In today’s podcast, three shrinks discuss many intriguing
questions about anxiety from listeners like you, and begin with a
question from a man who is worried about his relationship with his
11 year old son, who is just starting to get cranky and a bit
rebellious. Then we field questions posed by thousands of
individuals who attended one of Dr. Burns' free workshops on
anxiety sponsored by PESI more than a year ago.
Most of the answers included in the show notes below were
written prior to the podcast, so the live podcast will contain more
information than the answers presented below.
Guillermo asks: How can I get close to my 11 year old
Hi, Dr Burns
Thank you for all the knowledge you share through your books
and your podcasts. “the way you think creates the way you feel” has
changed the way i view life.
I wanted to share an exchange I had with my 11 yo son 2 days
ago. I was asking him to move some stuff around to clean his room
and he was not loving it so his attitude reflected that, then i
asked him about a particular lovely drawing of his that i found
(from kindergarten) and he was dismissive and said “just throw it
away” and i raised my voice and said “I CAN ALSO HAVE A BAD
ATTITUDE, WOULD YOU LIKE FOR ME TO TALK TO YOU LIKE THIS?” (I was
rude and loud)
To which, he got startled and teary eyed and said “no”. And i
immediately felt bad, noting that i pushed him away when i wanted
to get closer to him.
I later came to his room and apologized for my behavior and
gave him a hug. I said “im sorry i raised my voice, im sure that
hurt you and that hurts me bc you're the most important person in
the world to me” and i gave him a hug.
That same night I heard podcast 278 or 279 and you said “the
road to enlightenment is a lonely one, my friend” when responding
to someone asking about the other person in a relationship. I
thought, damn that’s true hahaha. I was going to say sorry but was
thinking about what happened, this just reinforced it so much!
After this I went over to his room to apologize.
I seem to be struggling to stay close to him as he goes into
his teenage years, any advice/thoughts that could help me improve
my role in this?
Thank you again for all you do,
I can't tell you what to do, but I
loved your last sentence, " I seem to be struggling to stay close
to him as he goes into his teenage years, any advice/thoughts that
could help me improve my role in this?"
In my book, Feeling Great,
my dear colleague, Dr. Jill Levitt did this exact thing with her
son with fantastic results. Said almost that exact thing!
ANSWERS TO DAVID'S PESI
ANXIETY LECTURE QUESTIONS
Is this rapid response merely first-aid. Am I right in assuming
the sustained work (psychodynamic, therapy, body work etc.) is
Nope! But of course, all humans are unique, and some will require a
longer course of treatment than others, but this is not due to any
“first aid” problem!
Matt’s Answer: I
agree with a lot of this. While we are frequently seeing
rapid and complete elimination of negative feelings, like
depression and anxiety, while using the TEAM model, we expect 100%
of people to ‘relapse’, at some point in the future.
Educating people about this is important and part of ‘Relapse
Prevention’. Part of Relapse Prevention involves accepting
the impermanence of things, including our euphoric, enlightened
experiences. As the Buddhists say, ‘we all drift in and out
Relapses, the ‘drifting
in-and-out’ is a sign of a healthy brain. Recovery is a bit
like learning a new language, including how to talk-back to your
negative thoughts. While you can learn a new language, your
healthy brain will not permanently forget your native tongue, so
you’ll occasionally go back to old habits in thinking.
So, achieving optimal mental
health requires an ongoing practice with the methodology.
Rather than some new methodology, however, the one that is
effective will be the one that helped you recover, in the first
place. If it was Exposure, you’ll have to keep on doing
that. If it was talking back to your negative thoughts, then
you’ll have to do that, occasionally, etc.
This can be a bit
disappointing or disheartening to hear, if you were expecting
permanence or perfection. Paradoxically, accepting the
imperfect and impermanent nature of our reality is what leads to
relief and recovery. That is to say, ‘Enlightenment’ is not a
‘perfect’ mental state but an acceptance of an imperfect one.
If this seems distasteful, Enlightenment may not be what you’re
For those of you willing to
embrace and appreciate your average, imperfect and impermanent
experiences in life, you are very likely to recovery. You’ll
still need Relapse Prevention, including a commitment to continue
to practice on an ongoing basis. This leads to a higher level
of recovery, in which you become your own ‘best therapist’.
Another place where I agree
with you is that one might achieve (imperfect) recovery from
anxiety and depression, and even take on the responsibility of
maintaining these results, and yet still not be satisfied with some
other aspects of life. It’s possible (in fact likely) for any
given person to suffer, not only from mood problems, like anxiety
and depression, but from other types of problems, like unwanted
habits or addictions, or relationship problems. TEAM contains
methodologies that address these concerns as well. ‘Recovery’
from these conditions is the same as for mood problems, in that
recovery will be imperfect and impermanent and require practice to
What type of practice that
might be depends on the individual and we can’t predict, in
advance, what types of exercises will be effective, for a
particular person. In fact, there’s a danger in assuming we
know what will be effective and closing our minds to alternative
approaches. It’s a common error, for therapists, to pick up
one tool and use that, regardless of results, rather than trying
new approaches. This is kind of like having a hammer in your
hand, and seeing all your patients as nails! I like how David
says it: ‘Treat people, not conditions’.
So, I think I agree with what
you’re saying, in that it requires trial-and-error with multiple
methodologies to achieve initial recoveries, as well as ongoing
practice to achieve optimal results.
I also feel compelled to
observe the tendency for certain dangerous and wrong ideas to
persist in our culture, kind of like ‘Urban Legends’ or
‘Mythology’. One example is the revolution that occurred in
medicine when people realized that pathogens, like viruses and
bacteria, cause disease. It had previously been thought that
disease states were caused by an imbalance of the ‘Four Humours’,
blood, bile, phelgm and calor (heat). The treatment, for
pretty much anything that ailed you, back then, was leeches and
blood-letting, in hopes of restoring the balance of these
‘humours’. A revolution in our understanding of disease
occurred with the invention of the microscope. It was now
possible to visualize microscopic organisms, like bacteria, that we
now know, after many experiments, are responsible for disease
states. This allowed us to develop medications, like
Penicillin, that kill bacteria and lead to rapid recoveries from
infections, like pneumonia and immunizations that prevent
Despite undeniable scientific
evidence, people are prone to believing the old mythology, keeping
the wrong and outdated model alive. For example, many people
are afraid, on a cold day, because they think that exposure to cold
temperatures will lead to having a disease, which is even called a
‘cold’. Meanwhile, we know, scientifically, that it’s not
cold temperatures or an imbalance of any ‘humour’, that is causing
colds, flus, and pneumonia. It is microorganisms, like
viruses and bacteria. If you don’t want to get a cold, it’s
better to sanitize your hands and wear a mask, than to bundle up on
a cold day. Instead of bloodletting and leeches, try vaccines
and antibiotics. Of course, people also make up new
mythologies, around these, much to their detriment and at great
cost to society. My advice would be to listen to develop a
skeptical mind and read the scientific literature. Or, try to
understand Neil DeGrasse Tyson, when he says, ‘Science is True,
whether you believe it, or not’.
A similar revolution in our
understanding has occurred in the field of Mental Health.
Like seeing bacteria, for the first time, after the invention of
the microscope, we are returning to the understanding (which
ancient Greek and Buddhist philosophers noted, as well) that it is
our negative thinking that causes our suffering, more than our
circumstances. We know, now, that psychoanalysis is not
required, to optimize mental health, any more than bloodletting or
leeches is required to treat Pneumonia. Thanks to Dr. David
Burns, there is now a rapid, highly effective and medication-free
treatment for depression and anxiety, called TEAM.
Is the Hidden Emotion Model suitable for anxiety caused by
early attachment wounds?
These big words are out of my pay scale, although they certainly
sound erudite! In fact, the cause of anxiety is totally unknown, so
when you say “caused by” we are in different universes! But the
simple answer is yes, in 75% of cases, anxiety is helped greatly by
the Hidden Emotion Model. Thanks!
Answer: The Hidden Emotion model would always be on
my list of methods to try, for an individual who wanted help
reducing their anxiety. That said, it’s better to select
methods based on an individual’s specific negative thoughts rather
than the presence or absence of trauma in childhood. In fact,
the assumption that we know the cause of anxiety is problematic
because it may lead to a kind of therapeutic ‘tunnel-vision’ and
delayed recovery, as time is wasted, trying the same approach,
repeatedly, expecting different results.
For example, assuming that ‘early
attachment wounds’ are the ‘cause’ of anxiety may trigger the false
belief that the most effective treatment would be many years, even
decades, of Psychoanalysis. This has been disproven,
scientifically, yet it lingers in our minds, as a kind of
mythology, passed down from our past. Rather than subjecting
our patients to decades on the couch, talking about their
childhoods, it’s far more effective to ‘fail our way to success’,
using multiple methods and measuring outcomes after each one, to
discover what is actually effective for them. Once you find
the method(s) that are helpful, these will continue to be helpful,
for that individual, throughout their lifespan, and it’s just a
matter of practice.
Another question about the Hidden Emotion model: when do you
consider it “niceness” in anxious people and when is it the
fear/anxiety to upset others due to the anxiety?
That can happen, but not usually in my experience. The “niceness”
typically results from automatic suppression of uncomfortable
feelings and problems. When they hidden problem or feeling is
brought to conscious awareness, in most cases the anxious
individual deals with it or expresses the feelings, and that’s when
the anxiety typically disappears completely.
As a part of my anxiety disorder, at times, I feel flat,
emotionless and disconnected from everything around me. How do you
David's answer. I
use T E A M, not formulas! I do not treat symptoms, I teat
Answer: You could start with a Daily Mood Log,
writing down the details of what was happening, in one specific
moment in time, when you felt this way. Include what you were
thinking and feeling, including ‘flat’, ‘emotionless’ and
‘disconnected’. For example, let’s imagine you had thoughts
like, ‘nothing will ever change’, ‘this is pointless’, ‘I’ll never
feel better’ and/or, ‘I shouldn’t be feeling so disconnected and
flat’ or ‘I should be more in-touch with my emotions’ and/or ‘I
need to be more up-beat’ or ‘people will reject me if I’m not more
enthusiastic’. You’d have to identify your particular
thoughts, these are just guesses.
After this, you could decide what,
if anything you wanted to change. If some change is desired,
you might imagine a ‘magic button’ that would achieve that change,
without any effort on your part. For example, the button
might eliminate all the upsetting feelings on your Daily Mood
Log. However, everything else in your life would remain the
same. Can you identify any reasons NOT to press that
button? Are there any positive values you have, related to
these thoughts? Would there be any down-side to pressing that
button? This represents your ‘Outcome Resistance’.
Typically, there will be many pieces of resistance that would need
to be acknowledged or addressed before methods will be effective in
helping you. You can read in one of David’s many excellent
books, like ‘Feeling Great’ and ‘When Panic Attacks’ how to make
the most of this approach and what the next steps are.
Thanks for listening today. MANY more cool questions on the
best treatment techniques for anxiety next week.
Matt, Rhonda, and David
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!