and concluded that the chemicals called "antidepressants" had few, if any, clinically significant effects above and beyond their placebo effects. In that paper, we also emphasized the ongoing power struggle between the needs of science and the needs of marketing. Science is devoted to discovering and reporting the truth, based on research, regardless of where it leads, while marketing, sadly, is ultimately loyal to the bottom line, even if deception is required. Here is the link to our article: And here is the full reference: Antonuccio, D. O., Burns, D., & Danton, W. G. (2002). Antidepressants: A Triumph of Marketing over Science? Prevention and Treatment, 5, Article 25. Web link: http://journals.apa.org/prevention/volume5/toc-jul15-02.htm I was sad when David retired from his clinical, teaching, and research career a number of years ago in order to spend more time on creating and recording music because, a passion he'd put on the shelf during the most active years of his career. I felt we'd lost an important and courageous leader in the behavioral sciences, and felt an emptiness, like an important pioneer was suddenly missing. The following link provides a highly readable brief overview of David's career focus and interests. I was thrilled to learn just recently that David has partly resumed his role as gadfly of the behavioral sciences, rejoining the fight for science, ethics and for truth, regardless of where that leads or whose feathers are ruffled. And now, we sit down together to reminisce about his personal life and experiences with many of the greats in our field, like Dr. David Healey, Irving Kirsch, and others who have also stood up for the truth, based on their research, in spite of intense opposition from the establishment. And, today David also brings us his music, with his colleague, Michael Pierce, RainFall. Some of his music has psychiatric / psychological themes, like his "Antidepressant Blues," Some of David's music has humanistic and political themes. He said: Here's a song we just released yesterday that i will assume would not be relevant to the podcast. It is called Final Embrace and was inspired by a heart-breaking international wire photo of a Salvadoran immigrant father hugging his daughter, both deceased, in the rio grande in 2019. Here's the link to the original news story. David's two-man group, RainFall, wrote and recorded the original acoustic version of this song in 2020. He explains: We decided to record a more dynamic updated version of the song with some electric guitar chords, electric bass, and drums. We are calling it "Final Embrace Electric". The story is still heart-breaking, and it still makes me cry to sing it. Here is a link to the new version of the song, And here are the heart-breaking lyrics: Final Embrace Electric (For Oscar and Valeria) By RainFall (David Antonuccio and Michael Pierce) I'm sorry I couldn't help you I'm sorry you lost your life You took a deadly risk I'm sorry for your wife What were you supposed to do? Stay home and watch your family die? Or take a chance at freedom Reach for the sky Some say you should have known better They say that you are a criminal But they don't know your fear, your pain, your hunger For them it's the principle Some say we were here first It's not our problem Despite your dire thirst We're full, no more asylum Let's ask them what they would do If their family were faced with danger If they're honest, they'd take the chance Hope for kindness from a stranger You tried to get in the front door But it was slammed closed So you swam the deadly current Despite the perilous flow You never lost your grip Though the river was not crossable Only another parent can know How that is even possible Everyone can tell you loved your daughter Even in that place You never let her go It was your final embrace I'm sorry I couldn't help you I'm sorry you lost your life You took a deadly risk I'm so sorry for your wife Everyone can tell you loved your daughter Even in that place You never let her go It was your final embrace Your final embrace It was your final embrace It was your final embrace Thank you for joining us today. Stayed tuned for Part 2 of the David Antonuccio interview next week! David, Rhonda, and David

"Doctor, why won't you ever tell me how you really feel?" Therapist Self-Disclosure-- Featuring Dr. Carly Zankman This week, Dr. Carly Zankman joins us to discuss a really interesting and controversial topic—self-disclosure by a therapist. When is it helpful? And when is it an ethics violation? When I was a psychiatric resident, my supervisors (mainly psychoanalytic) cautioned me NEVER to share my feelings with patients. This felt really awkward at time, but is there some wisdom in that advice? And if so, what IS the wisdom? How does it work or help? And if that rule—never sharing your feelings or personal life--is too rigid, then when and how should we share our feelings and personal experiences with our patients? What is the goal, and what are the best practices? As most of you know, I have often been extremely critical of what I was taught as a psychiatric resident, thinking the teachings were based more on tradition than on science or data. And when it came to never share your feelings, I sometimes used to think about this issue along these lines: Let's assume that one of our jobs is to help our patients become more vulnerable and genuine, by sharing how they really feel inside instead of acting fake and always presenting a happy or professional face to the world. That goal seems reasonable, and it's a prime goal of a great many therapists. But how are we supposed to accomplish that goal by acting fake and hiding our own feelings? That just did not seem to make sense to me! But there are lots of traps when it comes to sharing your feelings. What if the patient is attracted to you, or vice versa? What if you do not like the patient, or feel turned off by them or annoyed with them? In today's podcast, we will try to sort out some of these questions, with help from the vivacious and brilliant Carly Zankman, Psy.D. (INSERT CARLY'S BIOSKETCH AND BRIEF DESCRIPTION OF HER TEAM CBT CLINICAL WORK IN MOUNTAIN VIEW, California. Carly described being taught similar things in graduate school, cautioning the students against opening up in a personal way during sessions. However, one of her supervisors listened to one of her sessions with a patient, and said, "the greatest gift you bring to therapy is just opening up and bringing your own, genuine and authentic self into the room." Carly described being taught similar things in graduate school, cautioning the students against opening up in a personal way during sessions. However, one of her supervisors listened to one of her therapy sessions with a patient, and said, "Your greatest gift is bringing your own, genuine and authentic self into the room," and from that point forward, everything shifted in how she viewed her role in the therapeutic relationship. Carly describes working with a patient recently and receiving a 19 / 20 on the Empathy scale at the end of the session. Although 9 out of 10 therapists would say that's a terrific, near-perfect score, on our scoring key it is rated as a failing grade. That's because the patient is telling you that you didn't quite "get" something about them, or didn't quite connect with them in a completely warm and supportive way. Carly's patient was a 40 year old recently re-married woman with a new baby, and struggling with a lot of regret, guilt, shame, depression, and anxiety. Carly decided on a hunch it might be a good idea to share her personal story, since she saw this woman as a mirror image of herself. Carly asked the patient if she wanted Carly to share her story, and this patient lit right up and was excited. It turned out to be tremendously helpful and was what she needed to believe Carly's empathy was real and not phony. The patient said that in the past she'd had many therapists, but none of them had ever share their personal experiences or feelings. Why was that so helpful? How does it work? And what are some red lines that you do NOT want to cross as a therapist? These are just a few of the ideas we discussed on today's podcast. We listed and briefly discussed a few of the many situations where it might NOT make sense to share our feelings or experiences with patients. Rhonda pointed out that if you've had a traumatic experience and you're feeling quite depressed, anxious, or angry, and have not yet had the chance to do your own personal work, it would not be the best idea to share it with your patient, because you might be using the patient as your own therapy or support network. You also would not share feelings of sexual or romantic attraction to a patient strong personal feelings of unresolved depression, anxiety, or anger Some feelings you might share with your patient, but only if you have the great therapeutic skill to do so in a helpful, illuminating way, such as feelings of dislike or anger toward the patient. We also discussed the danger of therapy degenerating into a paid friend relationship, and asked how that differed from the work of Dr. Irvin Yalom, the famous Stanford psychiatrist who taught us that developing a genuine human relationship between the therapist and patient IS the goal of therapy. Finally, we exchanged ideas about the model of therapy as a "corrective emotional experience," and none of us seemed to take kindly to that model of therapy. Thanks for listening today! And thanks for the illuminating information from our brilliant and bubbly guest, Dr. Carly Zankman! Thanks for listening today! Carly, Rhonda, and David

Explore the complexities of schizophrenia as a brain abnormality and the limits of CBT. Learn practical TEAM-CBT strategies for families, including mood logs and communication techniques. Delve into the treatment of OCD, where cognitive methods can surprisingly match exposure techniques. Discover hidden emotions behind compulsive behaviors and the importance of allowing grief and anger after betrayal, as actionable insights are shared on moving forward from emotional pain.

In a gripping follow-up session, a loving mother confronts her fears regarding her daughter's safety while studying abroad. The discussion dives into cognitive flooding techniques, allowing her to face her worst fears actively. As she visualizes terrifying scenarios of abduction, hidden childhood traumas emerge, linking past experiences to current anxieties. Through supportive therapy, she learns to transform her panic into resilience, exploring themes of self-criticism and parental guilt. Finally, they focus on empowering her narrative, envisioning a safer outcome for her daughter.

In a gripping session, a mother grapples with overwhelming anxiety about her daughter's safety abroad. They explore techniques like the Magic Button and Positive Reframing to challenge her fears, revealing surprising benefits of anxiety tied to her parental instincts. Role-playing helps confront negative thoughts, leading to powerful insights and emotional breakthroughs. By the end, significant shifts occur in her feelings of sadness and anxiety, ultimately leaving her grateful and empowered to manage her concerns.

In this enlightening session, Dr. Jill Levitt, a clinical psychologist and Director of Training at the Feeling Good Institute, teams up with David Burns to conduct live therapy with Madeleine, a worried mother spiraling into anxiety after reading a disturbing article. They explore her deep fears for her daughter's safety, grappling with parenting guilt and feelings of inadequacy. The conversation delves into childhood trauma, emotional detachment, and how these experiences shape her parenting. This session emphasizes empathy and the importance of addressing resistance to foster change.

Dr. Matthew May, a seasoned psychotherapist, joins the discussion, diving into memory rescripting versus past projection, highlighting their therapeutic benefits. He elaborates on cognitive flooding and the affect bridge techniques, aimed at processing trauma. Addressing weight loss, David introduces the Triple Paradox to navigate resistance to change. The conversation also touches on spirituality, where negative thoughts are likened to 'demons' expressing hidden emotions. They explore how understanding these can lead to profound personal breakthroughs.

Am I Helping People Who Are Suicidal? Should I Worry about My Daughter's Anxiety? Disarming Yourself The answers to today's questions are brief and were written prior to the show. Listen to the podcast for a more in-depth discussion of each question. Here are the questions for today's podcast. George asks: Would my approach help someone who is suicidal? No Name asks: Do I need to worry about my daughter's anxiety? Jeffrey asks: Can you disarm yourself? George asks: Would my approach help someone who is suicidal? Dear David, Please tell me if this is too close to medical or other protected advice, but I had a question about something I tell people who are sometimes struggling with suicidal ideation. Throughout my life, I have had the thought "I don't want to be alive anymore" more times than I can count. But what I have come to realize over time is that this is just something my brain says when I'm upset; it doesn't really mean anything other than that. It's just a reaction to being very upset and that reframing helps me feel better about it, knowing that it's not a conviction but rather just how my brain expresses negative distress. Multiple people have found this helpful, but I wonder if telling certain people this would be dismissive/triggering/etc. In a dangerous way? Do you think I should stop sharing this experience? George David's reply: Hi George, Thanks for asking. I will make this an Ask David question, if okay with you, using your first name or some other name if you prefer. Short answer: to me, this is like giving advice, to my way of thinking, and I have spent the last 40 – 50 years indicating that this is NOT an approach that's ever worked for me. Can say more on the podcast. Thanks! Warmly, david No Name asks: Do I need to worry about my daughter's anxiety? Dear Dr. Burns, I am not very skilled at expressing how much you, Rhonda, the others and your work mean to me. So, I will just ask a question. My daughter, who has a lot of anxiety issues told me that when she has a problem, she will purposely stew over it when trying to fall asleep so that she will wake up with an answer to the problem the next morning. I cringed. Is there any way that this is a safe or helpful paradoxical technique? No name David's reply Thanks, I'll copy Rhonda. We are both grateful for your loving comments! Rhonda, we can make this an ask David if you like for a podcast. But short answer, at least, in my opinion, is that this is a cool way to use your brain. It is a skill. For example, I often get confused by a difficult statistics problem when analyzing data, and go to sleep confused. Nearly all the time, my brain wakes me up in the middle of the night with a brilliant answer. So, if she perceived is in a positive way, and isn't disturbed, you could try nourishing it, as opposed to worrying about it! We'll see what Rhonda thinks. Rhonda, I'll add this great brief question to our list for Tuesday. I am reluctant to postpone the Ask David as when we've done this in the past, we've ended up never answer at least 20 to 30 questions which are now too old to put on a podcast. Those who asked may no longer even be alive it's been so long! Warmly, david Rhonda's reply Thank you for this lovely feedback. It really means a lot to us. Your daughter is going through something so many of us experience. I am excited we can respond to your question on an Ask David podcast. Warmly, Rhonda Jeffrey asks: Can you disarm yourself? Subject: Question about using disarming technique on oneself, and also it being used against you. Endless gratitude to all of you for the pipeline of clarity and hope. I was wondering if one can use disarming on oneself. Much of the focus in feeling good seems focused on looking for and challenging our distortions, which seems the opposite of disarming. Maybe the reversal of agendas emphasized in feeling great is essentially putting the disarming back into the process in regards to ourselves. I would like to hear your thoughts on this. On a side note, if one is in a legal contention or divorce, I could see how disarming could be effective and pacifying, yet what if those admissions could be used against you. David's reply I would like to include this in an Ask David podcast, with our first name or a fake name. Please advise if okay. Short answer: the ideas and tools to treat individual mood problems, like depression, are the complete opposite of the ideas and tools to treat relationship problems. This is like matter and anti-matter. However, the Disarming Technique and the Acceptance Paradox connect these two opposed and radically different worlds. So, in a sense, you are right. The Acceptance Paradox is a lot like disarming yourself! Best, david Jeffry's reply to david Thank you for the succinct response, and I look forward to hearing it fleshed out in the podcast. I would be honored for you to mention my name: Jeffrey - from the outskirts of Jerusalem in Israel And thank you to the whole team for keeping the best things in life for free (although I do hope everyone receives the funds they need). Yet I feel converse maxim - "there's no free lunch" remains standing, app://resources/notifications.html And that is, because, as you state over and over - anybody serious in improvement must pay the price; whether in completing the daily logs, or Burns assessment quizzes, or facing your fears, challenging your assumptions or fine-tuning one's communication skills, one interaction at a time. The danger of apps, and screens in general, are the inherent passivity and superficiality they engender, so I am looking forward to seeing how this app overcomes that. Lastly, you had sought feedback as to audience preferences for podcasts: I think by now I and most regular listeners are clear in the general approaches of Team CBT, and how it differs from other schools and their adherents, so now I benefit most from the role playing to crystallize and internalize its application. I would also be willing to forego multiple scenarios in each session in order to spend more time reiterating and clarifying individual scenarios - assuming that David, Rhonda, Matt, etc, have the willingness to keep going. Keep on keeping us learning and laughing. Jeffrey David's reply Thanks for the kindly and thoughtful note. We'll certainly try, but as you say, there's no free lunch and no guarantees! We are sometimes just hanging on! I like your recommendation for podcasts: more role playing I think to bring techniques and ideas to life. Warmly, david Thanks, for listening! David and Rhonda