Corona Cast 1: Honoring Your Angst

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By David Burns, MD, David Burns, and MD. Discovered by Player FM and our community — copyright is owned by the publisher, not Player FM, and audio is streamed directly from their servers. Hit the Subscribe button to track updates in Player FM, or paste the feed URL into other podcast apps.

With the "Shelter in Place" orders in California, we are recording these podcasts from our homes instead of from the Murietta Studios. The sound quality may not be as high as usual until we all get the necessary recording equipment, and learn the new technology. Please bare with us during this transition. Thank you, David & Rhonda

David and Rhonda are joined in today’s podcast by Jeremy Karmel, who is working with David on the new Feeling Great app, and Dr. Alex Clarke, a former student of David’s who is practicing TEAM therapy / psychiatry at the Feeling Good Institute in Mountain View, California.

One of our loyal podcast fans, Phil McCormack, sent a heartwarming email which read, in part:

In light of the pandemic taking us into uncharted territories, I thought it might be interesting to hear of some tips from you that would help folks deal with the situation, kind of like the David’s Top Ten Tips podcast but this one focused on the hysteria which is prevalent as I write. I’m sure your fans would appreciate it and it might be a good jump start for your new book and app, both called Feeling Great.

I realize you are incredibly busy and don’t expect an answer. And if you want to tell me to screw myself, I can use your techniques to handle that!

I responded like this:

Thanks, Phil. I’m trying to put together at least two or three podcasts on the coronavirus from a variety of perspectives! Might read you question to kick start the first one we do, if that’s okay. david

Phil immediately shot back this email:

You’re an animal! I have no idea of where you get all your energy and motivation–obviously your techniques work (drug free!) so that must be part of it!

Kudos to you for all your effort. It is so, so much appreciated!! I sincerely hope you someday get the recognition you deserve!!! I think Feeling Great might be your ticket... Hope so.

Please feel free to read question and thanks for not telling me to “screw myself!” Really appreciate that!

Phil

How cool is that!

Rhonda and I are planning several podcasts on this important topic including today’s as well as a podcast on how Rhonda used TEAM to help a woman with severe feelings of depression, anxiety, inadequacy, despair and frustration about the current corona crisis in a single session.

We are also planning podcasts on how to communicate with friends and loved ones during the crisis, as well as a survey to assess changes in mood (depression, anxiety, anger, relationship satisfaction and happiness) since the corona virus hit, and possibly more. When the survey is ready, we’ll announce it and send you a link in case you’d like to let us know how you've been feeling, and how your feelings might have changed since the virus hit!

Rhonda kick starts today’s session by reading a list of negative thoughts from folks who are freaked out about the corona virus, including these:

Negative Thoughts with Probable Cognitive Distortions

  • The world will turn into an apocalypse.
  • I’ll be a carrier and won’t know it and then I'll infect my partner and children who will get really sick.
  • I’m divorced and I think my ex- will try to keep me from my kids. She won’t be as vigilant as I am about keeping our kids healthy. They’ll get sick and infect me.
  • I’m looking for a job right now, but no one will be hiring for a long time and I’ll never get a job.
  • I won’t have enough money to pay my rent and I’ll be evicted from my apartment and end up homeless (or) my business will go out of business.
  • I won't have enough money to have fun for several months.
  • My parents will contract the virus, especially one of my parents who has some chronic health stuff, and get really sick or die.
  • I’m going to get cabin fever.
  • I will lose a sense of self/connection to reality with how surreal everything is.
  • People in my life will die from the virus.
* * *

Negative Thoughts that are Probably Not Distorted

  • The numbers of infected people are way higher than what's being reported because there's no testing
  • The pandemic is worsening.
  • The pandemic will get much worse than we realize now.
  • Needier populations -- people who have lost work who really need it (restaurant workers, hotel, caterers, production staff, people with no savings, etc) — will suffer.
  • The social fabric is going to break down.
  • Things are going to continue worsening as climate change worsens.
  • I live too far from my parents to help take care of them.

Rhonda, Alex, David, and Jeremy begin by discussing several of the basic ideas of TEAM-CBT.

  1. We feel the way we think. In other words, the events of this world—like the corona virus—cannot have any effect on how we feel. All of our negative and positive feelings result from our thoughts, or “cognitions.” This idea goes back nearly 2,000 years to the teachings of the Greek Stoic philosopher, Epictetus, who said that people are disturbed, not by the things that happen, but by our views of them.
  2. Some negative feelings are healthy and some or not. Healthy fear is not the same as neurotic anxiety. Healthy sadness is not the same as depression. Healthy remorse is not the same as neurotic anxiety. And so forth. Healthy anger is not the same as unhealthy anger.
  3. Healthy negative feelings result from valid negative thoughts, like “We are in danger because of the spread of the corona virus, and we need to be vigilant to protect ourselves and our loved ones.” Unhealthy negative feelings result from distorted negative thoughts, like "The world will turn into an apocalypse."

Anxiety, panic, and depression, in contrast, result from distorted negative thoughts, like many of those that Rhonda read. For example, think about this thought: “My parents will die and I may never see them again.” Review the list of cognitive distortions and see if you can spot some!

This thought is likely to be at least somewhat distorted since your parents probably won’t die. For example, in China there have been around 3,300 deaths so far, and the epidemic has finally been slowing in the past few days. Since there are more than a billion people in China, the odds that you or someone in your family will die, while significant, appear to be incredibly low. So while there is clearly some risk, the distortion would be Magnification, Fortune Telling, and Emotional Reasoning, the three distortions that trigger all feelings of anxiety. In addition, you can see your parents right now if you like, using Skype, for example. So, while that thought also contains a grain of truth, it arguably involves Discounting the Positive as well.

  1. In spite of these considerations, TEAM therapist don’t try to “fix” or “help” just because someone may have distorted negative thoughts. Trying to help without first addressing therapeutic resistance is the most common error therapists make, and the most common error most people us make. For example, you will hear politicians telling people to “stay CALM,” or trying to encourage people with good news or promises which sometimes don’t seem entirely honest.
  1. Instead of jumping in and trying to "help," TEAM-CBT therapists first ask the person who is upset if they are looking for help. Sometimes, people aren't asking for "help" or cheer-leading, they just want someone to listen and provide validation and support.

If the person does want help with negative feelings like panic, depression, frustration, loneliness, or inadequacy, we do a little thought experiment and say: "Imagine that we had a Magic Button, and if press it, all your negative feelings will instantly vanish, with no effort, and you'll feel terrific. Will you push the Magic Button?"

Most people say they'd gladly push the button!

Then we say that while we don't have a Magic Button, we've got some tremendous techniques that could help them reduce or even eliminate their negative feelings, but don't think it would be such a good idea to do that because their negative thoughts and feelings may be expressions of their core values as a human being, and what is most beautiful and awesome about them, and that their may be some important benefits, or advantages of their negative thoughts and feelings. And maybe we should list those before making any decision to press the Magic Button and make everything disappear.

If you're upset, you can try this right now. First, circle your negative feelings and estimate how strong each category is, between 0 and 100%. If you click here, you can see an example of this on the Emotions table of the Daily Mood Log of a woman who was upset about the corona virus scare.

Then ask these two questions about each feeling:

  1. What does this negative feelings show about me and my core values that’s positive and awesome?
  2. What are some benefits or advantages of this negative feelings are. How might it help me, or my loved ones?

I call this new technique Positive Reframing. In other words, I want to honor your negative thoughts and feelings before we think about changing them! This is called Positive Reframing and it is the key to the incredibly rapid changes we typically see when using TEAM-CBT.

Typically, we come up with a list of a long list of compelling positives. Then I point out that if they push the Magic Button, all those positives will go down the drain, along with their negative feelings. Would they really want to do that?

Now you're in a trap, or dilemma. One the one hand, you are suffering and desperately want to feel better. But at the same time, you don't want to lose all of those awesome positives!

Fortunately, we can resolve this paradox. Instead of trying to make your negative feelings disappear by pushing the Magic Button, imagine that we had a Magic Dial instead, and you could dial each negative feeling down to a lower level that would allow you to keep all the positives on your list, and still feel better. What would you dial each type of negative feeling down to? For example, if you're feeling 80% panic or 90% depressed or angry about the corona virus, and you could dial each emotion down to a lower level, what would you dial them down to?

You can see an example of this if you click here. As you can see, this person has put these new levels in the "% Goal" column of the emotion table.

Jeremy provides a touching real life example of this. He feel intense anger because his fiancé, a nurse—is working in a hospital with a shortage of protective masks. He becomes tearful when he realizes that his anger is actually an expression of his intense love for her. The change in how he feels is almost instantaneous, and touching.

The group further illustrate this by using Positive Reframing with many of the negative feelings our podcast listeners like you may be having.

Jeremy concludes by drawing a critically important distinction between Positive Reframing, which is nearly always helpful, and “cheer leading,” which is rarely or never helpful, and can actually be downright irritating!

This table below highlights some of the critical differences.

Is Positive Reframing Just Cheerleading Warmed Over?

by David and Jeremy

Cheer Leading Positive Reframing You’re trying to cheer someone up to make them feel better. You are highlighting the benefits of NOT changing. You say generally nice things about someone, like “you’re a good person,” or “you’re a survivor,” or “don’t be so hard on yourself.” The positives are not general but embedded within specific negative thoughts and feelings. You don’t acknowledge the validity or beauty of the person’s negative thoughts and emotions. In fact, you’re trying to tell them that they’re wrong to feel upset! This is always preceded by doing superb empathy. Positive Reframing is actually a deeper form of empathy because you’re honoring the patient’s core values. Cheerleading is irritating to almost everybody who’s upset, because you aren’t listening or showing any compassion or respect. The effect is enlightening and leads to feelings of relief, pride, peace, and acceptance. You’re trying to control the other person. You’re telling them how they should think and feel. There’s no acceptance. You’re Sitting with Open Hands. You’re bringing hidden motivations to conscious awareness so they can decide where to steer the ship. Hollow praise sounds dismissive, glib, and insincere. This technique is very difficult and challenging to learn because you have to let go of the idea that you know what’s best for other people.

Thanks for tuning in, and let us know what you thought about today’s program!

Oh, if you clicked on the two links to the Daily Mood Log of the woman who was intensely upset about the corona virus, and want to find out what happened in her magical TEAM-CBT session with Rhonda, tune in to our next CoronaCast!

Until then,

Rhonda, Alex, Jeremy, and David

202 episodes