Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
434: The One-Minute Drill; Memory Rescripting; and More!
Mon, 03 Feb 2025
David, Matt, and Rhonda Answer Your Questions! What's the One-Minute Drill work? How does it work? What's Memory Rescripting? How does it work? How can I endure boring and irrelevant college work? Aaron asks: How do you do the One Minute Drill? Aaron asks how and why Memory Rescripting helped a college student overcome her fears of public transportation (e.g. agoraphobia). Gray asks: How can I endure having to do boring work in college and beyond? Two questions from Aaron W. C. who is a Licensed Master Social Worker in Idaho, and said, “I look forward to the podcast.” 1. Hi Dr. Burns, Can you share how you do the one-minute drill? In When Panic Attacks, you only mentioned the name but not how it works. Thank you, Aaron W. California David’s reply We'll explain and demonstrate it on the podcast. It's a partially helpful tool for troubled couples who argue and fail to listen. 2. Hi Dr. Burns, I completed rereading When Panic Attacks yesterday night. I have a question about one of the case examples you mentioned. In the book, you mention a patient that has a phobia of taking public transportation. She did the reimagination exercise of picturing herself castrating the men that harmed her roommate and branded the man that hurt her as a child. If remember right, the book does not link using the "reimagination exercise" to overcoming her fear of taking public transportation. How did the reimagination exercise help her overcome the fear of taking public transportation? I have reread the book two times this year! Thank you, Aaron W. California---LMSW (Idaho) David’s reply I am happy to include your question on an upcoming Feeling Good Podcast. Can I use your first name? Thanks! I can answer two of your questions, and can even demonstrate the one-minute drill, and discuss its uses and limitations. Best, david 3. Gray asks about feeling better about post-secondary education Hi David, I struggle with intense anger, frustration, and depression while doing college coursework, with recurring thoughts like, “This is pointless,” “This work is for nobody, ” "I'm just working to work," "I'm being hazed," and “I profoundly don’t care!” I’m interested in law school because I’d love being a lawyer, but I worry that I won’t be mentally healthy in that environment. Many lawyers say 80+% of law school is irrelevant and doesn’t adequately prepare you to practice law or even to pass the Bar, so I expect similar frustrations would resurface. I’ve looked into this very carefully and I’m convinced that the basic substance of my thoughts has bulletproof empirical grounding (outside of STEM, for sure). How could I manage these distortions when I’m in the midst of law school homework? P.S. I’m quite hostile to appeals about how I would actually learn important things in class or about developing resilience for its own sake, so I’d prefer to avoid that line of thinking unless it's really important. Thank you, Gray David’s reply Can you give me an example of one of your negative thoughts. They always contain some truth, by the way. Perhaps you’re trapped in a Hidden Should Statement. Are you wanting to feel happy about having to do boring homework, or are you wanting not to have to do boring homework? What’s your goal, in other words. All therapeutic failure, just about, is due to a failure of agenda setting. In other words, reducing resistance is the key prior to crushing distortions. Warmly, david There is certainly a great deal of irrelevant stuff one has to plow through to get a college or graduate degree, for sure. So there seems to be a lot of wisdom in your negative thoughts and feelings. I guess my question would be, what type of help, if any, are you looking for? Best, david Gray responds Subject: Re: Feeling better about post-secondary education My hidden should statements are something like "I shouldn't have to do this." and" I should be able to prove myself by doing real work instead". I am hoping to be able to do lots of boring/irrelevant homework and be okay about it, not even necessarily happy. Then I could go to law school and be in passable mental health. Thanks again! Gray David Replies Well, you’re right on all counts, including “I shouldn’t have to do this.” In fact, you DON’T “have to” do it. And if you do stick with it, there’s no rule that says you have to stop whining and complaining! I made the choice of going to medical school and hated it. Worst medical student they had. But I had to complete medical school and psychiatric residency in order to become a psychiatrist. Don’t think I learned much of anything in medical school or psychiatric residency that ever really helped any of my patients at that time. But now I have a life I really enjoy, although there are still negatives I have to put up with. Warmly, david One last thing to add. The boring, trivial work does not upset you. Only your distorted thoughts can upset you. The truth in your thoughts is real but does not upset you. You are saying that you SHOULD NOT have to do trivial boring work. Where did you get that idea. Did you think you were entitled to a universe that conforms to your demands? Why should the world be the way you want it to be? There’s an irritating voice in your brain that keeps telling you that you should have to do this and you shouldn’t have to do that. That voice is your enemy, your source of angst, and not the actual work. So, your first step is to make a decision, perhaps two Cost-Benefit Analyses. The first might be the Advantages and Disadvantages of loudly protesting and insisting it SHOULDN’T be this way. There will be many advantages and a few disadvantages as well. Now balance the Adv against the Dis on a 100 point scale at the bottom, putting the higher number under the column that feels the more desirable or impactful. For example, if the ADV are a lot greater, your two numbers might be 70-30. Then you might do a second CBS listing the Advantages and Disadvantages of ACCEPTING the fact that school often sucks. There may be some advantages and a few disadvantages as well. Now balance the Adv against the Dis on a 100 point scale at the bottom, putting the higher number under the column that feels the more desirable or impactful. For example, if the DIS of acceptance are a lot greater, your two numbers might be 25-75. Send me your two analyses when you’re done! If you come to the unlikely decision that acceptance is preferably to shoulding on yourself, there are lots of strategies that might help. But I’d need to know where you stand first, or the methods would be a waste of time. Anger, unlike most negative feelings, is highly addictive, and most people don’t want to let go of it. You could also do Positive Reframing of your anger and negative thoughts, which is super powerful, but this is getting a bit long. Best, david David follow-up for podcast audience: As far as I can tell, Gray didn’t respond to my email. Sad!
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 Borowski, 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.
Hello, Rhonda.
Hello, David. And hello, Matt. Matt May is joining us again. We're doing another Ask David episode, and this is the Feeling Good Podcast, and it is episode 434. I thought I'd start off again before you guys jump in with a really cool endorsement that someone sent you about the videos that you're sending, David. Awesome. She said, Dear Dr. Burns-
You and Teresa, who works on the videos with you, must work really hard on your ideas to create beautiful and meaningful videos. Seeing your friendly and kind face on video is like manna to me. I've been a fan for years. Your books are my go-to every day and they've transformed my perspective. I've read Feeling Good countless times. And each time it resonates in new ways.
As I practice the techniques and revisit it, my understanding deepens and evolves alongside my life experiences. And your book, Feeling Good Together, is simply life changing. It's hugely impacted how I approach relationships and communication. I am absolutely thrilled to see your new videos. I can see how much effort you have put into creating them.
It feels like I've been waiting for them my whole life. Now I can tackle chores while enjoying your warm and humble presence on my screen. Honestly, it is impossible to feel down when I see your friendly face and hear your wise and compassionate words. Thank you for all you do It is a privilege to learn from you, and I feel so grateful for your presence in my life.
You've made an incredible difference in my life and in the lives of so many others. With heartfelt gratitude.
Well, thank you so much for that wonderful comment. We've been very excited, Teresa and David have, as well as with some support and inspiration and a lot of elbow grease, too, from Jeremy Carmel. who's our CEO of our Feeling Great Corporation. And he really made it possible for us to create these videos.
And Teresa and I have been learning really fast because when we started out, we were totally lame. We were at poor advice from people who didn't know what they were talking about and did a crappy job. And now we're really having fun and getting beautiful feedback from And these are videos on our Feeling Great channel. They're free of charge. And we're very proud of them.
And so you gave us a shot in the arm. And if any of you are interested, take a look at the videos because they're some of my best stories. Tearjerker, some of them, and they'll make you laugh. And they have good educational content. and all about Team CBT and how to change the way you think and feel.
But today the idea came up, I want to ask you, Rhonda, that should we, and I don't think we're going to do this, but we had the idea maybe we could play one of the videos on a podcast and then talk about it on a podcast and I don't know. I think they're happy just sitting over there on YouTube on the Feeling Great channel. But, you know, we'd certainly be happy to do that.
Some of your videos are super fun. And they are new material, so... Sure. We could try that as an experiment for sure.
Yeah, yeah. But in the meantime, if any of you are interested, just go to YouTube and find the Feeling Great channel. And you'll find them all there with the little – they call them thumbnails or something like that and descriptions of them. And lately we've been learning how to use AI to get really cool titles and descriptions for them. So it's been an adventure for us, and thanks so much.
And we hope they will be helpful to people and interesting.
Ready to dive into some more questions? Okay. We have two questions from Aaron, who's a licensed master social worker in, in, um, should I say the state? Yeah. Idaho. Okay. And he wrote you that he looks forward to the podcast. And his first question was, can you share how you do the one minute drill in panic attack? You only mentioned the name, but not how it works.
Yeah, we can actually demonstrate that. It'll be a really fun thing. And I'll briefly describe it, and then we can bring it to life with a kind of role play. But the way you do it, this is like marital therapy 101. And by 101, I mean it's a very simple technique. You can learn to do it.
You can make it work the first time, and it works like a charm every time, but it's actually not a very sophisticated technique, and it's quite limited. It has some value, but it's definitely not the answer for everyone or maybe even for anyone. But when you're working with a couple, and now this isn't just for therapists because if you're not a therapist, you and your partner or your son or –
Whoever may want to do this, too, if you're having trouble communicating. But you sit in two chairs facing each other and you have to be in a kind of a quiet room with no TV, no radio, no alcohol. And just to do this, this one minute drill and you take turns. One is the talker and one is the listener.
And if you're the talker first, and you switch roles, so it makes no difference who starts, but you get to say anything you want for about 30 seconds. And when you're talking, your partner will not interrupt you and is not allowed to agree with you or disagree with you, but can take notes on what you're saying and tries only to hear what you're saying and reflect it back as accurately as possible.
And after you've expressed yourself and your partner has summarized it, you grade your partner from zero to 100 on how accurately did they understand your thoughts? How accurately did they acknowledge how you're probably feeling from zero to 100? And did they do this in a spirit of respect? And you get your rating from zero to 100. And if your rating is 95 or better, you switch roles.
And now the other person gets to be the talker and you're the listener. That's how it works. But if it's not 95% or better, then you say, what did I get wrong? What did I miss? And then they'll tell you the part that you missed, and then you can summarize that and hopefully get up to 95% once you've done that once or twice. So that's how it works.
And where it has its power is most people, when you have a problem in your family or with a friend or partner, child or neighbor or whatever, you get to arguing and contradicting each other and interrupting each other. And this forces you to be a world-class listener. And when you talk, you know the other person's going to listen and get it right. And that itself is a bit of a miracle.
Now, the technique has a lot of shortcomings as well, but it does have that value. Did I get that right, Matt and Rhonda? Perfectly. Yeah, that sounds great. Let's demonstrate. Let's imagine you two have a turbulent relationship and you're arguing a lot and over-talking each other and that type of thing. Okay.
Matt, can I be the talker?
First. Yeah, I just want to point out that you just interrupted me. This is what you do to Matt. You deserve what you get. Okay, so Rhonda, you'll be the talker, and good talker you'll be too, I'm sure. You can say whatever you want for these 30 seconds. And while she's talking, Matt, I want you to – you can take notes if you like, but you're going to be like a court reporter. Okay.
And try to understand and hear everything she says, her words and how she's probably feeling. And then when she's done, after 30 seconds, I want you to see if you can paraphrase it and see if you can get a score of 95% or better. Are you ready?
When do I get to go?
After you get your 95% score. Okay.
So you're talking about in Five Secrets, feeling and thought empathy, right?
Yeah, but also acceptance, the idea to be respectful, because if the person says, you never listen, I could say, oh, yeah, you say I never listen. That's exactly how you'd say it too. That's 100% accurate thought empathy, but it's sarcastic and hostile. So you'd get about a zero on that one, even though you've repeated the words.
So it's to be like a court reporter and to be respectful and to accurately say what the other person said and how they're feeling. And you're not allowed to agree with them. You're not allowed to disagree with them. You just have to get it right. So are you ready?
I'm ready. I'm ready. Are you ready, Matt? Yes. Are you going to time it, David?
Well, no, not exactly. But, you know, we'll know when 30 seconds is about done. It's not that literal. OK, Matt. By the way, you listeners can try, too. And that's what I'm going to do. I can take notes on what Rhonda says so I can see if I can get it all. OK, go for it, Rhonda.
Okay, Matt, you never listened to me. Last night we were talking after dinner and we made a plan and it was really specific. I told you exactly what I wanted. You asked me lots of questions and I gave you really specific answers. And then this morning when we were talking about it again, you got it all wrong. And it wasn't anything about the plan that we made.
And I'm, you know, because you never listened to me exactly what I'm saying. It's so frustrating.
Okay, so I... Yeah, last night we were talking a lot about a plan in very specific terms. I kept asking questions and you kept clarifying your preferences. And then this morning I got it all wrong. And it wasn't anything like the plan that you were describing that we were talking about the night before. And it's just so incredible.
And so now ask Rhonda, what grade do you go?
What grade did I get, Rhonda?
I would give you – I definitely would give you a 95 percent. Well, I give you –
Okay, I would give you about a 75%, Matt. Oh, 75%? Yeah, and Rhonda was very generous with you because while you got her thought empathy, her statements pretty accurately, you only acknowledged one feeling, frustration. And I can guarantee she had at least 10 feelings. Yes. Certainly six, a beginner could come up with six.
Can you tell her, tell Matt what he missed in terms of how you're feeling, Rhonda? Like you might be feeling hurt and sad and lonely and ignored and devalued and, you know, on and on.
Yeah, I was really hurt that you didn't, that it seemed like you didn't, pay attention to what I said. And I was a little scared that maybe there was some reason why you're not hearing what I've said. Maybe I was scared. Are you not hearing me? Are you not having the cognitive ability to understand what I said? So I got a little scared and it was irritating.
And Rhonda, just a question for you, Rhonda, did you feel sad or joyful?
I felt sad.
Uh-huh. So we could add that. And did you feel loved or lonely? Lonely. Uh-huh. So we could add that. Uh-huh. And alone. Uh-huh. And any other negative feelings that you were feeling, Rhonda?
Well, I hate to admit it, but I did feel angry.
Yeah, well, you mentioned that irritating. We can add angry. That's a good word, too. Now you can ask Matt to paraphrase again.
So, Matt, can you give it another go at paraphrasing?
Yeah, yeah. So so and by the way, I'm not supposed to agree, so I shouldn't disarm. Is that part of the or can I can I say you're so right? Last night we had this big discussion about a plan for today. Yeah, sure, that'd be okay. That's not provocative. Okay, I didn't understand. Exactly. And then this morning, I got it all wrong, actually.
I don't think I did any of the things that we had planned on doing. And you said it was frustrating to you. And I could also understand why you'd be feeling really irritated with me and angry. And you said you felt really hurt. That makes sense to me, too. You were wondering if maybe I just wasn't even paying attention or maybe there's some kind of cognitive problem that I'm not getting it.
And so that was scary for you as well. And you felt sad. You felt lonely. I wondered if you even felt defeated or hopeless. What's the point in trying to make a plan or talk to me about stuff if I don't really listen to you? How am I doing now?
Now that totally was a 95. Actually, that was 100 because I liked how you added the defeated and hopeless part.
Yeah, that's beautiful. And that's how it works. Now we can do another round of it, or that might be good enough to illustrate it. And I could tell you what's the strong thing here and what's the weak thing here. And I can also tell you if one of the two partners doesn't follow the rules, what that means. So you want to do another round or should we talk about the technique?
I'd like to hear your points there.
Yeah, me too. What happens if one of the two partners – oops, I'm interrupting you both constantly. Sorry.
Sure. Well, if one of the two partners interrupts and doesn't follow the rules, and that's happened to me, what would that tell you, Rhonda? Yeah. They give you multiple choice, if you like.
I'm thinking of it could tell you a lot of things. It could tell you they're not listening. They're not paying attention. They think that their thoughts are more important than the other person's. Some impatience and maybe even some irritation that they have to be doing this exercise in the first place.
Right. It's really telling me that they don't want to be here. And then when I'm doing couples work, which isn't very often, then I would say, why don't you and I, I meet with each member of a couple individually before I'll accept them into couples therapy and emphasize that if you want me to help you, you have to agree to focus on your own role in the problem.
And stop blaming the other person and do the changing yourself and change the way you're interacting. And you have to convince me that you really do want to develop a more loving marriage or relationship. And if the person then starts interrupting, they're kind of telling you that they didn't get that message.
And so I'd want to meet with them separately and say, perhaps you're telling me that you don't want to be in couples therapy. And that's cool with me. But I could see that you were kind of sabotaging that technique. What do you think?
And really hold their feet to the fire and entertain the idea that maybe I don't want to work with this couple as a couple because only one of them wants to be in therapy. I might work with the spouse individually, but I wouldn't let this person continue in couples therapy unless they could convince me that they really are looking for a more loving relationship.
And they are willing to change themselves rather than blame, constantly blame and attack the other person.
Yeah, that makes a lot of sense to me. For people who want to give this a try, I've made some observations over time about this method that might be worth hearing.
Yes, please share that.
That would be valuable, Matt. So one thing I've seen happen very, very often is that after being like heard for the first time, the speaker feels really excited and will want to keep talking. They feel like, oh my God, this is exactly what I wanted to be able to just like get things off my chest to be heard and understood.
And so they will then just continue the conversation rather than pausing to give the feedback. But the feedback is super vital and important. So that's the number one thing that I see go wrong here is that the speaker finds it hard to pause to give that feedback to the listener.
Interesting.
But I think for some couples, this works really well. For other couples, I haven't seen it work that well for them. But I like it a lot. I think it slows down the communication instead of both parties trying to get their message across. uh, simultaneously to break it artificially into a speaker and a listener. Uh, it's just a genius approach.
And, you know, the, um, where that's where it's, it's good. It can interrupt, you know, a pretty hostile process that's going on and it can make that interrupt that process and get them into a more peaceful interaction quickly where it falls short. Well, there's a couple of things to be aware of. One is, is that, um, the, uh, it doesn't lend itself to normal communication.
It's a very, you know, artificial kind of exercise. And you can't keep having a normal conversation, you know, on that very formal kind of thing. So there are other more challenging couples methods that allow for more spontaneous exchange that you can move into, like the... Don Balcombe's machine gun therapy technique.
He's from University of North Carolina and has developed some really neat ways of working with couples. And that's a more challenging but probably more challenging
superior technique and then the other thing is if you're going to be using this at least to get couples started um you you you also ask them uh individually uh like i would say to you matt would you be willing would well first would the two of you be willing to do homework between now and next week practicing this Hello.
Yes. Yes.
Yes. OK. And by the way, your two sounds are so one is so loud and the other is so dim. I hope Josh can can can correct that. But the then let's assume that you've decided on a time. And we won't go through that negotiation right now just to save time. But let's say you're going to do it every evening at 6 o'clock from 6 to 6.15.
And so then I would say to you, Matt, and you're going to do it every night, Monday through Friday, from 6 to 6.15. And you're going to go into your library. The kids are not allowed to come in. The TV is off, the radio is off and stereo is off or whatever. And you're no alcohol and you're going to sit in two chairs facing each other and do this exercise. Do you agree to do that, Matt?
I do.
And do you agree to do that, Rhonda? I do. I do. Okay. And now, Matt, I want to know, do you agree to do that if Rhonda refuses to come? In other words, do you agree to go into that room and sit down and you can bring a book and read it or something, but you'll wait even if Rhonda doesn't cooperate?
Why should I have to do that if she's not cooperating?
Okay, so I take it you're not willing to do that. Is that correct, Matt? And then I think I'm going to withdraw the assignment and stop doing the couples therapy. And is there anything else I can help you with?
Okay, all right, you win. I'll show up even if she doesn't.
Yeah, because this is agreement between you and me, Matt. This is not an agreement between you and Rhonda. Do you understand that, Matt?
Yeah, that makes sense.
And if you don't do that, you're telling David that you want to drop out of therapy. Is that clear?
That's clear.
And Rhonda. Now, Rhonda, do you agree to go and sit in the library from 6 to 6.15 every evening, even if Matt stubbornly refuses to show up?
Definitely.
I do.
I will.
Okay. That's great. And that's how I set up the homework so they can't sabotage it and blame the other person.
I like that.
I like it. Well, enough on couples therapy. It's not my favorite thing. It's very challenging, but you guys did a beautiful job with the demonstration.
Thank you.
That was fun. Thank you. Matt did the harder job. Thank you, Matt. It's hard for me to give you a negative grade, Matt, because I hold you very high in my esteem. All right. Here's the next question from Aaron. Hi, Dr. Burns. I completed rereading When Panic Attacks Yesterday Night. I have a question about one of the case examples you mentioned. In the book, you mentioned a patient...
who has a phobia of taking public transportation. She did the reimagination exercise of picturing herself castrating the men that harmed her roommate and branded the men that hurt her as a child. If I remember it correctly, the book does not link using the reimagination exercise to overcoming her fear of taking public transportation.
How did the reimagination exercise help her overcome the fear of taking public transportation? And I've reread the book two times this year. Thank you, Erin.
Okay, great. Well, thank you, Aaron. That's a great question. And what you do essentially in memory re-scripting, you have a person go back and relive a traumatic memory. In this case, it was a college student who was afraid of public transportation. And he When she was little, her mother was a single mother and would often go off in the evening for a date or a business meeting or whatever.
And the neighbor boy would babysit. And she said that it was very painful for her because when he would come over, when he thought she was asleep, he would creep into her room and put his hand under her nightie and fondle her.
and she would pretend to be asleep because she was so terrified, and she didn't want to get hurt, and she didn't know what to do, and she was so ashamed she never told anybody. And she was going, let's say, to Princeton, but when she would come home to Philadelphia for holidays, he was still living there next to her, and she was very, very bothered. And I had mentioned...
And she was very cooperative and did a lot of her psychotherapy homework, but she would not do exposure. She would not get on a bus even for one block, even if I promised to be waiting for her at the end of the block and she could get off. Even that was too much for her.
And so I mentioned to her, maybe she'd want to try this memory restricting, which is a very kind of grotesque technique in a way. But what I would do, I would kind of hypnotize you and bring you back into that memory. And then at the height of your anxiety, I'll let you be a movie director and change the script and have a different outcome. And you can decide what you want that to be.
And so she was very excited about that. And so I told her to close her eyes and imagine, you know, you're back and you've gone to bed and... He thinks you're asleep and he's creeping into your room. And can you see him? And she said, yes. And I said, what shirt is he wearing? She said, he's wearing a plaid shirt and sneakers and Levi's. And I can see him just as vividly as he's here.
And then what's he doing now? He's reaching under the covers and he's reaching up under my nightie. And how anxious are you feeling? She said, 100%. And I'm terrified and angry and frightened and devastated. And I said, now, if you like, you can change the scene like in any way you want.
You could have me come into the scene and help you or you could come into the scene as a powerful woman and do something to him. And you just change it like a movie director with a different outcome.
And so she wanted to come into the scene as a big, powerful woman, and she said, I'm going to grab him by the neck or by the collar, and I have a white-hot cattle branding iron in my hand with a P on it, and I'm now – branding his forehead, and he's screaming in pain, and I can smell his flesh burning, and I've branded a P in his forehead for pervert. And I said, how do you feel now?
And she says, I'm starting to feel a lot better, but I want to do more. And then she took him next door where there was a Christmas party going on and she made him stand in front of all the neighbors and shout out, I'm a sexual pervert and I deserve punishment. And then in the final scene, she put him in a jail in front of her house, an open air jail. This is all in her mind.
Mind you, it's kind of a fantasy. And there's no walls, but there are prison bars. And then on the jail, it says sexual pervert. So everyone will know he's a sexual pervert. And he has to sit out there and live in that jail. And she said that really helped her and she liked it. And then she went into a whole other, she said, there's another one I want to do. And it got even more grotesque.
And her roommate had been raped in the woods by a gang. in an old broken-down vehicle, and she wanted to reimagine that one. Even though she hadn't been there, the roommate told her about it, and she couldn't get these pictures out of her head.
And so she saw them raping her roommate, and then she grabbed them one by one and castrated them with a bayonet and watched them all bleed to death, all eight boys. And to me, it was incredibly grotesque. And I didn't know if it was good therapy or malpractice. It was frightening to me.
But she gave me really high grades at the end of the session on the empathy and helpfulness and appeared to have really liked the session. It's a controversial technique because it often becomes violent. And And the experts have debated about that and said, if you don't permit them to have their violent fantasies, then you're doing more repression.
And the idea is to give them, you know, the freedom of thought and so forth. And so that's what I did. But she came back the next week, and she showed me some plane tickets she had. She said, you know, you might like this. And she had gotten a round-trip ticket to Nepal. Her mother had a business meeting in Nepal, so she told her mother, she said, doctor wants me to take public transportation.
How about if I ride with you to Nepal today? The mother was going to be in Nepal for a week, and then I'll take a plane back alone, and I'll be for 23 hours alone on public transportation. Is that enough, Dr. Burns? I said, more than enough. And that's what she did. And she was then no longer afraid of public transportation.
Now, you've heard about memory rescripting, and the question is, why was that helpful to her? Where did she find the courage? to do the thing that she'd been unable to do? And Rhonda and Matt will now give brilliant answers to that question.
I can only make guesses. I think one could be just that the intensity of the anger that had been repressed was so great that it served a bit like a hidden emotion. Or perhaps she was afraid that she would express something like that. She was afraid to let it out.
And when you allowed her to just let it out and you accepted her while she was doing that, she learned, oh, it's actually OK to feel really angry about what happened to me. And so it's OK to have these intense feelings and images. And now I don't have to be perfect anymore or contain myself. I can go out in public without feeling ashamed.
Yeah, I love that. That's a great one. Do you have any hunch on it, Rhonda?
Well, when she's being molested by the babysitter, her life is out of control. And when you're on public transportation, your life is out of control. You're not the driver. And so she's taken the lack of control in other areas of her life. And when she regains the control in her re-scripting that you did with her, she then feels safe in other areas where...
Yeah, I think that's it. I love what both of you said, that she experienced herself as a powerful woman, not as a helpless little girl. As a little girl, she was helpless, and she's changing her mindset. and having the chance to feel powerful and to realize that she is powerful. So that, I mean, what a great answer you gave there, Rhonda. You both, you know, were spot on.
She was full of anger and she got the chance to express that anger. And that was a kind of powerful hidden emotion hiding behind her intense anxiety. And often the hidden emotion model will bring about a complete elimination of anxiety, especially in patients who were stuck and unable to completely get rid of their anxiety.
My first job out of graduate school, I worked at a rape crisis center in San Francisco. And we did this with our patients that wanted to continue working with us after the acute crisis is over. And there was a debate among the therapists. Should we encourage them to be empathic or loving and kind, or should we allow people to express their anger the way you modeled this client did?
Oh, I see. Uh-huh.
Interesting. Is it harmful for the client or the patient to fully give in to their anger? Does that cause more damage?
Oh, what was their consensus?
The consensus was what you concluded in your description, that it makes a person feel more powerful, but it doesn't lead them to commit violent acts themselves.
Yeah, interesting. Yeah, great. Very cool. That's a nice other dimension on that question. But I thought it was a neat question. And thank you, Aaron, for submitting those questions. I really appreciate it.
Go ahead. One other quick thought occurred to me is that a fear of transportation would also be useful to her if she was off to school. if she just couldn't come back home to where that person was who had molested her.
Oh, yeah. I see what you mean.
So it's good to be afraid of transportation. I just can't come home. I'm too afraid rather than acknowledging how angry she was.
Oh, yeah. That's a beautiful dimension there also, Matt. I love that. Yeah.
So Gray asked about feeling better about post-secondary education. And he wrote, hi, David. I struggle with intense anger, frustration, and depression while doing college coursework. I have recurring thoughts like this is pointless. This work is for nobody. I'm just working to work. I'm being hazed and I profoundly don't care.
I'm interested in law school because I'd love to be a lawyer, but I worry that I won't be mentally healthy in that environment. Many lawyers say 80 plus percent of law school is irrelevant and doesn't adequately prepare you to practice law or even pass the bar. So I expect similar frustrations would surface.
I've looked into this very carefully and I'm convinced that the basic substance of my thoughts has bulletproof empirical grounding outside of STEM for sure. How could I manage these distortions when I'm in the midst of law school homework? P.S. I am quite hostile to appeals about how I would actually learn important things in class or about developing resilience for its own sake.
So I'd prefer to avoid that line of thinking unless it's really important. Thank you, Gray.
Well, I'll just frame this a little bit and get you guys answers first. This is a fellow who sounds very angry and entitled, and he's warning us not to give him a particular kind of answer. He's saying, don't say things that others have said to me. But he's saying, I shouldn't have to do this boring work in order to get into law school and become a lawyer.
And he spends a lot of time feeling frustrated and pissed off that he should have to do these things that are irrational. And when 80% of law school is going to be irrelevant and won't adequately prepare you for to practice law and all this college stuff too is kind of a load of horse pucky. It's just things I have to go through and I shouldn't have to do this. Is that a good summary?
Yes.
Okay. So tell us, wise colleagues here, how are we going to respond to him? Because one thing I thought I wanted to tell you, Gray, is that you'll actually learn important things in class about developing resilience for its own sake.
Yeah, you'll learn how to think.
Yeah. Okay. So we're just making fun. Well, you know, David and Matt.
But David and Matt, I'm curious. I'm imagining that in medical school, not everything that you were studying was like super interesting or relevant to you as psychiatrists.
Yeah. I never learned anything in my seven years I spent at the Stanford Medical School and the seven or eight years I spent in residency and research after that. I never learned anything that helps me with patients. Not one thing. How did you plow through it? Well, I just said this is what I have to do if I want to get through medical school and residency.
And I wasn't convinced I wanted to get through medical school and residency. So I dropped out of medical school for a full year on two different occasions. And when I was in medical school, I often skipped most or all of my classes and I would just show up for final exams immediately. you know, study a week before finals and then take my finals. And then I was off again.
And meanwhile, I was being a hippie in downtown Palo Alto on the streets of Palo Alto and learning how to live life. And I learned more there than I ever learned in medical school about things that are helping my patients. Like, how do you score when you're orny? Well, I learned that. They never taught me that in medical school or residency.
And that's what a lot of patients wanted to learn how to do. And I was able to teach them, and they appreciated it.
So you had your eye on the goal.
Yeah. That won't be helpful to Gray. But what strategies will we have to work with Gray? Here are what you folks think.
You go, Matt.
Sure, I can start. I mean, I think first I'd begin with a lot of empathy that he's probably really pissed off and angry. He's doing all this stuff and it's not helping someone. It's not providing him with useful information that he can apply. And it's probably painful for him to be going through this. And maybe he just needs to let it out and vent a little bit.
talk to me about his feelings of frustration or annoyance or anger. What is that like for him? And then if he's feeling understood and I'm getting him, I'd ask him if there's some type of help that he was looking for. And I think there are some thoughts there that are in the version of a should, like I shouldn't have to do this, that I could probably help with. And
If we were to revise that thought, he'd probably feel less upset as he's doing that work. So that would be my brief answer.
Yeah, well, that's a good one. He certainly is in a should system. For sure, that's the key distortion in his thoughts. What is your thinking, Rhonda? Yeah.
I'm not thinking like a team therapist. I spent 25 years working within the field of family law and the lawyers would say exactly what he said. 80% of what they learned in law school wasn't relevant to their careers, but law school taught them other things. And I think that's true for being an undergraduate or whatever graduate program you're in. It teaches you everything.
the specifics, but it also teaches you like how to live and how to think and how to ask questions and how to have a critical mind. And those are all valuable and learning how to face your boredom and overcome it. That's a huge life skill that is secondary to learning the specific information. And so Matt was like really a specifically wonderful team therapist.
And I'm just thinking, yeah, a lot of empathy. Yeah. And it's true, he's going to have to go through all that stuff. And he may not like it. But the end result of being a lawyer will probably be very rewarding.
So you're going to tell him what he's actually going to learn is important and sell him on the importance of doing it.
No, I'm going to give him empathy and say, you're right. A lot of it is something you'll never use again.
Yeah, sure.
You're right. That's absolutely true.
I think you guys are definitely on the right path here. I think to take a page out of your book, Matt, I would start out with empathy and try to see the world through his eyes, although it's hard to avoid getting angry with him because I find him kind of irritating and entitled.
But he would need someone to see the world through his eyes and side with him, including the fact that maybe you don't want to go through this. You certainly don't have to. And maybe you want to go in a different direction with your life. It's really your choice. And maybe you could use the decision-making tool.
But if he then, you know, still decided he wanted to be a lawyer, and I have no doubt he's going to be a lawyer and a kind of a, An arrogant opponent, I'm sure. Wouldn't want to face him in court. But that you might want to do positive reframing, like what do all these negative thoughts and feelings show about you that's positive and awesome? You know, how strong are all your negative feelings?
Yeah. and then get into the idea instead of pressing the magic button and making them all disappear as he seems to want, which is not realistic. And maybe these intense feelings show his idealism and his integrity and that he's thoughtful and that he's not just doing what everyone else does. And so maybe that's the kind of guy we need in law school and in the law profession. And
And he can take pride in his anger and his resentment and his seeing all the holes in the system, because heaven knows there are really problems with the legal profession and with the psychiatric profession as well. And to see if he'd want to kind of dial them down, his negative feelings, maybe from a 100 to 30, and maybe 30 would be enough anger to carry around with you.
And then we could come in with methods to talk back to the negative thoughts, which are primarily should statements. And at that phase of the treatment, I'd see if he'd be willing to understand and accept the idea that actually the boring work will never upset him and has never upset anyone.
His entire problem is in his head caused by the negative voice in his head saying, you shouldn't have to do this. You shouldn't have to do this. You're better than this. The universe should make an exception for you. It should be easy. It should be relevant. It should be better than it is.
And it's that voice that if you're willing to learn to talk back to it, then you can eliminate much, if not all of these negative feelings. Thank you.
What about a cost-benefit analysis regarding those thoughts?
Well, yes. Isn't that the same as what we call assessment of resistance and positive reframing and looking at the positive side and the negative side? We could certainly do a paradoxical cost-benefit analysis with an angry person. Say, let's look at all the advantages of your anger and entitlement and statements. And then maybe this isn't something that you'd want to let go of.
That's another way of dealing with the resistance. And the resistance has to be dealt with at the agenda setting level before you go into the methods. But then if he's willing to get rid of the anger...
or to reduce it drastically, then you can use externalization of voices, externalization of resistance, you know, identify the distortions, explain the distortions, and all of the regular team CBT methods for crushing negative thoughts. And one last thing is to emphasize the idea when he says, I shouldn't have to do this, he was a therapist, to say, you know the good news? You don't have to.
Are you saying you'd prefer not to? Mm-hmm. Let's look at all the reasons not to. And you'll see what you would like to do, what choice you would like to make. But yes, Rhonda, I can remember sitting in the Tressiter Student Union up on the second floor somewhere with my anatomy book, looking at some page with all these pieces of some part of the body there labeled.
and covering my hand up, seeing if I could remember the names of all of these body parts. And it was just strict memorization, just doing it over and over again until I could get the page right. And hopefully I could remember it the next day when it came time for the exam. But I remember the summer before college, I got a job working in a bank. And I thought I was so lucky.
And I had to, my job was just going through the checks and, you know, one by one and filing them. We filed checks by hands. And so I would sit for three or four hours just filing checks alphabetically in a file system. And I just had to make up games to try to pass the time. But I was basically grateful that I had that job because I was earning a halfway decent salary to help with college.
That's all.
Okay. Love that answer. Love that. If I ever have any legal problems, can I give him a call?
Yes. I'm sure he'll put up a fierce defense for you. He'll probably charge you a pretty handsome fee too. Okay. Well, thank you, Gray. And we wish you well in your courageous fight against injustice. And I'm sure you'll have a tremendous career in the future. In law school.
If he follows the suggestions that you made, David, that would be very helpful for him to come to some resolution in his own life.
Oh, absolutely.
I mean, you gave him very specific suggestions for what to do. Yeah. And that could put him on the right path, whatever it is for him.
Yeah. Yeah. He needs to have a good relationship with his therapist, somebody who likes and admires him and who he likes and admires because he's got the power to sabotage. And anyone, that's what he's hinting to us. Don't do this. Don't do that. That's not going to work. Okay. That's about it.
I've just so enjoyed our time together. Thank you for having me on the podcast.
Thanks, Matt. It's always great seeing you and working with you and Rhonda.
It's incredibly great to have you, Matt. Thanks. Thank you. Look forward to next time. Okay. Bye, Matt. 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. 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.