Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
411: Ask David: What’s Self-Esteem? What’s Self-Acceptance? Do We "Need" Them?
Mon, 26 Aug 2024
Ask David: What’s Self-Esteem? What’s Self-Acceptance? In today’s podcast we address six common questions about self-esteem, including: What is Self-Esteem? How does it differ from self-confidence? How does it differ from self-acceptance? What’s the difference between conditional and unconditional self-esteem? What’s the best way to develop self-esteem? What do you mean when you say that once you develop unconditional self-esteem, you should get rid of it as fast as possible? Please keep the questions coming. We enjoy the exchange of ideas with all of you. Thanks! Brandon Vance and Heather Clague begin today’s show with a pitch for their upcoming Feeling Great App Group, an 8 week experience that will begin in September. If you use the Feeling Great App, or plan to get it, this group would be an inexpensive and incredible enhancement, so you can meet with like-minded people once a week to schmooze, practice the techniques in the app, and get your questions answered by compassionate and personable experts. For more information go to www.FeelingGreatTherapyCenter.com/appgroup. Feeling Great App Group Sept-Nov 2024 Led by Brandon Vance MD and Heather Clague MD, meets online for 80 minutes for 8 weeks, offered Mondays 4-5:20pm Pacific Time, September 23rd - November 11th. Cost is $12 per session ($96 total) plus the cost of the app ($99 per year after 7 day free trial). Sliding scale for both the group and the app are available. No one turned away for lack of funds. Feeling Down? Try the Feeling Great App for Free! It's now in the IOS and Android app stores, and you can check it out for free. It's works super fast. Let us know what you think! Thanks! Rhonda, Matt, and David appreciate your support. Keep your questions and testimonials coming. They mean a lot to us!
Hello, and welcome to the Feeling Good Podcast, where you can learn powerful techniques to change the way you feel. I am your host, Dr. Rhonda Barofsky, and joining me here in the Murrieta studio is Dr. David Burns. Dr. Burns is a pioneer in the development of cognitive behavioral therapy and the creator of the new Team Therapy.
He's the author of Feeling Good, which has sold over 5 million copies in the United States and has been translated into over 30 languages. His latest book, Feeling Great, contains powerful new techniques that make rapid recovery possible for many people struggling with depression and anxiety.
Dr. Burns is currently an emeritus adjunct professor of clinical psychiatry at Stanford University School of Medicine. Oh, how subdued. Hello, David, and welcome to our listeners around the world and throughout the galaxy. This is the Feeling Good podcast, and it is episode 411. In addition to our wonderful Matt May, we have two very special guests, Heather Klage and Brandon Vance.
Heather and Brandon are going to be facilitating an app group to support the app, people using the app, and we want to give them the opportunity to describe it and talk about it and David, have you described whatever it is that you want and you expect Heather and Brandon to be doing in the group?
Well, the first thing I think we should remind them that's going to be the Feeling Great app that we'll be working on. And Brandon and Heather, you guys are geniuses at running large book groups. And now the Feeling Great app group, it's going to be amazing. And the Feeling Good or the Feeling Great app is the kind of AI powered app. Feeling Great Therapy, similar to the book Feeling Great.
And a lot of people, in addition to using an app and getting really rapid changes in how you think and feel, like to connect with others and have people to schmooze with and ask questions and practice with. And Brandon and Heather have an amazing way of talking about it. And we'll do that now. And I will shut up.
Well, we are really excited about this. Brandon started the Feeling Great Book Club, yay, many years ago. And then I had the privilege of joining him as the co-leader a few years ago. And that's been really powerful. You know, I... It's great for people to it's accountability to do it and they form connections and they can ask questions.
And then the small groups, which we now have facilitated by volunteers, people really gel. And there's even been some groups that have continued to meet after the book club was over. And so, yeah, we're thrilled that the app is out now because I think it'll be the perfect companion to the app. And I'll turn it over to Brandon.
Yeah, such an effective and efficient and enjoyable app to use. And so it's just really exciting to be able to support people in using that and then working on these tools for anxiety and depression and coming together.
And so Heather and I have found that there's such a power in groups and people coming together, supporting each other, hearing each other's experience while they're working through something like initially the book clubs. working through David's book, Feeling Great, but now with the app. And so we'll have 10 weeks of groups and we're structuring it around the different lessons that are in the app.
And then during that, people can also be using this fantastic AI chatbot, which is like a really great therapist, a really efficient and wonderful therapist following the team model. And so this starts September 23rd, goes on for 10 weeks.
No, it's actually eight weeks.
Oh, I'm sorry. It's eight weeks at 4 p.m. Pacific time. And so... So there's an ability during those eight weeks to meet as a large group and have demonstrations and ask questions from Heather and I. And then to break out into small, more intimate groups to get help from each other.
We'll have questions that structure those smaller groups so that people can really dive deep into the different topics that are discussed and sometimes practice activities as well in those small groups. And then we come back into the big group to summarize things and ask other questions from Heather and I. That's really, really fun. I've been loving doing that, loving working with Heather.
And it's really exciting to be then using this similar kind of structure to then work with you out.
And I would say that Heather and Brandon are both shrinks, MDs, psychiatrists, like Matt, who's with us today, and David. So this is like super shrink day. But one thing about Brandon and Heather is that they're really not only fantastic teachers and therapists of the highest order of magnitude, but their heart is in the place of... giving help to people who were suffering.
Ha, ha, ha.
And it's filled with treasures of experiences to help you change the way you feel and discover greater self-esteem, which is the topic, one of the topics in our podcast today. So I think I had interrupted you, Heather. So back to you.
Right. Well, thank you for commenting on accessibility. We do really want it to be accessible. And so we have a sliding scale that will it's it's it's the cost is twelve dollars per session. So for the eight sessions, but we'll lower that to whatever level people need. And then, David, you have also generously offered to make the app available to anyone who needs to needs that.
So there shouldn't be any financial barrier to people joining.
Where do they go to sign up and find out about it?
They can go to the feelinggreattherapycenter.com slash app group.
Group. Yeah. It's one word. App group. A-P-P-G-R-O-U-P.
Maybe you can put the link in the show notes. Sure do that.
But just because I might be not reading the show notes or something, it's feelinggreattherapycenter.com. And it's that one word, feelinggreattherapycenter.com forward slash app.
App Group, A-P-P-G-R-O-U-P.
Yeah, and then you'll find all the info, and you can sign up and something very important that Rhonda will now say.
Okay, the important thing is it's going to begin September 23rd. It's going to be held at 4 o'clock p.m. Pacific Standard Time, and it will run for eight weeks following September 23rd.
And that's a Monday, so it's going to be on Mondays.
Nice. What else are you guys doing when relating to team therapy or other things in your life that you want to share with us?
I'm so glad you asked. So Brandon and I actually, this is another one of Brandon's brilliant ideas is to teach the five secrets in a small group setting. So whereas I think the depression and anxiety tools can work well taught in a larger group setting to learn the five secrets, you have to practice, practice, practice, and get feedback.
We actually do cover a little bit of that in our other groups, but we do these deep dive five secrets practice groups where where people do role plays and they give each other feedback. And that inspired me to bring it to my hospital where I work at Highland Hospital.
And I got to give a five secrets class on verbal de-escalation of agitated patients for first year ER residents and some people that work at a respite facility. And it was really rewarding. And we're hoping to, we're submitting a proposal to present this for the National Update for Behavioral Emergencies, the Association for Emergency Psychiatry.
Because I think there's a lot out there for verbal de-escalation of agitated people in an emergency room, but they often make the, they don't address the common mistakes that people make, which is jumping into help too soon or failing to disarm, not naming anger. So- Very excited about that contribution.
So you're making Highland Hospital my favorite hospital in the United States. A leader, once again. I spent two years, first year of my internship and then my first year of residency there. And I totally loved Highland Hospital. And I think it's so cool that you're doing some work there, Heather. And that's really neat. I can picture it in my mind right now. Nice.
I just want to say briefly how proud and grateful and excited I am because I've worked very closely with Brandon and Heather for many years. And I just can't think of anyone more qualified to do a fantastic job on this project. I think it's going to be phenomenal. And I'm just really grateful to the two of you for doing that. I have maybe a couple of comments. One is that
I think some people might still be reluctant to do an AI for therapy. And I wondered if we could address that concern. Like people might say, well, I don't want to be talking to a robot or something like that. But I think you've got some excellent data to show that that's actually not the experience that the users have. And I wondered if maybe David or Brandon or Heather, you could address that.
Well, I can tell you a study that we actually did of that a year ago with a couple of hundred people who signed up for a beta test. And we asked them, I was interested in a sophisticated study of empathy to see if people could experience empathy from the AI that we're creating today. Actually, it was before the AI. We just had the classes and lessons and a little kind of a self-help tool.
But we asked them, how much warmth and understanding do you get from the people in your life, the important people, on a scale of zero to 100, where zero would be none at all and 100 would be the best? And I was very saddened to see that the mean, the average, was only about 45%.
Meaning that these people who were, you know, going to the app and struggling with a lot of pretty severe mood problems weren't getting a lot of warmth and support from the people in their lives. And then we asked them to predict how much warmth and understanding do you think you'll receive from the app?
from the Feeling Great app, and they estimated slightly more, like 55 on a 0 to 100 scale rather than 45. So they had some optimism that it would be slightly better But the actual number was 85 on a zero to 100. It was vastly beyond what they expected.
And I think that many people with the using our, now that we've got the AI as well, are experiencing better empathy even than from their loved ones or from shrinks who were theoretically experts in empathy. And so I think that's surprising. And then the other thing is, does it make any difference?
Because there's been a controversy since the time of Carl Rogers, who said that empathy is the necessary and sufficient condition for personality change. And so idealistic therapists for decades thought all you have to do is be warm and caring, and then the patient will recover. And that turned out to be not true for the most part.
But I did publish a study, the first study in the world literature to measure the causal effects of empathy from therapists, human therapists. This was using my clinic in Philadelphia.
And the data, and I published it in the world's top psychology research journal, Journal of Consulting and Clinical Psychology, showed a modest, not an amazing, but a modest causal effect of empathy on reduction in depressed feelings. It wasn't enough to cause recovery. but it was significant.
And the study also showed that other techniques are necessary to get all the way to complete recovery from depression. But I decided to repeat that with the app, and I used something called...
projection into linear space, which is a pretty sophisticated statistical technique where you can measure circular causality and purge variables of contaminating influences that could throw your statistics off. And that study has shown that the empathy that people receive from the app does have actually fairly significant causal effects on reducing depression and anxiety.
There was no causal effect in the opposite direction. Depression and anxiety levels don't influence their estimate of the app's empathy and warmth and understanding. But the degree of warmth and understanding they experience does have causal effects in improving their moods. Again, it didn't cause complete recovery, but it can happen fast within the first 10 minutes with the app.
And that can do a lot to, to raise somebody's optimism. And then you need many other techniques to, to go further. And that's, we've been, you know, I've developed 140 techniques to antidote depression and anxiety, and we're training the, the, uh, our, our AI, uh, to, to use, uh, all of them, not all of them yet, but we're adding, you know, frequently. So it, it's kind of a cool thing. And, uh,
You know, I once had this fellow, Sterling Morey, come from England. He was a medical student with no experience sitting in with me doing therapy in the early part of my cognitive therapy practice. He came to Philadelphia to learn cognitive therapy, so... I let him sit in with me, and he was nervous as hell, and he was young and had no psychology classes or anything.
But his empathy was world class, and people loved him instantly. And I was the teacher. He was the student. And I said, man, I've got to learn what this guy is doing because it's amazing, and he's way ahead of me. And then I learned to do what he does, and that's what I've trained the app to do. And the patients didn't care that he was young and inexperienced.
All they cared was that his skill at understanding and providing compassion were just over the top. And that's what the app does, too. It's very kindly, and it doesn't get irritable. Of course, I don't either, but some people do. But anyway, yeah, you'll love it.
And then if you enhance that app experience, and this is a chance to get a really beautiful compliment to working with the app, you'll have a life-changing eight weeks for sure.
Yeah, that's been my experience with folks who have used the app is that they describe it as fantastic empathy and tremendously healing. Uh, even for severe, uh, emotional states. And, uh, I guess that's, that's what your data was saying is that it's better than talking to a friend. It's probably better than talking to most therapists and, uh, and it has real results.
Yeah. So, uh, You can take a free ride on it and then you can buy it for a year for $99. And if you can't afford the $99, just contact us and we'll give it to you for free because this isn't so much about money as trying to change the world and bring relief to so many people who are struggling and may be listening at this very moment to this podcast and wondering, Is my life worth living?
And why am I so worthless and inadequate? And is there any hope for me?
That's really huge and so touching. I mean, and so generous to be able to give it for free to people who can't afford it. I mean, I'm I'm really touched by that. And this is that the app does seem, you know, as I've been using it, it does, it is really engaging. And one thing about team therapies is such a clear model and where therapists go wrong is usually when they're not following the model.
And so the AI does follow the model and even something with like empathy, that is something kind of of the soul. you've distilled the five kind of major elements of empathy and also noted the pitfalls. And the AI doesn't make the pitfalls, and it does follow that model. And it's pretty remarkable in how tuned in it seems.
Yeah, it's amazing. It's really amazing. We think the app is going to be a major breakthrough. And I'm just so grateful that Brandon and And Heather, you two are going to add the cherry on the top of the chocolate sundae. Nice. So go to feelinggreatapp.com forward slash app group.
Sorry, feelinggreattherapycenter.com forward slash app group.
Feelinggreattherapycenter.com forward slash app group. App group, exactly. Okay. Now we're going to have our first Ask David question here in a minute, which is going to be on self-esteem. You guys can hang around and shoot the breeze with us, or you can shoot off to your other duties for the day.
Well, thank you so much for having us. Really wonderful to be on here.
Yeah.
Absolutely. We'll have to have you back.
Favorite people in the world. I love you both.
Yeah. I love you all. All three of you. All three of you.
So three, which is the one that you don't love? Yeah.
Well, we'll have to have you come back after the group's over and tell us what happened and how it went.
Bye.
See you then.
It was nice.
Very nice. And you couldn't have picked two better people to run this group. And Heather and Brandon, they're incredibly awesome.
Yeah. Yeah. They're very unusual. Unusually skilled. Yeah, unusually skilled and unusually warm and unusually giving and committed to providing help for people. They're jaw-droppingly wonderful. Well, let's get on to this group, which is also jaw-droppingly wonderful. At least two of us are.
People can guess who the person is that isn't. All right. Moving into an Ask David. And we're going to start with a David question. And he asked, is self-esteem the same as self-confidence? And what's the best way to develop unconditional self-esteem?
There's a lot of questions. It's going to be all about self-esteem. And I think the first question is, and we have, you know, five questions from listeners. And so, but we promised self-esteem today, so we made that the number one question. But here are the questions about self-esteem. Well, first of all, I guess we could say, well, how does self-esteem differ from self-confidence?
And we'll get everyone's opinion on that. How does self-esteem differ from self-acceptance? Because self-acceptance is a big buzzword these days. The third question is, what's the difference between conditional and unconditional self-esteem? The fourth question is, what's the best way to develop self-esteem?
And the fifth question is, what do you, David, mean when you say that once you've developed unconditional self-esteem, you should get rid of it as fast as possible? That doesn't make sense. Did you really say that, David? Yes, I did when I was a younger man. What did you mean by that? I'll have to wait until we get to that question. Okay, cranky one. So let's start out.
Should we start out with a sixth question? What is self-esteem? Yes. All righty. Well, there's some great answers to that. And... Matt or Rhonda will give us the first definition.
You actually wrote about self-esteem in the therapist's e-book, right?
Oh, yeah. The e-book, the book, 10 Days to Self-Esteem, my first book, Feeling Good.
Yeah. So, Matt, do you want to jump in or do you want me to?
Yeah.
Well, you know, from gathering information from all of the sources, wouldn't you say self-esteem is the degree to which you value yourself and perceive ourself based on our thoughts and our belief system?
OK, well, that's a great definition. How about how about you, Matt? What's your definition?
I cheated and I looked it up online. It means to respect and admire oneself.
To respect and admire oneself. That's cool. And I would say that self-esteem is the decision to – can you hear that furniture being moved around upstairs? You can?
But maybe Josh can edit it out.
Yeah, let me just give a shout upstairs. You guys can talk and say some cool things. So you can turn off that noise.
I'll try to say some cool things.
Ice cream. Ice cream. Ice tea. Igloos.
Or bears.
Well, do you think that self-esteem is consistent? I think that self-confidence comes and goes. It's not consistent. Maybe we could define self-confidence.
Sure. Did you look that up too?
Yes, I did. I did too. I looked it up too.
From what I gather, self-confidence is something like believing that you can do something, believing in your skills or abilities to do something. And whereas self-esteem is like admiring oneself and respecting oneself.
Do you think you could have too much self-confidence? Is that when people become arrogant?
Yeah. Yeah, I think that'll be part of the answer to David's question is why would we want to get rid of it? But yeah, I think we could have too much self-confidence believing that we could do something like, say, open heart surgery if we're not a surgeon. And that would be excessive self-confidence. And we could have too much self-esteem, too.
We could we could think highly of ourselves, even if we're doing something kind of terrible. And it would be inappropriate to be approving of ourselves and more appropriate to acknowledge our wrongdoing and let others know that we were not having a lot of self-esteem right now. We're kind of hating ourselves for something that we've done and and then to let go of the self-loathing, too.
Right. Because there could be some value in not having self-confidence, like having doubt that I could climb Mount Everest might keep me safe.
Exactly. Yeah. So I think it's very situational, context dependent. And was it adaptive to have confidence here, self-esteem here or not?
Well, I don't know what I missed out on, but where are we now in our dialogue? So we defined self-confidence as...
And as positive feelings that one has about oneself and the belief in yourself to be able to, how did you say it? To awareness of your strengths and belief in your abilities.
Well, I was thinking self-confidence is related to thoughts like I can do this. I have the skills and the abilities to do this. And that that could be adaptive or maladaptive. Like you could... have not enough self-confidence where you actually have the skill to do something, but you don't believe in yourself.
And so you might not, even if you're a cardiac surgeon, give CPR to someone if you have too low of self-confidence and you don't believe in your abilities. Whereas self-esteem would be the sense of admiration for oneself and respecting of oneself, not listening to our inner critic. for example, and but loving ourselves, admiring ourselves. And that can be an antidote to self-loathing.
But it's also not always appropriate to feel that way. I think there are, in fact, times when to say To say, gosh, I'm really hating myself right now for the way I treated you. I really hurt you and I don't like that I did that. I'm not approving of myself right now because I treated you badly. But that would be a more adaptive mood state in certain situations.
And like so many of the things we've talked about before, there's a balance necessary.
Right. And I don't think there's like one mood state or thought that we need to cling to in all situations because they're usually not valuable in all situations.
Yeah, the way I think about self-esteem, it's the decision to love yourself as much when you fail as when you succeed, or perhaps even more when you fail and when you're hurting. And that's when we love, say, our animals the most, when they're hurting, like if they've been in an accident or something. They're sick or children or, you know, loved ones. And it's nothing that you have to earn.
It's something that you give yourself as a gift. And then to me, self-confidence is more the idea that something is... I'm probably going to be reasonably successful at something like... And the show today, we're kind of just doing this spontaneously without any preparation whatsoever, except to line up some great questions to answer.
But I have a lot of self-confidence because I've worked with Rhonda, you and Matt, you on so many times. And I know... how spontaneous and wise and loving and caring and great it is just to hang out with you and answer these questions for people and that type of thing. But, you know, I do a lot of things that, you know, I don't succeed at.
And there are people who are way more successful than we are on podcasts. I guess there are people who have millions of viewers every podcast. I don't know how they do it, but they're, better at marketing than I am and Rhonda is for sure. But I just love being with you guys and respect you. And it's fun to bring our gift, what we have to share to people.
And there's no judgment of being, gosh, I have to have success or so much success to be worthwhile or to have self-esteem. So that's my way of thinking about it. Self-esteem. And then here's another question we've got, since we've got you experts here. Actually, there's no expertise. These are just metaphors, ways of thinking about things that might be helpful to some people. But self-acceptance.
or acceptance in general, is a huge buzzword. And we did some podcasts not far back with some research I did in a survey showing that self-acceptance is, in fact, something which causes a tremendous boost in negative feelings, you know, reduction in negative feelings and a boost in positive feelings.
And at the same time that people resist self-acceptance because people think they can't distinguish healthy self-acceptance from unhealthy self-acceptance. And they think that self-acceptance means accepting the fact that you're going to have a terrible, mediocre life and you're never going to be able to contribute anything. And they think of it as a bad thing.
But what is the difference, folks, between self-acceptance and self-esteem? This is critically important. And Rhonda will now explain in lucid terms what is the difference.
I copied Matt and I asked chat GPT. What unconditional self-esteem was. And the AI response is the belief that your worth is not based on external factors like your accomplishments or your failures or your appearance or your social position. And self-acceptance is a state where you approve of yourself regardless of both your positive qualities and your negative qualities.
So it's a state of approval.
Okay. It's imagining that you have a self that you're approving of, and that's what self-acceptance is?
Yes. And you accept yourself regardless, negative or positive attributes or tasks that you've completed.
Do you accept yourself or do you accept your attributes?
Well, it's a state of being and it's an action of accepting and approving of yourself.
So there's a self involved there. What's your idea about it, Matt?
So to distinguish between self-acceptance and self-esteem? Yes. Yeah, I would consider self-acceptance to be a set of beliefs or thoughts about oneself that is acknowledging shortcomings, flaws, and failures with a light heart. I have many of those flaws, shortcomings, and failings. And so it's a very honest way of appraising oneself. I'm accepting myself with all these flaws and shortcomings.
Whereas I think of self-esteem as I'm focusing on the, I'm admiring, I'm focusing on the positives and kind of defending against the negatives. So I personally like self-acceptance more than self-esteem. It feels more genuine and true to accept ourselves warts and all. than to focus on the positive and defend against or respect ourselves so that we shut down the negative.
Right, right. So you're fully embracing yourself, your strengths, your weaknesses, your limitations, your uniqueness, your beauty, your ugliness. It's fully embracing and acknowledging yourself.
Yep. The good, the bad, and the ugly.
Yeah. And then what is unconditional self-esteem?
That you don't have to earn it, that there's nothing that you have to do to improve or there's nothing you have to have in terms of popularity or wealth or success in order to you just choose to do it. As you said, David, it's a decision that I will approve of myself the way I am and without judgment.
Right. That's beautifully stated. And then what does it mean that... And by the way, when people are growing up, like in school, you're taught conditional self-esteem. You know, the teachers will tell you, well, you're special because you have a pretty singing voice or you have pretty eyes or because you're good in sports or something like that.
So you think that you have to have some special kinds of... superior appearance or skills in order to be worthwhile.
And then... So, David, does that mean that conditional self-esteem fluctuates?
Well, yeah, because, you know, what happens if you lose your eyes? I saw someone who had actually lost their eyes. And so if they've been taught that you're special when they were little because of your pretty blue eyes... then, you know, you're in a pretty precarious situation.
And like if I was to base my self-esteem on my running speed, I would have had pretty mediocre self-esteem because I've never been a super fast runner. And now that I can barely walk due to my low back pain, I'd be really in a, what the... Buddha called an S.H. hole. The hell realm. Type of thing.
So then would you say that unconditional self-esteem is a healthier state to be in?
Well, yes. It's just the decision to love yourself as you are, including your strengths and your weaknesses. And you just make a decision that you're worthwhile. And it doesn't have to be earned in any way. And then... What does it mean? Some fellows said once you've developed unconditional self-acceptance or unconditional self-esteem, you want to get rid of it as fast as possible.
What does that mean?
Who was that fellow that said that?
He's old now. That would be a hint.
I have a couple of thoughts on that, David. But yeah, thanks for bringing that up because it is a little confusing. Why would you want to get rid of self-acceptance or self-esteem? One answer to that is that if we're still focused on the self, then we're missing out on a whole lot. And letting go of that, you know, gazing into the mirror, which is a bit narcissistic, really,
And focusing on our experience and others and our relationships and our work and things that are meaningful to us, it's more like looking through the window than looking into the mirror.
Yeah. So what's the secret then of a happy life?
Maybe knowing when to do those things.
And when to detach from ego and self? Moving beyond the need for the external validation or the, how do you put it, that ego-driven pursuit of self-worth?
Yeah. Like, say to me, David, you're really kind of worthless, right? David, you're kind of worthless. I don't know what you're thinking about, but whatever it is, it's just the tip of the iceberg. Can you tell me what you've noticed recently?
That's powerful self-acceptance. That's the acceptance paradox, right, David?
Yeah. And it's moving beyond the idea that we have a self or need a self. and that things have to be measured. And when I'm with you two, I'm grateful because it's a really wonderful experience. Rhonda, I love your kindness, your humor, your great sense of humor. Matt, there's nothing really that I... But just teasing. But that it's just it's just, you know, grateful to be here.
We won't be here forever. You know, these are the good old days right now. Right.
Right.
And and it's just it's just it's a great thing. And if you don't feel like you have to be special or you have to be worthwhile or even that you have a self, you know, I lost mine, as you both know, once. when jogging home from the train station in Philadelphia, just kind of fell off. And I've never really missed it. Now, occasionally it tries to invade my body again.
And I start thinking I have a self and then I suffer with with ego or thinking, you know, getting all uptight about about something or I'm not measuring up or something like that. But these are just metaphors, and one idea of enlightenment is just letting go of all of that and living your life, talking to yourself in a loving way and treating yourself in a loving way.
That's, I think, the secret of self-esteem and beyond is the decision to be kind and loving to yourself. I make the decision to be kind and loving to our cat, Sweetie Pie, and she didn't earn it in any way, but it's just a great joy to be with her, and she just purrs like crazy, and she's quick to show her gratitude.
And just to give, my wife said, maybe it's enough for a life just to, if you really are dedicated to being very loving to a cat, maybe that would be enough. And I certainly feel the same way. Well, have we covered all the bases on self-esteem? I think so. We've done a pretty good job.
Yeah.
Yeah. Yeah.
And the practical side of it is if you're feeling down and unhappy, then you have low self-esteem. And that's always because of your thoughts, talking to yourself in a mean, self-critical way. And the decision to stop doing that, that's the decision that leads you out of depression and into joy. Right. We fight against self-esteem. We fight against self-acceptance.
And we think that being mean to ourselves, saying, oh, David, you screwed up. You're not good enough. You should be ashamed of yourself. You're such a loser. You have this defect. You've got that defect. all that kind of stuff, that's all depression and unhappiness really is.
And the capacity to get out of it is simply to make the decision to stop doing that to yourself and to treat yourself in a loving way. Not because you've earned it, because you can't earn it, but because you've made a decision. But, you know, that may go in one ear and out the other. When you see it, it's kind of an enlightenment. But it's hard to get when you're feeling down.
And so go to the Feeling Great app and check it out. And we'll take you by the hand and show you how to make that happen. Now, I'm hearing an airplane. Yep. Oh, that's on my side. Almost like a cat purring.
I read this book a long time ago called How We Choose to Be Happy. And these two psychologists interviewed a bunch of people who were confirmed to be happy. And there's a big story about how they confirmed who was happy. But they weren't people that lived a life without tragedy. Like somebody lost their house in a fire. Somebody was a Holocaust survivor.
Someone found their father after their father had died by suicide. And so they were people who had tragedies in their life, and yet they were happy. And one of the common threads is exactly what you said, David, is they woke up every day and they made a conscious decision to choose to be happy. Like you're saying, people can make conscious decisions to choose to accept themselves.
To be kind to yourself.
To be kind to yourself, to show yourself compassion. And to me, that is the key to a joyful life.
Yeah. I get emails from people all the time. And there's so many of them now, I'm really starting to drown in emails trying to catch up. Yeah. I kind of took kindly to a fellow who said that he's struggled with, you know, chronic depression and anxiety for all of his life.
No one's been able to help him, and I just asked him for more information, and he wrote back a really long email, which is hard for me because I'm a slow reader, but it was just filled with bitterness, anger toward himself and anger toward other people. everything falling short of his expectations, he himself and others.
And I haven't even finished reading it, but I felt so sad that he's living in a self-created hell, but he doesn't realize that he's doing that creation and that we create our own emotional reality and interpersonal reality at every moment of every day. But you have to, you know, want to change. You have to want to discover that.
And then you have to have the tools to make that a reality for yourself. And that's where TEAM is so powerful because we have so many tools to help someone find your way out of those black holes. And I certainly hope something can change. can happen for this individual.
But part of it is just focusing on some specific moment when you're upset rather than, like, he's in what I call a blizzard of depression and anxiety and anger. In other words, everything is swirling. Everything is bad. And that's one of the things about team. And I'm just babbling here, but these are things that I think about often.
Is, you know, the fractal focus on one moment when you're upset and then see what your thoughts are at that moment, that the negative thoughts and if you're interacting with people, what's happening in those interactions. And then first decide if you'd like to change the way you were feeling at that specific moment.
And then also all of the reasons that you've been stuck, the very good reasons why you're angry, why you're anxious, why you're mad at everybody, why you're depressed and what they show about you that's really positive and awesome. And sometimes when you see that, suddenly the doors to change will open up. That's a bit of a paradox. And it has nothing to do with our show today.
So why don't we get on to the next question?
I have one maybe subtle point and then one question. I'm not sure if we fully explored the question of what is the best way to achieve self-esteem, unconditional self-esteem, and unconditional self-acceptance. That's the premium version, Matt.
That's the premium version. Yeah, this is the free podcast. We're going to hit a paywall here. Yeah, give us your thoughts on that, Matt. I think that'd be really neat.
Yeah, so I'm not sure that there's one path that's correct for everyone. That's true.
We all have our own path to enlightenment and a little different from someone else's.
Yeah. But the understanding like which methods are more likely to be effective is based on what kinds of negative thoughts you're prone to. That our thoughts are like just habits that get produced by our brains.
And so to address them in a customized way, like in one moment in time, just one thought helps because in every other moment in the future where you are upset, you'll have the precise same set of negative thoughts, just like I'll always have the same thumbprint. And if I know what method is helpful for me, it will always work for me in the future.
Yeah, that's one of the neat things. And if you're really good as a therapist at empathy and positive reframing and reducing resistance, we can often get to the method that works for a person in a remarkably short period of time. But one person might be helped dramatically by the cost-benefit analysis. I can remember a very angry patient with borderline personality disorder who...
You know, the first time I saw him, I didn't know he had that diagnosis. He was just this angry physician, and apparently he'd had years of failed therapy, which I didn't realize until I talked to the person who did the intake evaluation, which was after my session with him.
But he was a doctor, and he worked in a hospital, and he was just pissed off at people, and he would have temper tantrums and get in trouble. And one of his colleagues got promoted, but he didn't, and he thought the colleague's research was phony and only phonies get ahead and all of this.
And he was asked if there was any hope for someone as severe as him with so much anger and so much depression of a severe nature. And this was even in the days before paradoxical agenda setting, but the idea of it was forming in my mind before it became full-blown. I said, well, before we try to change it, let's see if we can list some of the advantages of feeling depressed and angry and anxious.
And we started listing all of the advantages, especially of his anger, And we must have come up with 18 benefits. And then at the end, I said, well, gosh, you know, this is a line from one of my students, Matt May, that we have tremendous techniques and could probably pretty easily turn your anger around, but... I don't think that would be a good idea because look at all the benefits to you.
You know, you feel morally superior and you're honest and you have integrity and you're not one of the phonies and blah, blah, blah. And he read his list and he burst into laughter and he practically fell on the floor. He was laughing so hard. And he said, this is ridiculous. I see now what I've been doing. He says, I'm cured. And it was like 15 minutes after I met him.
And that was just happened to hit on the thing that helped him. And then that weekend I went. on a hike or a jog, actually, with Tony Bates, who was a clinician in my clinic in Philadelphia. And I said, Tony, that patient you sent me was so easy to treat. It was unbelievable. And he says, yeah, you're joking, right? And he says, no, no, he was maybe the easiest patient I've ever had.
And he said, no, that's impossible. That fellow has severe borderline personality disorder. He's been severe since childhood and no one's been able to help him. And I said, oh, no, that guy couldn't have borderline personality disorder. He was just a dream. He was a pleasure to work with. He's really nice and funny. And Tony says, no, I did the...
diagnostic screening, and he has severe borderline personality disorder. And he says, you don't know what the heck you're talking about. I had a session with him. Tony says, look, Bundy, when you get back to the office, you'll see my summary. And I looked at it, and sure enough, the guy had severe borderline personality disorder.
But we just happened to stumble across the thing that opened the doors to his enlightenment. And I think what's really great is that each person can find a path that works for them. And so one of the great things about TEAM is hope that every person can change and transform your life, no matter how much suffering or how desperate your circumstances might be.
Love that story, David. And I also experienced, I'm not sure if I have severe borderline personality disorder, but I did suffer from the love addiction and the approval addiction where my self-worth was tied up in whether or not other people loved and approved of me. And I did the cost-benefit analysis on that. And it just dissolved right there in front of my eyes.
Yeah, I was thinking, oh, I need to wait around for other people to approve of me before I do, because that'll motivate me to be a wonderful friend and partner. And then I realized, no, that's putting me in a terrible mood and it's not allowing me to connect with the other person. And it's me being real needy and that drives people away.
And when I saw the cost benefit analysis play out, I realized this isn't something I want to do. I want to skip the middleman and just approve of myself.
So are you saying that's something some of our listeners might want to play with if they looked at my list of 23 self-defeating beliefs like the love addiction, the approval addiction, the achievement addiction, perfectionism, and so forth, all these things we think we need in order to feel happy and worthwhile, and then simply take a piece of paper, draw a line down the middle, and list the advantages of that belief on the left and the disadvantages on the right?
And if you're doing, say, the love addiction, it's not the advantages and disadvantages of being loved. It's the advantages and disadvantages of basing your self-esteem on being loved, on needing love in order to feel happy and worthwhile. And then say, how is this going to help me? And there's a lot of ways it will help you. And how is it going to hurt me? And then balance it.
Is it 50-50, 60-40, 40-60? Yeah. And that's a simple exercise anyone listening to the show right now could do. And while no one thing is guaranteed to work for everybody, that can be a tremendous eye-opener.
Yeah, it was super helpful to me. And then the other thing that you recommended to me was to go collect rejections. And that was the behavior that actually really annihilated that belief that I need approval or love from other people. And it gave me tremendous self-esteem, self-confidence, acceptance of myself. Because I realized nothing bad happens if someone rejects you.
That you still have the ability to like yourself from within. And if you're doing that, you're kind of impervious to rejection. And then once I had that experience, then suddenly I connected with someone. And my love life went from rags to riches that day.
Yeah, I was talking about that on the Sunday hike when when you were a resident and we were getting together for a couple hours or more every week to go over your cases and your personal life. But do you remember one day like when you found that and then suddenly you became super attractive to women? Yeah. And I remember the day you said, Dr. Burns, you used to call me Dr. Burns.
I have a problem. I made a mistake and I have three dates scheduled tonight.
Yeah.
Well, and anyway, kind of cool. Let's go on to some of the other questions and give a little variety to our listeners.
We've been talking for an hour.
Yeah, well, we could call this a day. Okie dokie. All right.
All right. Well, thank you, everyone, for listening. I hope you found this as fascinating as we found it.
And if you didn't find it fascinating, we hope you'll come back next week for what's about to happen now, which is going to be incredibly fascinating.
It's great spending time with you, Rhonda and David.
It's great spending time with you too. It's such an honor for me. This has been another episode of the Feeling Good Podcast. For more information, visit visit Dr. Byrne's website at feelinggood.com, where you will find the show notes under the podcast page. You will also find archives of previous episodes and many resources for therapists and non-therapists. We welcome your comments and questions.
If you want to support the show, please share the podcast with people who might benefit from it. You could also go to iTunes and leave a five-star rating. I am your host, Rhonda Borowski, the director of the Feeling Great Therapy Center. We hope you enjoyed this episode. I invite you to join us next time for another episode of the Feeling Good Podcast.