1. Nick asks: “What if you want a positive relationship
with someone who does not want the same thing?”
2. Debbie asks: Hi David, I can't stop ruminating and
obsessing about weird states of minds or when I was afraid of
harming someone or remembering. Everyone says to let go but why do
I hang on. Where in your book can you help me?
3. Dean asks: I’m having trouble sleeping. What should
4. Kathy asks a question about social anxiety / panic
and the hidden emotion technique.
Note: The answers below were generated prior
to the podcast, and the information provided on the live podcast
may be richer and different in a number of ways.
1. Nick asks many general
relationship problems that all need specific
Thank you for all the amazing work you do. Your books and
podcasts have helped me to understand and start to transform a lot
of negative and unwanted frames that I carry around. I'm also
working with a Level 3 therapist who I found through the Feeling
One area I'm working on is building my empathy skills using the
Five Secrets model. I see how powerful it is in situations where
both people are open to a positive relationship. But I struggle
with the idea that each of us creates our own interpersonal
reality, and can always create a positive outcome regardless of the
other person. Can you help me understand how to apply the technique
to some challenging situations?
- What happens if you want a positive relationship with the
other person, but they fundamentally do not? I find that this
situation leads the other person to react to the Five Secrets with
anger or indifference.
Or they view you as weak for exposing your emotions and
vulnerability, and try to exploit them for advantage over you. Is
it even worth trying to have a positive relationship with such a
I try not to impose on people who do not want a positive
relationship with me. You could also provide a specific example, as
I always insist on having! These vague questions to my ear are kind
David, you’ve said that the cause of all relationship problems
is Blame. I agree with this and sense that Nick’s question is
driving at that point, as well. If someone doesn’t want to
participate in our definition of a ‘positive’ relationship, the
approach that is most in line with the 5-Secrets and Empathy is to
let go and stop demanding the other person change. That’s the
cause of the problem: trying to force people to do things,
our way, regardless of what they want. This will cause them
to resist and will damage the relationship.
David, you have also talked about the opposite mindset of
blame, where we can wield 5-Secrets honestly and effectively, the
concept of ‘Open Hands’. When we have the attitude of ‘Open
Hands’, we can welcome other people and receive them or gracefully
let go. This mental state avoids conflict and the ‘blame game’ in a
healthy, non-avoidant way.
For example, if someone says, “I don’t want to have a
relationship with you”. We might reply, using the 5-Secrets,
‘You’re right, I’ve been disrespectful and inappropriately pushing
you too hard in the direction of having a relationship with
me. I appreciate your letting me know, clearly, that this
isn’t something you want. While I can imagine you might be
angry with me, I’m sure you don’t want to talk about that, but
prefer, instead, to end the relationship as quickly as
possible. I’m feeling awkward and would like to get out of
your hair as soon as possible, too. What can I do to
facilitate ending this relationship in a way you would be satisfied
To put it another way, while you can maximize your chances of
having a positive interpersonal experience with someone, using
these communication skills, the 5-Secrets, they are not ‘mind
control’ and trying to use them that way will only make matters
worse, hence the importance of the internal mindset of ‘open
hands’, accepting others’ preferences and being willing to let go,
perhaps grieve, refocus our attention elsewhere, if that’s not what
they want. Otherwise, we are in the ‘chasing’ and ‘blaming’
role, which is doomed to fail, as has been discussed on previous
It may also be useful to consider whether it’s actually
possible to ‘not have a relationship’ with someone. My sense
is that there is, in fact, a relationship, even between total
strangers and between people who have decided, mutually, to end
their relationship. We could point out how those two types of
relationships might differ, say, if you were to bump into each
other in a grocery store. In the latter example, you might be
expected to try a bit harder to avoid contact, with an agreed-upon,
‘ex’ than you would, with a stranger. There are rules and
expectations and ways in which both people think about the other
person and define their ‘relationship’, even if you are saying that
it has ‘ended’. The conflict comes when we don’t have the
same agenda and don’t agree on the terms and rules of the
There are many other related topics, including the ‘gentle
ultimatum’, ‘interpersonal decision making’ and ‘blame CBA’ which
could be useful for Nick.
- What if you believe the other person does have a fundamental
desire for a good relationship, but they are so attached to their
anger, fear or depression that their only reaction is hostility and
defense? Perhaps such a person can't or won't admit to their
emotions, and rejects the empathy. Should you keep trying, and at
what point if any should you give up?
Need a specific example! I may have mentioned that!
A specific example sure would help! The problem seems
related to the ‘blame game’ which we just talked about. We
are demanding the other person change, and stop being so hostile
and defensive. Instead, consider using Interpersonal Decision
Making and look at the three options that are available, in any
relationship. If you decide to take responsibility for the
relationship, try the Relationship Journal, so you can see through
the blame that is causing the problem. You could also use
positive reframing to admire their hostility, defensiveness, anger,
fear and depression.
Perhaps there are mistaken or lying about the facts, and
unwilling to admit it. Or you disbelieve what they say because it
doesn't match their actions or is calculated to deflect blame. For
example, you may have a conflict over who cleans the house. The
objective fact is that you do this 80% of the time and have done it
the last 5 times in a row, while the other person has consistently
left garbage lying around. Yet the other person says
"I feel like you never do housework and I am always the one
cleaning, and I'm sick of it". How can you find truth in such a
Work this out on a Relationship Journals. Write down what you
said next, and follow th steps clearly spelled out in Feeling Good
Together. Or, I could send you one.
Disarming is really challenging because it requires us to let
go of our version of the ‘truth’, at least temporarily, in order to
see the other person’s truth. People often don’t want to do
that, even for a moment! Furthermore, if the other person is
angry, they are likely to distort the truth in their statements,
for effect, to be more persuasive. The problem with this, is
that it will call our attention to the lies they are telling,
tempting us away from seeing their truth. Without knowing
more about the situation, I could only guess at what their ‘truth’
is. Here are some possibilities, though: Is it possible
that they have some reasonable expectation for us to do more of the
cleanup than them? Are they offering something else in the
relationship that offsets their lack of cleaning? Do they do
the majority of the cooking? Do they do the shopping?
Do they pay more of the bills? Also, were they the last one
to do the cleaning? When they clean, do they spend more time
on it or do a more thorough job? When they clean, do they
clean up their things as well as yours? Do you do that?
You stated that they leave their ’garbage lying around’. Is
that how they see it? Is it possible that they put their
things precisely where they wanted them to be and didn’t want you
The point is that disarming requires seeing the bigger picture,
not just the one data point that best supports your blaming
them. Try to see past this and, if you can’t, considering
Interpersonal Decision making and the Blame CBA, where you would
write down the good reasons to blame the other person and insist
that your version of the truth is complete and correct and that
theirs is wrong and bad.
Nick carries on
- What should you do in situations where you both have
attachments to other incompatible goals? In Lee's case on episodes
96-98 of your podcast and Chapter 27 of Feeling Great, both Less
and his wife had the same fundamental values with regard to raising
their daughter. So once he applied the Five Secrets, they were able
to move past their ego defenses and share the same perspective. But
what if there is a zero-sum situation where both of you have
different core values? For example, choosing a grade school for
your child. One parent sincerely believes in their core values that
their child will benefit from attending a rigorous school where
they will be challenged and grow. The other parent sincerely
believes in their core values that children should be in a relaxed
environment where they can play as much as possible. Can the Five
Secrets help with this type of conflict?
Read the chapter in Feeling Good Together on the idea
that the attempt to solve the problem IS the problem, and the
refusal to solve it is the solution.
I think you’ve got some work to do! Now we’ll see if you do
In this case, you could agree to disagree and let a
professional decide what would be best for your child.
Studies conducted longitudinally by Chess and Thomas showed that no
one parenting style was ‘best’ overall, but rather that outcomes
for human being were determined primarily by how well the parenting
style suited the child.
2. Debbie asks: Hi David, I
can't stop ruminating and obsessing about weird states of minds or
when I was afraid of harming someone or remembering. Everyone says
to let go but why do I hang on? Where in your book can you help
You can read my book, When Panic Attacks. You can use
search function on website for many illuminating podcasts on
anxiety and OCD. You can sign up for the free anxiety class. Go for
it. Then ask specific questions about something you're working on
based on these resources.
Well, you’re not alone! Nobody can ‘stop
ruminating’. Try a mental experiment, where you try to ‘stop
ruminating about a blue-eyed tiger’. Tell yourself, ‘I must
stop ruminating about a blue eyed tiger! I must stop
ruminating about a blue eyed tiger!’. You will come to
realize that it’s Impossible and the harder you try, the more you
obsess. One possible solution is to find something else,
something better, to become the focus of your attention.
Imagine a ‘Miracle Cure’ were possible. What would you
most wish to see happen in your life?
You could then use the Decision Making Form, to weigh
different options, comparing the miracle cure to the status quo,
for example. There are, after all, real advantages to
ruminating and obsessing. You might have a sense that you’re
being responsible, protecting others, preventing yourself from
going into weird states of mind and harming people. This is
part of your moral nature, doing no harm, being considerate and
thoughtful, sacrificing your needs for others. That’s a good
thing! Also, you might be afraid of committing to pursuing
your dreams, for good reason. There are real disadvantages of
doing that. The risk of failure, humiliation, conflict,
disappointment and defeat, for example. Until you are
convinced that you would want some other version of your life,
despite the many advantages of rumination and the disadvantages of
change, other methods are unlikely to be effective. If you
firmly decide and are committed to change, meaning that you have
convinced yourself that this is what you want, on the Decision
Making Form, then there are lots of methods that could be
For example, you could use the Get Specific method and
an assessment of Process Resistance. When do I want to
be cured? What would I be willing to do, to have my dreams
come true? What are some small steps I could take to
get there (Anti-Procrastination / Little Steps for Big
Feats). What time will I do these tasks? Sit down
and schedule time in your day to pursue your dreams (Activity
Scheduling). If intrusive thoughts come in, try ‘Self
Monitoring and Response Prevention’. If temptation is
especially tenacious, try the Devil’s Advocate
Technique. I’d recommend looking into things like the
‘Hidden Emotion’. Is ruminating a form of ‘niceness’,
an avoidance of a conflict? For example, who are you angry
with? Have you told them? If you go live your best
life, who would object? You can also give yourself a certain
amount of time, per day, to obsess, wholeheartedly (worry
breaks). How much time would you like to spend
ruminating? Schedule this time and if you’re ruminating
outside that time, remind yourself that you have plenty of time to
ruminate later. Again, there are a lot of methods that could
help and finding the right ones will be a bit of trial and
3. Dean asks: I’m having
trouble sleeping. What should I do?
Hi Dr. Burns, I picked up a copy of 'Feeling Great'
and am excited to start reading it.
I have been battling anxiety, depression, and severe chronic
insomnia for the past year. Do I start with TEAM-CBT for
anxiety/depression and deal with that first, or do I supplement
with CBTi-for Insomnia and do both at the same time?
I met with the Mayo Clinic last fall and they said the root
cause of the Insomnia is some depression. I have been to a lot of
doctors, specialists, and therapists and so far no one has been
able to help. Thank you!
I am not familiar with the insomnia app but it can likely give
you some of the basics of sleep hygiene in case you do not already
know them. TEAM can be helpful, to say the least, for the mood or
relationship issues that may be triggering the troubles sleeping.
Often, we may have trouble sleeping because we are upset about
something. Sleep difficulties are a non-specific manifestation of
being upset about something.
There is no special relationship with depression, however. It
could be anxiety, anger, anything. Let me know what evolves for
And, of course, sleep difficulties do not always result from
emotional disturbance, but this is often the case. For humans,
problems don't usually just come from out of the blue, but from
The best response to the question, ‘How do I get to sleep at
night’, that I’ve heard is, ‘try to stay awake’.
Meanwhile, I have a couple of thoughts on diagnosis and
Having a diagnosis of ‘anxiety’ or ‘depression’ is like having
a ‘diagnosis’ of ‘cough’ or ‘fever’. Our feelings are
symptoms, not the source. g. if someone has symptoms of
a cough and fever, that could be the result of any number of
different underlying causes: bacteria, viruses, fungi,
allergic reactions, autoimmune disease, toxin exposures, etc.,
etc. To make more accurate guesses about an appropriate
treatment regimen, we need greater specificity. In the
treatment of symptoms like depression, anxiety and insomnia, we
would need to know much more about a specific moment in time when
you were having these symptoms, what you were doing, what you were
thinking and details about the feeling state you were in before
deciding how to prioritize the methods that would be part of a
treatment plan, which we call a ‘recovery circle’ in TEAM.
In medical school, they train physicians to ‘cast a very wide
net’, when considering all the possible causes of the symptoms a
patient is experiencing. This list of possible causes is referred
to as a ‘differential diagnosis’ by physicians. The idea is
to organize this list according to what is statistically most
likely given all the information we have on hand and to conduct
various tests to narrow down these options, in order to prioritize
a treatment strategy that is most likely to be effective.
Meanwhile, we want to keep open in our minds that our diagnosis
could be wrong and that we will need to monitor the outcome
carefully, with frequent testing, rather than assume we know the
‘root’ problem with 100% certainty, so we can modify the treatment
strategy based on results.
While it’s tempting to try to try to optimize treatment results
by matching the diagnosis with a ‘school’ of therapy, (ERP for OCD,
EMDR for trauma, DBT for BPD, etc.), there are several problems
with this ‘schools’ vs. ‘tools’ approach to therapy. For one, the
reality is that people are quite complex beings and diagnostic
labels are quite imprecise and limited. Even when we have an
accurate diagnosis, we can’t predict precisely which specific set
of methods will be required to help someone recover.
Furthermore, even if someone has the exact same set of upsetting
negative thoughts related to their anxiety, depression and
insomnia, perhaps their thoughts circle from ‘I must get some
sleep, I’ll never get to sleep, I’ll feel terrible tomorrow,
Everything will go wrong, I’m a hopeless case, I’m a loser…I must
get some sleep (repeat)’, even if the thoughts are the same in
multiple different people, we can only make informed guesses,
rather than predict, perfectly, what method(s) will suit that
individual best. Will it be the double standard technique, or
cognitive flooding, sleep restriction, the hidden emotion, the
Socratic technique or memory rescripting, self-monitoring or
response prevention, something else?
The solution to this uncertainty is the Recovery Circle. The
‘recovery circle’ is a customized list of at least twenty methods,
that are selected based on the specific feelings, thoughts or
behaviors someone would like to see change. Each of these
methods will have some reasonable chance to help an individual,
with their particular thoughts and feelings and behaviors.
The idea is then to ‘fail our way to success’, using
trial-and-error, with measurement in between, to discover,
scientifically, what is the best method for that individual.
Once we do, we focus on practicing that method regularly to
gain skill with it, until our patients are not only cured, but able
to recover from relapses on their own, because they know the
methods that are most helpful to them.
Another consideration is that, in general, folks benefit from
an approach that is kind, empathic, respectful, grounded in science
and measurement, and attentive to resistance and motivational
barriers to change. One reason I would recommend TEAM to a family
member or friend is that it contains each of these necessary
elements of therapy and also has the greatest diversity of tools to
help someone, as well as a customized approach to treatment.
I think that’s why TEAM has been shown to be much more effective
than other forms of therapy.
All that said, it’s important to realize that TEAM itself is
incomplete and we would want to continue to expand up the model
and, when you’re in treatment, know that it’s fine to get a second,
third or fourth opinion on what methods and approaches are most
likely to benefit you.
4. Kathy asks about social
anxiety, panic and the hidden emotion technique.
Hi Dr. Burns,
Thank you so much for all the great information you put out
there! I had a question about hidden emotion. If I experienced
dizziness in a social setting ten years ago and now I panic
whenever I am in a similar situation anticipating the dizziness. Is
there still a connection to the original emotion that is still
hidden or is it a habit at this point? Thank you so much
Were you upset with somebody or something in that
You could use uncovering techniques, like the ‘What If’
Technique and the ‘Interpersonal Downward Arrow’, among others, to
figure that out.
For example, ‘what if you got dizzy? What’s the worst
that could happen?
You can write down your answer, and continue to ask yourself,
‘what if that happened, what would I be anxious about?’.
Then, as yourself, if that happened, what would other people think
about me? How would they treat me? What kind of people
are these people, I’m imagining? How do I feel about people
About the Podcast
This podcast features David D. Burns MD, author of "Feeling Good, The New Mood Therapy," describing powerful new techniques to overcome depression and anxiety and develop greater joy and self-esteem. For therapists and the general public alike!