178: Social Anxiety Be Gone! The Awesome Atlanta TEAM Therapy Demonstration!

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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.

In today’s podcast, Rhonda and David are honored to interview Dr. Michael Greenwald, a courageous clinical psychologist who helped make the Atlanta Intensive a truly amazing event. Michael volunteered for the live demonstration to work on his lifelong problem with social anxiety, which seems to be a popular topic these days, and likely a personal problem for many podcast fans.

My co-therapist was Thai-An Truong, a highly respected TEAM therapist and TEAM therapy trainer from Oklahoma City. Thai-An also joins today’s podcast via Zoom and dialogues with Michael for the first time since the intensive.

The session with Michael was powerful and inspiring, with a good 50% of the audience in tears (of joy) at the end. Michael recorded the session on his cell phone, but the quality was not up to the quality of our podcast recordings, so he agreed to fly up to the “Murietta Studios” from his home in Los Angeles so we could at least describe what happened and share the magic with you. If we can find a way to do some sound enhancement on the cellphone recording of the session, we will likely publish it as a separate mid-week podcast for those who like to hear the incredible therapeutic process unfolding in real time.

If you review Michael’s Daily Mood Log at the start of the session, you’ll see that he was feeling depressed, anxious, ashamed, worthless, lonely, self-conscious, discouraged and stuck, and all of these feelings were intense. In addition, he told us that he wasn’t feeling much joy, self-esteem, pleasure or satisfaction in his life.

But the strongest feeling was anxiety. He said that coming up on stage to face his fears was an enormous challenge, and that this was the first time he’d ever done something like this. We will do T = Testing again at the end to see what changed, and by how much. We’ll also ask Michael to complete the Empathy and Helpfulness surveys, so we can find out how he experienced Thai-An and David during the session.

You may be saddened by the upsetting event Michael recorded at the top of his Daily Mood Log, which was “sitting with my son and trying to make conversation with him.” He said their conversations were always pretty superficial, and that he would typically leave the room after short interactions with his son because he felt so anxious.

Here’s an example of a typical exchange. Michael’s son, a graduate student in clinical psychology, was working on his applications to internship programs.

Michael: What’s up?

Son: I’m working on my applications to internship programs.

Michael: That’s good. How’s it going? Are you getting them in on time?

Son: Yah, it’s fine.

Michael: Are you completing them? Do you want me to look at them?

Son: All fine.

If you review the negative thoughts on Michael’s Daily Mood Log, you’ll see that he felt like a failure as a father because he did not know how to get close to his son or how to tell him just how much he loved him. He was telling himself things like this:

  • Something is wrong with me because I can’t talk to him. 100%
  • I am failing him as a father. 100%
  • He deserves so much better than me. 100%
  • He must wish he had a different father. 95%
  • And more.

I was sad to see that Michael had been beating up on himself pretty badly for years, and I'm pretty sure that the therapists in the audience felt the same way, because it was so clear that he was a tremendously humble, giving and loving father who was totally devoted to his sons. I found myself thinking, "My gosh, I wish I'd been half the father that Michael is!"

The E = Empathy phase of the session lasted about 30 minutes. Michael indicated that Thai-An and I had done a good job, and that he felt understood and accepted, so we went on to A = Assessment of Resistance in a step-by-step manner, using these tools:

  • The “Invitation Step” to find out if he was ready to roll up his sleeves and get to work on his social anxiety
  • The “Miracle Cure” question to find out what he hoped would happen in the session
  • The “Magic Button,” to see if he’d want all of his negative thoughts and feelings to disappear suddenly, just by pushing it
  • “Positive Reframing,” asking Michael these two questions about each negative thought or feeling:
    1. “What does this negative thought or feeling show about you and your core values that’s positive and awesome?”
    2. “What are some benefits, or advantages, of this negative thought or feeling?”

At first, these questions didn’t make any sense to Michael, since he was so used to thinking about his negative thoughts and feelings in a negative light, thinking they were “bad” and were the result of some kind of personality defect or mental disorder, like “social anxiety disorder” described in the DSM5. This is also the hardest part of TEAM-CBT for therapists to learn, because it is so anti-intuitive.

But as the list of positives grew, Michael began to “get it,” and we could actually see his mood lightening up before our very eyes. It was so cool, and this was the first hint the audience had that something remarkable was afoot. This, for sure, is one of the most powerful and innovative components of TEAM-CBT.

  • The “Pivot Question” and “Magic Dial” Question. Michael decided it wouldn’t be such a great idea to press the Magic Button, since then all of the positives on the Positive Reframing list would go down the drain along with his negative thoughts and feelings.

He decided, instead, to dial down his negative feelings to much lower levels that would allow him to feel better without losing any of the positives. You can see this on the “% Goal” column of his DML

For example, he decided that it would be desirable to dial his depression down from 85% to 20%, since some sadness was appropriate, given his difficulties getting close to his son. In fact, if his depression disappeared completely, it would be like saying he didn’t really care. Michael decided to dial down the rest of his negative feelings as well in the range of 5% (for discouraged and stuck) to 15% (for anxiety), and 10% for the rest of his negative feelings.

This ended the A = Assessment of Resistance phase of the session, and that took about 25 minutes.

We then went on to M = Methods, focusing on his negative thoughts, one at a time, and attacking them with a variety of techniques like Identify the Distortions, Externalization of Voices, Acceptance / Self-Defense Paradigms, Examine the Evidence, and the Paradoxical Double Standard Technique.

At the end, we went into the audience so Michael could ask participants if they were judging him, and what they thought about him as a father. This is called the Survey Technique, and it is usually pretty threatening to people with social anxiety, or any of us, really! But as you’ll hear in the podcast, the feedback he received was jaw-dropping.

Thai-An joined us at the end and dialogued with Michael about the loneliness he’d struggled with, as well as how he could most effectively share his feelings of love and insecurity with his son. His “homework” after the session was to call his son and report back to all of us the next morning!

The next morning, Michael reported that he’d had the most phenomenal dialogue ever with his son! He was practically floating on air, and reports that after the intensive, his life has changed dramatically in many ways, including:

  • A terrific relationship with his son.
  • Feelings of true joy, even ecstasy, that he’d never previously experienced or even thought possible.
  • Way better connections with people in general, due to being open and vulnerable for the first time.
  • Greatly improved clinical experiences as a result of using TEAM-CBT in his clinical work. In fact, he is thinking of starting a free weekly TEAM-CBT practice group in the Los Angeles area, and hopefully opening a Feeling Great treatment center somewhere down the line. Make sure you contact Michael if you are interested joining his weekly practice group. (drmichaeldg@gmail.com)

You can see his amazing mood scores at the end of the session on his final DML. He also gave us perfect scores on the Empathy and Helpfulness scales, and described his experience as a “transformation.”

After the session, he added that he’d seen that people really could improve quickly during other live demonstrations at my workshops, but felt skeptical that a TEAM session could trigger joy, even euphoria, as he’d never actually felt those kinds of feelings. But now, he realized this was actually possible!

I would like to thank Michael, as well as my amazing co-therapist, Thai-An Truong. Thai-An is located in Oklahoma City and specializes in treating post-partum depression with TEAM-CBT. She also does one-on-one case consultation as well as awesome online TEAM training for mental health professionals, including free weekly webinars as well as her “TEAM-CBT bootcamp intensives.” If you would like to contact Thai-An, she can be reached at Thai-An Truong thaian@lastingchangetherapy.com.

After the show was recorded, I received this amazing email from Michael. I think you'll enjoy it!

Dr. Burns,

Just some additional thoughts I'd like to mention about the changes I've noticed since the Atlanta therapy demo. The ones you put in the show notes are totally accurate. But the positive changes I've experienced since the demo go way beyond those. I'm not writing this to suggest you include these; I'm great with what you wrote. I only wanted to elaborate a bit on how things have been for me because it's such an incredible change for me. Please feel free to add to the notes, or not, at your discretion. And by the way, we are now two months post-demo and my mood scores remain essentially at zero with high positive feelings.

My stress tolerance has increased a great deal. Prior to the demo, when I made a mistake or did something stupid, I would rip into myself with intensely harsh criticism and self-judgment (I think I shared with you about the time I dropped the bottle of Cologne as one example showing the different reactions to myself). Now, when the same sorts of things happen, those harsh voices are absent or merely a whisper, and easily dismissed. So there is no accompanying self-hatred like before. I'm far more outgoing with people in general. I feel closer than ever to my friends and family. I've been more present and available to my friends and family. I'm more open and far less defensive than I've ever been in my life. I feel more positive feelings than ever, and I laugh more than ever. I have more compassion for others as well as for myself. I'm more aware of my emotional world and have more access to my feelings. I'm able to connect more with others in general. The types of situations that would trigger feelings of irritability or anger, no longer do. I'm more able to be available for others, whether in my personal or professional life. I'm closer with my wife, and, honestly, with everyone in my family and social circle. I've been in several social gatherings since the demo, and my levels of anxiety have never been lower, and my level of engagement and participation has never been higher; I'm like a different person. I'm more optimistic and hopeful than before.

So I know this is a bit of rambling, but I just wanted to mention these things. As I had discussed with you during our visit, I've been struck by how far-reaching the benefits of the therapy demo have been for me. We focused on the one moment of one problem on the DML. We blew away those negative thoughts and feelings. That outcome, had it been limited to that specific target, would have been amazing and a total success for me. But as per your model, that was a 'fractal'. And the change in the brain circuits happened with that fractal and the new networks were created, and I feel that they continue to grow. For me, it's truly been the opposite of the drop of ink in the glass of water, discoloring everything, as a distorted thought or belief will do. The therapy demo was the drop of 'clarity' that shined the light on all my distorted thoughts and beliefs at one time. Maybe that's corny, but this is what it feels like to me.

So feel free to use or not use any of this as you see fit. I only wanted to mention these things. There's more, but I think this gives the flavor. Thanks again.

Love,

Michael

Thanks for listening today! By the way, if you are looking for CE credits or training in TEAM-CBT, my upcoming workshop on therapeutic resistance on February 9, 2020 will be a good one. You'll learn how to use the techniques described in today's podcast.

See below for details and links!

David

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