Feeling Good Podcast | TEAM-CBT - The New Mood Therapy

• 471: TEAM Trauma Treatment: Featuring Dr. Jill Levitt

  TEAM Trauma Treatment-- How Does It Work? And Why?  Featuring Dr. Jill Levitt Today's podcast features one of our favorite guests, Dr. Jill Levitt, who is one of the greatest psychology teachers on planet earth. We explore trauma, and how it is treated. We focus in particular on the unique features of trauma treatment using TEAM CBT. Jill is currently the Director of Training at the Feeling Good Institute in Mountain View, California, but she has had intensive training in trauma treatment beginning during her psychology internship at the Cornell Medical Center (? is this correct) in 200? (dates please Jill) and continuing until (date please.) She worked with adults survivors of childhood physical and sexual abuse, as well as victims of the 2011 tragedy at the world trade center, which happened when she was working in New York. She got extra training from several outstanding experts in the treatment of trauma and anxiety, including the renown Dr. Edna Foa, from Temple University in Philadelphia, as well as (please list if you like, Jill!) Rhonda also has extensive experience in the treatment of trauma since she worked for (x years, please fill in) at th San Francisco Rape and Trauma Clinical. Rhonda emphasized the importance of shame and toxic but high irrational self-blame so often seen in trauma patients of all ages, including, of course, children. Jill and Rhonda emphasized the importance of the selective use of exposure techniques with trauma patients, and the unfortunate fear that many, and perhaps most, therapists have of these techniques, wrongly fearing that the patient will decompensate and that the therapist, too, will become overwhelmed when hearing the patient recount their horrific experiences in detail. I, David, will add that I've never had a negative experience with the use of exposure techniques, like cognitive flooding, memory rescripting, and many more with any trauma patients. However, I always do E = Empathy first, as well as A = Paradoxical Agenda Setting, to guarantee that the patient and I will be working together as a collaborative team. Rhonda asked us to talk a bit about "vicarious trauma" that the therapist might experience when working with trauma patients. Both Jill and David said they've never experienced this, and that only our thoughts, and not the experiences our patients describe, can upset us. We believe the concept of "vicarious trauma" is highly (but not intentionally) misleading and needlessly frightening to those working with trauma patients. Of course, if a therapist does become triggered when working with any patient, including a trauma patient, that is grist for the mill for the therapist to work out with their own therapist, using perhaps the Daily Mood Log to explore and challenge the therapist's upsetting negative thoughts. Perhaps the most important theme today focused on the treatment of trauma patients--as well as non-trauma patients--individually, using TEAM to pinpoint one moment the patient was upset, and exploring their negative thoughts and feelings with the help of the Daily Mood Log, as well as the other vitally important components of T E A M. I (David) do not place much stock in treating patients with "formulas" based on their "diagnosis" or problem. I did 20 or more two day trauma workshops around the US and Canada several years back, and treated a volunteer from the audience at each workshop on the evening of day 1, using a two-hour TEAM CBT session. In all or nearly all of these sessions, the individuals experienced a triumphant and blow-away elimination of all their negative feelings by the end of the demonstration. But here's the interesting thing: although I occasionally included cognitive exposure, it was perhaps the technique I used the least often with these individuals. Far more powerful for most were techniques like Explain the Distortions, the Paradoxical Double Standard Technique, and the Externalization of Voices. Sometime, an interpersonal technique, including the Five Secrets of Effective Communication, was helpful, even life-changing. If you are interested, you can read about those sessions in Chapter X in my most recent book, Feeling Great, as well as illustrations of the data from all the patients, showing the dramatic changes in negative and positive feelings from the start to the end of the sessions. Why did these individuals recover so dramatically and quickly--within a single session? I believe it was because I focused on what was upsetting THEM, and developing an agenda and selecting methods to focus on what they wanted. This, to my way of thinking, is different, even radically different, from imposing a pre-set agenda on patients simply because we think they have some type of trauma diagnosis. David described the three elements of an "abuse contract" between the abuser and the victim: I get to hurt or exploit you for my own pleasure. The Blame will be 100% on you. I am a blameless, superior god. We must keep this as a secret, even between us. If you violate this, I will hurt you very badly. Thanks for listening today! Jill, Rhonda, and David

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• 470: Ask David: Rhonda's Three Questions!

  Procrastination: Be Gone! And "Physician, Heal Thyself!" Really? Why? The answers to today’s questions are brief and were written prior to the show. Listen to the podcast for a more in-depth discussion of each question. This will be podcast #470 on 10/6/2025 Procrastination: Be Gone! And Physician, Heal Thyself! Really? Why? The answers to today’s questions are brief and were written prior to the show. Listen to the podcast for a more in-depth discussion of each question. Rhonda asks: Why do people procrastinate? Rhonda asks: Wouldn't you first deal with the negative thoughts that are a part of the procrastination before working on it? Rhonda asks: Here is a question I have: You often say, "physician heal thyself," and encourage personal work by the therapist. Why does the therapist have to face their own issues to help someone else? A heart surgeon doesn't have to have heart surgery in order to conduct surgery on their patient. Why does a therapist have to do their personal work? Rhonda writes: I have been thinking a lot about procrastination since we met last week.  Why do people procrastinate? It's one thing not to put away a stack of files on your desk, it's another thing to procrastinate on something major, like finishing your dissertation, doing your taxes, or some things that have a major consequence.  It's a habit like anything else so there is a cue, the pattern, and the reward. Cue: I don't want to finish my dissertation because it's overwhelming and I don't think I am smart enough to finish it, and I don't want to face it. Pattern: Procrastinate Reward: Relief that I have avoided it another day. So, wouldn't you first deal with the negative thoughts that are a part of the procrastination before working on it? I've also been thinking a lot about positive reframing. I always do it, even with a client who has done it before, to remind people, and keep alive, their positive qualities, and to encourage more embracing/accepting of their symptoms as beautiful parts of themselves. With clients who have experience doing Positive Reframe, reframing their THOUGHTS, not just their feelings, can give a lot of insight. Here is a question I have, you often say, "physician heal thyself," and encourage personal work by the therapist.  Why does the therapist have to face their own issues to help someone else?  A heart surgeon doesn't have to have heart surgery in order to conduct surgery on their patient.  Why does a therapist? David replies People procrastinate because they don’t want to do the thing they are putting off. There is no one reason, since we’re all different. And we all tend to avoid things that seem unpleasant, and gravitate towards things that are more pleasant. I classify it in the general category of “Habit / Addiction.” For years I dealt with the reasons people procrastinate as a first step, including the thoughts they have at the moment they procrastinate. I thought my job was to “help” the person who was procrastinating. This was universally unsuccessful, and not their failure became MY failure. This allowed them to continue procrastinating, since the doctor was trying to help them, and responsible for helping them. I decided, instead, to go with an approach that works. It took a number of years to figure that out! But it was a huge relief! We don’t say that a psychiatrist or psychologist has to have schizophrenia or be cured of schizophrenia to help someone with schizophrenia. And we don’t say that a mental health professional has to have OCD to treat someone with OCD effectively. No one has ever claimed that. What I am saying is that a heart surgeon has to have credibility and training in successful heart surgery to get the license practice surgery. But how does a mental professional get credibility? Well, let’s say that you’ve once had severe public speaking anxiety, as I have had. And social anxiety as well. So, when a patient comes to me with social anxiety or public speaking anxiety, I can say, “Oh, I’ve had that too, and I know exactly how awful that can feel. And, it’s going to be a pleasure to show you the way out of the woods.” This message is generally welcomed by patients because it conveys two messages: I know how much you’re suffering, because I’ve experienced it myself. I have the skills and the confidence to treat you successfully. Would you want to go to a therapist for the treatment of your own public speaking anxiety, or shyness, if you knew that the therapist had these problems and still hadn’t found a cure for themself? There are other powerful reasons for doing your own personal work: You can see the impact of therapist errors if colleagues have tried to treat you without good empathy or methods. You can see what recovery / enlightenment mean at a much deeper level! You can see how and why certain techniques can be so critically important and helpful, and why many others will not be helpful. Once you have done your own work successfully, and experienced your own “enlightenment” or “recovery” or whatever you want to call it, you are no longer a mental health professional / technician type of therapist. You graduate to the “healer” class! During the live show, I went through the structure of the new approach to procrastination, and she sent this email right after finishing her “Mission Accomplished” or “I stubbornly refused” task. Dear Matt and David! Successfully completed! Thank you, Rhonda Thanks for listening today! Rhonda, Matt, and David

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• 469: Ask David: Is AI trying to steal your career?

  #469 Ask David-- What if AI steals my job? I'm freaking out! Recently, I got a cool question from Megan Morrone, a technology and science editor at Axios. She asked about job anxiety due to fears of AI taking over our work. Initially, I declined to speculate, since I’ve never treated anxiety due to AI stealing someone's job. But the more I thought about it, I realized I had quite a few, perhaps humble, things to say, so here it is, with help from Matt and Rhonda. I’ll include a link to her column at the end of these show notes. She wrote: Dear Dr. Burns, I’m a technology and science editor at Axios, working on a story about job anxiety and how it affects workers today. Would have time to chat with me about it? I’m hoping to schedule a brief phone or Zoom conversation before Tuesday. 15–20 minutes? We’d potentially discuss: Why job-related anxiety feels especially pervasive right now What strategies are most effective in managing it How CBT approaches can be applied in workplace or career contexts Please let me know if you have availability. Best, Megan Morrone She subsequently clarified her focus: Hi! I'm looking at anxiety around AI stealing your job. Would you be able to speak to that? Any chance you're Monday between 7:30AM-9:30AM Pacific or anytime after 12:30pm Pacific time? I'd only need 20-30 minutes and we can do it via phone or video call. David’s response Hi Megan, I thought of one point I could make if it would further your cause. Every negative emotion has a healthy and an unhealthy version. For example, healthy fear—when you’re facing a realistic danger—is not the same as a panic attack or a phobia or social anxiety, etc. Healthy fear, or healthy sadness, and so forth, or not emotional problems needing treatment, but realistic emotions telling us to take action. Sadly, with AI as the latest revolution, lots will change, some good, some bad. And sadly, many will lose their work due to being taken over by AI. Our son, for example, used to get high paid work anytime he wanted in user interface work for companies with prominent web presences. But now AI does all of that, apparently. So, he has to look for something entirely different, and he’s tried a lot. With a wife and a baby, the financial issues are real. Now, if someone starts getting overwhelmed by feelings of anxiety, self-criticism, and inadequacy, and hopelessness, that IS something I can help with—big time, Bu the practical problems in finding new and different work will remain even after the person has regained self-esteem and optimism. So sometimes scrambling and being flexible, if possible, and getting coaching with an expert in jobs and career development, perhaps, on what might be practically possible, is called for, and not psychotherapy. I LOVE working with anxiety and can usually guide my patients to extremely rapid recovery, which is tremendously rewarding, for them and for me! But when the problem is real, my expertise does not match the needs. Hope this helps in some small way. Of course, sometimes a good shrink can help with sorting out options in the real world, but that generally requires a different type of specialized training. It is profoundly sad, and we have personally experienced it, that so many people are facing this tragic uncertainty and worry about making ends meet and finding themselves lost due to this overwhelming and unpredictable new revolution. For what it’s worth, my book, when Panic Attacks, is a mass market paperback that has helped many anxiety sufferers and illustrate a great many methods. Also, our Feeling Great app is currently free of charge and causes dramatic reductions in anxiety, depression, and a host of other negative emotions in less than 90 minutes the first time people sit down and use it. It actually includes a highly trained AI designed to use the exact methods I use in my work, and our data suggests that it vastly outperforms most human therapists but will probably not replace them because some serious problems require human intervention. Best, david David responds to Megan a bit further Wonderful, I had one or two additional thoughts for you. People faced with layoffs due to AI (or any reason) face two challenges: the inner challenge and the outer challenge. The outer challenge involves finding, of course, some new way to work and support yourself and your family. The inner challenge has to do with your thoughts. One of the Self-Defeating Beliefs behind a great deal of depression and anxiety is the Achievement Addiction, which means measuring your self-worth based on your work, your achievements, and so forth. This goes back to the Calvinist work ethic, as you know, which is one of the cornerstones of western civilization: you ARE what you DO. So if you do good things, you are a good person; but if you are not doing anything productive or constructive, you are worthless. So it is super easy to fall into a pattern of self-critical (and distorted) negative thoughts when you lose your work, including “I’m worthless,” and “I’m letting my family down,” and “this is my fault,” or “it’s unfair,” and endless varieties of these themes that can trigger immediate depression, anxiety, shame, inadequacy, hopelessness, anger, and more. So that is the inner battle. And that’s where good psychotherapy CAN play a hugely important role, so you don’t have to double your trouble and face a loss of your job plus the loss of your self-esteem and dignity at the same time. Thanks, and good luck with your article! Warmly, david We discussed a great deal more on the live podcast. Megan just emailed me again, and here’s what she said: You’re way ahead of me! The story hasn’t been published yet. But you can plug our Axios AI+ newsletter https://www.axios.com/signup/ai-plus So, check it out! And thanks for listening today! Matt, Rhonda, and David  

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• 468: The 2025 Feeling Good Podcast Survey

   The 2025 Feeling Good Podcast Survey Featuring Sevde Kalidiroglu, Director of Marketing, Feeling Great app This is the third survey of our podcast fans since the first podcast was broadcast on October 27, 2016, and the most recent was roughly five years ago. Our awesome Director Marketing at the Feeling Great app conducted the survey and prepared the report which you can review if you CLICK HERE Essentially, we wanted to know a little bit about who you are and why you listen, and what you like the most, and least, and what kinds of changes you'd like to see. 183 of you graciously completed the survey. Thanks! We discussed many of the findings on the podcast, and you can click the link above for the full report, but here are just a few highlights: Roughly 1/4 of you are mental health professionals, and 3/4 are general public. Men and women were represented equally. 60% of you are from the US, and 40% of you are international listeners. The age range is heavily tilted toward the older generation, with 66% of you above 50 years of age, and not a single podcast fan less than 20 years old! And why do you listen? Nearly 90% of you are listening to improve your emotional well-being. This was great to hear, and consistent with the many emails I receive describing the help so many of you have gotten from the podcast. In fact, one recent podcast fan fired their therapist due to lack of progress, having made much more progress from listening to the podcast. Many of you listen in order to learn TEAM CBT techniques, including therapists who want to improve their clinical skills as well as individuals who want to learn techniques they can use in their daily lives. Other reasons for listening include: Improve my own emotional well-being 87.1% Learn therapy techniques 57.9% Learn about mental health topics 53.4% Support friends/family 49.4% Entertainment 20.2%“ One respondent wrote: "The podcast helps me apply tools to real-life problems that day—whether loneliness, meaning, or mood swings.” If you click on the survey, you'll find a plethora of interesting findings, clearly presented. Rhonda and I are grateful to you, Sevde, for compiling this information, and we are all very grateful to you, our loyal fans, for sticking with us all these years! We will try hard to be mindful of the take-home messages at the end, which included: Key Recommendations 1. Keep Live Therapy and How-To episodes front and center 2. Reduce episode length & polish editing 3. Bridge podcast and app more clearly (especially in the U.S.) 4. Refresh branding and improve accessibility 5. Add diversity in guest speakers and clinical styles 6. Prioritize topics like perfectionism, trauma, resistance, and self-defeating beliefs 7. Keep posting webinar recordings as podcast episodes Thanks for listening today! Sevde, Rhonda, and David

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• 467: Ask David: How can I help grandma and my mom?

  #467 Ask David-- How can I help my elderly, demanding grandma? How can I empathize with hostile political figures? The answers to today’s questions are brief and were written prior to the show. Listen to the podcast for a more in-depth discussion of each question. Today’s questions. Brittany says that her elderly grandmother has become very needy and demanding, and that her mom finds grandmother’s behavior irritating. She wants to know how she can help her mom / grandmom. Jenny asks: How do we empathize with people we are extremely angry with, including prominent political figures?   Brittany says that her elderly grandmother has become very needy and demanding, and that her mom finds grandmother’s behavior irritating. Brittany wants to know how she can help her mom / grandmom. Hi Dr. Burns, A few months ago my grandma fell down her stairs and broke some ribs. She was in a nursing home for a short while since she needed physical therapy and assistance doing daily tasks. Before the accident, she lived alone and was completely independent. During her recovery, she pretty much had round the clock visitors. More than any other person in the nursing home. My grandma complained constantly and anytime someone would say “you look good” or “you seem to be doing better” she would very quickly respond with how terrible she feels etc. Having listened to your podcast on how to deal with complainers, I could see it was because nobody was acknowledging her feelings. They just wanted to say things to cheer her up. She is now recovered and back home, but she refuses to do things on her own again that she is capable of and the doctor cleared her to do. She has a terrible attitude and is constantly calling up family members and her friends to run errands for her. Example: my mom picked up some lettuce she asked for her. Then my grandma called her friend to go get her one afterwards, saying the one my mom bought was too small. She acts completely ungrateful. She texted me that she has been so lonely with no visitors but then my mom tells me that is not true. That she has had people coming over every day and taking her places. My mom is at her wits end dealing with her demanding attitude and ungratefulness. I know Jill had an example before where her mom was saying how hard things are and nobody is there for her and Jill used the five secrets. This situation feels a little different. How can my mom get her life back and get my grandma to do things on her own again? -Brittany David’s reply Hi Brittany, How about including this as another Ask David? One problem, as I see it, is that your mom is not asking David for help. So I could only help you with your response to your mom, acknowledging how difficult things are for her. In other words, use the Five Secrets of Effective Communication. Of course, this assumes you want help with your interaction with your mom. It can be hard not to "HELP" when a loved one, like grandma, AND your mom, are suffering and struggling. Sadly, I have learned that trying to help third parties is not satisfying or effective most of the time. But modifying the way I interact with people is almost always helpful. Don't know if this make sense. Certainly we can see what Matt and Rhonda have to add / suggest. Warmly, david Brittany’s response to David: Sure, I think it would be a great ask David. I would be interested in your approach if it were my mom asking you for help. What would you tell her and what your five secrets approach might be. -Brittany David’s response: I always prefer have a specific example to a hypothetical question. I can only help you with YOUR responses to your mom, or to anyone. Can you give an example of something she has said to you that you want help responding to effectively? Warmly, david Jenny asks: How do we empathize with people we are extremely angry with, including prominent political figures? Dear David and Rhonda, Your session on dealing with cancer was incredibly heart-warming and so compassionate. I will be sharing that with my sister who is in a similar situation and now completely healed from her cancer! My question deals with anger. Many of us are dealing with anger and frustration at our country, president, and White House, who are taking rights away from us that we have earned over the past 80+ years. I find applying your positive ideas about anger to be very helpful: to view anger as having a high moral sense of justice and fairness, and to view frustration as keeping vigilant and to not get discouraged. But I want to investigate further how these anger/frustration ideas can be applied to White Supremacists and Steven Miller. Because when you hear these people talk they are so incredibly angry, and are directing their anger at other people in destructive ways. How could we, if given the opportunity, talk to them and feel empathy with them? Thanks so much, Jenny David’s response: If you like, we can include your excellent and highly relevant question in an upcoming Ask David podcast. Thanks for listening today! Matt, Rhonda, and David

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