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

419: Ask David: Changing an SDB; Intense Public Speaking Anxiety

Mon, 21 Oct 2024

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Ask David How Can I Change an SDB (Self-Defeating Belief)? How Can I Cope with Intense Public Speaking Anxiety? Featuring Rhonda Barovsky, Psy.D., Matthew May, MD, Jason Meno and David Burns, MD (Jason is an AI Scientist on our Feeling Great App Team) Anonymous asks: How can I change an SDB (Self-Defeating Belief)? Hiranmay asks: How can I deal with my intense anxiety before public speaking. Answers to Your Questions Note: These answers below were written BEFORE the podcast, and the live discussion always adds new and different angles. Today, Jason Meno, our beloved AI guy on our app team, also chimes in on the many super questions submitted by Andrew (#3 - #10.) 1. Anonymous asks: How can I change an SDB? Dear Dr. Burns, I’m an avid listener of the Feeling Good podcast and for the past few weeks, an avid user of the Feeling Great app. Thank you for your incredible work and dedication to making people everywhere feel better about themselves. I have a question about self-defeating beliefs that I’m hoping you can address, either on the show or on your website. You have mentioned on several occasions that SDBs are the root cause of negative thoughts and consequently of negative feelings. Yet, to me it doesn’t feel like SDBs are really addressed enough on the podcast. There seem to only be a handful of episodes covering the topic. It also seems there is a very limited toolbox of methods to use on SDBs, almost like dealing with them is considered an afterthought. If SDBs really are the cause of it all, shouldn’t the primary focus be on defeating them first and only then, on defeating negative thoughts? I’m just a little bit lost when it comes to defeating SDBs, which seem to be way harder to deal with than negative thoughts. Any insights or thoughts on the subject will be greatly appreciated. Sincerely, Anonymous David’s reply Dear Anonymous, Will start a new Ask David with your excellent question. Thanks, david First, you can look up Self-Defeating Beliefs in the search function on my website, and you'll find many great examples. Here's what I got just from "Self-Defeating Belief." You could also search for a specific type, like Perfectionism, Perceived Perfectionism, Achievement Addiction, Love Addiction, Approval Addiction, Submissiveness, etc. In general, there are two approaches to any SDB. Four approaches can be used in this order: Do a Cost-Benefit Analysis of the SDB. If Disadvantages outweigh Advantages, use Semantic Technique to modify the SDB. Do an experiment to see if the SDB is actually valid. Use the Feared Fantasy Technique to put the lie to the SDB at the gut level. Here's our latest thinking, which is a step beyond the four steps above. Do a Daily Mood Log on one specific moment when you were struggling with your SDB. We will discuss these ideas in greater depth on the show, of course! You can also find a great deal on SDBs in my books, like Feeling Good, the Feeling Good Handbook, and more. But right now, I don't even know what SDB you might want help with / more information about. Also, in the Feeling Great App, there's a terrific class called "Your PhD in Shoulds." It includes a lesson on perfectionism. 2. Hiranmay asks: How can I deal with my intense anxiety before public speaking without working on the negative thoughts I have afterwards, like “I am going to mess this up” “People are going to notice something obviously wrong in my presentation that I missed, and I will look like a fool.“ “This talk is important, it must go well! Here’s his email: Dear Dr. Burns, I love your books and the feeling good podcast. They have made such a huge difference in my life (in a good way of course). I have an “ask David” question on acute anxiety: If I have to play a badminton match or give a presentation, I usually get some or a lot of anxiety the day before the big event as well as the morning of. I then use all the methods you have taught, and the anxiety reduces. However, it usually comes back with a bang just before I give the talk or play a match. Cognitive techniques are not very helpful to me 30 minutes or 5 minutes before the presentation or match. I don’t have the time to sit down and write my thoughts or cannot focus at all on my thoughts. Are there any strategies to reduce this form of acute “relapse” or nerves. Here are some more details: Event: 30 minutes before my presentation. I just entered the seminar room, and the first speaker is about to start their talk. I am next. I can feel my heart starting to pound and I am getting the familiar sense of anxiety and nerves. Thoughts: “I am going to mess this up”. “People are going to notice something obviously wrong in my presentation that I missed, and I will look like a fool“. “This talk is important, it must go well”. Although to be honest, this is my analysis of what my thoughts were after the fact. 5-15 minutes before the presentation, I usually just notice my thoughts racing. To reiterate: I am not looking for help with working on these thoughts after the presentation. Any strategies to acutely deal with anxiety or rather relapse of anxiety when I don’t have time to use all the wonderful TEAM tools would be very helpful. Thanks so much. Best, Hiranmay (pronounced he-run-may) living in Basel, Switzerland. David’s Reply Sure, as a starting point I’d like to see your work with these thoughts on a Daily Mood Log. Do you have one that you could send me, with the percents filled in, etc. That will allow me to see what your strategies are on challenging these thoughts, and whether you can knock them out of the park, or only challenge them “somewhat.” Best, david You can see Hiranmay's excellent DML if you check here. David Continues Hi Hiranmay, It sounds like are not interested in help with the thoughts you recorded in your email below, since this, by definition, is “after the presentation.” If you like, you could perhaps “make up” some thoughts you might be having BEFORE you start to speak. As someone who has had, and recovered from crippling public speaking anxiety, I have tons of powerful techniques, but would need some help from you so I’ll have something to go on. By the way, I absolutely DO NOT BELIEVE you when you say those are not the thoughts you are having in the minutes before you begin to speak! So, your requirement that we are not allowed to work on them is a bit of a hindrance. As an aside, I will include this in an Ask David podcast, if that is okay! Sincerely, david I asked H to send me a copy of his Daily Mood Log, which was really well done, and responded with a few suggestions. Then I sent this note: David’s Subsequent Response One thing I noticed on your Daily Mood Log is your fear of making a mistake, or having a critical question from someone in the group, or not being able to impress your audience sufficiently. These fears are common in public speaking anxiety. We've all struggled with them at one time or another, I think!  I have changed my focus from needing to impress the audience with myself or my talk, and instead I try to remember to try to impress them with themselves, and how awesome they are. Here's an example. I once gave a presentation on the serotonin theory of depression for about 1,000 psychiatrists at a prominent medical school in Texas. It was going well and suddenly a man at the rear stood up and started shouting something like this: “I’m so sick of all you establishment researchers thinking you know so much and ignoring my work. I have discovered the cause and cure for depression in my laboratory. (He claimed it was some kind of vitamin deficiency.) But everyone is ignoring my work (and more ranting and raving.) There was a chilled silence in the room. Here’s how I responded: “I appreciate was you’re saying, and I agree. I think our current focus on deficiencies in brain serotonin is extremely misguided, and predict, as you say, that research will show that the chemical imbalance theory of depression is not valid. And often, the most important breakthroughs come from laboratories like yours, where someone who is unknown discovers the actual cause of an illness after being ignored for years and years. I’d be honored if you’d approach me at the end of my talk so I can learn more about your pioneering research!” Notice I did not defend myself, but tried to make HIM feel good. At the end of my talk, about 20 or more people came crowding up to the podium with questions and such. I saw him at the back of the group, pushing his way to the front. I braced for another attack. He said, “Dr. Burns, that was the best presentation I’ve ever heard by far on the serotonin theory of depression. If you would give me permission, I would love to show your slides to my students and colleagues!” I have very little fear of being attacked by people in the audience, and I now speak all the time in front of groups. I used to have paralyzing public speaking anxiety. But the monsters I feared were all in my brain! Warmly, david   Andrew asks 8 cool questions! (#3 - #10) which are listed below, along with my answers. Jason Meno also sent some awesome answers, which you'll find below as well, right after my answers to the 8 questions.  

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Transcription

7.637 - 26.352 Dr. Rhonda Barofsky

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.

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26.492 - 43.142 Dr. Rhonda Barofsky

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.

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43.362 - 49.884 Dr. Rhonda Barofsky

Dr. Burns is currently an emeritus adjunct professor of clinical psychiatry at Stanford University School of Medicine.

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58.567 - 62.389 Dr. David Burns

That's my elderly weird rump.

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62.989 - 89.638 Dr. Rhonda Barofsky

That's your elderly weird voice? Okay. Well, I want to welcome you, David. We have Matt May with us and Jason Minow, who I'll introduce in a minute. This is Episode 419. And we're also inviting everyone from throughout the United States, Canada, Mexico, all of Latin America, Europe, Southeast Asia, throughout the entire world and galaxy. Today is an Ask David episode.

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89.698 - 109.713 Dr. Rhonda Barofsky

And we also have a person who has been on our podcast before. Jason Minow. Jason, you were on before when you were talking about your personal history, which was really interesting and appreciated you. And Jason works for the Feeling Great app. He's the AI and product guy, but he's really the everything guy. So welcome, Jason. We're happy to have you.

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109.733 - 110.774 Jason Meno

Thank you.

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112.095 - 138.611 Dr. Rhonda Barofsky

I thought I'd start by reading an endorsement that's particularly relevant for today's podcast because it's about... Me, Matt, and David. And somebody wrote, I have such appreciation for the three of you and the labor of love that are the podcasts. The warmth and friendship shared among you, Rhonda, Matt, and David, rings true for the genuine affection you must have developed for each other.

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138.631 - 139.872 Anonymous

I hate you.

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143.096 - 144.116 Matthew May, MD

Right back at you, David.

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144.937 - 170.645 Dr. Rhonda Barofsky

While sharing your ideas and wisdom, you also set a fine example for healthy, respectful relationships. I hold David in the highest esteem for his generosity in making all his years of work available to the world as a gift. Your, Rhonda, Matt, and David's altruism is inspiring and making the world a gentler, kinder place. It fills me with hope. Jodi.

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171.914 - 192.262 Dr. David Burns

Thank you, Jody. And you certainly warm our hearts to write those beautiful words. And it means a lot that we're not getting rich off the podcast, but that's our riches. You're our riches. And we feel especially wealthy today because of you.

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192.282 - 193.122 Dr. Rhonda Barofsky

Yeah.

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195.442 - 198.144 Matthew May, MD

Well said, David. I really appreciate that also.

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199.444 - 234.323 Dr. David Burns

And I want to give not only a warm hello to you, Matt, which is always a joy to hang out with you a little bit, but also to introduce with great pride Jason, who's... really kind of the star of our app development. He's been translating TeamCBT into our app using artificial intelligence and making some absolute magic.

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235.862 - 269.554 Dr. David Burns

But Jason's magic is not just from his fantastic programming skills, but from himself, from his incredible background, from your knowledge of Buddhism, of mystical concepts, and your tremendous commitment to being real and to using the app yourself to see if it works well. on you. And you're just such a warm and kindly person.

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269.634 - 292.678 Dr. David Burns

And one of the people for the Ask David wrote eight questions rather than one. And they were all such cool questions. And I just had a hunch that You, Jason, would also have a lot to say about them. And so Jason contributed a wonderful segment for the show notes answering all or most of those eight questions.

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292.918 - 304.726 Dr. David Burns

And I don't know what it was about them, but there was something about that fellow and his questions. It was very, very awesome. And so we have a lot of cool things to talk about today.

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304.746 - 329.457 Dr. Rhonda Barofsky

Great. Well, let's dive in. So Anonymous asked you how I can change a self-defeating belief. And he wrote, Dear Dr. Burns, I'm an avid listener of the Feeling Good podcast and for the last few weeks an avid user of the Feeling Great app. Thank you for your incredible work and dedication to making people everywhere feel better about themselves.

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330.318 - 351.175 Dr. Rhonda Barofsky

I have a question about self-defeating beliefs that I'm hoping you can address either on the show or on your website. You've mentioned on several occasions that self-defeating beliefs are the root cause of negative thoughts and consequently of negative feelings. Yet to me, it doesn't feel like self-defeating beliefs are really addressed enough on the podcast.

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351.896 - 372.205 Dr. Rhonda Barofsky

There seem to be only a handful of episodes covering the topic. It also seems there's a very limited toolbox of methods to use on self-defeating beliefs, almost like dealing with them is considered an afterthought. If self-defeating beliefs really are the cause of all, shouldn't the primary focus be on defeating them first and only then on defeating negative thoughts?

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373.285 - 386.591 Dr. Rhonda Barofsky

I'm just a little bit lost when it comes to defeating self-defeating beliefs, which seem to be way harder to deal with than negative thoughts. Any insight or thoughts on the subject would be greatly appreciated. Sincerely, Anonymous

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387.554 - 419.131 Dr. David Burns

Well, I'll give first round to you three, and then I'll mention a bunch of techniques for challenging self-defeating beliefs. We're working on a class on self-defeating beliefs for the app, actually. So it's been at the top of the agenda in recent weeks, so it was a great question. But let's let the... The three of you share your expertise, and then I'll chime in.

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419.151 - 427.154 Dr. Rhonda Barofsky

Well, Matt has already put a great deal of work in responding to this question, so I pass it to you, Matt.

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428.915 - 451.079 Matthew May, MD

All right. I'm happy to say a few things about it. Maybe to clear up one point quickly is that, in fact, you can work with a self-defeating belief the same way you would any other negative thought in the team model. In fact, if you've learned other ways to defeat negative thoughts, you can just apply that to your self-defeating belief.

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453.134 - 471.974 Matthew May, MD

I think it might be useful just to define what a self-defeating belief is. I noticed that I struggle a little bit to define exactly what a self-defeating belief is. I might use words like a summary of or composite of negative thoughts. It's...

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474.216 - 506.192 Matthew May, MD

It's tempting to use words like core or a central thought, and it seems almost – I imagine like a fire and little sparks coming out from it and kind of igniting other negative thoughts. And I've put up an example of how to find your self-defeating beliefs in the show notes using uncovering techniques. Okay. And so what is an uncovering technique?

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506.693 - 510.958 Matthew May, MD

Maybe I'll leave that as a new thing to define and someone else can talk for a little bit.

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512.821 - 548.288 Dr. David Burns

Okay, we've got Rhonda and Jason are up to that. Well, let me just make one comment on what you said. What is a self-defeating belief? I'll attach the list of 23 self-defeating beliefs to the show notes. So if you read the show notes, then you can look and circle the ones that resonate with you. And they're all different, but it's the philosophy that's going on under the surface.

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549.729 - 577.85 Dr. David Burns

And a lot of self-defeating beliefs are what we call self-esteem equations. It's like I need substance X to be worthwhile, to be happy and worthwhile. That's the belief. And it might be perfection. I have to be perfect to be worthwhile. Or my worth depends on my achievements. Or I need love to be worthwhile. Or I need approval to be worthwhile. And then the theory of it is that that...

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579.131 - 608.776 Dr. David Burns

perfectionism or love addiction or approval addiction or whatever is with you all the time, but it only kicks into upsetting you when a particular kind of negative event happens. So that, let's say you have the approval addiction, I need everyone's approval to feel happy and worthwhile. then if you are getting people's approval, you'll feel great. You'll be terrific.

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609.356 - 637.154 Dr. David Burns

But we would predict that you would crash when you get disapproval, when people are judging you, when people are criticizing you, then you'd have a lot of negative thoughts flowing through your mind. You tell yourself, oh, my gosh, I'm a loser. I'm no good. These people hate me or whatever you're you're thinking, and then you're going to get sad, anxious, and depressed, and guilty, and ashamed.

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637.795 - 657.919 Dr. David Burns

So that the self-defeating belief tells us what kind of things will trigger your mood slumps, and it will explain the timing to a certain extent of mood slumps. That's the basic theory at any rate. and it has what's called heuristic value.

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658.019 - 677.707 Dr. David Burns

It makes sense to people and seems helpful to people, which isn't the same as scientific truth, because sometimes when you try to test these things scientifically, they don't pan out. But that's the basic idea and theory of a self-defeating belief. Back to you guys.

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678.427 - 690.418 Dr. Rhonda Barofsky

What I learned from you before is the equation that a self-defeating belief plus an event causes a negative thought or cognitive distortion, which then leads to the emotional suffering.

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692.079 - 693.36 Dr. David Burns

That's exactly right.

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695.782 - 708.854 Jason Meno

Jason, do you want to add anything? Sure. When I think about self-defeating beliefs, I kind of see them as... I see negative thoughts as the very end branches that is coming out of a self-defeating belief.

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709.254 - 723.82 Jason Meno

And so that's why like when you use the uncovering techniques, like Matt said, you start with that negative thought and you're kind of like out on the edge branch of, you know, of suffering in your life and the way you're thinking. But when you start uncovering, you say, well, why is that upsetting to you? What does that mean to you?

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724.6 - 732.283 Jason Meno

You start getting back to your value system and you start getting back into like the meaning you make of the things that happen to you. And that at its core becomes a

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732.803 - 752.356 Jason Meno

self-defeating belief but i agree with matt too that whenever a self-defeating belief comes up with me like when i'm doing a mood log sometimes when i'm writing out my negative thoughts i realize like oh hey that's like one of the common self-defeating beliefs right there and so there really is no difference on the mood log often between the self-defeating belief and the negative thought um

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753.444 - 774.125 Jason Meno

When Anonymous said that they seem to be a little harder to defeat than normal negative thoughts, I do agree with that. Definitely when you're starting to get closer and closer to the most upsetting parts of your thinking, they can be extra challenging, definitely when you're applying methods. But at the end of the day, it's just another belief that you're working on in your mood log.

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775.592 - 776.432 Jason Meno

That's my take.

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777.313 - 807.178 Dr. David Burns

Okay, that's cool. I'll give you some techniques for challenging self-defeating beliefs. One thing to do first, let's say you have this idea, my worthwhileness depends on my achievements. And you brought that up as a potential problem in therapy, that that's maybe a source of your anxiety and a source of your... depression or whatever.

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808.44 - 835.291 Dr. David Burns

And it might have come up from an uncovering technique, like a downward arrow technique. And then how would you change that? That idea of my worthwhileness depends on my accomplishments or my intelligence or my success in life. And the cost-benefit analysis is based on the idea that the term self-defeating beliefs is somewhat misleading, right?

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836.051 - 861.681 Dr. David Burns

And Albert Ellis called them irrational beliefs, which is also somewhat misleading because it implies that they're bad or they're going to defeat you or they're kind of irrational. The way I look at a self-defeating belief, it's more like a two-edged sword. It actually has a lot of benefits for you as well as a price to pay.

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863.522 - 880.272 Dr. David Burns

The first thing is to do a cost-benefit analysis and put a line down the middle of a piece of paper and put the advantages on the left and the disadvantages on the right. And it wouldn't be the advantages and disadvantages of achievement. That means you didn't get the point.

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880.872 - 905.762 Dr. David Burns

It's the advantages and disadvantages of basing your happiness and feelings of worthwhileness on your achievements or your accomplishments. And there are a lot of advantages. When you accomplish something great, you'll feel terrific. That's certainly an advantage. And it'll motivate you to work hard and accomplish more and maybe make more money. That's certainly a positive.

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905.822 - 930.234 Dr. David Burns

And then other people may admire you because you're so hardworking and industrious. And because you have high values, you may end up doing more high-quality work, and on and on. And so those are very real advantages. And then in the right-hand column, you can list the disadvantages. When I fail, I'll fall apart.

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931.335 - 963.798 Dr. David Burns

When I'm worried about failure, I'll be struggling with anxiety and maybe performance anxiety. And And, you know, I may be afraid to take on new challenges for fear of not performing perfectly or failing. And when I fail, I may view it as some kind of emotional defeat rather than an opportunity to learn from the failure. What can this tell me? What specific errors did I make? And so forth.

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965.239 - 991.873 Dr. David Burns

And so you'll find tremendous numbers of advantages and disadvantages in any self-defeating belief. And then you can weigh them on a 100-point scale, which put two numbers at the bottom of the columns. On my cost-benefit analysis, there's a little graph. You know, kind of like a barbell or a dumbbell or something, a line with two circles at the end.

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991.933 - 1019.553 Dr. David Burns

And you put the, like, if the advantages seem greater, you might put 65, 35 in the circles. If it's a wash, you might put 50, 50 in the circles. And if the disadvantages are greater, you might put, like, 20 in the advantages circle and 80 in the disadvantages circle. And then you only work to change that self-defeating belief if the disadvantages outweigh the advantages.

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1019.633 - 1036.678 Dr. David Burns

If the advantages are greater, you don't need to change it. It's working for you. If it's 50-50, I'd say let's not work on it because it takes a lot of work and you're kind of on the fence. And maybe you can come back on another occasion if you change your mind and decide that this thing isn't working for you.

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1037.458 - 1066.141 Dr. David Burns

But if you find that the disadvantages are greater, then you can use techniques like the semantic technique, positive reframing, the experimental technique, the feared fantasy, as well as any of the more than 100 techniques like be specific is a great technique for self-defeating beliefs. But I'll just tell you how one more of these techniques works would be the semantic technique.

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1066.901 - 1087.991 Dr. David Burns

If you don't decide that it's not to your advantage to base your self-esteem and worthwhileness on your achievements or accomplishments, you could say you can rewrite it in some way that makes sense to you, a way that will eliminate all of the disadvantages and maintain all of the advantages.

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1088.631 - 1117.096 Dr. David Burns

Like you might say, I love working hard and creating things, and it's a lot of fun to come up with something. Say if I'm writing something or whatever, your area of achievement might be carpentry or painting or whatever. But if I come up with something really terrific that people love, It doesn't make me any better than any other person.

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1117.996 - 1143.615 Dr. David Burns

And if I fail and have trouble in an area, it doesn't make me any less worthwhile than another person. So it's to get that judgmental. dimension out of it. And that's just an intellectual exercise, the semantic techniques. But if you're going to get rid of one belief, you have to have another belief to hang your hat on from an intellectual point of view.

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1144.115 - 1157.161 Dr. David Burns

How will I judge myself if I'm not going to base my self-esteem on my achievements? And I think Jason and I would both

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1158.642 - 1184.877 Dr. David Burns

point out too that our cats tell us an awful lot about this belief because we can love our cats and love being with our cats without having to be special or without the cat having to be special just by being with each other and petting the cat and hearing the cats purr and love us and receive our love. And then positive reframing is always great.

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1184.957 - 1210.743 Dr. David Burns

We treated someone with perfectionism recently, Amy, and she was just beating the hell out of herself because she was failing with two of her patients. She's a psychiatrist, a high-powered, highly skillful psychiatrist, but she was just cruelly telling herself she was a fraud and a failure because she was stuck with two of her patients. And before...

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1211.723 - 1238.761 Dr. David Burns

Changing her negative thoughts and her beliefs, we had her see what was beautiful and awesome about her negative feelings and thoughts and what it showed about her as a human being and her core values that was positive. And because she was feeling defective and like a loser in a mental case and like she was defective in some way. And she was telling herself, I should give up psychiatry.

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1238.801 - 1267.43 Dr. David Burns

I should refund my patients money. She was just being horribly hard on herself. And then when she saw how beautiful these things were, they showed her love for her patients, her commitment to her work, her willingness ever since a little girl to work her ass off at things has brought her tremendous accomplishment. And she can be proud of her depression and her guilt and shame and anxiety.

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1267.45 - 1298.846 Dr. David Burns

And they have motivated her to learn and to grow and have high standards and all of that. And once she saw how the beauty within herself and what she thought were symptoms of an illness, then suddenly the change is just, you know, a few yards away, where the stones throw away, is the way I like to say it. So that's very crucial to see the beauty in your self-defeating beliefs,

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1300.206 - 1333.88 Dr. David Burns

as well as recognizing that you may be paying a heavy price. And you can do an experiment to see if the self-defeating belief is true. Is it true that everyone who accomplishes a lot is more worthwhile? Would we say that Putin is especially worthwhile? Because he's certainly accomplishing a lot. He's murdering people. He's murdered a million people now already. And so those are some of them.

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1336.202 - 1360.994 Dr. David Burns

of the approaches, but what you said, Matt, was really pure gold, that you can just put a self-defeating belief in the middle of a recovery circle with arrows pointing out of it, and each arrow is a different method, and you can select from the list of 50 or 100 or more methods, you can select 5, 10, 15, 20 methods to crush a self-defeating belief the same way you can crush a negative thought.

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1362.313 - 1364.815 Dr. David Burns

So thank you, everybody.

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1364.835 - 1372.159 Matthew May, MD

David, could I invite you to demonstrate how to find a self-defeating belief in a role play?

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1373.199 - 1381.084 Dr. David Burns

How to find one? You mean using a downward arrow technique or using the list of 23 or how to?

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1381.724 - 1386.387 Matthew May, MD

Yeah, I was going to ask you to demonstrate the what if technique and I'll pretend to be a patient.

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1389.728 - 1408.772 Dr. David Burns

Sure. The what-if technique is a good one to get to core fears when you're struggling with anxiety. It doesn't always get to a self-defeating belief, but can sometimes get to a self-defeating belief. The individual downward arrow would always get to a self-defeating belief.

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1409.759 - 1423.264 Matthew May, MD

I think we'll find our way there with this one. I've pre-written something. Okay. And I think this will be a way to bring it to life. Let's say I've got a belief or a negative thought that I'll fail my test tomorrow.

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1423.284 - 1423.464 Dr. David Burns

Okay.

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1423.584 - 1428.566 Matthew May, MD

And I'm freaking out because I'm afraid I'll fail my test.

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1429.006 - 1437.97 Dr. David Burns

Yeah, I'll fail my test. Yeah, great. Jason, would you like to be my co-therapist? Sure. Or the solo therapist? Sure.

0
💬 0

1443.6 - 1444.66 Jason Meno

I'll be your co-therapist.

0
💬 0

1445.381 - 1468.049 Dr. David Burns

Okay, great, great. So we'll skip empathy. We'll skip positive reframing, which we've learned in the Tuesday group is always a huge mistake. But we'll do it anyway just to uncover the self-defeating belief. And you want to kick it off, Jason? So what's the negative thought again? I might fail my test.

0
💬 0

1468.874 - 1488.291 Jason Meno

Okay, sure. So let's say you did fail your test. Why is that upsetting to you? What does that mean to you? Well, then I'll fail the class. And let's say you do fail that class. That would be a pretty terrible thing, but I'm wondering why is that so upsetting? What does that mean to you if you failed that class? Well, then I won't be able to get a good job.

0
💬 0

1489.692 - 1491.634 Jason Meno

And if you didn't get a good job, what would that mean?

0
💬 0

1492.616 - 1515.306 Dr. David Burns

And by the way, you guys are moving awful fast. I'm writing everything down. And when you do this with yourself or for a patient, always have both people write it down with an arrow under each thought. And that way you can go back and review the chain. But you're off to a great start. I'll let you carry on. Jason? Jason?

0
💬 0

1515.956 - 1532.424 Jason Meno

Yeah, so you said one of your fears here of if you fail that class, then you won't be able to get a good job or get a good job at all or you might lose a job. And I'm wondering why is that upsetting and what does that mean to you if that happened?

0
💬 0

1533.604 - 1537.186 Matthew May, MD

Well, then maybe I'll never get a good job. I'll never get a good job.

0
💬 0

1538.393 - 1549.939 Jason Meno

And if that's true, it would be terrible. I mean, jobs are very important in our lives. But I'm wondering why would that be upsetting? What does that mean to you if you could never get a good job?

0
💬 0

1549.959 - 1560.084 Dr. David Burns

What are you most afraid of? Let's say you never get a good job. You always have kind of an average job. Yeah, that would mean I was a failure at everything.

0
💬 0

1561.484 - 1587.97 Jason Meno

I see. Yeah. So that sounds like... So that belief that if I can't get a good job, then I'm a failure at everything. Would we call that the self-sustaining belief or would we go further than that? There's more. There's more. OK, let's get going. So let's say you did fail. You were failing at everything. What if that were true? What does that mean to you? Why is that upsetting?

0
💬 0

1589.372 - 1590.613 Matthew May, MD

That would mean I would be worthless.

0
💬 0

1593.619 - 1598.801 Jason Meno

That seems to be the—I think we might have hit the bottom of the barrel with that one.

0
💬 0

1599.381 - 1618.609 Dr. David Burns

Just for the fun of it, we can go another dimension down, and let's imagine, Matt, that you were in fact worthless, and this might sound like a ridiculous question, but imagine that I'm from Mars, and I don't understand— You know what happens here on the surface of the earth.

0
💬 0

1618.709 - 1635.019 Dr. David Burns

And so I would be asking you, and then on the earth, surface of the earth here, if you're worthless, why is that a bad thing? Because we don't have that way of thinking on Mars. What happens if you're worthless? You can't get coffee at Starbucks or what happens then?

0
💬 0

1635.699 - 1638.801 Matthew May, MD

It's even worse than that. Then everyone would reject me.

0
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1639.947 - 1662.552 Dr. David Burns

Oh, I see. Uh-huh. Everyone will reject me. And then if that were true, take it one more step, then is there something negative about that? I mean, it sounds kind of awful, but what would you be afraid of? You mean everyone in the world or everyone who knew you or all human beings?

0
💬 0

1663.732 - 1666.233 Matthew May, MD

Everyone would reject me because I'd be so worthless.

0
💬 0

1667.322 - 1677.331 Dr. David Burns

Oh, you'd be wealthy, though, because you'd be like the most famous celebrity in the world. I'd be very special. You'd appear on talk shows and get tremendous honoraria.

0
💬 0

1679.353 - 1684.538 Matthew May, MD

I would be the most worthless person, but then I would also then be miserable forever.

0
💬 0

1685.298 - 1685.739 Dr. David Burns

Okay.

0
💬 0

1685.979 - 1686.58 Matthew May, MD

If that were true.

0
💬 0

1687.701 - 1721.668 Dr. David Burns

So then we review the list. I might fail my test. and then what's the worst that could happen? Then I might fail my class. Then I'll never have a good job. That would mean I'm a failure, and that would mean that I'm worthless. And if I was worthless, everyone would reject me, and then I'd be miserable forever. And now let's turn this back to... Our expert of experts, Rhonda Barofsky.

0
💬 0

1721.688 - 1726.512 Dr. David Burns

And what are this individual's self-defeating beliefs?

0
💬 0

1728.633 - 1745.086 Dr. Rhonda Barofsky

Oh, there was quite a few of them, actually. I have to pull up the list. I don't have them memorized, but I can do that pretty easily. Well, here, I pulled up the list, too. Do you have it, Jason? No.

0
💬 0

1745.707 - 1745.847 Jason Meno

No.

0
💬 0

1747.933 - 1752.256 Dr. Rhonda Barofsky

So there's a lot of them, actually. I must never fail or make a mistake.

0
💬 0

1753.356 - 1768.305 Dr. David Burns

Is that a self-defeating belief on the list? Yes. It's perfectionism. Oh, perfectionism. Uh-huh. Oh, yeah. If I'm not perfect, I guess, or if I fail, my world will fall apart, something like that? Right.

0
💬 0

1769.345 - 1783.173 Dr. Rhonda Barofsky

I must never fail. I must never make a mistake. That's perfectionism. My worthwhileness depends on my achievements or my intelligence, my talent, my status, my income, my look. So the achievement addiction.

0
💬 0

1783.193 - 1784.813 Dr. David Burns

Yeah, that's a good one.

0
💬 0

1786.734 - 1788.495 Dr. Rhonda Barofsky

I guess the approval addiction as well.

0
💬 0

1788.515 - 1789.776 Dr. David Burns

Mm-hmm.

0
💬 0

1791.137 - 1792.417 Dr. Rhonda Barofsky

That I need everyone's approval. Yeah.

0
💬 0

1793.198 - 1793.378 Dr. David Burns

Yeah.

0
💬 0

1796.377 - 1801.72 Dr. Rhonda Barofsky

You know, if people reject me, there's something wrong with me. If I'm alone, I'm going to be miserable, worthless.

0
💬 0

1803.38 - 1804.241 Dr. David Burns

Fear of being alone.

0
💬 0

1804.461 - 1806.442 Dr. Rhonda Barofsky

Fear of being alone. Fear of rejection.

0
💬 0

1806.462 - 1813.906 Dr. David Burns

How about perceived perfectionism, Rhonda?

0
💬 0

1814.346 - 1820.449 Dr. Rhonda Barofsky

People won't love me and accept me as a flawed and vulnerable human being. Definitely. Perceived perfectionism.

0
💬 0

1822.62 - 1824.201 Dr. David Burns

So we've got five.

0
💬 0

1824.221 - 1828.123 Dr. Rhonda Barofsky

Maybe even emotional perfectionism. I should always feel happy, confident, and in control.

0
💬 0

1830.464 - 1842.231 Dr. David Burns

I didn't see that in the downward arrow. I see that as something you're reading into it. Oh, really? Yeah, he's not saying he's worthless if he's unhappy. He says he's worthless if he fails.

0
💬 0

1843.392 - 1849.015 Dr. Rhonda Barofsky

I guess I did just assume that if he failed, he would be unhappy. And he wouldn't be able to accept that.

0
💬 0

1850.367 - 1875.504 Dr. David Burns

Well, you could ask. You can always ask if you have a hypothesis. And when you do, sometimes a person will say, that makes that consistent. And more often they'll say, that doesn't sound quite right. But it's fun to throw those things out to open up the person's brain as much as possible. But that's how you come up with a self-defeating belief. And you came up with one, two, three, four...

0
💬 0

1876.645 - 1887.819 Dr. David Burns

five, six, I think, here, just really, really quickly. Mm-hmm. What are your thoughts, Matt? Does that seem correct?

0
💬 0

1888.881 - 1907.087 Matthew May, MD

Yeah, yeah. I was... trying to create a very realistic sample of what it's like to go through this process of an uncovering technique to arrive at the self-defeating beliefs. And I think that that went really well, and I agreed with all of those points.

0
💬 0

1908.729 - 1924.086 Matthew May, MD

that Rhonda and you named, I summarized it as, I must be successful, accomplished, productive, and popular, or I'm worthless and will be miserable forever. That I require all those things in order to be worthwhile and happy.

0
💬 0

1924.106 - 1950.169 Dr. David Burns

Yeah. Jason, before we move on to another question, can you give us a – and you don't have to do this. I don't want to take advantage. But can you give us a Buddhist perspective on what we've been talking about, these beliefs? Rhonda might also. And Matt might also.

0
💬 0

1955.074 - 1957.725 Dr. Rhonda Barofsky

Well, you know, Jason, you want to say something about attachment?

0
💬 0

1960.058 - 1966.24 Jason Meno

The thing that I think of when it comes to self-defeating beliefs are, in Buddhism, what are called the five aggregates or the five skandhas.

0
💬 0

1967.3 - 1987.906 Jason Meno

And one of those are perception, which is kind of the... When something happens to you in your life, there's an automatic process that's your reaction to what's happening, even before thoughts start occurring, even before thoughts start reaching your consciousness. It's just that, for example, you see the face of someone you really don't like.

0
💬 0

1988.786 - 2009.191 Jason Meno

And there is just this ingrained belief deep down inside that that's a terrible person, like you believe that. And so when you first see that, it's actually like your nervous system has been embedded in it, a programming of your belief. And so when you see this person you don't like, you have this gut reaction, this sudden intense perception that that's what's happening to them.

0
💬 0

2010.239 - 2027.551 Jason Meno

And then only after that do the negative thoughts start bubbling up and you can actually see how you're making meaning of things and how you're actually concluding based on stuff. So in Buddhism, there is this kind of difference between the gut reactions you have to things, which you could say perhaps are negative.

0
💬 0

2028.362 - 2051.521 Jason Meno

defined by your self-defeating beliefs like when you believe that the moment you make a mistake that you're going to lose your job or that you're going to be a failure that no one's ever going to love you that might be very ingrained in your perceptions of of the way you make meaning of things before thoughts even begin arising so that's that's one one way to think about it would be self-defeating beliefs are kind of embedded in your perception of the world

0
💬 0

2055.009 - 2071.487 Dr. David Burns

Yeah, and so if you have the perception that no one is going to love or appreciate me, people are out to bust me, then you'll be kind of reading that into situations.

0
💬 0

2073.264 - 2091.111 Jason Meno

Yeah. And even your own actions, like you might be avoiding taking any action to meet other people in the world or, or to, you might be avoiding or trying to stop yourself from doing things in your life. Um, because that's again, a core belief of like you're, you're jumping to conclusions underneath the surface of, um,

0
💬 0

2092.872 - 2110.13 Jason Meno

Like the moment someone offers up like, hey, you should come on to the podcast and talk, you know, your gut reaction might be like, no, I don't want to do that. There was no thought between the reaction and the offering, because there was like some self-defeating belief that that was kind of...

0
💬 0

2111.071 - 2135.496 Jason Meno

uh embedded in how you made sense of that do you know anyone who has that type of reaction jason yeah me yeah you asked me if i wanted to come onto this podcast i was like no you know you're like well why not i'm like well i'm kind of shy and i kind of don't want to do that and you're like oh that's a great thing to do yeah how are you feeling now shy oh you are really right now

0
💬 0

2136.479 - 2153.266 Jason Meno

Well, I think I think actually what I'm most the thing that's like spiraling in my head a bit is mostly like wanting. I care a lot about the listeners questions and I want to make sure like we don't. I'm not sure since I don't know how things work on the podcast all the time. So I'm kind of worried about like, oh, are we going to get to enough people's questions?

0
💬 0

2153.306 - 2157.248 Jason Meno

Did we answer this person's questions well enough? Will they be satisfied with these answers?

0
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2157.848 - 2183.126 Dr. David Burns

Oh, I see. Well, I think that is important, and that's what we do want to do. And we've spent an hour on the first question, and we have only nine to go. But these are all great questions, and so we don't need to worry about how many we get through. I think it is nice to have some quality in the way we answer them, that we're giving people something.

0
💬 0

2183.947 - 2196.133 Dr. David Burns

And then we can, you know, turn this question list into... Two or three podcasts or, you know, so how are we doing on our answer to this question, Jason?

0
💬 0

2196.953 - 2219.017 Jason Meno

Pretty great. I think the question of like how to challenge, how to change a self-defeating belief is good. The only maybe only one dimension of it we didn't get to directly, I don't think, is they said if self-defeating beliefs really are the cause of it all, if that should that mean that the self-defeating belief would be the primary focus of to challenge first before negative thoughts.

0
💬 0

2219.218 - 2230.7 Jason Meno

Like basically should you first try to defeat your self-defeating beliefs? Should you even work on your negative thoughts at all? It seems to be that's like another question that's embedded in this.

0
💬 0

2231.24 - 2244.402 Dr. David Burns

Jill Levitt and I have, that's a great question you asked there. And Jill Levitt and I have gone somewhat in the opposite direction. We used to think of working on a self-defeating belief as kind of an abstract thing.

0
💬 0

2244.842 - 2259.379 Dr. David Burns

thing you can do and then you've got the daily mood log which is a very practical thing you can do and lately we were of the belief that actually doing a daily mood log at a particular moment that you're upset

0
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2260.06 - 2280.221 Dr. David Burns

and talking back to your negative thoughts at that moment and crushing them, you know, being convincing that that's actually the best way to work on a self-defeating belief at one moment in time when you're upset. And you can work on it by talking back to the negative thoughts that you're having at that moment, if that makes sense.

0
💬 0

2283.286 - 2303.021 Matthew May, MD

That's cool. I have a response to your question about a Buddhist way of thinking about self-defeating beliefs, too. I'm not a Buddhist, but I like— There are no Buddhists at the time in the United States. Is that right? Yeah. I'm just sort of beginning as a Buddhist. But the—

0
💬 0

2306.205 - 2329.638 Matthew May, MD

I think a thought like, you know, I need this or that or this other thing before I could approve of myself and love myself or be happy or feel worthwhile is, like Jason said, it's this concept of attachment. I need these things before I could be okay. I think the Buddha pointed out that that is a common thing.

0
💬 0

2330.137 - 2356.37 Matthew May, MD

problem that people have that they don't want to be happy right now they want all these other things first and that if we let if we're willing to sacrifice and let go of those requirements then we can be happy right here right now yeah and if we're not if we're attached if we're demanding we have to have these other things then we simply cannot be happy in that moment i i i love that um

0
💬 0

2359.656 - 2361.358 Dr. David Burns

Any comment on that, Jason?

0
💬 0

2363.3 - 2395.115 Jason Meno

It reminds me of, what are they called? There's a word for it in Pali. It's like the three marks of existence, I think. It's like everything is impermanent. As long as you attach yourself to impermanent things, that you will be quite dissatisfied. If you try to place all of your happiness on your ability to succeed or not fail, then it's impossible not to fail.

0
💬 0

2395.295 - 2416.081 Jason Meno

That's a requirement of the world and life, that you will make mistakes. And so as long as you place your happiness happiness on things that are going to fall apart or won't meet your perfection standards of how things should be, that because of that, yeah, you're going to sign yourself up for a lot of pain.

0
💬 0

2418.086 - 2435.106 Jason Meno

But then there's another idea, too, which is anatta, which is a whole other thing of non-self. And that basically there's no thing that you can really point to and say this is a complete and utter failure. Because then you start getting into questions of what's called dependent origination and what makes up origination.

0
💬 0

2436.227 - 2451.215 Jason Meno

a person, what makes up a thing, what makes up your, uh, the meaning you make of, of how the world works around you. It's, it's, it's just made up of pieces and parts and there's no one thing you can point to and say, this is everything that makes up your happiness. This is everything that makes up your suffering.

0
💬 0

2451.895 - 2458.679 Jason Meno

So there's, there's all sorts of pieces that you could go with the three marks of existence in Buddhism to explain some of this stuff too.

0
💬 0

2461.164 - 2466.845 Dr. David Burns

I didn't completely get what you said, but Rhonda is going to summarize it now so I'll understand it.

0
💬 0

2468.085 - 2490.09 Dr. Rhonda Barofsky

Well, if you let go of the external things outside of your body, if you're attached to the external things, achievements, love, accomplishments, perfectionism, those outside things, if you let go of those, that brings you the possibility of happiness when you find your own inner peace and joy, which seems to be a very key component to Team CBT.

0
💬 0

2491.115 - 2501.357 Dr. David Burns

Yeah. And that's something you can learn with externalization of voices, too. I think so. Yeah.

0
💬 0

2503.038 - 2512.36 Matthew May, MD

And the acceptance paradox. Yes. We've probably demonstrated that a hundred times, but we could always do it again for one of these self-defeating beliefs.

0
💬 0

2513.12 - 2519.001 Dr. David Burns

Yeah. Do you want to do the achievement one? We can do externalization of voices.

0
💬 0

2520.151 - 2530.756 Matthew May, MD

The achievement addiction? Yeah. I'm worthless. Maybe I could play, do you want me to play the negative thought in a role play?

0
💬 0

2531.196 - 2537.819 Dr. David Burns

Yeah, I'll be the positive thought if you like, but we need some specifics so we know the context.

0
💬 0

2539.54 - 2546.54 Matthew May, MD

My worth is my work. OK, my achievements, I have to be really successful in order to be worthwhile.

0
💬 0

2547.08 - 2560.747 Dr. David Burns

OK, yeah. And and you can say, David, you're getting kind of older over the hill and you're getting less less successful. And so you're going to be less worthwhile or something like that. Would that work?

0
💬 0

2561.465 - 2573.456 Matthew May, MD

Yeah, David, I'm your negative thoughts, and I just wanted to let you know that you're getting older, you're less successful, you're not accomplishing as much. And I just wanted you to know that that means that you're worthless.

0
💬 0

2574.557 - 2580.963 Dr. David Burns

Oh, okay. Thank you. Are you done?

0
💬 0

2581.003 - 2588.234 Matthew May, MD

Yeah. I think that was a good example of the counterattack.

0
💬 0

2588.915 - 2594.181 Dr. David Burns

Yeah. Right. Could I talk to you for a minute, Matt?

0
💬 0

2594.642 - 2597.946 Matthew May, MD

Yeah, definitely. I've been looking forward to meeting up with you again.

0
💬 0

2598.567 - 2603.969 Dr. David Burns

You know, there's quite a few people who have achieved more than you have.

0
💬 0

2604.629 - 2607.771 Matthew May, MD

So many. So many. I don't even know all of them.

0
💬 0

2609.211 - 2612.573 Dr. David Burns

Well, you should be ashamed because they're better and more worthwhile than you are.

0
💬 0

2613.073 - 2620.616 Matthew May, MD

I'm not, though. And that's another flaw that I have is that I have such low standards that I just go around approving of myself for no reason at all.

0
💬 0

2624.658 - 2628.039 Dr. David Burns

Uncle, you're beating me big time. It's kind of fun, isn't it?

0
💬 0

2631.166 - 2631.426 Dr. David Burns

Yeah.

0
💬 0

2631.946 - 2633.527 Matthew May, MD

Someone should write a book called Feeling Good.

0
💬 0

2655.92 - 2656.12 Dr. David Burns

Yeah.

0
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2656.533 - 2675.331 Dr. Rhonda Barofsky

All right, so this is Haranmeh, and he asks, how can I deal with my intense anxiety before public speaking? And he wrote you, how can I deal with my intense anxiety before public speaking without working on the negative thoughts I have afterward? The thoughts I have afterward are I'm going to mess this up.

0
💬 0

2675.531 - 2689.259 Dr. Rhonda Barofsky

People are going to notice something obviously wrong in my presentation that I missed, and I'll look like a fool. This talk is important. It must go well. And here's his full email. Dear Dr. Burns, I love your books and the Feeling Good podcast.

0
💬 0

2689.319 - 2691.401 Dr. David Burns

I was just thinking maybe we have enough already.

0
💬 0

2691.581 - 2692.541 Dr. Rhonda Barofsky

Do you have enough? Okay.

0
💬 0

2692.561 - 2703.421 Dr. David Burns

Do you think, Rhoda? And they can read his note in the show notes, the full thing.

0
💬 0

2705.382 - 2716.41 Dr. Rhonda Barofsky

Can I just reiterate that he's not looking for help with the thoughts after the presentation or dealing with his upsetness that he didn't go well. He wants to look for strategies to deal with anxiety before the presentation.

0
💬 0

2717.091 - 2746.113 Dr. David Burns

Right. Well, my own thinking here is that we can use dynamic techniques between the presentation and practice really hitting these thoughts out of the park. That's the starting point. And then once we're convinced that he can do that, then he could just practice, you know, talking back to them before the talk. And...

0
💬 0

2747.254 - 2769.532 Dr. David Burns

but to work on them between talks dynamically to really get to enlightenment rather than just chipping away at the negative thoughts. So I would personally suggest using externalization of voices and the feared fantasy technique to attack these thoughts. Great.

0
💬 0

2776.687 - 2781.409 Matthew May, MD

I like that idea a lot, David. I didn't hear all the thoughts. They went by kind of quickly.

0
💬 0

2782.709 - 2800.777 Dr. David Burns

I'm going to mess this up. People are going to notice something obviously wrong in my presentation that I missed, and I'll look like a fool. And this talk is important. It must go well. Yeah. So who wants to play the role of Hieronymy's positive self?

0
💬 0

2802.937 - 2804.018 Matthew May, MD

I would be willing to try that.

0
💬 0

2804.614 - 2815.922 Dr. David Burns

Okay. And how about the three of us can be the negative Hieronymy, and we'll attack you with these thoughts and see how you can handle it. Do you want to start us off, Jason?

0
💬 0

2817.203 - 2820.765 Jason Meno

No. That's my no practice for the day.

0
💬 0

2821.225 - 2824.808 Dr. David Burns

Yeah, good. Okay. Rhonda, would you like to start us off?

0
💬 0

2825.348 - 2836.754 Dr. Rhonda Barofsky

Okay, Matt. I'm your negative thought. Oh, hi. It's good to see you again. Yeah, yeah. You know, I've been messing with you lately, and I just want to know that, you know, you're going to mess this talk up.

0
💬 0

2838.056 - 2856.946 Matthew May, MD

I definitely feel nervous and kind of worried about the talk. But I think even if I really mess it up, that most people are really kind and forgiving. And I could just ask them for feedback and connect with them even if I really mess it up. I think I've also done a good job practicing and preparing. And I know a lot about the topic.

0
💬 0

2856.986 - 2864.149 Matthew May, MD

So I bet I can actually do a pretty good job even if I'm just winging it. And either way, I'm going to be satisfied with the outcome.

0
💬 0

2865.189 - 2865.929 Dr. Rhonda Barofsky

Who won that, Matt?

0
💬 0

2866.99 - 2867.73 Matthew May, MD

I think I won that one.

0
💬 0

2868.228 - 2871.829 Dr. Rhonda Barofsky

And did you win it small or large? I thought it was large.

0
💬 0

2872.31 - 2877.532 Matthew May, MD

Large or huge? I think it was pretty huge. There might be room for something else in there.

0
💬 0

2877.732 - 2880.313 Dr. David Burns

You're doing such beautiful, beautiful work.

0
💬 0

2881.113 - 2881.873 Matthew May, MD

Let's try that again.

0
💬 0

2883.474 - 2885.515 Dr. David Burns

So did you win large or huge?

0
💬 0

2886.435 - 2889.056 Matthew May, MD

It felt huge to me. I'm going to say that was huge.

0
💬 0

2890.296 - 2896.879 Dr. David Burns

Okay. Jason, would you want to take a turn in this or...?

0
💬 0

2898.618 - 2918.017 Jason Meno

Well, I'm a little confused because the question in the email says cognitive techniques are not very helpful to me 30 minutes or five minutes before the presentation or match. I don't have time to sit down and write and challenge my thoughts and I can't focus at all on my thoughts. Are there any strategies to reduce this form of relapse or nerves? So I'm not sure if this approach.

0
💬 0

2918.237 - 2943.442 Dr. David Burns

Sure, I see what you're saying, and that's important. I have a hypothesis that he hasn't really gone into a state of enlightenment on these thoughts. He hasn't used externalization of voices or feared fantasy. So my suggestion would be to use these techniques and get into enlightenment, and then it will be easy for you to use them before you do your talks. But if you're only halfway, you know,

0
💬 0

2944.082 - 2966.332 Dr. David Burns

beating these thoughts, then you're going to be very vulnerable just before it. But you have to have had the experience of enlightenment to really have stepped out of the world where these thoughts are intimidating you. That's what I'm thinking. But we could go in an entirely different direction, too.

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2967.099 - 2989.106 Dr. Rhonda Barofsky

No, I have to say that I agree with you, David. I mean, it doesn't matter if he does these techniques a week before or a day before or five minutes before. I mean, if he defeats them and practices defeating them regularly before the talk and does reach that state of enlightenment the way Matt did, then five minutes before the presentation, he can remind himself of how he defeated them a week ago.

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💬 0

2989.93 - 3003.842 Dr. David Burns

Right, right. That's right. Let's try a different order. How about I'll be the negative Rhonda, and you can be the positive Rhonda, and I'll hit you with one of these and see how you can do, Rhonda.

0
💬 0

3004.763 - 3007.425 Dr. Rhonda Barofsky

Okay. As long as I don't have to be as good as Matt.

0
💬 0

3009.39 - 3011.59 Matthew May, MD

Well, you'll probably outshine me, Rhonda.

0
💬 0

3012.271 - 3035.275 Dr. David Burns

Yeah, Rhonda, I don't mean to hurt your feelings, but that was lame what you just said. And he's already outshined you. And people are going to notice there's something obviously wrong when you do this role play. And you're going to miss, you know, hitting it out of the park. And you're going to look like a fool. I didn't mean to hurt your feelings, but I just wanted to let you know.

0
💬 0

3036.775 - 3056.951 Dr. Rhonda Barofsky

Well, actually, it did hurt my feelings. My feelings are a little hurt. I'm sensitive. And I am so used to being lame on the podcast that one more experience of being lame, just add it to the pile. And people like that I'm lame because it makes them really relate well to me. Like that's what people said all the time at the intensive.

0
💬 0

3057.011 - 3075.405 Dr. Rhonda Barofsky

We love hearing you make mistakes because it makes you feel so real. And we realize then Team CBD is kind of hard. Because if you're making mistakes, then it's okay for us to make mistakes. And I'm not sure if that makes me look like a fool, but if it does make me look like a fool, I'm in really good company. And it's really fun.

0
💬 0

3075.745 - 3082.986 Dr. Rhonda Barofsky

It's freeing and kind of a joyful experience to be a fool and not have to be pressured to be perfect all the time.

0
💬 0

3083.987 - 3084.687 Dr. David Burns

Great. Who won?

0
💬 0

3085.347 - 3085.647 Dr. Rhonda Barofsky

I won.

0
💬 0

3086.287 - 3086.967 Dr. David Burns

Big or small?

0
💬 0

3087.787 - 3088.507 Dr. Rhonda Barofsky

I think that was big.

0
💬 0

3089.047 - 3089.728 Dr. David Burns

Big or huge?

0
💬 0

3090.548 - 3091.308 Dr. Rhonda Barofsky

I think it was huge.

0
💬 0

3092.273 - 3094.734 Dr. David Burns

I thought it was huge, too. How did you get to huge?

0
💬 0

3095.254 - 3096.535 Dr. Rhonda Barofsky

I think it was a lot of acceptance.

0
💬 0

3097.315 - 3104.397 Dr. David Burns

Yes, right. Right. Do you want to push it up to a higher level, Rhonda?

0
💬 0

3104.658 - 3106.418 Dr. Rhonda Barofsky

I absolutely do.

0
💬 0

3106.438 - 3131.158 Dr. David Burns

Okay, that will move from externalization of voices to feared fantasy. And Jason, Matt, and David will be the audience from hell. This is an imaginary world. This is not assertiveness training. And in this imaginary world, if you think that people are going to be judging you, they really do.

0
💬 0

3131.838 - 3150.067 Dr. David Burns

and they actually get right up in your face and say the things that you think other people would be thinking but would never dare to say to you. So you can confront the monster that you've been afraid of and see if the monster has teeth. Are you okay with that, Rhonda?

0
💬 0

3150.307 - 3150.628 Dr. Rhonda Barofsky

I am.

0
💬 0

3153.549 - 3161.253 Dr. David Burns

Let's see. You want to start it off, either Matt or Jason? I can if no one else wants to.

0
💬 0

3163.65 - 3164.271 Matthew May, MD

Go for it, David.

0
💬 0

3165.454 - 3166.676 Dr. David Burns

You're going to go for it or I should?

0
💬 0

3167.497 - 3168.098 Matthew May, MD

I think you should.

0
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3168.499 - 3194.617 Dr. David Burns

Okay, yeah. Could I talk to you for a minute, Rhonda? Sure. Do you remember before your talk today, you were saying that people were going to notice there was something wrong with your presentation and you were thinking that you'd look like a fool. And then you decided that it's OK to make mistakes and that people seem to love you and accept you as human. And that's freeing.

0
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3194.857 - 3212.721 Dr. David Burns

That's what you said, right? Right. Yeah, but I heard your talk today, and I noticed a lot of ways you screwed up in the presentation. And I think you did look like a fool, and I judge you as a fool.

0
💬 0

3214.83 - 3233.918 Dr. Rhonda Barofsky

Oh, you know, I've gone to a lot of your talks, David, and I've learned from every single one and I really admire them. I admire your talking. And I was wondering, is there something specific? Is there some specific feedback that you could give me? Because I love the way you talk and I always learn from you. I really admire you and I wish that I could be more like you.

0
💬 0

3233.958 - 3236.919 Dr. Rhonda Barofsky

So do you have anything specific that you could tell me about how I could improve?

0
💬 0

3237.37 - 3249.701 Dr. David Burns

No, I think you're uneducable, and I don't really have time to go about teaching you. I'm on a much higher level. Yeah. I want to spend my time with more important people.

0
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3252.684 - 3264.354 Dr. Rhonda Barofsky

Okay, yeah, well, it's true. I'm not very important, and then I give you freedom to go find them, and I'm just going to hang out with the lowlifes like Matt and Jason. Yeah.

0
💬 0

3266.547 - 3267.467 Dr. David Burns

Okay, who won?

0
💬 0

3267.928 - 3268.268 Dr. Rhonda Barofsky

I won.

0
💬 0

3268.808 - 3269.508 Dr. David Burns

Big or small?

0
💬 0

3270.289 - 3270.549 Dr. Rhonda Barofsky

Big.

0
💬 0

3271.129 - 3271.589 Dr. David Burns

Big or huge?

0
💬 0

3271.649 - 3278.633 Dr. Rhonda Barofsky

Huge, although that one honestly was harder because I felt like my defender coming up like, and I had to hold that in.

0
💬 0

3278.653 - 3283.035 Dr. David Burns

Do you want to do a role reversal with either Jason or with Matt? Sure.

0
💬 0

3286.917 - 3288.658 Matthew May, MD

You can hit me with that, Rhonda, if you'd like.

0
💬 0

3289.618 - 3301.871 Dr. Rhonda Barofsky

You know... Matt, I listened to your talk this afternoon, and I have to say that there was something obviously wrong, and you looked really foolish.

0
💬 0

3301.891 - 3321.922 Matthew May, MD

I did. I was thinking the same thing. I was thinking, oh, my gosh, what am I talking about? I'm not making any sense here at all, and I was feeling kind of anxious and worried. I'm such a relief to talk to you about it. I'd love to get your thoughts on it, and I just so admire you for being a straight shooter. Oh, yeah, thanks. Your opinion on my talk.

0
💬 0

3322.301 - 3332.629 Dr. Rhonda Barofsky

I mean, I am really an important person. I talk a lot, and I'm in high demand. I actually don't have time to talk to you because I need to go hang out with the other very, very successful people in the world.

0
💬 0

3334.03 - 3347.441 Matthew May, MD

Well, I've always thought that you're a really awesome, important human being, and I'm really glad for the feedback. If you have any specific pointers for where I could improve, I'd be delighted to hear about that. But I don't want to hold you up. It looks like they're kind of waiting for you over there.

0
💬 0

3347.661 - 3352.045 Dr. Rhonda Barofsky

Yeah, okay. Well, Matt, who won that?

0
💬 0

3353.467 - 3354.248 Matthew May, MD

I felt good about that.

0
💬 0

3354.509 - 3359.843 Dr. Rhonda Barofsky

Yeah, that was superb, I think. What do you think, David?

0
💬 0

3360.744 - 3378.687 Dr. David Burns

Yeah, I thought that was great, too. I'd love to be in the receiving role of a feared fantasy, and I don't know if you would want to do it, Jason, also. I don't want to suck you into this, that, or the other thing, because we want to get you back on the show as often as possible.

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💬 0

3379.867 - 3392.386 Jason Meno

I'm going to be a broken record a little bit and say I don't think we've answered this person's question. You know, they're they're talking about how 30 minutes before their presentation, they're about to enter a seminar room. They're the first speaker.

0
💬 0

3393.126 - 3403.97 Jason Meno

The first speaker is about to talk and they're next and they can feel their heart starting to pound and they're getting this sense of nerves and anxiety coming up again. So the question is, is how can they deal with that right in that moment?

0
💬 0

3404.366 - 3417.81 Dr. David Burns

OK, well, I'm glad you raised that question because there's a really fantastic answer to that. It's blow away and everything that this person was was was hoping for. And Jason will now reveal that answer.

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💬 0

3418.91 - 3442.022 Jason Meno

I'll give my shot at it. Awesome. But, you know, because I face this a lot, like I faced it right before coming onto this podcast myself. Like there's always this anxiety that comes up and. I think one thing that needs to be said is that anxiety is normal. Like there's like healthy nerves that come up when you're about to do something that's exciting or interesting or difficult or challenging.

0
💬 0

3442.602 - 3454.39 Jason Meno

So I think it's important to like, OK, yeah, I feel my heart pounding. I feel my my palms start to sweat. I feel my thoughts start to race a little bit. And some of that for me personally is just leaning into it.

0
💬 0

3454.45 - 3472.766 Jason Meno

It's exposing myself to that and being willing to not fight against it or make the interpretation that like, oh, this means I'm going to blow it or this means something bad is going to happen. Instead, there's a lot of different things that I can do to deal with those nerves right then and there. One, my personal favorite technique is just cognitive flooding.

0
💬 0

3473.286 - 3489.053 Jason Meno

Like what's the worst thing that could happen? What's what's like I did. I've been doing it in this meeting, actually, like. I'm sitting here and I'm like imagining like, oh, the comments in the YouTube comments, someone's going to say like, oh, Jason, what a fool or like, oh, his his face is ugly or, you know, like I started imagining all these cruel comments.

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3489.153 - 3509.085 Jason Meno

And then the moment I really try to get my anxiety up, actually, in that moment, suddenly the anxiety disappears. And so those are kind of some of the tech. I mean, so these exposure cognitive flooding technique is one of my favorite ways to to work with these nerves. But a lot of it is also just like acceptance of like, oh, yeah, my heart's pounding. I'm really excited right now.

0
💬 0

3509.125 - 3510.926 Jason Meno

Like, oh, yeah, I'm feeling a bit anxious about this.

0
💬 0

3511.386 - 3532.849 Dr. David Burns

Yeah, that's fine. Yeah, I love that. That that's cool. Everyone might have their own. little thing. As you use these techniques, find the formula that works for you. I used to tell myself before giving a workshop, say a two-day workshop before it starts,

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3534.17 - 3562.018 Dr. David Burns

often I'm in a bad mood because the audio-video typically doesn't work right, or the audio, and they don't have a technician there to fix it, and I get pissed off. And then I say, and I'm supposed to be Dr. Feelgood, and I'm like, Dr. Feelpissed right now. But then I used to tell myself, well, David, remember that the way you feel just before the talk has nothing to do with how the talk goes.

0
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3563.522 - 3591.87 Dr. David Burns

Because I've seen that in the data, and that's very helpful for me. And also I have people evaluate me on a feedback scale every time I do a presentation or a Tuesday group teaching. So I find out what is my rating, and I know what is a C, what's a B, what's an A-, what's an A. And I have them write down what they like the least and what they like the most.

0
💬 0

3592.67 - 3621.039 Dr. David Burns

And knowing that I'm going to get that data is very helpful, too, because if there's something that people don't like, it's generally something specific. Not that you suck as a human being, but when you didn't find truth in my question, I felt hurt or something like that. And then you can learn from those specific things. I treated a woman for public speaking anxiety who had...

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3624.122 - 3640.541 Dr. David Burns

She was in a Fortune 500 company, and she had to give some kind of talk, and she was pregnant. And when she got up to give her talk, she passed out.

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3641.182 - 3641.643 Dr. Rhonda Barofsky

Oh, goodness. Yes.

0
💬 0

3642.12 - 3671.716 Dr. David Burns

And was very humiliated by that and asked me for some help through the Internet since I'd never met her. But again, she was saying I shouldn't have passed out and this is a terrible and bad thing. that I deserved to feel ashamed of. And she had the fear that, you know, it might happen again.

0
💬 0

3672.316 - 3707.438 Dr. David Burns

And then I guess people had high regard for her regardless and asked her to coach someone in public speaking anxiety in the company. And she asked me, what if this person finds out that I fainted? And I said, well, why don't you tell him and find out what he thinks? And she said, oh, that would be terrible. He'll lose trust in me and blah, blah, blah.

0
💬 0

3708.378 - 3737.972 Dr. David Burns

And I said, well, you don't have to do it, but I would strongly encourage you to do it because it's hiding that creates shame. And once you get it out and open, it might fall into a different perspective. And so she agreed to tell him. And the next week I met with her again just through email exchange. She she was very excited because she told the student of hers. and said, what do you think?

0
💬 0

3738.032 - 3763.429 Dr. David Burns

And he says, this is by far the best thing you ever said. It's so helpful to me to know that someone as polished as you could faint or feel anxious. And what then she started doing in each of her presentations, I said, now you could tell your audiences, too. You know, you don't have to hide it from anybody.

0
💬 0

3763.489 - 3788.447 Dr. David Burns

So she started all of her talks as, I just want you folks to know that I often have intense public speaking anxiety, and sometimes I even pass out. And that will probably happen at any moment. But if I do, just splash some cold water on me and slap me around a little bit, and I'll get up and I'll be just fine. And then the audience all laughs.

0
💬 0

3789.348 - 3822.745 Dr. David Burns

And she used that in all of her talks from that day on. And then she contacted me a year or two later, and she'd won an award as the top – public speaker and top public speaking teacher among Fortune 500 companies. It was a very prestigious thing, and it just came about by, like what you were saying, Jason, to accept the anxiety rather than fighting it and thinking you've got to make it go away.

0
💬 0

3822.765 - 3828.869 Dr. David Burns

Matt, I heard you get very anxious sometimes.

0
💬 0

3830.323 - 3836.429 Matthew May, MD

I do, David, and I've also got some other thoughts that might be helpful for this person.

0
💬 0

3836.81 - 3837.871 Dr. David Burns

Okay, go. Go ahead.

0
💬 0

3837.931 - 3846.819 Matthew May, MD

Yeah. Right. So you're pointing out that maybe it's not so much the anxiety that's the problem but the shame around it.

0
💬 0

3847.28 - 3852.285 Dr. David Burns

Yeah. The attempt to control it and thinking it's some awful thing that you shouldn't be having. Yeah.

0
💬 0

3852.83 - 3870.163 Matthew May, MD

Yeah. And so I, I agree. I think one of the best, uh, antidotes is to start talking about the feelings openly. And that's, uh, and there are multiple other social exposure exercises that people, uh, with social anxiety can do, uh, that can relieve.

0
💬 0

3870.183 - 3871.144 Dr. David Burns

Self-disclosure.

0
💬 0

3871.604 - 3893.426 Matthew May, MD

Self-disclosure. Right. Yeah. You know, I noticed I'm feeling a little anxious right now. Um, and then, uh, positive reframing can be helpful too. Like we get anxious because we care a lot about this project that we're doing in this audience and we want to give something really meaningful to people. And to remind ourselves of that can be helpful.

0
💬 0

3894.527 - 3901.092 Matthew May, MD

I'll sometimes use the magic dial on myself, like how anxious do I need to feel right now to make sure everything goes perfectly.

0
💬 0

3901.772 - 3935.097 Dr. David Burns

Yeah, yeah. I had to give a talk on anxiety at Harvard once. and on cognitive therapy. And I decided to do it on public speaking anxiety, And I imagined that it would be like a seminar with maybe eight psychiatric residents and a couple of faculty or something like that. And when I got there, I found out it wasn't anything like that at all.

0
💬 0

3935.137 - 3969.002 Dr. David Burns

It was a full-day continuing education program with eight speakers. And I was the last speaker of the day. Right. And the other speakers were these hot dog Harvard Medical School researchers talking about their genetic research. It was all basic cellular technology stuff. And I said, oh, my God, I'm in the wrong spot. There were 1,000 psychiatrists in the audience.

0
💬 0

3970.406 - 4002.181 Dr. David Burns

And I started getting more and more nervous and telling myself, oh, I wish I wasn't here. This is the worst day of my life. And I felt so inferior to those other speakers who were these internationally renowned scientists and scientists. And then I got up, by the time I went up to speak to the podium, my mouth was so dry that I couldn't make any sounds come out of it.

0
💬 0

4003.382 - 4023.45 Dr. David Burns

And I was looking out at these 1,000 psychiatrists staring at me. And... And then I just, on the spur of the moment, said, my talk today is on using cognitive therapy for anxiety, and I'm going to be focusing on public speaking anxiety.

0
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4023.95 - 4046.217 Dr. David Burns

And I said, but to get started, I'd like to know, have any of you had intense public speaking anxiety where you got so nervous at the start of a talk that you felt that you wouldn't even be able to make any sounds, and your mouth got dry, and you're just really in a state of panic? Hold your hand up if you've ever had that experience. And I swear that 75% of the hands went up like that.

0
💬 0

4046.637 - 4072.304 Dr. David Burns

And they said, well, that's how I'm feeling right now because we've had all these fantastic speakers, and I'm just going to show you some kind of humble cognitive therapy techniques. And they laughed, and they really liked it, and it turned into a really nice experience. But again, it's sharing... where you're at, rather than hiding it in shame.

0
💬 0

4072.344 - 4104.812 Dr. David Burns

That hiding in shame is where things get really, really intensified. And it's so much fun to accept your failures and flaws and shortcomings. Once you've accepted it yourself, I think it almost makes you more appealing to have some flaws as a human being, especially if you're treating others with love and presenting yourself as just a flawed human being. Yeah.

0
💬 0

4105.839 - 4124.803 Jason Meno

Yeah. Another kind of on the spot technique I use a lot when when my mind is racing and I'm feeling anxious about something is a lot of that anxiety for me. And in terms of performance anxiety, it comes from that perfectionism of like, oh, I need to give this speech perfectly or I need to say all the right things.

0
💬 0

4125.623 - 4147.273 Jason Meno

And one of my favorite techniques that I think from feeling good was average practice was just imagining, well, What would a very average talk feel like? What would an average presenter act like? Would an average person feel really anxious right now? Yes. Okay, I'm doing great. I'm just following along and trying to be as average as possible.

0
💬 0

4147.774 - 4154.478 Jason Meno

And that kind of lessens a lot of that perfectionistic demandingness that often makes the anxiety ten times worse. Yeah.

0
💬 0

4154.978 - 4179.616 Dr. David Burns

I love that, Jason. I do when I write show notes, like, well, I've already written them for this episode, but I use the same strategy. Sometimes I write them after the show because it's not an Ask David, but I tell myself, do an anti-perfectionistic show notes. Just do something well below average.

0
💬 0

4180.536 - 4204.015 Dr. David Burns

And then send it out to people to check it out and edit it and change it and tell them it's just an unedited off the top of my head thing that isn't very good. And so please fix it up and correct it and delete things and add whatever you want. And then that makes it real easy just to spit out some average junk. which is what the show notes consist of.

0
💬 0

4204.996 - 4229.675 Dr. David Burns

And then I send them out to everyone to, you know, say the people who are on the show and say, check this out, change anything you want. And then most of the time people say, oh, this is great, just the way it is. It's so interesting. And Rhonda, sometimes you'll find some typos or something and it makes some corrections that I always appreciate. But it's like you can get away with being average.

0
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4229.835 - 4230.516 Dr. David Burns

Yeah.

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4234.057 - 4258.945 Matthew May, MD

I have a couple of other comments. I love what Jason and David and Rhonda have already said about this. One concern I have is that sometimes people with anxiety are hoping that the anxiety will go away first, and then they'll face their fears. But my experience has always been the opposite, that if I'm facing my fears on a regular basis, then my anxiety goes away.

0
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4259.815 - 4277.854 Matthew May, MD

And so it may just be that there's kind of a process resistance and that one of the best techniques this person could do is just to keep giving public speeches and more frequently and longer speeches and get more involved in that. And then I suspect their anxiety, in fact, would kind of go away over time.

0
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4278.447 - 4301.926 Dr. David Burns

Yeah, my first academic talk was at Oxford in England at a conference, and I was terribly anxious, and I was just certain I would blow it. It was even worse than the Harvard thing. It was a lot worse. And I did blow it. It was even worse than what I had imagined, and I couldn't sleep a wink the night before.

0
💬 0

4302.006 - 4334.894 Dr. David Burns

I was just up wandering around the Oxford campus, and owls were hooting at me sarcastically, and the whole world seemed against me. And my talk wasn't until the end of the following day, which was the end of the conference. And I was so nervous, it was just horrible. It was the most humiliating experience I've ever had, I think. But then I worked to getting over that.

0
💬 0

4335.194 - 4363.893 Dr. David Burns

And it's just like what you say, Matt. Now I'm teaching tonight. This is my second podcast today. And I'm confronting it all the time. And now the thing that I was so afraid of, I love doing. But I still get a little anxious from time to time. Before this morning's podcast, I was very anxious because I thought this guy was going to challenge me and rip me to shreds.

0
💬 0

4363.973 - 4394.43 Dr. David Burns

I don't know how I got that idea. But probably because my computer was failing and I was in a state of high anxiety. But he was just so sweet and kind, and so it was just a wonderful, wonderful experience. He's the guy who wrote F Depression and F Anxiety. And so I thought he'd be real aggressive. But he was just the kindest guy you can imagine.

0
💬 0

4398.833 - 4418.092 Dr. Rhonda Barofsky

Well, I think we've come to the end of today's podcast. And I want to really appreciate everything that everyone has said and the topics that we've talked about have been really – like someone – the person who wrote Anonymous that we didn't give self-defeating beliefs a deep enough dive into the subject. We definitely did do that. And I want to thank you, Jason, for keeping us on track with –

0
💬 0

4420.134 - 4431.139 Dr. Rhonda Barofsky

Hiran May's question, he came from Basel, Switzerland, looking for something specific, and you made sure that he got what he asked for. So we really appreciate your focus on that detail.

0
💬 0

4431.159 - 4443.524 Dr. David Burns

I loved having you on today, Jason. I'm so grateful. It was just that much richer, our podcast, because of you. Just don't ever do it again. You got it.

0
💬 0

4448.834 - 4452.997 Matthew May, MD

That was a little fantasy right there. Yeah, exactly. Acceptance.

0
💬 0

4453.017 - 4453.517 Jason Meno

Yeah, totally.

0
💬 0

4453.597 - 4478.594 Dr. David Burns

Oh, yeah. No problem. It was just I loved the comradeship today and the talk and everything that we did. And we got two of our 10 questions answered. We didn't get to the first of yours, Jason. And so we'll probably, you know, use that same list for the next Ask David, should we, folks?

0
💬 0

4478.934 - 4479.275 Dr. Rhonda Barofsky

Why not?

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💬 0

4480.196 - 4510.62 Dr. David Burns

Yeah, because those eight additional questions, I'll leave them in the show notes, but then I'll say we'll be addressing numbers three and four and five in upcoming podcasts. But, you know, just so nice to hang out and pretend like we're experts or something. You feel like you have something you can give to somebody. Maybe you have a little understanding that they don't, that they will appreciate.

0
💬 0

4511.441 - 4531.129 Dr. David Burns

So let us know, Haraname, was this helpful to you? And also, who was our first one? That was Anonymous. Yes. Oh, anonymous. The self-defeating belief was anonymous. Oh, okay. Well, email us if you hear the show. I hope you will. And tell us what you think.

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💬 0

4531.769 - 4555.05 Dr. Rhonda Barofsky

Okay. Thank you so much. Till next time. This has been another episode of the Feeling Good Podcast. For more information, 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.

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💬 0

4555.35 - 4575.267 Dr. Rhonda Barofsky

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.

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