Manage episode 257361824 series 1691042
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 while we are learning to use the new technology. (I apologize for the echo in this week's podcast. It won't be there again-Rhonda) Let us know what you think! Thank you, David & Rhonda
David and Rhonda are joined again in today’s podcast by Jeremy Karmel, who is working with David on the new Feeling Great app. In our first Corona Cast, we promised to present an example of how TEAM-CBT can be helpful for individuals who feel depressed and anxious about the personal impact of the pandemic.
Rhonda kick starts today’s session by describing her treatment with a patient we're calling Alice just a few days ago. Alice woke up feeling stressed and having trouble settling in and getting to work. If you click here, you can see how she filled out the first few steps of the Daily Mood Log just before the start of her session with Rhonda.
The Upsetting Event was simply waking up and feeling out of sorts. She circled and rated her negative emotions, which were fairly intense, especially the feelings of depression, anxiety, inadequacy, despair, frustration. Her anxiety was only minimal, but she was also feeling tremendously "jittery."
Why was Alice feeling so upset? Her feelings didn't result from the corona virus epidemic, but from her thoughts about it. As you can see, she was telling herself:1. This could be the new normal. 2. My life is going to waste. 3. I should be handling this better. 4. I could catch the virus and die. 5. No one is in charge.
She strongly believed all of these thoughts except #4, which she only believed 40%. You may recall that in order to feel upset, two things must be true:
- You must have one or more negative thoughts on your mind.
- You must strongly believe these thoughts.
How are we going to help Alice? In the old days, I would have jumped right in to help Alice challenge her Negative Thoughts, but now we have a far more powerful and systematic approach called TEAM-CBT, as most podcast fans probably already know!
These are the four steps of TEAM-CBT:
T = Testing. Rhonda tested how Alice was feeling at the start and end of the session.
E = Empathy. Rhonda provided warmth and support without trying to "help" or "cheer-lead."
A = Assessment of Resistance. This is one of the unique aspects of TEAM-CBT, and it's the secret of ultra-rapid recovery. Rhonda used the Miracle Cure Question, Magic Button, Positive Reframing, and Magic Dial to bring Alice's "resistance" to change to conscious awareness, then quickly reduced it before trying to "help."
M = Methods. Rhonda helped Alice identify the many cognitive distortions in her thoughts. For example, her first Negative Thought, "This could be the new normal," was an example of All-or-Nothing Thinking, Overgeneralization, Mental Filtering, Discounting the Positive, Fortune Telling, and Emotional Reasoning.
The goal of the M = Methods phase is to crush the Negative Thoughts that are upsetting you. Do you know how to do this? You have to come up with a Positive Thought that has two characteristics:
- It must be 100% true. Positive affirmations and rationalizations and half truths are worthless. Cognitive therapy is based on the Biblical idea the "The truth shall set you free."
- The Positive Thought must drastically reduce your belief in the Negative Thought you've recorded on your Daily Mood Log, and ideally your belief in it will go all the way to zero.
In fact, the very instant you stop believing the Negative Thought, your feelings will change, and often quite dramatically.
Rhonda helped Alice challenge her Negative thoughts with a powerful technique called the Externalization of Voices. For example, Alice was telling herself that "I should be handling this better" because she'd been having trouble adjusting to the home isolation and had been procrastinating instead of focusing on her writing, and she was also telling herself that "My life is going to waste," thinking she'd be procrastinating and feeling miserable forever: "The new normal."
The Positive Thought that crushed it was, "I have a lot of experience as a self-starter, and I've got eight weeks of free time now to write, which is pretty awesome. In addition, I can give myself a break, instead of putting myself down, and give myself a little to regroup!"
After all, there are hundreds of millions of people around the world who are feeling isolated and in distress, and probably most of them aren't being nearly as productive as they usually are, but clearly, that isn't going to go on forever! Instead of putting yourself down, you can give yourself some support and encouragement, in exactly the same way you might talk to a dear friend.
Once Alice crushed her Negative Thoughts with strong Positive Thoughts, her feelings suddenly changed. Although the session was only one hour long, Alice experienced incredible improvements in how she felt, thanks to Rhonda's compassion and skillful guidance. Alice's depression went from 95 to 5, and her anxiety dropped from 95 all the way to zero. The rest of her negative feelings dropped to very low levels or zero as well.
Did it last? Long-term follow-up isn't possible for such a recent session, but she did call Rhonda the next morning to say that she woke up Feeling Great . . . which is the name of my new book, due for release in September. You can see the cover below! If you want, pre-ordering on Amazon may be available by the time you hear this podcast.
In next week's Corona Cast 3, we will switch our focus to the impact of the pandemic on personal relationships, using a real example of a young woman named Zeina who felt her mother, aged 72, was not being sufficiently careful about social distancing. Zeina felt panicky because she feared her mother would get the virus and die.
They ended up arguing and feeling frustrated with each other. We will illustrate a sophisticated TEAM-CBT technique called "Forced Empathy" that brought tears to Zeina's eyes, and we'll also talk to you about how you can improve your relationships with friends and loved ones as well during these challenging times.
Thanks for tuning in, and let us know what you thought about today’s program!
Until next time,
Rhonda, Jeremy, and David