Featured pic of Cody in one of the small group practice
sessions in David's virtual Tuesday training group.
Live Therapy with Cody,
Part 1 of 2
I recently treated Cody, a young man wanting help with his
fairly severe social anxiety since childhood, during one of our
Tuesday evening Stanford training groups. My co-therapist for this
session was Rhonda Barovsky, PsyD, the Feeling Good podcast
co-host.
The full session will be broadcasted in two parts, starting
today and finishing next week.
Part 1
T = Testing
At the start of the session, Cody’s depression score was only 6
out of 20, indicating minimal to mild depression, but his score on
the loss of self-esteem was “a lot.”
His anxiety score was 11 out of 20, indicating moderate
anxiety, and his anger score was only 2, minimal. However his score
on the Happiness test was only 11 out of 20, which is only
moderately happy, indicating a lot of room for improvement. If you
like, you can review his Brief
Mood Survey at this LINK. We’ll of course ask
him to take this test at the end of today’s session so we can see
what, if impact, we made on his feelings.
E = Empathy
Cody described his shyness like this:
“I’ve been shy for as long as I can remember and feel
introverted. It started in middle school. I felt like I never fit
in or connected with people very deeply. In middle school, you
really want to fit in.
“I wanted my friends to like me, and one day they all started
to torment me. Our seats in school were assigned, so I couldn’t get
away from them. I cried at recess every day for months. Then, one
day, they suddenly went back to being my friends again, and I never
understood why.
“When they were tormenting me was the most painful moment of my
life. I felt like they were judging me.
“I’ve worked on my own and I’ve gotten over 90% of my social
anxiety. At first, I was afraid of answering the phone or even
ordering a pizza, so I got a job where I was required to answer the
phone and got over it.
“Now I’d like to date, but this has been a problem for me.
Also, when I’m treating someone, and this topic of social anxiety
comes up, I get uncomfortable. I think if I could overcome the rest
of my shyness, it would boost my confidence.
“The podcast you and Rhonda did with Cai on Rejection Practice
(LINK) inspired me tremendously, and I managed to do one Rejection
Practice. By now I’m chickening out again. I go to the mall
determined to do it, but I just keep putting it off. Asking women
to reject me seems incredibly frightening, and I’m afraid people
will judge me or see me as a predator. I love in a small town, and
most people know each other.
“When I was thinking about the session all day today, I felt
nervous and my stomach tightened up.
Cody brought a partially completed Daily Mood Log to the
session, which you can review
at this LINK. As you can see, the Upsetting
Event was thoughts of approaching someone at the mall for Rejection
Practice.
His negative feelings included the entire anxiety cluster,
shame, the entire inadequacy cluster, unwanted, humiliated,
embarrassed, the entire hopelessness cluster, frustrated, annoyed,
and anger with himself. These feelings ranged from a low of 35% for
shame to a high of 100% for foolish and humiliated and 90% for the
hopelessness cluster.
And as you can see, many of his negative thoughts focused on
the theme of being judged by others who might see him and think he
was strange, or a disrespectful jerk, and so on. He was also
convinced that women would be annoyed by him, and that the word
would spread so that he’d lose the respect of people he cared
about.
A = Assessment of Resistance
Cody’s goal for the session was to feel motivated to do the
Rejection Practice he’d been avoiding, and to get rid of the
negative thoughts that were holding him back.
He said he’d be reluctant, though, to press the Magic Button
and make all of his negative thoughts and feelings disappear, so we
listed what his fears might actually say about him and his core
values that was positive and awesome. Here’s the list we came up
with:
Positives
My anxiety
My anxiety shows that I care about peoples’ comfort.
My anxiety protects me from rejection or doing something
foolish.
My fears of being seen as a predator show that I want to fit in
with the social norms and not be weird or threatening to
women.
My fears show that I want to be respectful towards women.
My fears of being judged show that I care about friends and
family.
My anxiety shows that I care about my reputation.
My feelings of inadequacy show that I’m aware that I have
things I want to work on.
Those feelings also show that I’m humble.
My feelings show that I really care about connecting with
others, which is one of the most important things in life!
My negative thoughts and feelings motivate me to work hard on
changing.
They also show that I have high standards.
My hopelessness shows that I’ve tried to do Rejection Practice
six times and have always chickened out. So I’m being
realistic.
My hopelessness also protects me from getting my hopes up and
then being disappointed.
My unhappiness gives me greater compassion for my clients.
My anger energizes me and motivates to do something new.
Tune in next week for the exciting conclusion of the live work
with Cody!
David and Rhonda
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!