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  • 524: Working With Elders-Aging, Control, and Legacy

    524: Working With Elders-Aging, Control, and Legacy
    2026/10/19
    Working With Elders: Aging, Control, and Legacy Hosts:Dr. David BurnsKevin Cornelius, LMFT Guests:Dr. Jill LevittThai-An Truong, LPC. LADC Episode Overview What happens when aging begins to change the things that once gave us independence, identity, and a sense of purpose? In this episode of The Feeling Good Podcast, Kevin Cornelius, Dr. David Burns, Jill Levitt, and Thai-An Truong explore the emotional challenges that can accompany aging—and the ways therapists, caregivers, family members, and loved ones can respond with greater empathy, dignity, and respect. Thai-An draws on her experience working with older adults in an inpatient setting and introduces two fundamental needs that can become especially important in later life: control and legacy. As people age, they may experience layers of loss involving physical strength, health, friends, spouses, independence, financial security, familiar surroundings, and even their sense of identity. At the same time, family members and caregivers may become increasingly focused on getting things done, making decisions, and addressing practical or medical concerns. That difference in agendas can create painful power struggles. The episode explores a different approach: slowing down, reducing urgency, and giving older adults as much agency as possible. Rather than interpreting resistance or insistence on doing things a certain way as simply being "stubborn" or "difficult," the conversation considers whether these behaviors may reflect a deeply human need for control, safety, familiarity, and dignity. The conversation then turns toward legacy and life review. Thai-An describes a process of listening for the stories, people, experiences, and themes that repeatedly emerge in an older person's conversations. Those stories can provide clues about the values that have mattered most throughout their life—and about how they would like to be remembered. The episode concludes with a moving demonstration of this process, with Jill Levitt role-playing her mother, Wendy. Through stories about the Peace Corps, Brazil, travel, family, grandchildren, and her career, the conversation reveals deeper themes of adventure, learning, connection, love, acceptance, honesty, generosity, and respect. Ultimately, this episode asks us to consider whether helping an older person is always about doing more for them. Sometimes, it may be about slowing down enough to listen, allowing them to remain the author of their own story, and helping them recognize that their life continues to matter. Key Takeaways 1. Aging can involve many layers of loss Thai-An emphasizes that loss can accumulate as people grow older. These losses may include: Physical strength and healthIndependenceFriends and peer relationshipsA spouse or life partnerFinancial independenceFamiliar surroundings and one's homeA previous role in the familyA sense of productivity or contributionIdentity and social status When several of these losses occur at once, older adults may be asked to make major decisions at precisely the time when they are feeling least able to cope with change. 2. Independence is about more than physical functioning The discussion highlights how deeply identity can become connected to independence. Kevin describes how his mother had previously derived meaning from helping other members of the family. When the roles reversed and she began needing help herself, she experienced shame and worried that she was becoming a burden. Thai-An suggests that losing the ability to contribute can challenge an older person's sense of worth. Someone who spent a lifetime caring for others may struggle when suddenly placed in the position of needing care themselves. 3. The need for control doesn't disappear with age One of the central ideas of the episode is that control is a fundamental human need. When older adults lose the ability to perform tasks independently, they may increasingly depend on other people to do things for them. As a result, they may become particularly concerned about how those things are done. What can look like being demanding, controlling, or "set in one's ways" may sometimes be an attempt to preserve agency in a life where many other choices have already been taken away. Jill points out that someone who previously handled things independently may understandably want things done according to their preferences once other people become responsible for those tasks. 4. Caregivers can unintentionally create control battles Family members and professionals often have legitimate reasons for wanting an older person to make a decision quickly: medication management, medical care, safety concerns, housing, transportation, or other practical issues. But urgency can collide with the older person's need for control. Thai-An describes the importance of "sitting with open hands"—reducing the pressure to make something happen immediately and instead creating room for the older person to participate in decisions about...
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    1 時間 1 分
  • 523: When Depression Is the Expression of Love

    523: When Depression Is the Expression of Love
    2026/10/12
    When Depression Is the Expression of Love Hosts:Kevin Cornelius, LMFTDr. David Burns When Depression Is the Expression of Love This episode is inspired by Dr. David Burns' Psychology Today article, "When Love Masquerades as Depression." Kevin and David explore the surprising idea that painful emotions such as depression, guilt, and shame can sometimes reflect a person's deepest values and capacity to love. What if depression, guilt, and shame aren't always signs that something is wrong with us—but can sometimes be distorted expressions of something deeply meaningful and positive? In this episode of The Feeling Good Podcast, Kevin Cornelius and Dr. David Burns explore this provocative idea through the story of Jim, a man who had struggled with severe depression for nearly a decade following the tragic death of his stepson. Jim believed he was responsible for his stepson's death. Friends tried to reassure him that it wasn't his fault, but their attempts to convince him otherwise didn't help. Instead of trying to talk Jim out of his guilt and depression, David listened carefully and discovered something unexpected beneath his suffering: Jim's extraordinary capacity to love, care for, and help other people. Jim had devoted much of his life to helping others. Even during his years of depression, he had stepped away from his successful business and devoted himself to helping people who had lost limbs from landmines. His depression, guilt, and sense of responsibility were connected to some of his most deeply held values. David and Kevin discuss how Positive Reframing, one of the central concepts in TEAM-CBT, can help therapists and patients discover the positive intentions and core values underlying painful emotions and behaviors. Rather than immediately trying to eliminate a symptom, the therapist first seeks to understand what the symptom may be doing for the person. The conversation also explores why trying to "fix" someone can actually increase resistance, why empathy is often more powerful than reassurance, and how dramatic changes can sometimes occur when people discover a new perspective for themselves rather than simply being told what to think. David also describes how working with Jim on a seemingly unrelated problem revealed the larger pattern underlying his suffering. Jim was worried that withdrawing money from a friend's bank could cause the bank to fail. As they examined the thought together, Jim suddenly recognized how exaggerated his sense of responsibility had become—and burst out laughing. David describes this as a moment of "laughing enlightenment." The episode offers a fascinating look at several fundamental TEAM-CBT principles: positive reframing, empathy, resistance, cognitive distortions, the fractal nature of psychological problems, and the possibility of rapid change. Key Takeaways Look beneath painful emotions. Depression, guilt, shame, anxiety, and anger can sometimes be connected to important values, relationships, and positive intentions.Positive Reframing can reduce resistance. Rather than immediately trying to eliminate a symptom or correct a distorted thought, therapists can help patients understand what the symptom represents and how it may have served a positive purpose.Empathy comes before fixing. Trying to cheer someone up or convince them that their feelings are wrong can be counterproductive. Genuine understanding can create the openness needed for change.Our strengths can become liabilities when taken to extremes. Jim's extraordinary desire to help others was a beautiful quality, but his belief that he was responsible for everyone's well-being also contributed to his suffering.Work on the problem the patient wants to work on. Jim's immediate concern about a friend's bank revealed the same underlying pattern of excessive responsibility that had contributed to his depression.The "fractal" idea in TEAM-CBT. Core patterns of thinking and suffering can show up in many different situations. Changing one specific problem can illuminate and change the larger pattern.Don't simply tell people what to see—help them discover it. Jim's breakthrough came when he recognized for himself how unrealistic his sense of responsibility had become. David describes this as a rapid moment of insight.Hopelessness can itself be a cognitive distortion. Previous unsuccessful attempts at treatment do not necessarily mean that someone is a hopeless case.Therapists can have the same blind spots as their patients. David reflects on his own belief that he should be able to help everyone, recognizing both its motivating power and its potential costs.Recovery can transform a person's life. Jim ultimately became fully engaged with his relationships, work, and life, and continued to express gratitude years after his recovery. Read the Article "When Love Masquerades as Depression" by Dr. David Burns, published in Psychology Today. Read the article on Psychology Today Listener Survey We'd love to hear ...
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    44 分
  • 522: What If the Real Antidepressant is You?

    522: What If the Real Antidepressant is You?
    2026/10/05
    What If the Real Antidepressant Is You? The placebo effect is powerful—and why that truth matters more than you think. Hosts:Kevin Cornelius, LMFTDr. David Burns What if one of the most widely accepted ideas in mental health isn't true? In this fascinating episode, Dr. David Burns and Kevin Cornelius discuss David's recent Psychology Today article, "What If the Real Antidepressant Is You? The Placebo Effect Is Powerful—and Why That Truth Matters More Than You Think." Together they explore decades of research on antidepressants, the surprising power of the placebo effect, and why giving yourself credit for your own recovery may be one of the most important—and hopeful—ideas in psychology. Whether you're taking antidepressants, considering them, or simply curious about the science of depression and recovery, this conversation will challenge assumptions, answer difficult questions with compassion, and leave you with a new perspective on where healing really comes from. Episode Summary Can a sugar pill relieve depression? The answer, surprisingly, is yes. But what if that isn't the most interesting question? In this thought-provoking episode, Dr. David Burns and Kevin Cornelius discuss David's recent Psychology Today article, "What If the Real Antidepressant Is You? The Placebo Effect Is Powerful—and Why That Truth Matters More Than You Think." Together they examine decades of research, clinical experience, and one of the biggest controversies in psychiatry: Do antidepressant medications work because of their chemistry—or because of the hope and expectation they inspire? David explains why his own experience treating thousands of patients led him to question the effectiveness of antidepressant medications long before large-scale analyses reached similar conclusions. He shares the story of discovering research comparing antidepressants with placebos, and why those findings changed the way he thought about depression treatment forever. The conversation then takes an unexpected turn as David tells a memorable story about a fictional "miracle drug" named Placebo. Through this thought experiment, he explains why the placebo effect is often misunderstood—and why recovering on a placebo doesn't mean someone is "faking it." Instead, David argues that people may be activating their own remarkable capacity for healing through hope, expectation, and changes in the way they think. Kevin raises thoughtful questions that many listeners may be asking: If antidepressants aren't doing the healing, why do so many people feel convinced they helped?Why do people become angry when the placebo effect is discussed?If the placebo effect is real, does that mean cognitive therapy is "just a placebo" too?How can we distinguish between hope, expectancy, and treatments that produce unique therapeutic benefits? David also discusses new research from the Feeling Great app suggesting that while expectancy contributes to improvement, TEAM-CBT techniques appear to have measurable therapeutic effects above and beyond placebo alone. The discussion also explores: Why David believes patients deserve the credit for their own recovery.How understanding how you recovered can help protect you from future episodes of depression.Common side effects and withdrawal symptoms associated with antidepressants.Why David encourages listeners never to stop psychiatric medication without working closely with their prescribing clinician.Drug-free approaches to depression, including TEAM-CBT, Feeling Good, Feeling Great, and the Feeling Great app. Toward the end of the episode, Kevin asks David what gives him hope after more than five decades of clinical work. David shares exciting early findings from ongoing research on the Feeling Great app, reflects on the future of TEAM-CBT, and closes with an encouraging message for anyone who believes they're hopeless: in his experience, hopelessness itself is almost always the illness speaking—not reality. Whether you're curious about antidepressants, fascinated by the placebo effect, or simply looking for hope in your own recovery, this episode will challenge assumptions and invite you to think differently about where healing really comes from. Memorable Takeaways The placebo effect isn't fake—it may be one of the most powerful healing forces we possess. Hope, expectation, and belief can produce genuine emotional and biological changes.You deserve the credit for your recovery. If you improve, understanding how you got better gives you the power to do it again when life knocks you down.Healing doesn't have to come from a pill. According to David, lasting recovery comes from learning to change the thoughts and behaviors that keep depression alive.Question assumptions—even the popular ones. Science advances by following the evidence wherever it leads, even when the conclusions are uncomfortable or controversial.A treatment can create hope without being the source of healing. The conversation explores ...
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    47 分
  • 519: What Therapists Get Wrong—and How to Fix It

    519: What Therapists Get Wrong—and How to Fix It
    2026/09/14
    Episode 519: What Therapists Get Wrong—and How to Fix It Hosts:Kevin Cornelius, LMFTDr. David BurnsGuest: Jeremy Karmel What happens when therapy becomes something you simply keep doing rather than something that actually helps you get better? In this lively and provocative episode of The Feeling Good Podcast, Kevin Cornelius, LMFT, joins Dr. David Burns and Jeremy Karmel for a candid conversation about some of the biggest problems they see in modern mental health care—and what therapists can do differently. Jeremy brings a unique perspective to the discussion: he experienced severe depression in college and spent months in different therapies and therapy groups without getting better. Then, working with one of David Burns' students, he discovered powerful cognitive therapy techniques that produced dramatic results in just two weeks. The experience left him both grateful and frustrated—and motivated to understand why effective treatment can sometimes be so difficult to find. David, Kevin, and Jeremy explore several common pitfalls in therapy, including the failure to measure results, getting lost in the past, talking about problems in vague and general terms, and assuming that every therapist is qualified to treat every kind of problem. Accountability: Is Therapy Actually Working? The conversation begins with one of David's central concerns: accountability. If someone has been coming to therapy for months—or even years—how do they know whether treatment is actually helping? Kevin shares his own experience of spending several years in therapy without clearly defined goals or any systematic testing of progress. Although he valued the relationship with his therapist, he now sees the lack of specific goals and measurement as a major limitation. By contrast, his current approach involves establishing concrete treatment goals and measuring progress before and after sessions. Jeremy points out that many people in therapy cannot even answer a basic question: What are you working on? Without clear goals, it becomes difficult for patients to hold therapists—or themselves—accountable for results. Do We Really Need to Find the Cause in the Past? The group then tackles another controversial question: Does effective therapy require uncovering the origins of a problem in childhood or the distant past? David tells the story of a woman with a severe elevator phobia who had been told in psychoanalysis that the roots of her fear were in childhood—and that overcoming it might take several more years. During a workshop, David instead helped her confront the feared elevator directly. Within minutes, her fear disappeared, and she subsequently rode skyscraper elevators without difficulty. The larger point isn't that the past is irrelevant. Rather, David argues that therapy can become unnecessarily focused on discovering hypothetical causes when the more practical question is: What is bothering you right now, and what can we do about it? The conversation extends this idea to trauma and PTSD. David describes an approach that focuses primarily on the patient's current distress rather than repeatedly dwelling on the traumatic history. Jeremy shares an example of someone whose debilitating trauma-related flashbacks improved after confronting the traumatic memory directly. From General Problems to Specific Moments: The Power of Fractals Another major theme is the distinction between general problems and specific problems. People commonly come into therapy saying things like: "I don't know who I am.""I have low self-esteem.""I'm bad at relationships.""I'm always depressed.""I have trouble with people." But what does that actually mean? David and Kevin argue that the therapist's job is to find a specific moment when the supposedly general problem was actually happening. What was going on? Where were you? Who was there? What were you feeling? And, most importantly, what were you telling yourself? David describes these specific moments as "fractals": individual situations that contain the repeating pattern of a much larger problem. By solving the specific problem, you may simultaneously begin solving the general problem. Jeremy illustrates this with his own tendency to argue. Looking at specific interactions through David's Relationship Journal helped him recognize a recurring pattern: instead of listening and looking for truth in what another person was saying, he would shift into arguing. Is Your Therapist Actually an Expert in Your Problem? The final major theme may be the most provocative: Therapists aren't necessarily experts in every problem their patients bring to therapy. David and Jeremy use dating as an example. A therapist may have extensive training in psychotherapy without having any particular expertise in dating, flirting, relationships, or the practical skills involved in meeting potential partners. Kevin offers an important distinction: therapists don't necessarily need to give advice about every ...
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    45 分
  • 521: Ask David-Friendship, Rejection, and Anxiety About Sleep

    521: Ask David-Friendship, Rejection, and Anxiety About Sleep
    2026/09/28
    Ask David: Friendship, Rejection, and Anxiety About Sleep Hosts:Kevin Cornelius, LMFTDr. David BurnsGuest: Dr. Matt May In this Ask David episode of the Feeling Good Podcast, David Burns, Dr. Matt May, and Kevin Cornelius tackle two listener questions: one about the painful experience of feeling that your efforts at friendship aren't being reciprocated, and another about anxiety-induced insomnia. The conversation explores a common theme underlying both problems: our suffering often comes not only from what happens, but from the thoughts and assumptions we make about what happens. When Friendship Doesn't Feel Reciprocal Brittany writes about a recurring pattern in her relationships. She is usually the one who reaches out, initiates conversations, and tries to build friendships, but she doesn't feel that others make the same effort. She wonders: "What am I doing wrong?" Kevin suggests an important alternative: perhaps she isn't doing anything wrong at all. There may be many explanations for another person's lack of reciprocity. They may be busy, uncomfortable making new friends, or simply not interested in the same kind of relationship. Most importantly, we aren't the right friend for everybody—and everybody isn't the right friend for us. David introduces the TEAM-CBT technique of Reattribution, encouraging Brittany to consider explanations other than the automatic conclusion that something is wrong with her. The group then explores Changing the Focus, one of the Five Secrets of Effective Communication. Rather than silently wondering what another person is thinking, Brittany could directly—and respectfully—acknowledge the tension and ask the other person how they experience the relationship. But saying something this vulnerable can feel risky. What if the other person really does reject us? David, Matt, and Kevin explore this fear through a Feared Fantasy role-play, imagining some of the harshest things another person might say. The goal isn't to create a perfect response; it is to discover that even rejection can be faced, accepted, and explored with curiosity. The role-play produces one of the episode's central insights: accepting another person's criticism or rejection can sometimes be much more powerful than trying to defend ourselves against it. When Trying to Sleep Becomes the Problem The second listener, writing from China, describes three months of anxiety and insomnia. They desperately want to get eight hours of sleep, but the fear of not sleeping creates tension that makes falling asleep even harder. Then, when they realize they haven't slept well, the panic starts all over again. David immediately points to the value of a Daily Mood Log. Rather than guessing what is causing the anxiety, he recommends identifying the specific negative thoughts, emotions, and belief ratings connected to the insomnia. Matt suggests using the What-If Technique to uncover the fear underneath the anxiety: What are you afraid will happen if you don't get enough sleep? Perhaps the fear is that you won't be able to function, that something terrible will happen, or that you will lose control. Once the underlying fear is identified, it can become something that can actually be examined and challenged. Kevin also challenges the assumption that everyone needs exactly eight hours of sleep to be healthy. The discussion emphasizes that anxiety about the need to sleep can itself make sleep more difficult. David summarizes the idea bluntly: the problem may not be insomnia itself, but the distorted thoughts about insomnia. The "shoulds"—I should be sleeping; I have to get eight hours—can turn a bad night of sleep into a major emotional crisis. The group also discusses behavioral approaches to insomnia, including sleep restriction, getting out of bed rather than lying awake and frustrated, and paying attention to factors such as caffeine and sleep habits. Important: The discussion of alprazolam, Tylenol, and other sleep-related medications reflects comments made during the podcast and should not be interpreted as individualized medical advice. Medication decisions should be discussed with a qualified medical professional. Key Takeaways Not every lack of reciprocity means something is wrong with you. Consider alternative explanations before concluding that you are unlikable or doing something wrong.You aren't the right friend for everyone. Sometimes the healthiest response is to recognize that two people simply aren't a good match and move on.Changing the Focus can bring hidden tension into the open. Rather than guessing what someone thinks, talk openly about what you're noticing and ask for their perspective.Vulnerability is often what makes honest connection possible. Saying "I feel hurt" or "I sense some tension" can feel risky, but it can also create an opportunity for genuine understanding.Use the Feared Fantasy to face rejection. Imagine the worst response you might receive and practice responding to it rather than...
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    43 分
  • 520: Ask David--Grief, Love and Letting Go

    520: Ask David--Grief, Love and Letting Go
    2026/09/21
    Ask David: Grief, Love and Letting Go Hosts:Kevin Cornelius, LMFTDr. David BurnsGuest: Dr. Matt May In this Ask David episode of The Feeling Good Podcast, David Burns, Kevin Cornelius, and Matt May explore three emotionally difficult situations: watching a child struggle and desperately wanting to help, grieving the loss of someone you love, and trying to pursue a romantic relationship with someone who has clearly said no. The common thread? Our suffering often increases when we try to control something—or someone—that we cannot control. When Your Child Is Struggling The episode begins with a parent asking how to help a daughter who is having a difficult time. David offers a counterintuitive suggestion: sometimes the best way to help is to stop trying to help. Rather than pushing advice, solutions, or therapy, parents can learn to listen with genuine empathy. David recommends learning the Five Secrets of Effective Communication, which can help parents create an environment where their children feel understood and are more willing to talk. David also emphasizes an important principle from his own clinical practice: he doesn't try to help people against their will. Unless a child is very young, the person receiving therapy needs to want the help and ask for it. Matt adds another important dimension: parents and therapists may experience guilt, frustration, anger, or self-blame when they can't make someone else better. Those feelings don't mean you're a bad parent or therapist. They may simply reflect how deeply you care. What Is Healthy Grief? The second question comes from someone grieving the death of a spouse and wondering whether intense misery and despair are signs of unhealthy grief—and how long healthy grief is supposed to last. The discussion offers an important distinction: Healthy grief can be extremely painful. Sadness itself isn't necessarily something that needs to be "fixed." If the painful thoughts are accurate—"I'll never see my spouse again" or "I miss the person I loved"—then the appropriate response may be empathy rather than cognitive restructuring. But grief can become complicated by distorted thoughts, such as: "It's my fault that she died.""I should have done more.""I should have known.""I should have prevented this.""I'll never be happy again." These thoughts can add guilt, shame, anger, and hopelessness to the natural pain of loss. David also challenges the idea that there is a prescribed timetable for grief. There is no universal schedule that says when someone "should" be finished grieving. Trying to force yourself to recover according to an arbitrary timeline may simply create another layer of suffering. Instead, David encourages listeners to lean into grief rather than judge it. Deep grief can be understood as an expression of deep love. When Romantic Pursuit Becomes a Trap The final question comes from Ahmed, who became interested in a divorced woman, expressed his desire for marriage very early, and continued pursuing her even after she made it clear that she wasn't interested. The discussion explores the difference between genuine connection and emotional pursuit. Matt identifies several thoughts that can fuel what he calls a "love addiction," including: "I can't be happy without this person." Or the belief that if you're sincere, thoughtful, and persistent enough, you can eventually convince someone to love you. David and Kevin challenge that idea. If someone has clearly communicated that they aren't interested, continuing to pursue them isn't likely to create attraction. Instead, it may be a sign that you're avoiding the pain of acceptance and letting go. David shares personal stories about learning to overcome his own fear of rejection, including deliberately seeking out rejection so that it would no longer have the power to frighten him. The ultimate goal isn't to convince one particular person to love you. It's to become comfortable enough with yourself that you don't need any particular person to make you happy. As Kevin puts it, there is something much more appealing about someone who is already enjoying their life and invites another person to join them than someone who is essentially saying, "Please be with me so that I can be happy." Key Takeaways 1. You can't make someone want help. When someone you love is suffering, your instinct may be to push harder. But sometimes the most helpful thing you can do is listen, empathize, and give the other person the freedom to choose whether they want help. 2. Empathy may be more appropriate than problem-solving. Not every painful emotion is a symptom that needs to be eliminated. When someone's sadness is based on reality, especially after a profound loss, compassion and empathy may be the most appropriate response. 3. Look for the thoughts behind emotional suffering. The distinction between healthy and unhealthy grief isn't simply how intensely someone feels. Ask what thoughts are creating the emotional pain. ...
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    34 分
  • 518: Why So Much Therapy Doesn't Work (And What Actually Does)

    518: Why So Much Therapy Doesn't Work (And What Actually Does)
    2026/09/07
    Episode 518: Why So Much Therapy Doesn't Work (And What Actually Does) Hosts: Kevin Cornelius, LMFT Dr. David Burns Guest: Jeremy Karmel What happens when therapy doesn't work? In this provocative episode of The Feeling Good Podcast, David Burns and Jeremy Karmel join Kevin Cornelius to examine some uncomfortable questions about the mental health field: Why do some people remain in therapy for years without getting better? Why do so few therapists measure their patients' progress? What happens when therapists become overly attached to one particular school of therapy? And how can we make psychotherapy more effective, accountable, and evidence-based? Jeremy brings a particularly personal perspective to the conversation. After experiencing severe depression in college and trying numerous forms of therapy without success, he worked with Matt May using TEAM-CBT and experienced a dramatic recovery in roughly two weeks. That experience ultimately led him to become deeply involved in TEAM-CBT and in the development of the Feeling Great app. David and Jeremy describe a list of more than 30 concerns about the way mental health care is commonly practiced today. They emphasize that the goal isn't simply to criticize therapists, but to encourage a radical improvement in the effectiveness of psychotherapy. In This Episode 1. Can financial incentives create a conflict of interest? David and Jeremy explore a difficult question: If therapists are paid by the session, is there an inherent incentive to keep therapy going longer than necessary? They contrast long-term therapy without measurable improvement with a model in which the therapist's goal is to help the client recover as quickly and completely as possible. David argues that therapists should be able to define what successful treatment looks like and determine whether their interventions are actually producing meaningful change. Kevin offers another perspective from his experience at Feeling Good Institute, where brief TEAM-CBT therapy can lead to rapid improvement while also generating referrals because clients recognize that the treatment is effective. 2. Are schools of therapy becoming like "cults"? David and Jeremy question the tendency within psychotherapy to become attached to particular theorists, schools, and treatment models. Instead of assuming that one approach explains every psychological problem, they argue for flexibility. Depression, anxiety, relationship problems, and other difficulties may have very different causes and may require very different interventions. David describes TEAM-CBT as a framework for effective psychotherapy rather than allegiance to one particular technique. He has developed more than 140 techniques and emphasizes selecting methods according to the individual's specific problem. Jeremy points out that therapists and patients can be tempted to treat the ideas of famous figures such as Freud or Carl Rogers as unquestionable truths rather than hypotheses that should be tested against evidence. 3. The refusal to measure Perhaps the strongest theme of the episode is the importance of measurement. David argues that therapists need to know whether their patients are actually improving—not simply assume that they are. His approach involves measuring symptoms at the beginning and end of sessions and tracking changes over time. If a person begins a session feeling 90% depressed and ends at 80%, that's useful information. If the numbers don't improve from week to week, the therapist has evidence that something needs to change. On the other hand, dramatic changes can provide tangible evidence that treatment is working. Jeremy shares the story of a friend who had apparently been depressed for 18 months or more while receiving therapy, yet neither the therapist nor the patient had been systematically measuring whether the depression was improving. 4. Therapists aren't always accurate judges of how their patients feel One of the most surprising parts of the discussion is David's argument that therapists' clinical intuition can be remarkably inaccurate. He describes research in which highly trained clinicians interviewed patients extensively and then estimated how depressed, anxious, angry, or suicidal the patients were. Their estimates were extremely inaccurate compared with the patients' own ratings. The lesson is humbling: We cannot reliably assume that we know how another person feels simply because we've spent a lot of time talking with them. Measurement provides information that intuition cannot. 5. Measurement can transform the therapist, too David explains that measurement isn't simply a way of judging the patient—or judging the therapist. It can become one of the most powerful tools for improving clinical skill. If a therapist believes a session went wonderfully but the patient's ratings show otherwise, the therapist has an opportunity to learn. Likewise, if a particular intervention consistently produces dramatic improvements,...
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    54 分
  • 517: How a Bloody Trauma Case Cured My Lifelong Blood Phobia

    517: How a Bloody Trauma Case Cured My Lifelong Blood Phobia
    2026/08/31
    Episode 517: How a Bloody Trauma Case Cured My Lifelong Blood Phobia Hosts: Kevin Cornelius, LMFT Dr. David Burns Episode Summary Can your greatest fear become one of your greatest strengths? In this deeply personal episode, Dr. David Burns shares the remarkable true story of how a severe lifelong blood phobia nearly ended his medical career—and how one unforgettable day in the emergency room transformed that fear forever. David recounts his unconventional path to becoming a psychiatrist, including almost dropping out of medical school, taking years away from medicine, living without money while trying to create a life centered around helping others, and eventually finding his way back to psychiatry through a residency at Highland Hospital in Oakland. On his very first day in the emergency department, David was confronted with what seemed like his worst nightmare: a critically injured bombing victim covered in blood. Unable to avoid the situation, he was asked to help clean gunpowder from the patient's wounds. What began as overwhelming terror became an unexpected turning point that permanently erased his blood phobia—and ultimately shaped his career treating anxiety disorders. Along the way, David and Kevin explore why exposure is one of the most powerful treatments for anxiety, why motivation is essential for lasting change, and why courage doesn't require the absence of fear. This inspiring conversation is a reminder that the experiences we most want to avoid can sometimes become the doorway to profound growth. In This Episode Why David never intended to become a physician—and almost quit medical school.The childhood experiences that contributed to his lifelong blood phobia.How avoiding feared situations keeps anxiety alive.The extraordinary trauma case that unexpectedly became David's own exposure therapy.The surprising moment his fear disappeared completely.David's concept of the "200% cure"—when something you once feared becomes something you genuinely enjoy.Why therapists sometimes avoid using exposure therapy, even though it is one of the most effective anxiety treatments.Why motivation often determines whether people are able to face their fears.The role of acceptance and willingness during exposure.A moving reunion with Highland Hospital decades later through the surgeon who recently performed David's successful colon surgery. Key Takeaways Exposure works because avoidance keeps fear alive. The natural impulse is to escape what frightens us. Unfortunately, every act of avoidance teaches the brain that the feared situation is dangerous. When we stay in the feared situation long enough, anxiety eventually peaks and then naturally declines. The feared catastrophe rarely occurs, and our confidence grows. Courage means acting while you're afraid. Kevin highlights an important distinction: You don't have to eliminate fear before taking action. Real courage is moving forward even while your anxiety feels overwhelming. David's anxiety remained at a 100 out of 100 for nearly fifteen minutes before it suddenly dissolved. Anxiety cannot remain at its peak forever. One of the biggest misconceptions about anxiety is the belief that once it starts, it will continue indefinitely. In reality, anxiety naturally rises and falls. If we stop escaping and allow ourselves to experience it, it eventually loses its power. Motivation makes exposure possible. For years David simply avoided blood. Everything changed because he had something more important than avoiding fear: he wanted to become a psychiatrist. Having a compelling reason to face anxiety often makes difficult exposure exercises possible. Sometimes fear transforms into enthusiasm. David describes what he calls the "200% cure." A 100% cure means you're no longer afraid.A 200% cure means you actually enjoy doing the very thing you once feared. Many people who overcome fears discover new passions that once seemed impossible. Therapists can become afraid of their patients' anxiety. Kevin and David discuss an important obstacle in treatment: therapists themselves sometimes avoid exposure because they're afraid it will overwhelm the client. Ironically, protecting people from anxiety often prolongs suffering. Learning that anxiety is uncomfortable—but not dangerous—is one of the most healing discoveries patients can make. Exposure requires willingness, not comfort. The goal is never to feel relaxed before confronting a fear. The goal is to become willing to experience anxiety while pursuing what matters. Memorable Quotes "When you confront the thing you're afraid of, you discover that the monster has no teeth." "You don't have to be a hero. You just have to make the decision to do it." "The 100% cure is you're no longer afraid. The 200% cure is that you love doing the thing you were once afraid of." "The real harm is believing that anxiety itself is dangerous." Resources Mentioned Dr. David Burns' accompanying Psychology Today article, "How a Bloody...
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    38 分