299: Ask David: Retirement
blues;
patients who refuse homework
(and the therapists who love them);
ADHD; David's new pooping story; and more!
We regret that our beloved Matt May, MD could not join us today
due to an emergency involving his website. We look forward to him
joining us next time for more exciting Ask David’s that will
include: Does the “self” exist? Does God exist? And MUCH more!
We open with two announcements:
1. Return of the awesome
Feeling Great Book Club, with Drs. Brandon Vance
and Heather Clague, will meet weekly, starting on September 13th.
This will be a terrific experience, and only costs $12 per week
with a sliding fee scale if you cannot afford it. You will go
through the Feel Great book, learn techniques, have fun, and
practice in small groups. This is a fantastic opportunity for
everyone. For more information, go to:
https://www.feelinggreattherapycenter.com/book-club.
2. The TEAM-CBT World
Congress, Warsaw Poland, August 18 - 21. This first of a
kind event will take place live and virtually, and will be somewhat
like David''s famous Intensives with teachers from around the
world, many of whom have been featured on this podcast. The
CONGRESS will feature interactive sessions which participants can
learn and practice the elements of the powerful TEAM system while
receiving expert coaching on TEAM techniques. This event is
organized by Daniel Minte, Mariusz Wirga, and Yehuda Bar Shalom.
For more information, please go to: https://teamcbt.eu
Today’s questions: Retirement depression /
anxiety; patients who refuse to do exposure or psychotherapy
homework; treating procrastination and ADHD; David’s new pooping
story, and more!
1. Paul asks: Are
you planning on doing a podcast about people who are about to
retire and are very anxious about the prospect and also depressed
about closing that chapter in their lives? I’m in that boat.
2. M asks: My
patient refuses homework and isn’t getting better. I think I’m a
victim of what you’ve referred to as “reverse hypnosis.” What
should I do?
3. Heather asks:
Hello David! How would you treat ADHD with TEAM-CBT?
4. A asks: Hello
sir, Is it okay if I do the written work by typing in my laptop on
a word processor or is it must that I write on a paper?
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.
In some cases, I did not have time to polish and edit my
responses below. I’ve been super busy developing the Feeling Good
App, which is coming along tremendously well. It has the potential
to help millions around the world who are struggling with
depression and anxiety, but I have to be super careful with my time
these days. If interested in beta testing, you
can sign up here.
1. Paul asks: Are you planning on doing a podcast about
people who are about to retire and are very anxious about the
prospect and also depressed about closing that chapter in their
lives? I’m in that boat.
David’s reply
Have you read the introduction to Feeling Great? Or done any of
the written exercises in that book, or in any of my books? Of
listened to my free Ted Talk on my website?
We can provide more specific information in the live discussion
on the podcast.
2. M asks: My patient refuses homework and isn’t
getting better. I think I’m a victim of what you’ve referred to as
“reverse hypnosis.” What should I do?
Dear Dr Burns, Many thanks for your blogs, podcasts, books and
TEAM CBT. I have experienced (and I am experiencing) being
hypnotized with a Panic Attack patient with Border Line PD- .
I know this after the sessions. During the sessions I feel I
cannot even think well. I see this client through SKYPE, And cannot
see her face to face due to distances.
I have try to follow your approach, but she’s resistant, I do
include exposure exercises that she never completes. How to do a
Shame Attacking Exercise when I cannot go with the patient to the
places she needs to in order to do the exposure.
I have even been in the phone and she driving, but 2 years
later nothing works. Any thoughts will help!
Many thanks in advance. M.
David’s reply
Thanks, great question! Some training or individual case
consultation or both, or workshops, would help a lot. We have two
free weekly training groups for therapists in California and
therapists around the world.
For example, the last two weeks in our Tuesday group we have
focused on the negative thoughts and feelings therapists have
during sessions that interfere with their ability to do excellent
work. So your question is very timely and relevant!
Also, the www.feelinggoodinstitute.com has free and paid
training. Two of the finest teachers are Mike Christensen and Dr.
Jill Levitt, and there are many others as well.
Jill has just released an introductory recorded class on
TEAM-CBT that you can purchase and watch whenever you like. She is
a brilliant teacher!
And yes, you HAVE been hypnotized during sessions!
David
3. Heather asks: Hello David!! How would you treat ADHD
with TEAM-CBT?
Hi there! It is Heather Donnenwirth, from podcast 267. I hope
you are doing well. I really enjoyed being apart of the podcast
with you, Rhonda, and Kyle. Thanks again for including me in that
experience.
I have another question for you about the podcast you did on
ADHD. I totally agree with you about ADHD not being a diagnosis and
agree that is more helpful to treat the symptoms.
Many of the clients that I work with have been diagnosed with
ADHD or are convinced that they have it. Procrastination seems to
be a common symptom of "ADHD" that people want help with and that
can be treated easily with the TEAM model and with the
anti-procrastination and motivational tools.
The symptom that people ask for help with that I am feel less
confident about helping them with is difficulty with focus and
distractibility, and would love your thoughts about how to treat
these symptoms? I have improved my own focus with motivational
techniques and with practicing bringing my attention back to what I
want to focus on when my mind starts to wonder. Also, taking notes
has helped me to stayed focused, but I am curious if you have any
other ideas about increasing focus?
Sometimes the people I work with have distorted thoughts about
focus as well, such as: "If I'm not interested in something, I
can't focus on it," and "I need medication to focus," etc.
Anyway, I value your knowledge and opinion and wondered if you
have any tools for increasing focus?
Also, do you treat hyperactivity and excessive talking? I have
also noticed that parents some time play an enabling role with kids
diagnosed with ADHD, and don't require their children to do
schoolwork that they think is too hard or if they are bored and
having a hard time focusing.
Sorry this is long!!! I hope you are doing well!!!
Warmly,
Heather Donnenwirth
David’s reply
I’d just ask the person to focus on one moment when they had
that problem and then do a Daily Mood Log, as you’ve pointed out,
and also brainstorm with them on how to solve the problem. But
first, would have to do empathy and assessment of resistance, same
as with anybody!
As you point out, the motivational factors can be enormous. For
example, Adderall is just the same as Dexedrine, and highly
addictive and euphoric street drug. If I had some right now, I’d be
highly excited and write 30 pages of stuff!
In addition, I can use ADHD as an excuse for not doing stuff
that’s boring. Someone who is motivated can easily find a
solution.
The summary before college I was lucky to get a job in a bank
in Phoenix. My job was filing checks by hand. Boy, that was
boring!
I made it a bit less boring by trying to find the most unusual
names while I was filing checks alphabetically. One of the many
unusual (to my young and uneducated ear) names was J. Karekin
Moojian!
As freshman in college, I found I had trouble concentrating and
grasping what the professors were saying in lectures to large
classes of a couple hundred or so students. And I had NO IDEA
whatsoever what the teacher was talking about!
What helped was simply asking another student as we were
walking out of the class. I’d say, “What was the professor trying
say?”
Then the other student, who seemed way smarter than me, would
just give a one sentence summary, and I’d suddenly “get it.” So, if
you’re motivated, you can find a way!
In medical school, I had to memorize gross anatomy. I had
little aptitude and no interest. I had never even take a biology
class in college, and did not know what was in the “abdomen” or
“thorax.”
So I made up little games, sitting for hours in the library
memorizing stuff. It got me through—just barely1
David
4. A asks:Hello
sir,Is it okay if I do the
written work by typing in my laptop on a word processor or is it
must that I write on a paper?
Is it okay if I do the written work by typing in my laptop on a
word processor or is it must that I write on a paper. Thank
you.
David’s reply
Interesting question! Probably okay either way. No research on
this issue!
I slightly favor doing it by hand, but that is likely because I
have done it that way for 40 + years! d
Thanks for listening and reading today!
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!