Live TEAM-CBT Therapy Demo w/ Drs. David Burns & Jill Levitt | A Journey from Panic to Peace

In this live, unscripted therapy demonstration, world-renowned psychiatrist and bestselling author Dr. David Burns—joined by Dr. Jill Levitt—works with a courageous volunteer navigating depression, anxiety, and self-doubt. Watch real-time therapy unfold using the powerful TEAM-CBT framework, as Dr. Burns builds rapport, dismantles resistance, and sparks breakthrough change.

 

What You’ll Experience
 

• Observe Real-Time Expert Therapy: See the nuance, pacing, and breakthroughs of a master therapist in action.
   

• Learn Proven Techniques: Discover interventions to untwist distorted thoughts, reduce resistance, and foster rapid change.
   

• Enhance Your Clinical Effectiveness: Gain practical tools to track progress, overcome therapeutic roadblocks, and bring clarity and compassion to sessions.
   

• Deepen Your Knowledge: Stay for the live discussion and Q&A with Dr. Burns and Dr. Levitt to learn how to integrate TEAM-CBT into your own practice.
  
   

IN THIS WEBINAR:

 

Dr. David Burns: I've changed my mind.

 

Jill Levitt: Welcome everyone to watch Therapy Unfold live with Dr. David Burns. And we're really excited to do this live workshop with you today. We're also really grateful for our volunteer Madeleine who you're going to meet later on in the workshop today. We're going to start by presenting some information about the TEAM-CBT model and then we're going to do a hopefully wonderful live demonstration and then we'll take some questions at the end and share with you some ways that you can continue to learn and grow and train with us. So we are going to start with a poll actually just to learn a little bit about who you are our audience. So let me get that started.

 

Dr. David Burns: So tell us do we know how many are registered Jill.

 

Jill Levitt: Well we had over 2,000 people registered and people just starting to join. We don't have 2,000 with us yet but, so just tell us about yourself. Are you a member of the general public? Are you a therapist who's joining us in the FastTrack course which starts well it starts today but starts live next week? Are you a therapist who's not in the FastTrack course? And then we get to learn a little bit about who you are. I'm going to give you like 10 more seconds because the numbers are still rolling in and then I'll share the results. Okay. So about 13% of you are members of the general public and then 12% of you are therapists that are joining us for the fasttrack course and 76% of you are therapists who are not yet enrolled in the fasttrack course. All right. So about 87% of you are therapists it looks like. So just helpful to know our audience and I think we'll have hopefully our presentation today is going to be helpful to all of you whether you're a therapist or a member of the general public. And so first actually I just want to introduce you to Dr. David Burns who is my dear friend and colleague and world-renowned psychiatrist CBT legend best-selling author and creator of the awesome feeling great app which David is going to tell us about later today and is offering for free right now. So hi David. And we're going to hear a lot from David today. And everything we talk about and teach is based on David's awesome TEAM-CBT model. I'll tell you a little bit about who we are at the Feeling Good Institute and who I am.

 

So our mission is to elevate the practice of therapy so that patients can recover faster and more fully. We train and certify therapists in TEAM-CBT this powerful framework developed by Dr. David Burns. And we help therapists move through a sort of structured five-level certification process to really enhance and build their skills. And Feeling Good Institute was founded by Maor Katz, Angela Krumm and myself. We all had trained with David at Stanford many many years ago. And back then the only way to learn TEAM-CBT was from David at Stanford or from David in some of his intensives and workshops he did around the world. And we started Feeling Good Institute with the kind of dream to make David's tools techniques and training style more accessible to people kind of around the world without compromising depth or quality. And everything that we do today with our trainings kind of mirrors that mission. And this is hopefully an interesting and maybe shocking slide but it turns out that therapist effectiveness over time does not improve with experience alone but only gets better with deliberate practice. And so due to this research and our experience with David's teaching style we don't just teach techniques. We really try to replicate David's training style which is built on the idea that we only get better as therapists through practice and feedback. And we actually double down on this philosophy and kind of really lean into it. We've added the data-driven research-based deliberate practice exercises when we work with therapists to really help you guys build your therapy skills. And so sort of practice feedback more practice is the way that we train therapists. And we've been seeing great, great progress when we stick to that model. And so at the end of the workshop today after we hopefully do an awesome work with Madeleine our volunteer we're going to share with you a little bit about the FastTrack course which is a course that we've created to help therapists to not only learn through didactics but to have great opportunities to practice and build their skills and really kind of level up their training. So what we'll do today is kind of the tip of the iceberg and then we'll help you to learn how you can learn more at the end of today.

 

And so you'll learn both opportunities for training if you're a therapist and then opportunities for working on yourself if you're a patient or a therapist using the Feeling Great app. Today I also need to make sure I'm covering before we get started and we're about to get started in the content just how you get your continuing education credit if you're a therapist. So make sure that you're here until 1:00 p.m. Pacific for 4 hours. And at the end we'll share the link to the CE survey. And at 1:00 today Pacific time you need to complete the CE survey in order to get your CE credits. Then you'll get your certificate within a week of today. So you won't get it immediately. And if you have any issues just contact us at certification feelinggoodgoodinstitute.com. These are our learning objectives what we will surely be covering and lots more today. I won't read them to you. And then this is our plan. We'll teach you about the model of TEAM-CBT. We'll do a demonstration. We'll share some teaching highlights get some feedback from our volunteer and hear from all of you get some questions and connect with you all through some Q&A. If you do have questions throughout the workshop today I just want to say rather than sending them to David or myself please send them to Mike Christensen in the chat box. And Mike if you can make sure that people can chat you directly so you can collect these. And then I'll start by just going over the model and then I'm going to turn things over to David to dive more into the specifics. So the the TEAM-CBT model this is an acronym for how we believe all effective therapy works based on the T stands for testing. Testing means that we use measures of symptoms and the therapeutic alliance at the beginning and end of every session with every patient so that we can track progress over time so that we can connect with our patients and get feedback and repair alliance ruptures. So we look at are we making progress within sessions and between sessions. This helps us to really inform therapy. You know how we're doing and how we need to pivot and make changes and address alliance ruptures.

 

The E in TEAM stands for empathy. And that is that we spend a lot of time as you'll see us do today connecting with our patients listening not telling them how to change and what to change but really understanding what the world is like through their eyes and and connecting with even difficult to connect with patients. And the A in TEAM stands for assessment of resistance or sometimes paradoxical agenda setting depending on when you've learned it. The idea here is that we also are really interested in understanding why our patients are thinking and feeling the way that they are and kind of making them proud of those symptoms. Thinking about what are good reasons not to change what are good reasons to kind of keep doing what they've been doing and really understand their resistance so that we can help to melt it away. And then the M and T stands for methods and that's what most of you think of when you think of CBT right? Cognitive behavioral interpersonal methods that we use with our patients to really bring about you know rapid and profound change. And the idea is that we have this framework that we always fall back on. And it's kind of a pathway to enlightenment for us as therapists and for our patients. And you'll see David and I really carefully and methodically kind of work through this framework today. So I'm going to let David talk a little bit now and then we'll kind of take turns.

 

Dr. David Burns: Well one thing is that the TEAM structure is a structure for how what research shows and what we believe through our clinical experience how all effective therapy works. It's not a new school of therapy and it's also the sequence we follow in therapy sessions. We'll follow it today. First we're going to do testing and then we're going to empathize with Madeleine and then we're going to have her grade us in in in empathy. And we think that empathy our research and clinical experiences that it unlike the humanistic therapist who think empathy is everything. We think it's really desirable but it has little or no healing power if you're measuring things like depression or panic or a relationship conflict. But it's a necessary first step to develop that trust with the patient and that warmth and that acceptance especially if you're going to use powerful methods which we are. And then we we'll go on to the assessment of resistance and and you know in American culture or western civilization and to a certain extent now in the Asia and China as well there's a tendency to think of emotional upset in terms of a series of mental disorders that you can read all about them in the DSM. But the problem with that formulation is that you know if you've been depressed and anxious and then some strength tells you have a major depressive disorder you think that person knows something about you above and beyond the fact that you're depressed but they don't. That's just some arbitrary term in in the DSM. But the problem is what when you're told that you have a disorder it creates a lot of shame potentially as well as the feeling that an expert's going to have to fix you. As if you have a broken leg you'd have to go to an expert. And and and so at the assessment of resistance we we're going to try to transform all of that shame into pride. And so instead of feeling broken and defective, we want our patients to to see that your depression your anxiety your inadequacy your anger your hopelessness whatever comes from your core values as a human being.

 

And that these your so-called symptoms really reveal something beautiful about you. Not a mental not a mental disorder. There are three or four true mental disorders but most of the hundreds of syndromes described in DSM are are not my way of thinking or from any philosophy of science or or empirical point of view not true mental disorders. And another thing about this sequence and then once we've melted away the resistance we jump in with methods and we're agnostic about methods. I use a lot of cognitive techniques because our research has indicated and confirmed that negative thoughts do in fact that is the cause of depression and anxiety. So we certainly direct a lot of the methods at reducing and challenging distorted negative thoughts. But we really use methods drawn from over a dozen schools of therapy. So I know we're jumping around here on the slides. And the last point that I wanted to make is that one of the unique features is like today we're going to do an extended session. I always do an extended session a two-hour session. You don't have to do that to do TEAM. Jill uses for the most part normal you know one-hour sessions and and does beautiful work. But the neat thing about a double session is you can often complete a course of therapy in one double session which is what we'll try to do to today. We can't always do that but I think it's kind of a new benchmark for the behavioral sciences because we usually think if someone's depressed that's going to take months years or even more than a decade of treatment and we're going to try to complete that process in a very short period of time. And as far as the T equals testing I I've developed something called the brief mood survey and you can see it in your handout package but it it measures depression anxiety depression suicidal urges and various other things quickly and accurately. It uses brief assessment instruments like the depression scale has an accuracy of about 0.95. It's much more accurate say than the Beck depression inventory or the PHQ 9. And one of the unique things is we measure symptoms in the here and now not over the past two weeks like the back or the PHQ because we want to know how the patient feels at the start and at the end of every therapy session. And we're looking for changes within the therapy session. So this format makes both the therapist and the patients accountable for for the first time. A lot of therapists don't measure. They they think of what they're doing as kind of mysterious like they think they're providing a corrective emotional experience for patients or or some such thing or resolving subconscious conflicts but we're we we're into a scientific data-driven form of of therapy where we measure things and then use those measurements to find out how effective or ineffective we we've been. And I would say that's the most important thing in the TEAM model. It represents a radical philosophical departure from conventional therapy and it requires courage on the part of the of the therapist because you'll discover that your perceptions of patients feelings or your perceptions of your own empathy will for the most part not be accurate. But you will see accurately how the patient is feeling and how the patient feels about you with these brief highly accurate assessment instruments. And it's like an if you have an emergency room this would be like having an X-ray machine for the first time. And the testing is like giving you the therapist this this X-ray machine that we use at the start and end of every patient with with every session with every patient. And it is mind-blowing and powerful and TEAM owes its life its creation to the use of these instruments.

 

Jill Levitt: And David I just wanted to mention one thing on this slide. We mentioned the handout on page eight. So I just wanted to make a few comments about the handout packet because we're getting some questions. So you all were sent Zoom reminder emails. That's how you got in today. And in your Zoom reminder emails you were given both the handout packet and the slides. And actually the slides are not necessary by any means that you have them today. The handout packet would be very helpful. And so if you didn't already go into your email find that Zoom reminder and go ahead and download the handout packet. And if you're struggling with it though and you don't have it because your company has a firewall and for some reason you can't download the handout packet it's okay. It's not entirely necessary and we will follow up with people you know after the workshop but we won't be able to help people individually. But Mike also is dropping the link to the handout packet as well as to the slides in the chat box today. So you have many ways to access it. Do you want to say anymore or you feel like you're?

 

Dr. David Burns: And then another goal of testing is to monitor therapeutic progress as well as the therapeutic alliance. So at the end of the session patients will take a highly sensitive empathy scale complete it, helpfulness scale and various measures of of the relationship with the therapist and this is will also be eyeopening to therapists who aren't used to me measuring your therapeutic empathy. My research at the Stanford inpatient unit and and other locations has indicated and and confirmed by independent investigators that therapists have less than a 10% accuracy of knowing how empathic you are during sessions. And you can think you're the most wonderful therapist in the world and your empathy scales may be failure of with every patient at at every session. And if you have the courage to to discover that and then to get some training and empathy you can you can transform your therapeutic style in weeks really by practicing certain empathy drills and get great at the thing that you're weak at. But you have to have the courage to to look at how you're doing through the eyes of your of your patients. And that's something very foundational in TEAM therapy. And you want to go back to the empathy now Jill? I mean I can continue either way.

 

Jill Levitt: Yeah. No I'm happy to. Yeah as as David is saying empathy is necessary but not sufficient. Right. So we have a lot more to offer beyond empathy. And yet I know when I learned cognitive behavioral therapy a very long time ago. I learned all the methods but I actually didn't learn a framework for connecting with patients and for really understanding them deeply. And so I felt super grateful when I started learning and training with David that there was this whole kind of empathy component. And so you'll see us spend a good deal of time today with our volunteer Madeleine connecting with her and using the five secrets of effective communication. So we say it often times will take something like 30 minutes with a new patient to just listen to to repeat to kind of deepen understanding. And sometimes takes longer. Sometimes we you know as David I think David mentioned but we'll ask our patient how are we doing on empathy? We'll ask them for a grade A B C D. We'll ask them what is it that I'm not quite understanding? Really important that our patient feels totally understood before we then move on to assessing resistance and using methods. These are sort of our empathy dos. Meaning what do we try to do when we're using the five secrets of effective communication? Well we try to paraphrase what the patient says not in a robotic way but an authentic way. We call that thought empathy. We also try to acknowledge how the patient might be feeling. So oftentimes patients will not use feeling words but we will. We'll say it sounds like you're feeling really frustrated or irritated annoyed anxious and make sure that our patient that we understand how our patients feeling and that we reflect that back to them. We also provide compassion and warmth using I feel statements. So we're going to share how we're feeling or feeling kind of moved or feeling sad for our patient. And that's kind of how we connect as human beings. And we also do something it's not on this slide called disarming where we really see the world through our patients eyes where we really agree with and connect with our patient. And that's this piece about sort of go with the patient to the gates of hell. If our patients are suffering tremendously we're not trying to jump in and change that. We're trying to really show them that we deeply understand that and it builds trust and connection. Before again coming in with sort of the big methods and the empathy don'ts. This is maybe more important than the dos because so many therapists kind of get in their way of doing effective empathy. So when we're trying to empathize and connect with our patients we're not actually trying to help them. We're not trying to change them we're not trying to cheerlead or make them feel better make interpretations or give advice. We're trying to do a lot less right? We're trying to listen connect see the world through their eyes and not not change them and not give them advice. And did you want to say anything about empathy before we move on here David?

 

Dr. David Burns: No I thought you did just a great job Jill.

 

Jill Levitt: Okay. And then assessment of resistance. Again we touched on this but just to deepen this a little bit there's two different kinds of resistance that we see in our patients. And one is called outcome resistance. That's when our patients may feel a bit ambivalent about the outcome that they say that they want. Do they really want the outcome that they're asking for? So a student you know let's say a college student who comes to us and is nearly flunking out of school and is feeling incredibly sad and anxious. Do they really want to feel on top of the world fantastic completely good you know under the circumstances? Would that make sense and why not? Maybe they want to hang on to some level of their anxiety because it kind of serves them well and motivates them or their depression shows what they value. And so we spend a good deal of time addressing and then sort of melting away outcome resistance to make sure our patients can sort of argue for change and convince us that they really do want the change that they say they want. And then process resistance is kind of a different ballgame. And this is the idea that even if the patient can convince us that they really do want to get better that they really do want to feel happy or content or not anxious, are they going to be willing to do the work that's required to get there right? Because coming to therapy doesn't mean just showing up and talking for 50 minutes once a week. It means doing homework or it means facing their fears or it means having difficult conversations. Are they going to be willing to do the work required to actually get that positive outcome? And so we have lots of methods that you'll see us use and that we use with our patients to address and then reduce resistance and thereby kind of boost motivation. And then we David and I love this slide which is ask yourself what happens when you don't address resistance right? What happens when your patient feels a bit ambivalent or mixed or is dragging their feet in therapy not doing the work of therapy and you just kind of cheerlead them and prod them along? And then it feels a lot like this right? It feels like you're pushing your patient to change while they're digging their heels in. And that's probably the worst kind of therapy for both patient and therapist. It leads to therapist burnout and you know, tension between patient and therapist probably patient dropout or just seeing patient for you know years and years while they kind of yes but you. So we're trying to avoid engaging in this kind of therapy.

 

Dr. David Burns: And I might make a I I sometimes make outrageous statements that I totally believe but other people get ticked off sometimes. But what I might say is that if you've really learned TEAM it becomes virtually impossible for a patient to resist you. And by resistance we we mean any anytime the patient is you know yes budding you or you know not not doing their homework or or or questioning things that there's a kind of tension in the relationship rather than two people working to together in a in a joyous way to change the patient's life.

Jill Levitt: You want to talk about this David?

Dr. David Burns: Yeah. Well sure the one of the tools we we use in the paradoxical agenda setting we will will often ask you know what what would you like in today's session and we'll ask Madeleine that and and often the patient what they're wanting is to make all of their negative thoughts and feelings disappear. And we have this thing the magic button. And if you press this magic button you'll go into a state of euphoria with no effort. Will you and all your guilt and shame and depression and anxiety will disappear in a flash. Will will you press that magic button and the vast majority of patients says, "Yes I press it. You know where show me the button. I want to press it right now." Then we say well we have no magic button. But we have some pretty magical techniques. And I I think if we use them we could probably achieve that goal by the end of today's session. But I don't think it'd be a good idea. I'm not convinced to to use those techniques. And then the patient will get upset and say, "Well why not?" And I say, "Because maybe we need to look at your positive thoughts and feelings from your daily mood log. You've got six different negative feelings that are very elevated. And you've got eight negative thoughts that you believe 100%. And before we make all that disappear maybe we should look at them one at a time and ask two or two questions or maybe even three. But the two questions would be how is this negative feeling or thought helping me? What are some benefits of feeling anxious or ashamed or angry or or or whatever? And the second would be what does this negative thought or feeling show about me and my core values as a human being that's that's positive and awesome?" And so we go through a bunch of the negative thoughts and feelings and generate a list of positives. That that's what positive reframing is. And typically we can come up with a list of maybe 10 to 15 sometimes 20 or more overwhelming positives that have been hiding in the patient's negative feelings. And I'm probably jumping the gun a little bit here. And but then at that at that point we can say my my my goodness. Why would you want to press that magic button? Because if if if you do and all your negative thoughts and feelings disappear then all these positives you know your high standards your compassion for other people your anxiety which keeps you vigilant and keeps you and your family safe and you know etc etc. All those values will go down the toilet along with your negative thoughts and feelings. Why would you want to do that? And so we've intentionally driven the patient into a state of confusion. And then we and and and it's that's very important because they thought they want to have zeros on the all their mood scores but they don't really because of all these beautiful things about about them. And we need to bring that to to conscious awareness and then we'll go on to some of the next slides and talk about how we resolve that with the magic dial. Well yeah so so this this is the the positive benefit. I I'll say what the conclusion is is is that then we we say to the patient suppose in instead of a magic button we had a magic dial so you could dial each emotion down to some lower level. Now at the beginning of the session your depression was at 100.

 

How much depression would you want to have on a zero to 100 by the end of today's session? How much would be enough to keep all those positive values the beautiful things that your depression says about you keep all those core values and benefits but suffer much less? And then the person might say, "Oh 10% I I want to lower it to 10%." Then I might say, "Are you sure? That's enough. Can I try to sell you on 15% or maybe 20%?" And now this is another paradox at work because I the therapist am trying to sell the patient into maintaining the symptoms as much at as high levels as as possible. And paradoxically that induces the determination of the patient to want to lower them to to some lower level. And typically on the goals the after the positive reframing we have a goal column right on the daily mood log. And so often they'll have a 5% or a 0% or a 3% or 10% sometimes a 20 20% but they generally want to lower all their their feelings to a much lower level. But what's happening there's a kind of magic happening that they the the shame disappears and they get pride because they see and they have to see this for real. It can't be an intellectual thing. It has to be something they feel at the gut gut level that the these symptoms really do show a lot about their inner beauty and their values as a as a human being and that these negative thoughts and feelings really are helping them in in in many ways. And so they no longer feel defective broken or hopeless as you would if you think these are all from my mental disorders. It's from your mental orders from your what's right about you not what's what's wrong about you. And and and paradoxically once we sell the patient on how beautiful these symptoms are and get them to see that the resistance to change suddenly disappears. And that's why we can get in most of the time such dramatic and rapid changes in the treatment of depression anxiety and all kinds of of negative feelings. And if when I was a psychiatric resident you you would have told me that it's possible to you know get someone completely out of depression in a single therapy session I would have said you need to take some thorazine because you're hallucinating. It's it was so far beyond what what we thought what you know in those days and still many of the training programs emphasize that to treat depression it's going to take months or years and some people say more than 10 years. I'll keep talking a little bit.

 

You can jump at any point Jill because when you talk it's just so beautiful you're teaching. But the the the the methods I've we use over a hundred methods that I've created or learned and extensively modified but they're they're they're drawn from a good 12 schools of psychotherapy not only cognitive therapy but behavioral therapy interpersonal therapy psychodynamic therapy paradoxical therapy and and and so on and so forth. And in the early days of cognitive therapy I used to say that you're going to if someone has a thought like I'm not as good as I should be. Maybe some of you in the audience sometimes tell yourself that I'm not as good as I should be. And if you're one of the 80 or 90% therapists I'm sure you have a lot of patients who say I'm not as good as I should be. And but if if you've done a skillful assessment of resistance in the sequence TEAM just like like that generally only a few methods will will will be will be needed to you know identify and explain the distortions double standard, externalization of voices and then whammo the patient smashes the the negative thoughts you know with a tremendous power and and clarity and the belief in them goes to low levels often all the way to zero. Depends on the kind of thought it is. Do you want to jump on the cognitive model Jill?

 

Jill Levitt: Sure. And then you can jump in. You're welcome to jump in. But yeah the cognitive model is based on the idea that it's our thoughts and not the events of our lives that trigger negative feelings. And so I often tell people if two people experienced exactly the same thing the way they would feel about it was entirely dependent on what they were telling themselves about that event. Or we can think that if two people prepared exactly the same amount for a presentation and they both went into that presentation equally well prepared and one was telling themselves I've got this I know everything I am going to kick butt in this presentation you know they're going to be feeling really excited and kind of motivated and eager and enthusiastic. And someone else could have prepared exactly the same amount and they're telling themselves you know I didn't do enough and this isn't going to go well and if if I bomb this I'm going to lose my job and they're going to be feeling incredibly anxious and stressed and kind of down and self-critical. And it's has nothing to do with the presentation how much they prepared has everything to do with what they're thinking and what they're telling themselves and that's what drives the feelings that are coming up for them. So we say that you know feelings of depression and anxiety are the world's oldest cons right? They kind of trick us. Our thoughts can really trick us. And and to the contrary or the good news is that when we change the way we think we can change the way we feel. And so our goal in the cognitive model is to really help people articulate what the thoughts are that are driving their negative emotions. We work really hard and you'll see us to get really specific about what those thoughts are that are causing each of those feelings. Different thoughts cause feelings of humiliation or shame and other thoughts might cause feelings of anxiety or worry. And so helping our patients to articulate what those thoughts are and then using so many different cognitive techniques as well as behavioral techniques and other techniques to really kind of crush the negative thoughts is what leads to sort of meaningful change and that's the cognitive model.

 

Dr. David Burns: And I I would say that people have been arguing about this philosophers scientists you know all kinds of people since the time of Epictetus 2,000 years ago. He was the first to say we're disturbed not by the events in our lives but by our thoughts about them. But everybody doesn't believe it. It's such a basic thing. And and some people say no it's the other way around. The emotion focused therapists say no feelings cause thoughts. Thoughts don't cause feelings. And so we've recently tested this in two large databases with an N of nearly 7,000 users of our feeling great app and have proven for the first time that negative thoughts are in fact the cause of depression. That's what causes depression. That's what the research showed as well as other other negative feelings and that this is a direct causal effect in the brain and it's a high-speed causal effect and and that the very moment you stop believing the thoughts in that moment the depression can can disappear. So this is although an ancient model it's a new model. It's a powerful model and it and all of the therapy is directed at crushing and exposing those those distorted negative thoughts that are the cause of of the patient's suffering. And then one of the methods that we use after we've done a good job of articulating the negative thoughts on the daily mood log which we'll share with you today and after we address motivation and resistance. So that positive reframing and kind of magic dial that David talked to you about. One of the methods that we use and it's it's one you'll see us use today for sure. We always kind of lead with it actually is called identify and explain the distortions. I like to think of distortions as essentially thinking errors. They're kind of these quick thinking errors that our minds make when we're feeling down or anxious. And you have listed here the thinking errors and also actually it is in your handout packet on page two of the daily mood log at the bottom you can see the list of cognitive distortions. And I would say that you know when I learned cognitive behavioral therapy a very long time ago originally in graduate school I learned identified the distortions but it was something we would just kind of say oh yeah this is all or nothing thinking or oh yeah this is discounting the positive or mental filter but we didn't do a whole lot with it. We kind of just circled it or wrote it down. And now David has kind of developed this method that's called explain the distortions. And this is where we ask our patients who tell us oh this is an example of all or nothing thinking we say how is this an example of all or nothing thinking and do you want to say more about that David?

 

Dr. David Burns: Yeah there's two two questions because this has been a major breakthrough because for decades I I said explain it's fun to identify the distortions but it's almost never going to help anybody you need all this other firepower. But then I created explain the distortions and suddenly we have a lot of firepower to use just that technique to to crush the negative thought in many cases. And so let's say you have the thought like a patient had had the thought I'm I'm I'm deeply and permanently damaged. This was a young man who had 20 years of abuse from his mother and older brother when he was growing up. And he was sure that he was was defective and you know irreversibly permanently damaged. And then going into that thought he could see oh this is all or nothing thinking and and why and it's overgeneralization and why and this is mental filter and discounting the positive and emotional reasoning and labeling and should statements and and self-lame. And then what you can do is is take those one at a time and and say you you say this is you know overgeneralization. Tell us why Bradley that you that thought is an overgeneralization. Tell us why it's an overgeneralization and why that makes the statement untrue or or grossly misleading. That's the first question. And the second question explain why that's incredibly unfair or even cruel that distortion. And then then what he came up with well this imagines that I have some kind of metaphysical self that that's that's damaged beyond repair and and what I'm really doing is focusing on several of my weaknesses and shortcomings and generalizing to my whole self. And that's totally nutty because although I do have many weaknesses I have to to work on I also have some tremendous strengths that I that I can be proud of. I had a rocky start to to to my life and and I have a lot a lot to show for myself and then it's cruel because that distortion makes that thought it's like belittling. It's like what my mother and older brother did to me when when I was growing up said things like this. Oh you're no good. You're defective. You're you're damaged goods. No one's going to love you. No you know blah blah blah this really horrible stuff. And he was he was a little kid when he started hearing this. He didn't have the judgment to challenge it. But that's that's how you do. And and when they answer those two questions one why does this distortion make the thought unrealistic and untrue and second why does it make it cruel and and unfair often they'll be able to then generate a positive thought that crushes the negative thought. So it's a powerful new approach.

 

Jill Levitt: And then oh sorry that then then we talk about we kind of covered this but that emotional change can actually occur instantly. And so I mean we covered the idea that thoughts drive feelings. But then it also follows that the moment that we can crush a negative thought then no long the moment this distorted negative thought no longer seems true to us kind of is the moment that we feel better that emotional change or that we you know let go of those feelings of depression or anxiety and that emotional change can happen actually kind of in in an instant. And do you want to speak about how this idea goes back 2,000 years?

 

Dr. David Burns: Well we've said that already but it it's it's a such a simple thing that a lot of people don't get it don't believe it don't don't understand it. But that's what our research also showed is that the very moment this was a big study and independently replicated in two independent databases using highly sophisticated statistical modeling techniques. It it confirmed that not only do distorted negative thoughts cause depression and anxiety they cause it instantly. And the moment you stop believing those thoughts in that instant the the the feelings will will change. And and just to give you a simplistic example that our colleague Dr. Mark Noble a kind of a neuro a brain expert from the University of Rochester. He he said, "Imagine a a cave person in in in the evening this this fellow and he hears a snapping of a twig twig behind him and he that snapping has no effect on him but his thought does." Because he tells himself, "Oh my god that could be a tiger." So he goes into panic. You see and that's how the brain works. It creates emotions almost instantly. This is nothing that takes months or years to unfold. The the brain is is working instantly like a computer. And then he turns to look and he sees it's his wife who has stepped on a twig and she's just going off to the do do something or other and then he sees that his negative thought was wrong. And in that instance his anxiety and panic totally disappear. And that's the model that we're that we're using in therapy. And we're being accountable for it because we're measuring things precisely within and from the start to the end of of of therapy every therapy session.

 

Jill Levitt: And we see this happen all the time in therapy sessions too where someone can go from kind of sobbing to laughing and you can see the moment it happens. We have video clips of these things too when like one no longer believes a negative thought that's been kind of torturing them and it replaces that with a totally believable you know positive or rational thought. And so the necessary and sufficient conditions for emotional change are important. So the idea here is that the positive thought if we're challenging our negative thoughts with new positive thoughts and I like to think of them as rational thoughts not like just positive affirmations but the positive thought has to be completely true right? So you'll see us using a daily mood log today and we'll be helping our patient or volunteer hopefully move from negative thoughts to positive thoughts. Well that new positive rational thought has to be completely true so it can't be a little bit of BS. It can't be a half-truth. If a patient says I believe it 50% I'm saying well what part of it isn't true? We'll need to make this thought completely true in order for it to be helpful to you right? But the other thing that's super important is that that that sorry I was going to say this slightly differently. I'll read what's on the slide and then I'll I'll say what I was going to say is that the moment the patient sees that the negative thought is not true they will almost instantly feel less depressed and anxious. I was just going to say the other thing is that that new positive thought has to completely crush the initial negative thought. So it not only has to be true but you know the sky is blue is true but it's not all that helpful right? So it has to completely invalidate or crush that original negative thought in order for it to be helpful. And so that's kind of what we wanted to share with you at the outset. Our goal is to work with our volunteer live today and our volunteer is a therapist who's also a human being. So just like the rest of us you know struggling with something and looking for some help. And our hope is that throughout the live session today you'll be able to kind of anchor yourself in what we've reviewed with you today kind of noticing where we're doing testing where we're doing empathy where we're assessing and reducing resistance and the methods that we're using. And we'll try to stop and make a couple of teaching points along the way. And then after our live demonstration which will be somewhere around 2 hours or so, we'll also make some teaching and summary points and we'll take questions from you guys. So if you have questions throughout you can send them in the chat. We won't be looking at them during the presentation but Mike will be kind of summarizing them and then asking some questions of us kind of toward the end of the workshop. And also David I just wanted to remind us that we'll take a quick kind of usually bathroom break maybe after the empathy phase. That's usually what we do. So that Madeleine and you and I and our audience can take a quick break. So just people have also messaged me saying is there are there any breaks in the four hours? So we will take a break but we can't really promise you exactly what time that's going to be at. And so should let's let's introduce Madeleine and right? And maybe I'll I'll wait a second. Let's introduce Madeleine and welcome Madeleine and then we can check in with Madeleine on her testing and do some empathy. I was also thinking at some point after we go through the daily mood log I'll stop screen sharing so people can see a large version of the three of us. I think that would be more meaningful for people. So maybe remind me to do that if I forget. So welcome. Yeah I think I think Mike has you now highlighted as well. So everyone should be able to see you. Do you want to say hi?

 

Madeleine: Hi.

 

Jill Levitt: So I think what we'll do is we'll start as we well David do you want to start with Madeleine's testing actually the what she shared with us on her brief mood survey and then we can ask Madeleine to share what she's been struggling with and we can do some empathy and start there.

 

Dr. David Burns: Oh yeah the testing. Sure. I'll go through how Madeleine is feeling right now at the start of the session. The depression on on the brief mood survey which goes from zero to 20 is five. So there's a little bit of depression but not a huge amount and the suicide is zero. So there's no suicidal urges. The anxiety which goes from 0 to 20 is an 18. And so Madeleine you're and thanks and hello Madeleine we're so thrilled to have you and so grateful is is 18 out of 20 and that's almost the most intense anxiety a human being can experience. The anger is zero and the positive feelings which measures happiness and self-esteem and intimacy and optimism and all those positive feelings goes from 0 to 40. And your score there is 20 out of 40 indicating that although you're not real depressed you're a little bit but you're very anxious but these are robbing you of feelings of happiness. And and so that's one thing we'll we'll hope we can can can work on during the session not directly but in indirectly. And also the relationship satisfaction with your husband is 25 out of 30. And that indicates a pretty good marital satisfaction. That goes from 0 to 30 and 25 is up toward the top of the scale but there's probably a little room for improvement in a in a couple of couple of categories there too. And the thing that you.

 

Jill Levitt: I just wanted to let people know what David's reading now. So later on when we really get into it with with understanding Madeleine we'll share with you some slides and and anchor you in your handout packet. What Dr. David Burns was going over was just that T equals testing. So what's called the brief mood survey and we do have a version of it on page eight in your handout packet. Although not Matt this is not Madeleine 's brief mood survey in your handout packet. Madeleine just filled this out five minutes before this morning and just sent her scores to David and I. So I'm just letting people know that was kind of in the moment how Madeleine 's been feeling this morning right? And we'll ask you Madeleine to fill it out again at the end of the session and then write Jill Levitt and Dr. David Burns on empathy and helpfulness and so forth so we can see the impact of the session.

 

Dr. David Burns: And just to get us started and then we'll let you talk because Jill Levitt and I are kind of monopolizing right now. But when when you volunteered you sent a daily mood log and and the upsetting event was that you'd read a news article about an abducted and missing 23year-old woman. And in response to that you panicked and and felt sad and down and unhappy 85% out of a 100. So that's like major feelings of of depression. Anxiety was 100 out of 100 anxiety and panic. Feeling inadequacy was a was a 100. So that was another extremely severe negative feeling and feeling frustrated was 90 out of 100 and upset was 100 out of 100. And then you told us how you have you know a lovely daughter who's in college and and and that you began to worry about her and had a sleepless night and boy I I I know what a sleepless night can do to to worries a mushroom in the middle of the of the night and you had five negative thoughts. And then we'll get into a little talking and empathy but my daughter is not safe being far away and surrounded by creeps and sociopaths and that's 100%. Number two, I did not adequately prepare her innocent soul for this world. That was a 100% belief in that one. And number three, she is too naive and polite and will be taken advantage of or worse. And that's 90%. I am helpless so far away and cannot protect her. That's 100%. And then finally if anything bad happened to her I could never forgive myself. And that's 100%. And we have some other information too but let's let's let let's do a little empathizing.

 

Jill Levitt: Yeah. Yeah Madeleine let's turn it over to you. That's let's kind of more start. Yeah. Start with just sharing us when you decided to reach out to us and asked for some help and volunteered for today. Tell us what was going on for you. And you know David kind of summarized it but I think it'd be helpful for everyone to hear from you in your words what what you've been struggling with.

 

Madeleine: Well I just was at the hair salon and I was reading a magazine. I don't go to the hair salon very often to get my hair done and I was reading one of those magazines. You know it had Helen Mirren on the front and I think she's a great actress. And so that's when I ran ran across that article about this poor young woman who was abducted like in right on a cruise ship with her parent. It was just the weirdest kind of story. And and this has happened to me before where I read you know you read these horrible stories in the news about young women getting abducted and killed and and and I so I was sitting there reading it and I was like why am I reading this? And then I couldn't let go of it. My my brain couldn't let go of it and my daughter's studying abroad right now. And so I started I I couldn't sleep that night but I wasn't I and I was lying in bed awake going, "What is my problem? I don't there's there's nothing going on here. Why am I? Why can't I sleep? Why am I so restless? Why can't I sleep? There's there's nothing wrong. I don't there's not there's no problem right now. Everybody's fine." And I kept thinking thing and then finally it you know my thoughts went to that article and then all these other thoughts started spinning and I and I'm I'm sorry if I get emotional but I just I get emotional too quickly and I apologize. I'm trying to I want this to be a really helpful session for for everybody and and Jill Levitt and Dr. David Burns are so generous that I really want to make this this good. So let me just wait.

 

Jill Levitt: Let me let me just pause and say tears are good Madeleine There's no. It's not like if you cry it's bad.

 

Madeleine: And if no they just get in the way of they just get in the way sometimes.

 

Jill Levitt: So I'm I'm really happy to just give you a minute to your feelings and share them with us.

 

Madeleine: Yeah. So I mean I mean generally I come and I'm an anxious person but I don't usually spin and I started spiraling that night just completely completely spiraling into the black hole of you know my my daughter's not safe. This could happen to her. She's she's she's naive. She's gotten herself into trouble before but you know she's fine now but but this could happen to her and and then start thinking about that young woman that that's been missing. And then I started thinking about the other news articles. I mean it all started when that with that Natalie Holay incident. And I'm sure many of you heard of that especially if you're in the States.

 

Dr. David Burns: Oh yeah. Right.

 

Madeleine: You remember that? It was just I thought, "Oh my god I'm never going to let my daughters go away on spring break because you know and I I've never been able to let go of that and the pain that those that family must be feeling you know and her daughter just went on spring break and was doing what all kids do go out to a bar and dance." And so that's always stuck in my mind that I I've got to be super vigilant as a parent and and and be super protective but it that's not healthy at the same time to be like that. You know they've got to live their lives. But I just start spiraling into a dark dark place. And when I read that article in the hair salon and then that night I couldn't sleep and then I finally figured out that was why then I started spiraling back down into all those poor women that were abducted and killed or or whatever and I couldn't stop thinking about it and yeah that's what happened.

 

Dr. David Burns: I have a question for you Madeleine and I I just love what you've been saying. Thank you for for that for bringing your heart and your your fears to to this. When you got tearful a few minutes ago you you kind of pushed it out and said you know the this just gets in the way. But I think both Jill Levitt and David very much admired your your tears and and your vulnerability at that moment. And and I was wondering when you were feeling tearful what were you thinking or what were the pictures in your mind at just that moment?

 

Madeleine: Thinking about those those poor women young young women. Yeah. Just being taken being taken advantage of and being abducted and and hurt and and it just it's just terrible. It's just so wrong. I'm sorry. I'm sorry. It's just so wrong that people can be so cruel to each other like that and hurt somebody like that.

 

Dr. David Burns: It's mindblowing isn't it?

 

Madeleine: And women are at a disadvantage. Women are a disadvantage generally. We're we're you know not as big not as muscular. We're at a disadvantage.

 

Jill Levitt: Absolutely. Yeah. So just feeling so sad and disturbed and and vulnerable. It sounds like too.

 

Dr. David Burns: is that it's it's amazing isn't it Madeleine the to what we when we look into the chasm and see the darkness in the hearts of of humans and the joy and inflicting pain and exploitation it and and to think that that could happen to to anyone much less someone I love. It's kind of horrifying almost beyond belief.

 

Madeleine: Yeah. And so I woke up I mean I didn't wake up because I never slept but got out of bed that morning and I thought, "Wait a minute I never I I rarely do this. I mean I don't I've maybe done this a couple times in my life." This would be perfect for Jill Levitt and David's death. But I was looking at it from a therapist like you know this would be perfect because this this is doesn't happen. I don't do this often. And I went to a dark place. Bad spiral bad. And there was I I'm a therapist. I know exactly what I needed to do. I know it was not rational. I I know all these things but I could not do it. I was I was spiraling bad. And it was just crazy because I just don't it's not something I do all the time. I don't I mean I just don't. I don't watch horror movies because it they give me nightmares. So I don't I don't do those things. So I thought and that's when I wrote you and then of course I anyway.

 

Jill Levitt: And Madeleine you said you don't do these things but I did want to ask you know do you sometimes feel worried? I know this was just a moment in time that you shared with us in a really intense and upsetting moment in time but maybe you can tell us more. Do you sometimes worry about your daughter?

 

Madeleine: Oh of course all the all the time but I don't spiral like Yeah.

 

Jill Levitt: And are these some of the kinds of worries that come up for you meaning that you worry about her safety or worry that she's not prepared to protect herself or worry that something might happen to her? Maybe you can just say a bit more about that.

 

Madeleine: Yes. Yes. Of course. Yes. Of course. I think parents do that. You know we wouldn't be human if we didn't do that. Yeah.

 

Dr. David Burns: Picking up a little disconnect there.

 

Jill Levitt: Yes. When I asked you could you say more about that does that was that feeling kind of off-putting to you?

 

Madeleine: Off-putting when you asked me that question? Yeah.

 

Jill Levitt: Well you were saying sort of course and I was saying maybe you can just share a little bit more about that with us.

 

Madeleine: I mean I just you know I I'm not constantly worried about them and I I want to about this one in particular. I'm not constantly worried about her but ever since she she started college a couple years ago and she just I I don't think she's made great decisions about some of the the boys that she's young men I guess boys really she's gone out with and so now I guess I I my worry is a little bit heightened because I I yeah she she didn't make some great decisions and she's she's safe and everything's she's fine everything's good and she says she's learned from her mistakes and she shared everything with me didn't really want to know in the end but she shared everything with me and she she said that she's learned from her mistakes mama. Don't worry. And then I you know and and I said, "I feel like this is all my fault. I didn't prepare you." And so I mean we had what some people might say a beautiful moment but it's more of a scary moment for me. And I said, "Well you know I just I I think I just didn't teach you right." And she said, "Mom it's it's not your fault. It's not your fault and I I've learned from this. It's it's that has nothing to. It's not your fault. You did teach me." So now I worry more because because I feel like she was she just hasn't made great decisions about about the the young men she's she's gone out with.

 

Dr. David Burns: This might be a good time to share the daily mood log you filled out just before the workshop began. And so it's not in the handouts but the the one where you were thinking about the way you you raised your your your beautiful daughter and were kind of holding yourself accountable for you know using I guess the wrong parenting style or something of that of that type. If you'd like to share some of that I thought that was really really interesting and important too Madeleine.

 

Jill Levitt: Yeah and I'll just say David just I I put I did want to just share with people the daily mood log that we've been talking about so far where just you know this moment in time where Madeleine was at the hair salon and and read about this and some of the anxious thoughts right that you shared with us already that my daughter's not safe and then the one you just mentioned that I didn't adequately prepare her innocent soul for the world so like I didn't do enough to prepare her that she's too naive that she might be taken advantage of and that if anything happened to her I could never forgive myself. Like I'm completely responsible for her safety. And so I just wanted to make sure people saw those in the handout packet. And then what happened was we had a little bit of an email back and forth with Madeleine: not a lot but a little bit. And then Madeleine: you shared in that exchange that part of what comes up for you is that when you worry about your daughter you also feel just very very responsible for her and you sometimes blame yourself if she's struggling with things. You're you're feeling like it's my fault. And maybe you could just share a little bit more about that you shared with us. And and sure we can definitely share with the audience some of those negative thoughts that that you shared with us just via email.

 

Dr. David Burns: Yes. And if if anyone wants to add the new negative thoughts there's four. You can just add them to the if you're working with say paper and pencil if you have printed out the handout or just take another piece of paper and and and write them down. And I think it's really important to to to write them down when you're when we're working with with with negative thoughts.

 

Jill Levitt: What will you share with us Madeleine because it it was that? Yeah. We were talking with you just a a little bit about it this morning. The some of these feelings of shame and guilt and blame self-lame.

 

Madeleine: Okay. You're talking about the new ones about the parenting.

 

Jill Levitt: Yeah. But I was wondering if you could just talk more open-endedly about that is for you and then we can go over the the thoughts but I I just want to connect more with you and have the audience connect more with you and just have you share that with us.

 

Madeleine: Okay. I don't know where to start. I I when I I know when I mentioned David's question to my husband I said, "Yeah he had a really good question. He asked me what what is what is it about the relationship can you think of any relationship with your daughter and then my husband was like and I was like what do you mean? I was like our relationship's good." And he said, "No no it's not that. It's it's that you are are worried that she is is." He went straight to, "You're she's going to make the same kind of mistakes you made and that she's not that you and that you don't trust her to be safe." And I've already written that. Yeah. Just I don't and especially after this this her time in college now where she's not made great decisions about about who she hangs out with. So I just yeah I'm not I'm not trusting that she can keep herself safe which is so not fair of me. I understand that so not fair of me to be that way. It's like I'm not trusting her to keep herself safe and to make good decisions. And then and then on layered on top of that is I don't want her to make the same mistakes I make. Right. We all have that as parents. We know what and you know I I was fine I survived I made it through. But I I wasn't yeah I just I was a I talked to too many people. I trusted too many people and and that's something that I've always struggled with in and in in my life is trusting too many people So.

 

Jill Levitt: You feel like you've been too trustworthy and maybe are you saying you've been taken advantage of or you've had your own share of maybe some interpersonal trauma?

 

Madeleine: I wouldn't say I was I don't know that I was taken advantage of. I just but I was too trusting of people. So yeah. I mean there was there was some incidents where yeah people some stole some of my things and stuff cuz I you know anyway. But.

 

Jill Levitt: Right. So there's a fear that she would experience some of these difficult things that you experience?

 

Madeleine: Well no worse because I trusted people. I didn't I mean I was fine. I wasn't hurt. No you know I I was fine I wasn't hurt or anything like that but I think I was lucky. And I think you know like I tell my husband I think the world is different now. I mean.

 

Dr. David Burns: Yeah the times they are changing unfortunately. Yeah. It's not that like what's available on the internet. I didn't grow up. We didn't have that. I mean they were just starting computers when I was young. We didn't have that. They didn't have access to that all that kind of dark lurid information that's out there and the the violence that's so readily available to people and and that that wasn't there and and and I I think that shapes a lot of people's brains and minds and what you know and how they look at especi and I'm talking about in this particular incident how men look at women and you know or girls or you know boys look at girls and it's not it's it's just so so different because of what's available on the worldwide web you know and it's not the same kind of world. And I I think it's it's yeah that's why I I worry more because I think it's hard to be a kind and trusting person in in the middle of all that. Yeah. Very hard. Yeah. The the world is pretty pretty dark and horrible these days. I I sure agree with you on that.

 

Madeleine: And at the same time you know we can get lost in that that thought because you know you've often said David we all have our light sides and our dark sides. All of us as humans and I try to tell teach my my children that you know most of the and this makes me cry too. Most of the time people are good. There are a lot of good people out there and there's a lot of beauty in the world and we all get so caught up in the in the darkness and and and the evil but I think most of the people are good and you have to remember that. Sometimes it's hard to remember that. And when you see news like this it's hard to remember that.

 

Dr. David Burns: This is really hard for you right now. Just let those tears flow. The you just how do we live with the fact that there's so so much evil in the world right now kind of a epidemic of it

 

Jill Levitt: And holding that fact with the fact that there's so many people in the world that are good because it sounds like that also made you feel emotional almost like the bittersweet the the good and the bad.

 

Dr. David Burns: I know we got away a little bit from those four thoughts you down ear you wrote down earlier. Are we going to ignore them then or? I was starting to add them to my daily mood log. I thought they were really good.

 

Jill Levitt: Yeah. I'd love to have you share them with us Madeleine. Could you share with us those those feelings those thoughts that you shared with us this morning?

 

Madeleine: Yeah. I mean the first one goes back to when she was a baby and I I was not present there enough for her. I mean yeah I took a I I took a year a year off to be to be with her. So I was present. I was very present. But I just remember her as a newborn looking up into my eyes and searching and I was like I I don't know what I'm doing. I'm sorry. And I felt so insecure about being a new mother. I was like I I I'm sorry. I don't know what I'm doing. My my milk's not coming in for you. I I know you must be starving. And she her little eyes those little newborn eyes just looking at me like searching searching. And I felt like I was already letting her down because I didn't know what to do. It's just so stupid. It's so stupid. I've just never forgotten that. It wasn't the same with the second my second baby.

 

Jill Levitt: Like it was so overwhelming you know so much responsibility having this precious newborn and you were feeling so much like such an intense sense of responsibility right?

 

Madeleine: Yeah. Just she was just looking into my like deep into my eyes. A little newborn just looking deep into my eyes and I was like so sorry. There's there's nothing here. I don't I don't know what to do. I'm flying by the seat of my pants here. I'm trying my best.

 

Jill Levitt: So you felt like you were letting her down then? I mean that was one of the things like I wasn't present enough for her and so you shared that your thought was I wasn't present or there enough for her which you believe 95% that's what you told us this morning and at the same time you're realizing I took a year off from work and I was trying to breastfeed her and you know it sounds like when things didn't go according to plan you would feel really guilty and self-blaming.

 

Madeleine: Yeah. And then the second one she may not trust I'm there for her. And that that I think stems from we had our second child seven years later. And so I was like you know I'd forgotten how to do the baby thing. And in fact it was kind of a funny story. My husband was filming me trying to put diapers on because I'd forgotten how to put diapers on and he thought it was the most hysterical thing. I couldn't remember how to put a diaper on. And then I but I so I was all on you know all on board focused on this baby but she was still only seven. She still needed me and I felt like I you know I I yeah that's where that comes from. I may maybe wasn't wasn't as present with her as I needed to be you know when she was.

 

Jill Levitt: I just want to make sure I'm getting you right because all of what you're saying is so beautiful and powerful and important. So like when your second daughter was born seven years apart and so when you were tending to your second daughter the newborn phase which is so incredibly sort of intensive right? You felt like you were ignoring your older daughter that you weren't present enough so it felt again sort of like a personal failure right?

 

Madeleine: Yeah. I mean she looked so big compared to you looked so big but she wasn't big.

 

Jill Levitt: Yeah. Okay. And so that was another negative thought. She may not trust that I'm there for her. And you told us you believe that 60%. And again for the audience I'm just adding these thoughts to six seven eight on the daily mood log. Which you have on page five of your handout packet. And you had a couple more. Will you share that with us Madeleine?

 

Madeleine: Yeah. She's so anxious and it's all my fault. And I believe that about 75%.

 

Jill Levitt: So the thought is she is so anxious and it's all my fault.

 

Madeleine: And so perfectionistic like she she's such a people pleaser. So people please she has to always has to please people. She can't offend anybody. It's like it's too it's it's more than usual. It seems to me more than normal. She's really was so worried about offending anyone.

 

Jill Levitt: Yeah. And you believe that 75%? So she's so anxious and it's all my fault or she's a such a people pleaser and it's all 75%.

 

Madeleine: Yeah. Was and that goes back to was I too hard on her as a parent did I was too demanding i expected too much. So now she has to always please me and and and her dad and her teachers and all people of authority in order to be loved. That whole self-defeating belief thing you know.

 

Jill Levitt: So again this is blaming yourself for these qualities in her right?

 

Madeleine: Yeah. This way.

 

Jill Levitt: It's because I raised her wrong. So I was too demanding. So again in the theme of kind of just it's all my fault right?

 

Madeleine: Yeah

 

Jill Levitt: Yeah. It sounds so painful.

 

Dr. David Burns: You just really beating up on yourself ever since she was born, you know so you know kind of the theme I'm I'm not good enough I'm failing her as a as a mother as as a parent.

 

Jill Levitt: And it's so beautiful Madeleine too to see just how seriously you've taken this job of parenting her how important it is to you and how much you love her how much you want to protect her and kind of be everything for her.

 

Madeleine: Oh we tried so hard. It wasn't it wasn't easy for us. We got married later in life and it wasn't easy for us to to get pregnant. I say us because you know nobody really knows. It wasn't easy for us to get pregnant and and and we went through a lot you know of procedures and time and heartache to have children. So it was really it was really something that that we worked at. And wanted for years.

 

Jill Levitt: And I just wanted to also say Madeleine that I know that this is I just know that everything you're sharing so far is something that so many people can relate to. So I'm I'm not looking in the chat box on purpose because I don't want to get distracted. I recommend you don't either or David doesn't either. But I'm sure and I know myself that there's just so many people that can relate to this idea of so deeply loving a child and feeling incredibly responsible and that leading to some pretty strong self-blame and you know feeling deep feelings of responsibility and I just just want to say I'm sure many people are feeling very connected to you as you’re sharing that and probably connected to your journey of trying hard to have a child and so then once you do have a child David, I think I said not to look in the chat box and now I can see your eyes.

 

Dr. David Burns: Well I never would look in the chat box except when you told me not to. I couldn't resist. But there's very powerful you know statements.

 

Madeleine: Put that thought You put that thought in his head Jill.

 

Dr. David Burns: Yeah. I I assure you Madeleine you're touching a lot of hearts right now. Yeah. And then what was your fourth thought? I should have been more empathic and.

 

Madeleine: I should have learned to be more empathic patient and Yeah and sensitive.

 

Dr. David Burns: Yeah. And then what was the belief in that?

 

Madeleine: 100%.

 

Dr. David Burns: 100%. Yeah.

 

Madeleine: Well thank my mother even said when she was born now Madeleine she's French. Now Madeleine she is very sensitive. So you better be careful cuz she has mentioned before I might be a little bit like my father which nobody wants to hear that.

 

Jill Levitt: So you were warned by your mom you better be you better be sensitive and that you maybe have a tendency you're saying to be I think you used the word in an email to us gritty like you really wanted your dog to be independent and so yeah there's some part of you that's.

 

Dr. David Burns: And strong.

 

Madeleine: Yeah. Yeah. And I I had I learned this. I had to learn it too. I don't know that I was born that way. I mean we all are born with personalities. Maybe I was a little bit you know more like my dad but I had to learn this way because my heart was so broken when my parents divorced and I just looked up so much to my dad. And then when I when they divorced and I found out why what was going on it just broke my heart. And so I had to learn to be gritty. I had to learn to be strong and not to even though I still trust continue trusting way the wrong people but but I had to learn to kind of put up a wall to kind of steal myself to not to not let so much emotion in. I had to to learn to do that because it it was it was really hurtful. It hurt so much and to see what my mom was going through and and the hurt she went through over the my parents' divorce and I was only 11 or 12 and it was kind of a forming age you know. And so I had to I had to learn that. I had to learn to put people at arms length and to not you know not open yourself too much to to people especially you know guys that I would date later on you. Now I I had a tough time committing because of because of that because I had I'd be like "Nope I'm going to protect myself from getting hurt." So I feel like I kind of put up some walls a little bit.

 

Jill Levitt: Yeah. So you're sharing with us that when your parents divorced when you were really pretty young and in those formative years and that your heart was really broken that it was really devastating for you. And sounds like there really is a part of you that's very sensitive and open and emotional. All of which by the way I think are beautiful qualities but that maybe left you feeling really really raw and vulnerable with this divorce. And you're saying you kind of learned you're you taught yourself to kind of put up a wall to protect yourself to try not to be so open and loving and trusting and kind of to keep people a little bit at arms length as a way to protect yourself from the kind of hurt you felt as a kid. And then there's part of you then that's like "Oh but did I go too far in that direction was I too walled with my daughter not sensitive enough." Right? That's I mean am I am I getting you right?

 

Madeleine: Yeah.That's right.

 

Dr. David Burns: I'm wondering if it would be a good time to check in with Madeleine on our three dimensions. And I'm wondering Madeleine you know we like to operationalize things as you know to be specific so things can be measured and make the mysterious knowable and that's kind of one of the early goals of cognitive therapy going all the way back to the 1970s. And I like to think of empathy as having three components. And Jill Levitt and I would like you to to rate us with a letter grade A, B, C, D in each of those. And the first one would be thought empathy which would be to what extent are we understanding your thoughts and what you're telling your yourself. Number two to what extent do we understand how you're feeling inside your your emotions and number three to what extent have we created an atmosphere of trust, acceptance and you know warmth and and and that and that type of thing.

 

Madeleine: A a triple a.

 

Dr. David Burns: Ok. And that's that's that's beautiful. And as they so often say on TV Rolade spells relief. Then tell us why we're getting three three A's.

 

Madeleine: I felt like you were taking I felt heard and and you were taking the time and you weren't rushing me even though I felt like I needed to rush myself just because I know these things take a while. And so I I you would push back and you'd ask me for more information and you would when you talked you empathize with my thoughts. You were accurate and my feelings as well and in some cases went advanced empathy and drew out some more thoughts and feelings that I had and and and that's why.

 

Dr. David Burns: Yeah. Thank you for that. And you know the occas can't help but see some of the chats come onto the screen. I I guess some feature of of Zoom and just people are making beautiful comments about about you and and what you're contributing right here today. I'm wondering Jill would this be a time to take our five minute break and then we'll come back after after the break and I don't know if we want to take any any questions or maybe hold them until the end of the live demonstration.

 

Jill Levitt: We can for sure but yes definitely let's let's hold any interaction with the audience at the end because we have no idea how how much work we have to do and how long it'll take us but Yeah it's nice to take a break I think between empathy and resistance because we like to roll straight from resistance into methods if we if we can right? So yeah. Should we do a five minute bathroom break now for it's 30 Pacific time so we're going to start rolling again at like 10:35 Pacific time. And then yeah we'll we'll just get right back into it with you Madeleine. And people sometimes like us to spell out where we're at even though it seems obvious to us. And there there is a in your handout right toward the beginning a a checklist. So you can see us going through the the TEAM-CBT model. But essentially to keep it very simple what we've done so far is the T equals testing. And that's that's been incredibly important just to see not only through your tears and and your openness and your vulnerability but also in the assessment scales just the intensity of your of your negative feelings and your pain and and your suffering. And then also the E equals empathy to to form a a warm and trusting therapeutic connection without trying to help you in any way. And that's what we said in the talk that that we just want to go with you to the to the gates of hell and be there with you in your pain. And then once we're doing a good job on that then we'll go on to what is our goal for today's session and and then how how are we going to achieve that that goal so we'll get to that in just just about five minutes.

 

I'll also just mention to people that if you're a participant you won't be able to see the chat box and that's intentional. We've had lots of feedback in the past that the chat is very distracting for participants. So participants can send messages to the panelists. That's us. But but you won't see any chats other than things we send your way. But Mike will share questions and comments with us as a group at the end of the workshop today. Okay. So five minutes. It's 10:32. So let's give people an actual 5 minutes till 10:37. And then we will get rolling again with you Madeleine. So thanks and sorry for the for the break. We'll we'll pick right back up and get in. But I'm imagining you might want the restroom break too.

 

Madeleine: Yes. Okay.

 

Jill Levitt: We'll be back in five minutes. Well welcome back everyone. Hope you had a good little break there. I know we work hard and give you very little time off here. So thanks for hanging in with us. And so as Dr. David Burns said Madeleine we've spent some time doing testing and empathy and and now we're going to move a little bit into assessment of resistance. Right. Dr. David Burns did you want you tell me did you want us to me to get started or you?

 

Dr. David Burns: Oh you can to kick it off. You're doing just so awesome today and and all the time Jill. Thank you. That's very kind, Madeleine.

 

Jill Levitt: I just I just had one question for you Madeleine. I'm sorry to interrupt but then I'll turn it over to you. How are you feeling about you know working with Dr. David Burns and Jill Levitt in this public forum?

 

Madeleine: Nervous.

 

Dr. David Burns: Nervous.

 

Madeleine: Oh yeah.

 

Dr. David Burns:: And then what are the nervous thoughts?

 

Madeleine: That I'm going to say you know something stupid. That I'm going to say too much. That I'm going to.

 

Dr. David Burns: I want to write these things down. Yeah. I'm going to say say too much.

 

Madeleine: That I'm going to say things about my daughter that I I don't need to say that I don't you know I don't want to further feel guilty about saying things about my family that I don't need to reveal to the world. Sure. That's nobody's business but hers. So I right I'm be mindful of that. And that's mainly it. Yeah.

 

Dr. David Burns: Okay. Thank you. Great. I'll turn it back over to Jill.

 

Jill Levitt: Sure. And I did want to say I totally respect that Madeleine. You're you know sharing something that's really personal about you and you're you told us earlier today that you're happy to be open and share openly and at the same time you love and respect your daughter and don't want.

 

Jill Levitt: to share any of her kind of private business in a way that would be hurtful to her. And I totally respect that and yeah and appreciate that. So.

 

Dr. David Burns: And I and I think you've done a brilliant job of balancing those two Madeleine. It's just awesome.

 

Jill Levitt: Yeah.

 

Madeleine: Thanks.

 

Jill Levitt: And yeah so in sort of moving us from from empathy to kind of assessing resistance and getting into methods the first question that I often have is sort you know is called the miracle cure question. And so that was what I was thinking of leading with which is just if a miracle happened today Madeleine and you got just what you wanted out of this session what would you be looking for, how would things change for you?

 

Madeleine: I think the the main thing that just jumps to mind without me overthinking it is that you know next time I see something in the news again about some young woman getting abducted or kidnapped or raped or murdered that I'm not going to start to spiral again about about my daughters into that dark hole of of panic and anxiety and irrational thoughts.

 

Jill Levitt: Yeah. Right. So you're saying that your miracle cure would be that sometime in the future if you were to come upon something in the news or a magazine about women being abducted or raped or murdered that you would know not have this kind of anxious panic fearful spiral.

 

Madeleine: Yes.

 

Dr. David Burns: And then if you I'll I'll try No. You you're doing great Jill Levitt. Go ahead.

 

Jill Levitt: I want to hear what you were going to say.

 

Dr. David Burns: I was just going to say and so if we had a magic button you know.

 

Jill Levitt: Yeah go for it. Go ahead.

 

Dr. David Burns: Yeah. And so if we had a magic button here can you see it?

 

Madeleine: I see it.

 

Dr. David Burns: Yeah. And if you press that then that will happen instantly and all of your negative thoughts and tendency to to react to trigger events about rape and murder and and horrible things happening in the world especially to to to young women who were being taken advantage of that you would no longer react that way and you wouldn't have those you know powerful feelings of anxiety and spiraling and so forth. Would would you press that button?

 

Madeleine: You know it's just so tempting to say yes because it was such an awful place to be in that dark hole of spiraling anxiety. It was just an awful awful place. And and I couldn't get out of I couldn't claw myself out of it. And so it's so tempting to say yes. At the same time I'm I'm not a robot and I can't not have those I mean I guess if you're saying I'd press the magic button I would not have those feelings but then I would be a robot and that would be kind of weird I think.

 

Dr. David Burns: Right. Absolutely. In fact why don't we look at some of the positive aspects of your negative thoughts and feelings not only the panic but also the the guilt going all the way back to you know when your daughter was first born and and feeling that somehow you you weren't good enough as a mom and and ask two two questions about these negative thoughts and feelings. Number one how are they helpful to you and number two what do they say about you Madeleine and your core values as a human being that's beautiful positive and and even awesome and and so we we could to to make it simple to get started. We we could take your your anxiety and ask those two questions about your your anxiety and panic and then we can go on to some of these other other feelings and the sadness and and all of that. But what are some benefits of your anxiety and also what do they show about your core values that's pretty pretty awesome and the.

 

Jill Levitt: Audience just so you know so we're doing positive reframing with Madeleine right now. We did the magic button and the you can you should and can follow along and write this in page six of the handout packet. So we're going to we're asking you then just to reiterate we want to think about we agree with you Madeleine when you said I don't know I I tempted to say yes press the button feel amazing but I'm realizing like maybe that wouldn't make sense and maybe there are some good reasons to feel kind of anxious and worried and even panicky. So then we're saying we agree with you. So let's think about what they are. So Dr. David Burns asked you to think anxious, panicky, worried, nervous. How how does that show something really kind of beautiful and awesome about you and how is it maybe working for you beneficial to you?

 

Dr. David Burns: And as an aside if if see this is the page in the handout with this is the positive reframing tool or table and and if you don't have access to that to to write and keep up with us as as we're doing maybe you only have it electronically and can't easily type in it. Just take a piece of paper and and draw a line near the left edge and then and then anxiety put an x as the first emotion and and then in the raw on the right hand column we'll write the answers what are some advantages and and also how how does this reflect my my core values so we'll give you first shot at that Madeleine.

 

Madeleine: Well definitely an advantage is that it it keeps me vigilant as a parent. Yeah. Going on with my kids. What are you know what is she doing where is she maybe too much. And and then what does it show about me and my core values that that family is really important that being a good example for the next generation is important to me and raising strong women is is important to me.

 

Dr. David Burns: Yeah. Yeah.. I I love that. Family is important and raising strong strong women uh strong even setting an example because.

 

Jill Levitt :I I heard you say that too almost like breaking the chain wanting to be this kind of person and show my daughters how to be this particular type of person.

 

Madeleine: Yes. Yeah.

 

Dr. David Burns: And know so that's a third benefit of it.

 

Madeleine: Yeah.

 

Dr. David Burns: Being a role model for my children for my daughters. Yeah. Yeah. Okay. I'll add that. Are you writing this down Madeleine?

 

Madeleine: No I was busy chatting away.

 

Dr. David Burns: Yeah. So the the first is keeps me vigilant, shows that family and raising strong women is important and also that I'm a a role model for my my daughters and conceivably other other young women as well and maybe mothers as well. Can you think of any other positive Jill anxiety?

 

Jill Levitt: well I guess I wonder I mean we said it keeps me vigilant but just to flesh that out a bit you know that it protects myself and my daughters from danger.

 

Dr. David Burns: Oh yeah. Okay. I I'll add that. Protects self and daughters from from from danger. And the proof of that is is that you know my daughter and I have already talked about this and issues of safety and and and so forth. So it's not certainly not being neglected. But what's another emotion you'd like to focus on like this Madeleine? You've got a lot of them on your on the daily mood log.

 

Madeleine: Yeah. Probably can we do inadequate? Yeah. I didn't want to do that but let's do that. Speaking to me.

 

Dr. David Burns: Oh yeah that that's been there you know since the birth of your daughters and and probably going back even much earlier than that. So what what what is the inadequacy how is that helpful and an advantage for you and secondly what does it show about you and your core values that's positive and awesome?

 

Madeleine: Okay. So what it helps me to strive to be adequate. Okay. It's helps me to keep learning and growing.

 

Dr. David Burns: Yeah. Is is that is that real?

 

Madeleine: Yes.

 

Dr. David Burns: And is that important?

 

Madeleine: Yes.

 

Dr. David Burns: Is that powerful?

 

Madeleine: Yes. And and very big value of mine. Yes. To keep learning and growing and getting better. Yeah.

 

Dr. David Burns: Okay. So that's that's awesome. That's one. What are some other really cool things about inadequacy?

 

Madeleine: It kind of shines a light on on I guess some my mistakes and what I need to improve on. It's kind of the same thing I guess learning and striving.

 

Dr. David Burns: Yeah. It just show honesty about mistakes.

 

Madeleine: IYeah. Shows that that I'm realistic and and being honest with myself. Yeah. Authentic. That's important. Yeah.

 

Dr. David Burns: Yeah. Is that powerful?

 

Madeleine: Yeah. That's powerful. Is that real?

 

Dr. David Burns: That's real. Okay. That's that's awesome. What are some other cool things about inadequacy?

 

Madeleine: It it it Well I guess my core value of of of lifelong learning you know grow.

 

Dr. David Burns: Okay. Yeah Personal growth and learning. Yeah. Any other you huge positives you can see there in in adequacy because I I can sit some huge ones.

 

Madeleine: Shows that I'm I'm I'm fallible. That I'm fallible. Okay.

 

Dr. David Burns: Put Put is that, is that important?

 

Madeleine: Yeah. It's important. It's important. Okay.

 

Dr. David Burns: Put that down. I'm fallible. Does it also show humility?

 

Madeleine: Yeah. Yeah definitely.

 

Dr. David Burns: Is that important too? Humility. Yes that's very important. So it's shows that I'm I'm humble.

 

Jill Levitt: I wonder also if it shows just how much you care like it shows your your love of your daughters right? When we feel like we're failing someone that we love and feel kind of inadequate to me. It just shows how much you value that relationship that person.

 

Dr. David Burns: That's cool. That's almost like a magical one isn't it? That the love of your daughters is almost like a spiritually beautiful thing. Yeah. Well that's cool. Nice.

 

Jill Levitt: What about I I also had the thought it shows that you're responsible. I was think I was looking at your negative thoughts like when you tell yourself I was too demanding or when you tell yourself it's all my fault. These thoughts they show just how responsible you are. Like just accountable.

 

Madeleine: Accountable. Oh sorry. Yes.

 

Dr. David Burns: Accountable. Responsible. Oh yeah. That's huge.

 

Madeleine: And then that I take this you know being a parent very seriously.

 

Dr. David Burns: Is that true?

 

Madeleine: Yes.

 

Dr. David Burns: Does that bring you to tears?

 

Madeleine: Yeah. Because it's the most important thing I think I could do in life. It was just so hard to have children and then when we had them it was like I I need to be really on it. You know I need to do this right because it was so hard to to become a parent and I'm just so grateful. Wow. I just never imagined the amount of love I could feel.

 

Dr. David Burns: I think yeah the the the the the gratitude that you have of being a parent that that how beautiful is that because it was so hard to make it happen.

 

Madeleine: Yeah. It was really hard.

 

Jill Levitt: I have the chills having you share that. Just knowing you know how hard the journey was and just how grateful you feel to have these children and then how seriously you take your role as a mom right? Just again shows how important these girls are to you. Shows how accountable you are. Yeah. Just how much you value being a parent and a great Right. Yeah.

 

Dr. David Burns: Yeah. Someone just just wrote and we're not supposed to reveal these but you know you know I something like I I haven't been successful in having a baby with a lot of sad faces after it.

 

Madeleine: Yeah. That's so hard. I was there for many years. Yeah. 

 

Dr. David Burns: What are some other negative feelings that that might we could look at some of the positives. Let me look at the at the daily mood log and see what they are. There's some sad sadness and and frustration and and and upset. What’s beautiful about the sadness?

 

Madeleine: that that I just I care about all these I care about the world I care about humanity I care about you know people being kind to one another. And it's makes me so sad when when these I hear these things you know.

 

Dr. David Burns: Is that is that real? Is that powerful? Is that important?

 

Madeleine: Yeah. I can't change it. So that's one one huge positive in your sadness. What are some others?

 

Jill Levitt: That it shows that I care about the world. Right. That's what we wrote down.

 

Dr. David Burns: Yeah. What what what else does it show?

 

Jill Levitt: What else does your sadness show when you read terrible things happening to women?

 

Dr. David Burns: I have a suggestion if you need.

 

Madeleine: I don't know. Just I just don't understand. I don't understand it sometimes feels hopeless. I just don't understand.

 

Dr. David Burns: Well that's another point we could look at. But just looking at the sadness is is your sadness is that an expression of your love for your daughters if you press the magic button the sadness goes away?

 

Madeleine: Yeah. But I think it was the sadness was around reading the those news articles and just Yeah. And sadness thinking that yeah they are in danger. Yeah. Yeah. Sure.

 

Dr. David Burns: Yeah. So it's the love for my daughters and and maybe my my my love for the for the planet for for all humans and and and so much suffering that's that's going on.

 

Madeleine: Yeah.

 

Dr. David Burns: Would that be true?

 

Madeleine: Yes definitely.

 

Jill Levitt: Yeah. We'll add that love for for for the planet and shows that I'm realistic right that I'm Yes open to what's actually happening in the world I'm not sticking not an ostrich sticking my head in the sand right? I'm Oh yeah. I'm realistic. Things are some terrible things happen right? And I'm present. Yeah. Is that that true that you're kind of realistic and present to some of the atrocities of the world?

 

Madeleine: Yes. Yeah.

 

Dr. David Burns: And then how about frustration that that's another high one.

 

Madeleine: Yeah.

 

Dr. David Burns: Yeah. What are what are some wonderful things about being frustrated?

 

Madeleine: the it makes me want mo motivates me to to take action to Yeah. Yes. Go out there and advocate for Yeah. for change. Be be an activist in the community.

 

Dr. David Burns: Yeah.

 

Madeleine: Activist for for training safety for for change for Yeah.

 

Dr. David Burns: I I I love that. And because the frustration means that that you haven't given up and that you're continuing to pursue a goal that's somewhat somewhat elusive.

 

Madeleine: Yeah. Motivates me to not give up. Yeah. not give up I guess hope or you know continue kind of fighting or like fighting for Yeah. for justice and Yeah.

 

Dr. David Burns: Chose that you know I'm I'm you know I'm I'm fighting for for justice. So I've got three for frustration. Yep. Anything else either of you can think of for other things we should do positive reframing on? There's a general one just called upset which is kind of like like angry I think it's in the angry category. The the the upset What what is well an anger is a very.

 

Madeleine: Yeah it's a very big category for me in general. My husband makes fun of me that you know when he met me just angry angry girl angry white girl he'd say.

 

Dr. David Burns: Oh yeah. And what are some some positive things about your anger? Wait girl.

 

Madeleine: That's stupid but it's true. But I I you know sometimes that's not good. Sometimes it's too just too much. I don't need to be angry a lot. I need to instead take action. And so sometimes that one bothers me. But but in this case it was about being upset about the the terrible things that happened to these young women.

 

Jill Levitt: And what does that anger show about you that's really kind of beautiful and awesome?

 

Madeleine: That I that I want I want you know things to be just and fair and and and people to to get to love each other. It sounds so that sounds so idealistic but that's what it is right though unrealistic but but my anger shows that I'm being realistic that that those things are happening and it's not good.

 

Dr. David Burns: Oh yeah. It shows that I'm realistic and idealistic.

 

Jill Levitt: Yeah. Yeah. Right. Exactly. Because it's the discrepancy between what I want and what I see happening that makes me really angry. Right. So it's totally holding both of those values at the same time. I'm realistic and I'm idealistic and I want the world to be better. I want my daughter to be better. I want myself to be better. When you're angry in each of these ways kind of shows your high standards too actually doesn't it?

 

Madeleine: Yeah.

 

Jill Levitt: For the world, for your daughter, for yourself. Oh yeah.

 

Dr. David Burns: Oh yeah. So let's add a high standards. Is that true Madeleine to the right?

 

Madeleine: Yeah. But it's it's kind of not fair but it Yeah. Yeah. It's not not fair in the way that it having you know high standards for the world for yourself for your kids. It just puts a lot of pressure on on the system on on everything and it's not very fair.

 

Dr. David Burns: But but but there's some value in there right?

 

Madeleine: Yeah. Just you always striving to learn and be better and and try to meet that ideal right? Yeah. 

 

Dr. David Burns: So should we should we do go on to the pivot question Jill? You want to you're master of the pivot question.

 

Jill Levitt: Sure. Well Madeleine I'm so glad that we have had a chance to really think through with you the way that all of these negative emotions and negative and anxious thoughts are showing such beautiful things about you. And just you know to mention a few in summary your anxiety you know keeps you vigilant and protects yourself and your daughters and feelings of inadequacy and telling yourself you're not good enough just shows how much you care and kind of motivates you to always learn and grow and to be humble. And we can see that your sadness shows how much you care about the world and your daughters and your frustration gets you to be kind of an activist for change. And your anger shows you have high standards and want things to be different. And so there's so many ways in which your negative thoughts and feelings show such beautiful things about you and also actually are beneficial or kind of advantageous. And so given all of that why would you want to change, why would you want to push that button and and have all these thoughts and feelings disappear?

 

Madeleine: Yes. I I love that question because I would not want them all to disappear. I'd want to I'd want to keep the good stuff and get rid of the bad.

 

Jill Levitt: Right. So you want to hang on to you know some level of anxiety or inadequacy or sadness like kind of just enough to hang on to some of these beautiful qualities and benefits but kind of reduce them some to to reduce her suffering. Is there is is is that accurate? Are they are they too high or are they just right?

 

Madeleine: Yeah they're too high.

 

Dr. David Burns: Yeah. Okay. Let's let's see what you'd what you'd might like to lower them to today. The the sadness is 85% or was that that night for for sure. How how sad would you want to be feeling today between zero and 100? What would be enough sadness to keep all those positive qualities of your sadness but to reduce your your suffering? How much sadness do you need because there's a lot lot of lot of bad in the world.

 

Jill Levitt: You're showing people This is on the daily mood log in the goal column here.

 

Dr. David Burns: Yeah. On page four. Yeah. Yeah. That that's right. You're showing it perfectly Jill. Thank you. Yeah. Sure.

 

Madeleine: So 40 or 50 I guess.

 

Dr. David Burns: You want to I'll put 40 to 50 in the goal column. Okay. And then how how anxious do you want to feel today?

 

Madeleine: Yeah. Like 40.

 

Dr. David Burns: Ok and then how inadequate do do you want to feel?

 

Madeleine: 50.

 

Dr. David Burns: 50. Okay. And how frustrated do you want to feel?

 

Madeleine: 20.

 

Dr. David Burns: Oh okay. And how upset and angry do you do you want to feel?

 

Madeleine: 30. No maybe 25.

 

Dr. David Burns: 25. Okay. So you want to bring those two down a good bit but you wanted to keep the the sadness the anxiety and the inadequacy at a at fairly high levels.

 

Madeleine: Yeah. Let's say the upset but anger 30. Oh no I didn't circle angry there. I just circled upset. So upset. Yeah. So the anger if would be 30 right? Okay.

 

Dr. David Burns: Yeah. So the anger would be 30 and the upset would be be 25. Okay.

 

Madeleine: It's all the same columns.

 

Dr. David Burns: Yeah. Sure. I know. The same row. And Yeah. And so are you satisfied with these numbers Jill.

 

Jill Levitt: Yeah. I mean I guess I would say Madeleine it does it sounds like that. Yeah. You're seeing a lot of benefit to being you know worried and and anxious. And that I think we it means we did a beautiful job of positive reframing right? And that Madeleine is definitely feeling like you know she make it makes sense to feel moderately sad and moderately anxious and and moderately inadequate. And is that is that is that a fair summary Madeleine? That you're feeling like these emotions need to be kind of moderately high in order to kind of motivate you and in order to keep you and your daughter safe and kind of keep you on the path?

 

Madeleine: Yeah. I mean maybe that's a little high.

 

Jill Levitt: Yeah. Why would you want them to be lower? I wonder if we didn't I didn't hear that in response to the pivot question. What are they costing you? Why if they were too high why would you want them to be dialed down a bit? Why would that be important to you to feel less anxious or maybe less inadequate?

 

Madeleine: Yeah. I like that. What are they costing you? Yeah. I don't need any more sleepless nights. I don't need to be like constantly going back over these thoughts in my head over and over again thinking about these missing women. And I just I just can't. It just doesn't bring me my best self. Doesn't bring the world my best self. And I'm constantly going over these thoughts in my head over and over again.

 

Dr. David Burns: Well what would be if we could dial it down to to lower levels would you want to dial them down further?

 

Madeleine: Yeah.

 

Dr. David Burns: What what what would be a good level of sadness for you to be feeling today at the end of the demonstration?

 

Madeleine: Let's do that at 30.

 

Dr. David Burns: 30. Okay. I'll cross out the 40 to 50 and I'll put a 30 there. That's good. And how anxious, worried, panicky, nervous and frightened you do you want to feel?

 

Madeleine: You know what now this is the problem one. This is a problem one because I define myself so much by this I think.

 

Jill Levitt: Yeah. We don't want to dial it down too far because you don't let go of this part of you that feels really central to who you are. Yeah. But at the same time you're also arguing for I don't want any sleepless nights. This sucks. You know I'm tortured by it too. So it's that's hard. It's a struggle.

 

Madeleine: Yeah.

 

Jill Levitt: But I just I what would be just you know how much anxiety do you think you need to hold on to in order to still let's say protect yourself and your daughters.

 

Madeleine: All right. Maybe 35. Okay.

 

Dr. David Burns: A little bit 35. We don't want to give too give away too much of it.

 

Jill Levitt: Right.

 

Dr. David Burns: But and then how about inadequate at 50?

 

Jill Levitt: Yeah. How much do you need to beat yourself up in order to beat? Yeah. I don't need to beat myself up that much. Yeah.

 

Madeleine: Maybe 30 as well. Let's take that.

 

Dr. David Burns: Okay. All right. All right. So so we've got reasonable 30 30 for sadness is the goal, 35 for anxiety, 30 for inadequacy, 20 for frustration and 25 to 30 for upset and anger. Yeah. And so I think we're ready now to see if we can challenge some of these negative thoughts and lower these down. That will be our first strategy. We have quite a number of of strategies to be honest with you Madeleine. But which thought would you like to work on first if you've got your first five like my daughter is not safe and so forth and then the the the ones seventh that's one through five and then 6 7 8 and nine is you know I wasn't present enough for her. She may not trust me that that I'm there for her. It's kind of my fault that she's feeling some pressure and some anxiety in her her life as well. So which thought would you want to focus on first?

 

Madeleine: The first one. It's fine. First one.

 

Dr. David Burns: They're all my daughter's not safe. And and then the a very simple way to get started on a negative thought or what are the distortions in in in that thought?

 

Madeleine: Well I'm definitely magnifying that. So that would be magnification for sure, right? And then it is definitely all or nothing thinking.

 

Dr. David Burns: Yeah.

 

Madeleine: Also I'm definitely looking at it through a lens here the mental filter. Oh yeah. Right. I'm discounting the positive for sure.

 

Dr. David Burns: Oh yeah.

 

Madeleine: And then fortunetelling. Yes. Right. I've got that one too. And then probably emotional reasoning too. I've got that one too.

 

Dr. David Burns: Yeah. We're on We're on the same page. Those are all the ones that I had. They're exactly the same as yours. Yeah. Yeah. Now take take one of those distortions. They're they're all good and and explain to Jill and David a little bit about the distortion you're you're choosing. You can do this with all of them you know that but but one at a time and see how much juice we can get out of it. Which distortion would you like to discuss first? Then we have a few questions to ask you about the distortion like why why does that distortion actually distort the the validity of this thought and secondly why does why is that distortion being very unfair to Madeleine?

 

Jill Levitt: So first just pick one of the distortions. Magnification, all or nothing, emotional reasoning. What are the ones that you selected? Mental filter, discounting the positive, fortunetelling.

 

Madeleine: Yeah. Well we'll just start with the first one I have written down. Magnification.

 

Dr. David Burns: Magnification. So tell us why why that thought is magnification and and why that magnification is a is a bit of a distortion.

 

Madeleine: Well because I'm magnifying things. I you know she she is safe as far as I know.

 

Dr. David Burns: And do you have your paper your mood log in front of you?

 

Madeleine: Yes.

 

Dr. David Burns: Would you write in the right hand column she is safe and you were continuing to to talk but I just wanted to grab that one before it disappears.

 

Madeleine: Yeah she is safe. And while she's you know she's far away I mean it doesn't matter where she is really. I'm out there with her keeping her safe. She's not necessarily surrounded by creeps and sociopaths at all moments of her day. Yeah. So that's why it's magnification. It's mental filter because I read these news articles and and it's been going on ever since the whole Natalie Holay story that I obsessed over for a long time and so I I got that filter that I that I that I know is there.

 

Dr. David Burns: And that and why why does that distort the validity of this thought the mental filtering why does that make this thought misleading or untrue?

 

Madeleine: Well because the the mental filter Why does it Yeah make it because it's just I'm not seeing all the I'm not seeing that she's safe right now and that she's not always being surrounded by creeps and sociopaths. I'm just seeing these these news articles that are going to be of course they're designed to be inflammatory. But so it's just not it's not it's not true.

 

Dr. David Burns: Let's put put that in the right hand column in the positive thought column. I'm only seeing news news stories. So this this is not true. Write that down. So before we go on let me ask that. That's why though let's see how true these statements are. You just wrote down I think four things in the positive thought column or three. The first was she is safe. How much do you believe that between zero and and 100?

 

Madeleine: Well I don't know. I'd have to look on I'd have to look on Find my Friends. I I don't know what that is. To see where she is. See if I think safe.

 

Jill Levitt: So she's saying like she doesn't actually believe it just in the abstract. She'd have to know where she was and what she was doing to figure out whether or not her daughter is safe.

 

Madeleine: All right. Find my Friends is you can locate a person where they are geographically.

 

Dr. David Burns: Oh I see. Okay. That that sounds like a nice app to have. But how much do you believe right now that she's safe?

 

Madeleine: 100%. Okay.

 

Dr. David Burns: Put 100 next to that or maybe 95 because I don't really know. But you can put 95 to 100. That's perfect. She's not surrounded by creeps. How much do you believe that?

 

Madeleine: Well I mean I don't know. She might be.

 

Dr. David Burns: Yeah. She might have met Putin for example.

 

Jill Levitt: I was thinking that David maybe these positive thoughts do need to be modified a bit though. I'm actually hearing Madeleine saying she doesn't totally believe them. And so my opinion is I'll never know 100% in any moment that my daughter is safe. I would never know that she's not surrounded by creeps. I feel like we need a bit of a qualifying.

 

Dr. David Burns: It's highly unlikely that she's surrounded by sociopaths and creeps. Can we edit it like that? How much you believe it?

 

Jill Levitt: Exactly. So you could say she is likely safe, right? The likelihood is my daughter is safe. The likelihood is she's not surrounded by creeps. The truth is that news stories are rare and unusual and not generally you know a part of our normal existence or something like that right? I just think it's really important that we come up with thoughts that are not BS thoughts where you're not really believing them but thoughts that you really.

 

Dr. David Burns: Beautiful teaching point Jill. Yeah. So preferencing these things by it's not likely that she's unsafe. It's not likely that she's surrounded by by by creeps. And how much do you believe those statements now?

 

Madeleine: Yeah. I believe that. I believe that 100%. Yeah. 

 

Dr. David Burns: Right. And then when when you're saying I'm only seeing news stories how much do you believe that?

 

Madeleine: What what do you mean I'm?

 

Dr. David Burns: Well that was what you said Mental filter. I'm being biased by by news stories of unusual events and horrible.

 

Madeleine: Yeah. That they're that they're not they're not I hope they're not everyday events. That they're not Yeah. It's rare. It's rare. Yeah. Okay. Yeah. By news I mean getting less rare but and

 

Jill Levitt: Maybe even there is a better positive thought in there just like it's highly unlikely occurrence. Like terrible and awful but highly unlikely.

 

Madeleine: Yeah. That's that's more realistic.

 

Dr. David Burns: Yeah. And how much do you believe that?

 

Madeleine: Yeah 100%. Yeah.

 

Dr. David Burns: And then so the so this is not true. I I think so this thought is not is not entirely true. How much do you believe that?

 

Jill Levitt: Are you asking how much does she believe the original negative thought? I wasn't sure what you.

 

Dr. David Burns: Yeah. So you're asking how much do you believe the thought my daughter is not safe being far away and surrounded by creeps and sociopaths?

 

Madeleine: Oh and I toggle back in my mind too. She is likely safe that these are these are highly unlikely occurrences. These new these things these horrible things do happen but they're not it's it's highly unlikely that it's happening right now to my daughter.

 

Dr. David Burns: Okay. And so that's all 100% right?

 

Madeleine: Yeah.

 

Dr. David Burns: Okay. Now the second question I want to ask you and this is what the second question you always do and explain the distortions why are these distortions unfair to Madeleine? We've said we've we've said you know why why they're not true. But why are they also un unfair to to Madeleine?

 

Madeleine: Because it's just causing unnecessary bad feelings worry and bad feelings.

 

Dr. David Burns: Yeah. And can can you add that to the positive thought side too? It causes un unnecessary inflammatory It unnecessary and inflammatory sad sad feelings. And how much do do you believe that?

 

Madeleine: Yeah 100%.

 

Dr. David Burns: 100%. Okay. And and now how much do you believe your negative thought my daughter is not safe. She's far away and surrounded by creeps and sociopaths?

 

Madeleine: It's probably not true.

 

Dr. David Burns: Okay. So what would you say now how of true it is?

 

Madeleine: It's funny because I'm just I I can't say zero because then I would feel like I wouldn't be this. Yeah. You don't you don't want to be unrealistic. Yeah. You know you use your best brain here. Yeah. So but I don't I believe more that it's unlikely. So yeah I mean it's less than half now.

 

Dr. David Burns: So so you right now believe 40% that she's surrounded by creeps and sociopaths as we speak?

 

Madeleine No. I guess not 40% seems like a lot. So maybe 20%. Yeah if you put it that way. Yeah.

 

Dr. David Burns: So is your belief in that negative thought gone down to 20%? Right now? Okay. So so put 20% in the percent after column you which so that's a that's a great start. Where do you want to go now Jill ? Do you want to jump into a double standard?

 

Jill Levitt: Sure. We could do a double standard and maybe double standard and then externalization of voices.

 

Dr. David Burns: Yeah. Well why don't why don't you lead lead the the charge here through the forest.

 

Jill Levitt: Sure. Start with the double standard and then and then if Madeleine is still courageous and strong we'll jump into the extreme externalization of voices. Okay.

 

Madeleine: Can I ask you a question why you why you decided to go straight into methods on this one thought instead of continuing with identifying the distortions in the other thoughts?

 

Dr. David Burns: Well we could actually generally when somebody kind of gets a bit of a breakthrough they've learned something and then and then you can accelerate the the process very rapidly because we're teaching in a in a public forum. If we were leisurely seeing someone for an hour a week for many weeks we might want to use that same technique with two or three other thoughts. In part I'd say we have an embarrassment of riches. We we have I mean even from what we're telling you here we have tons of other methods we haven't even mentioned to to to you yet but you did beautifully on that. So I think your brain is probably going to be able to move really really quickly.

 

Madeleine: I see.

 

Jill Levitt: Yeah. I mean the only other thing I was going to say yeah we could try the double standard on this method although I also like the double standard for a lot of these other like self-blaming thoughts. But you know the I wasn't present for her and I'm that kind of let's use it for one of those. Yeah. Not good enough. But yeah I wonder but but but it sounds like this is the thought Madeleine really wanted our help with. The my daughter's not safe. Yeah. I I'm not sure which like but I I feel kind of tempted to work on one of those thoughts that.

 

Dr. David Burns: Let's do that. Follow your hunch there. That that's I was not present enough for her. She may not trust that I'll be there for her in the future. It's my fault that she's struggling with with anxiety and of of her own.

 

Jill Levitt: Well what do you I I don't want to I don't want to move in a different Madeleine I guess I would ask you did you want to try the double standard on this first thought this this my daughter is not safe?

 

Madeleine: I'm open to whatever. I'm sorry. I'm much healthier. I'm open to whatever you all want.

 

Jill Levitt: You try the double standard on that and then probably externalization of voices will be more effective for that thought. And then maybe we could go to double standard on some of these self-lame thoughts.

 

Madeleine: Yeah. I think that's good because I like the I like what Dr. David Burns said about how you know if seems like you've you've had some new learning around thought that I was really stuck on in my head.

 

Jill Levitt: Yeah. We could capitalize on your learning. Yeah. And to to drive a truck through that. Okay. So let's So so let's just say I we're going to try the double standard technique and then I think we'll hopefully move to externalization of voices for this one and then we can try the other double standard on some of the others. So in or if you want to just go EOV on this one. Yeah.

 

Dr. David Burns: Let's just go EOV and my hunch and hunch I agree that that's what my hunch was too. So we'll see the double standard for the kind of self-blame thoughts. That's always my preference.

 

Jill Levitt: Okay. So we'll try the externalization of voices technique. I I'll get started Dr. David Burns but very happy for you to jump in. Right. So or

 

Dr. David Burns: You can even start with that my daughter's not safe and then jump into the guilt thoughts.

 

Jill Levitt: Okay. So yeah so we're going to excuse me. We're going to do the externalization of voices method with you Madeleine. And so just for the audience to know this is a method where we're we're going to play different parts of you Madeleine. So I'm going to have you play the role I'm going to play the role of your negative thought. And I'm going to kind of hit you with that negative thought in the first person or in the second person you telling you what your negative thought is. And I'm going to have to have you respond in the first person I. And you're going to be the positive Madeleine. So I'm going to be kind of negative Madeleine and you're going to be positive Madeleine. You willing to give that a try?

 

Madeleine: Yes. Okay.

 

Jill Levitt: And do you want me to say anything more David in setting it up or?

 

Dr. David Burns: No that's fine. Just jump right in. Maybe show us your swimming stuff.

 

Jill Levitt: Okay. So yeah you know Madeleine you read that article about some terrible things happening to other women and you know your daughter is not safe. She's far away and she's surrounded by creeps and sociopaths.

 

Madeleine: Okay. So I'm supposed to be positive here.

 

Dr. David Burns: Yep.

 

Madeleine: Okay. I'm going to defeat you on that one. Okay. Well it's while it's true Jill Levitt I mean negative Madeleine while it's true negative Madeleine that she may be surrounded by creeps and sociopaths because a lot of people have those characteristics in the world unfortunately. Then it's probably not likely. It's probably not likely she's studying at a at a university and abroad that's a difficult program and and it's just probably not likely. These are these are rare occurrences. I mean these are these don't happen every day to people. I know it wasn't great. Ok.

 

Jill Levitt: Who who who won that Madeleine? Was that I was the negative Madeleine or the positive Madeleine?

 

Madeleine: Yeah. I think I think maybe the positive Madeleine won small. Yeah.

 

Dr. David Burns: Let's try a role reversal.

 

Madeleine: Very convincing. Yeah.

 

Dr. David Burns: Yeah. By the way as a teaching point this is why we do externalization of voices. We're looking for change at the gut level not a temporary intellectual whatever. We we want we're we're not going to settle for half a loaf of bread. Okay. So you'll be the negative and Jill Levitt will be the positive.

 

Madeleine: All right. So positive Madeleine I I just you you are you're getting close on that last one but I just want to tell you that you your daughter's not safe. She's surrounded by creeps and sociopaths and she's so far away surrounded by all these creeps and sociopaths.

 

Jill Levitt: Yeah. I guess I just want to say that's a really unhelpful thing to tell myself. We made the decision that my daughter could go abroad. She's at a really safe program or at I should say like a highlevel academic program. So we certainly weighed the options and felt like this was a great choice for her. And is the world unsafe? Absolutely. Do terrible things occasionally happen? Yes. And at the same time on the whole I believe that my daughter is safe. And the problem that I'm struggling with is not that my daughter is unsafe right now. It's just listening to this garbage that I keep running over in my head. And I'm not going to do that anymore.

 

Madeleine: Yeah. I'd say you won huge.

 

Dr. David Burns: How How did she win huge?

 

Madeleine: because I need to stop telling myself these horrible things.

 

Dr. David Burns: Yeah. That that's called the counterattack technique to to to raise the conscious awareness that the real problem and this might be a leap to to grasp it initially is not that your daughter's in danger that’s a small remote problem but we have another huge problem right Madeleine? And that's that you're hitting me with a lot of garbage and making my life miserable. You you're the sociopath at the moment my dear. Do you like that? That's harsh.

 

Great. Another thing to beat myself up over. You're really a sociopath.

 

Dr. David Burns: Slightly overstated but so I love your I love your laughter Madeleine. Oh go ahead. Sorry. It's nice. It's nice to see your your laughter and joy coming back. So let let's you guys can try it again.

 

Jill Levitt: Okay. So let's do a roll reversal again. Okay. I'm going to be the negative again. And you're going to try and you know if you liked what I said if that felt huge to you you're going to try and channel that right? Make it your own. Okay. So but remember Madeleine you know your daughter is not safe. She's far away from you and she's out there in the world surrounded by creeps and sociopaths and you know it.

 

Madeleine: Yes. And it's easy for me to get sucked into your BS because I hear this a lot from you and it's very easy to me for me to get sucked right back into that. But the reality is there are there is danger in the world that's not going to go away. It's just it's part of the world. It's part of humanity. There's there's light there's dark there's danger there is safety. And she is in a good program. She is in a program that's there's there are people on site. They get together. They do activities together. She's made friends. And just because there are creeps and sociopaths around here doesn't mean that they're going to necessarily target her. So I just need to stop listening to you because it's just not realistic. It It's not. It's unlikely and it's cruel. Yeah. It's just not fair to keep saying that. It's not helpful. It's not helpful. It's not helpful to me to keep listening to you. It's not helpful. I can't be I can't be a good a good I can't stand up and be there for her if I'm constantly thinking these dark thoughts. So I need to stop listening to you. Yeah. I need to stop listening to you and just know that yes it's out there in the world and and and things could happen but they're not right now. And she's fine. And most of the time people are fine depending on where you are. Sorry. Because I mean you know a lot of people are not fine today.

 

Jill Levitt: And so who who I I'm chuckling with you because you sort of like you got it and then you sort of like had a little bit of a tail end there where you were like those little thoughts came back up again.

 

Madeleine: Well because I don't want to be unrealistic and insensitive.

 

Jill Levitt: Exactly. The current political climate around the world right? I think actually where you veer off course Madeleine is when you try to be overly positive. So basically overgeneralization in either direction is notable. So you when you overgeneralize and say because the world is safe or because she's fine like maybe you don't need to say that. Yeah. Right. That's when you start to then doubt and get into that. When you try to convince yourself 100% that everything is perfect, you know then you don't believe it and then no just goes right back to you know badness.

 

Madeleine: Yeah. Right.

 

Jill Levitt: So let's let me let me see if I can Madeleine what I heard you say that sounded really powerful is you said it's easy to get sucked into this BS. But the reality is you know is there danger yes. But she's in a good program. She's got good friends. Just because there's creeps and sociopaths in the world doesn't mean that she's actually in danger. And I don't want to listen to this you know garbage. It's it's unlikely and it's cruel and it's not helpful to me. Yeah. And then where you got into trouble is where you tried to tell yourself and she's fine and she you know because then then you start doubting that again.

 

Madeleine: Yeah.

 

Jill Levitt: So could we try it one more time and see if you can just hang on to that sort of you know self-defense counterattack acceptance of the reality without trying to go too far in that direction?

 

Madeleine: Yeah.

 

Jill Levitt: Okay. All right. So I'm just gonna prompt you. Your daughter is not safe being far away and surrounded by creeps and sociopaths.

 

Madeleine: Okay. So she she's far away. She might be surrounded by creeps and sociopaths but that doesn't necessarily mean she's being targeted. And while the world is the reality is that the world's not a safe place, she's in a good program and she's made good friends. So I need to stop listening listening to your BS because it's just a skewed in the it's all skewed to to one side and it's not it's not it's not reality. So I need to just remember she's in a good program and that she and you know she's not necessarily the target of every creep and sociopath and you know I think she's got a good radar really sometimes. I think I think sometimes she does.

 

Jill Levitt: And who won that Madeleine you or me?

 

Madeleine: Yeah. No I won. I won. That was that was huge because I I feel I feel like I believe it.

 

Dr. David Burns: How did you get to huge?

 

Madeleine: That just just remembering she's in a good program and that you know there'll always be creeps and sociopaths around but doesn't mean that you know that that the that your loved one loved one is the target of that creep and sociopath and that she and that she can defend herself.

 

Dr. David Burns: Okay. You want to go on to another thought with David? Okay. Well I know you you defeated that you know negative Madeleine over over there but I I you're not going to defeat this one. And and and what I want you to know is that you you did not adequately prepare her innocent soul for for the world. And teaching point I'm just reading the second thought on the daily mood log and putting it into the second person You.

 

Madeleine: Yeah. I mean you're you're right. Negative Madeleine I I don't think that I did prepare her. I I did everything I could. I tried. I tried to toughen her up a little bit. Not always tell her that I was I never told her I was proud of her because and now I maybe I sort of regret that. Although as soon as I told you all that then I I sent her a text telling her that I wanted her to know that we were really proud of what she was doing. So that felt good. But I but I Yeah. Anyway back on track here. Yeah. I I I guess I did my best. I I don't you know I I don't know how much more I could have done. I tried to make her tough. I tried to make her get into sports, be athletic. Tried to teach her boundaries, to stand up for herself which she did many times. I don't know how much more I could have I could have done to prepare her. It's It's really up to her and her personality and her disposition.

 

Dr. David Burns: Hey who won?

 

Madeleine: I think I won.

 

Dr. David Burns: Big or small?

 

Madeleine: Yeah. Big.

 

Dr. David Burns: Big or huge?

 

Madeleine: Big between big and huge. Yeah.

 

Dr. David Burns: Well let's see if we can get it up another half a notch. You You try to attack attack me. Then if I can't do it we'll get the expert in and let Jill demonstrate. But we'll get give a shot at it.

 

Madeleine: Okay. Listen Madeleine you you did not adequately prepare her innocent soul for this world.

 

Dr. David Burns: Wow. What a what an amazing statement is that. As as the Buddha often called it gee we just came across another pile of bullshit. But let me see if I can respond to that. I I I was I'm I I I was and continue to be a damn loving mother and she's she's really lucky to have me and I feel gratitude to have her and my other daughter too. What a blessing that is. And as far as being a perfect parent or something you know I'm not into grading parents but but but I think if I had to graded another mother who was like me I'd give her a pretty damn high high grade. But that that's that's not my my failure and my weakness. I I do have a tremendous failure however. What's that? Listening to your BS. Yeah. That that's right. You see the sociopath is with with with us here today. What does a sociopath do?

 

Madeleine: Oh my goodness.

 

Dr. David Burns: A sociopath wants to hurt people right?

 

Madeleine: Oh my goodness. This is harsh. Yeah.

 

Dr. David Burns: And and you're trying to hurt me. I'm not going to let you do that. Who won?

 

Madeleine: Yeah you did. Huge.

 

Dr. David Burns: Yeah. And how how did I do that?

 

Madeleine: Yeah. And I mean and the way you you're saying it it almost makes it sound like I'm just narcissistic. It's even wor It's getting worse.

 

Dr. David Burns: No I didn't say narcissistic. Soci I said sociopathic. That's worse than narcissist. But just like you know it's all on me and you know yeah.

 

Jill Levitt: It's not taking taking responsibility for for other people. I don't think that is narcissistic and and I think it's self-critical and self-blaming. And that's that's what David is highly I just want to be clear. And language is funny. That's right. You know it's right the difference. You know it's no no one I could think could ever walk away from this thinking you're narcissistic. I think it's that you're taking an unneeded amount of responsibility.

 

Dr. David Burns: Yeah. That's right. And I think the the counterattack is a powerful tool to use in whatever style style you want. But I think it's crucial to point out that the problem in your life isn't your daughter's safety. The problem is your safety. And and and you're not safe in the presence of this belittling voice in your head that's very mean and relentless. Yeah. And that that's the the your only problem that that's what what we're trying to obliterate today to give to give Madeleine a life of freedom and safety and joy and pride. Now let's see if you can do it. Could I talk to you for a minute? I know that Snake in the Grass Burns was trying to persuade you that everything's okay or some kind of baloney he was using but I I don't want you to forget that you did not prepare her innocent soul for this world. So you're to blame and don't you forget it.

 

Madeleine: Okay. Wow. Yeah. And I do I definitely take a lot of responsibility for some some parenting mistakes a lot of parenting mistakes I've made still making. At the same time I I think you're wrong. I think I I really did my best to to prepare her without making her I did make her anxious without making her overly paranoid about everybody to so that she could have make friends and enjoy life and see the beauty in life that surrounds us. So I I it's just not it's not true. I you know and she she can stand up for herself. She's an adult now. She she's learned. So I'm I I need to stop stop saying that I that it's all it's all my fault.

 

Dr. David Burns: Okay. Who who won that one?

 

Madeleine: Yeah. I I won that one.

 

Dr. David Burns: Big or small?

 

Madeleine: Yeah. I won huge. Huge.

 

Dr. David Burns: How did you get to huge?

 

Madeleine: Saying that it's you know it's it's ridiculous to say that I you know that I didn't prepare her. I did. I did. I did my best. I wasn't Yeah. I did I did my best and and my best was pretty darn awesome. Well I wouldn't go that far but I but I did. I did my best and I did we did teach her and it's up to her now and I I need to stop. It's not helpful to beat myself up and listen to that because it's just not true.

 

Dr. David Burns: I love it. That's great. Your turn Jill . And then we'll have to wrap up and go into our you know after percent after.

 

Jill Levitt: and stuff. Well I would like to do the double standard technique with Madeleine on some of her self critical thoughts. Could I do that Madeleine?

 

Madeleine: Yes.

 

Jill Levitt: Yeah. Okay. So let me set that up and and and then I'll just pick some of these self-critical thoughts. So Madeleine in this role play the double standard technique I'm going to play a dear friend of yours. But you know rather than thinking of me as an actual friend that you know I'm going to be a friend/clone of yours. So think of me as someone that you care about that you love like a dear friend but I'm actually kind of a a clone of yours. I'm just like you. I grew up in the same family that you grew up in. I'm married to the same guy. I'm struggling with the same issues with you know my daughters and telling myself the same kinds of things that you've been telling yourself. And I'm going to have a conversation with you. And the the nice thing is you just get to be yourself. So you're Madeleine and I'm dear friend clone of Madeleine. Would that be okay?

 

Madeleine: Yes. Yeah.

 

Jill Levitt: So Madeleine I I wanted to talk to you for a minute. You know I've I I'm going to share with you just a little bit about myself and then tell you what I've been struggling with. You know I my husband and I worked tried really really hard to have our daughters and we we struggled a lot with fertility and when we finally had them we were so kind of overjoyed and grateful and and partly as a result I just take parenting so seriously. It's so important to me. I love my daughters so much. And you know I've been telling myself that I wasn't present or there enough for my daughter when she was a little girl. I had her sister and they were seven years apart and I you know was parenting my second one and I just I don't think I did everything exactly right and didn't didn't gaze into her eyes enough times and and wasn't there as much and so I keep telling myself I wasn't present and there enough for her and that's really awful. Do you think that's true?

 

Madeleine: Well as my dear friend and clone I I do know that you were there and you took it so seriously to be to be a good parent and to be there for her for your daughter and hold her and take her to all those doctor's appointments to get weighed in the beginning because she wasn't gaining weight and and then throughout the life I really I really throughout her life you really you know pushed her to do sports and to learn how to study correctly and to stand out for herself and to have good relationships. So I I just don't see I don't see that that's true. I mean just having observed you going through her life you were you were very present. Yeah. Did you mess up sometimes? Were you maybe too harsh sometimes? Did you give punishments when you shouldn't have given punishments because it wasn't that big of a deal her? Should you have told her you were more proud of her? Yeah probably. At the same time you did pretty good. She's turned out to be a wonderful young lady with lots of nice friends. And I think that you and your husband did pretty good with her. Yeah.

 

Jill Levitt: So what you're saying is that of course I made some mistakes and that I could always look back and think about ways that I could parent differently because I care so deeply about being a good parent. I'm probably could find ways of improving on on my parenting every day and at the same time that I was a pretty awesome parent that I was attentive and loving and thoughtful and also that I was pretty intentional. I wanted her to grow up to be kind of tough and to be able to protect herself. And so I I did some things. We could look at it as good bad. We we'll never know. But overall you're saying you think my husband and I actually you know like worked really hard and gave her a lot of love and a lot of care. And is that is that really true what you're saying? Do you really believe that or are you just kind of you know trying to make me feel better in this moment?

 

Madeleine: No. I see it and I think it's realistic. I think that that just seeing the result in in your daughter I think that you all I think you all did a great job. And then also you know part of it is she is who she is. She she is who she is. They they come out with their own personalities and and she's someone who's just very very sensitive and very loving and very caring, you know.

 

Jill Levitt: Oh so you're saying I'm not totally responsible for every aspect of her personality? I can't I'm not totally responsible for how sensitive she is or how anxious she is. That that's not actually all my doing. She kind of has a a will of her own to be who she is and that I'm not 100% responsible for for every aspect of her personality. Is that right?

 

Madeleine: Yeah that's right. She they they come out with their personalities and this is her. She's very very sensitive and this is her. I.

 

Jill Levitt: You don't think that's my fault or my responsibility entirely who she is and how she is?

 

Madeleine: No. I don't think it is. I think you're you and and and she is who she is and and you've done a wonderful job parenting and then the rest is really up to her how she wants to manage her behaviors and her thoughts and her.

 

Jill Levitt: Wow. So I'm going to take a take a break here Madeleine and say and is is is that true? If that if what you just said was true for me and I'm a clone of yours is that also true for you? Is it also true to say that that you did a great job and that she is who she is and that she's responsible also for how she turns out and for her actions and behaviors?

 

Madeleine: Nah.

 

Jill Levitt: It's just a bunch of bullshit you're feeding me.

 

Madeleine: Yes. Yes.

 

Jill Levitt: Is Is that true for you also true?

 

Madeleine: It would also be true for me. And so how can.

 

Jill Levitt: Let's write that down on your daily mood log in the positive thoughts column Madeleine what what would you say there that as a as a parent.

 

Madeleine: I can only go I can only I can only teach and and by by example and you know straightforward. I can can only teach and and be a role model. And then the rest is up to the rest is up to up to her and who she is what her personality her own values.

 

Jill Levitt: Wow. And how much do you believe that thought? I'm writing that down in the positive thoughts column. As a parent I can only teach and be an example and be a role model and the rest is up to her and who she is and her own values. How much do you believe that thought?

 

Madeleine: Yeah 100%.

 

Jill Levitt: Yeah, And then so then how much do you believe the thought? Well we'll look at both of them but I I was not present or there enough for her. How true is that thought?

 

Madeleine: Yeah. Still a little bit a little bit true.

 

Jill Levitt: What how how true would we rate that? And and and also it seemed like that thought was like and and that's awful you know and that's responsible and therefore I'm responsible for everything you know. Yeah. Zero to 100. How true is that?

 

Madeleine: Yeah. So it's probably I think I could have done maybe 30% better.

 

Jill Levitt: So 30% true. Okay. Okay. Great. And we would we would want to change it entirely because we all want to be honest and look back and think about ways we could do things differently. You're still parenting her right? You still have choices about the way that you parent. So it seems to me that would you know and then the other thought though that we targeted in the double standard technique I think was that original thought. Wait let me find it and have you read that. I just got on the wrong page. Yeah. That that maybe that that that you didn't adequately prepare her innocent soul for the world. So again that it's this idea that like I'm totally responsible for how she's turned out.

 

Dr. David Burns: And those are two different thoughts.

 

Jill Levitt: Yeah. It is. We didn't capture it but it seemed like a big thought that was driving Madeleine's distress. Yeah. Yeah. So maybe we could just write that down and ask "How much do you believe that thought?" I'm I'm totally responsible for how she's turned out.

 

Madeleine: No. I mean that's just not that's just not realistic either. There's you know there's her experiences shape her you know her dad's influence shapes her her personality. Yeah. So I can't I can't be that would not be that'd be unrealistic.

 

Jill Levitt: How much do you believe that that I'm totally responsible for?

 

Madeleine: Yeah. No I'm not because then I would be taking responsibility for how you know how wonderful she is and that's all me. That's not. I was thinking that too. We can't take you take responsibility for all the bad take responsibility of all the good and I I can't do that. I was thinking how quickly and easily we as parents can take responsibility for the poor things and the poor choices and never give ourselves credit for the amazing stuff. And right you've shared she's a be she's a wonderful person. She has wonderful friends. You're not taking credit for all that.

 

Dr. David Burns: No. Yeah. Listen you guys are you guys are doing great and I'm I'm wondering Madeleine because I'm attending to time and we want to give wrap it up and give some time to the our audience for questions and comments but are there any of these negative thoughts that are still eating away at you? You only role played a couple of them but.

 

Madeleine: Yeah and I'm mindful of the time too. The the only thing that that that I I fear would bother me again is if reading another news article. I don't want to start. We can get to that later if you like.

 

Dr. David Burns: And so we might want to plan to have you do some exposure cognitive flooding Yeah. After this this presentation right now I'd rather focus just on what what we've been doing here. Okay. Yeah. And then you can decide if you want to do some pro prophylactic powerful you know intimidating techniques. I told you we have a great deal how to do that for homework. A great deal more. But are there any of these thoughts that right now are still getting stuck in your throat or whatever?

 

Madeleine: No. I think we've addressed everything with with the role with the back and forth the double standard and right of.

 

Dr. David Burns: yeah definitely a awesome. And then let let's just see how you're feeling right now and and then we can see how the audience is doing. We can also tell you some other things that you might want to follow follow up with. But how sad, down and unhappy are you feeling at this moment? We're going back to your daily mood log and looking at the percent after column.

 

Madeleine: I I don't feel sad down or unhappy. Is that a zero?

 

Dr. David Burns: Yep. That's a zero. Okay. Put a zero there. And then how anxious, worried, panicky, nervous and frightened do you feel?

 

Madeleine: Like 10.

 

Dr. David Burns: 10. Put a 10 there. How inadequate do do you feel? So the first one went from 85 to zero. The second one from 100 to 10. The inadequate was 100. What's that now?

 

Madeleine: I don't feel inadequate. So maybe well maybe a little bit 15.

 

Dr. David Burns: Oh 15. Okay. Great.

 

Madeleine: Yeah.

 

Dr. David Burns: It's nice to keep a little inadequacy.

 

Jill Levitt: A little humility right?

 

Madeleine: Yeah.

 

Dr. David Burns: How how frustrated are you feeling? That was 90.

 

Madeleine: Not feeling frustrated 10.

 

Dr. David Burns: 10. And then finally how upset and angry? They were both in the 25 to 30 range was my goal.

 

Madeleine: Yeah. I'm not I'm feeling no less than that. So set maybe yeah 10 15.

 

Dr. David Burns: Oh awesome. Great. And now these are some very dramatic reductions far far beyond what you had had aimed for. And what what the first question is are these honest? Are you just being nice so as not to embarrass David and Jill in their live demonstration? And secondly if if if these are honest what what do you think the healing dimension has been so far? But why why why did they go down so much?

 

Madeleine: So they are honest even though I was I'm a paid volunteer. But they are honest. And then the healing dimension was just really so the distortions. Yeah. That's good. But then forcing me to write down what I was saying. That was good because in the moment so that instead of like going back later and saying well can you come up based on all that stuff can you come up with a positive thought because I think that gets people kind of tangled up I've noticed you and so that just making me write it down right write down what you just said she is likely safe she you know so I think that really powerful because I was believing it I said it and and then going right into a me using that all those thoughts that I believe and then going right into a method to really to you know make them bloom.

 

Dr. David Burns: Yeah. And so just to take a simple teaching point out out of that is I've been saying ever since I wrote Feeling Good was published in 1980 I've been saying to people when you're upset write down your negative thoughts. But I don't say that anymore. Now I say write down your effing negative thoughts damn it. And because it's so very important based on what you said and then you can begin to see how you're fooling yourself with with distortions and so forth. And and really it this is like getting out of prison. Even when we did the positive reframing you still thought you'd be in a 40 40 or 50% sadness prison and an anxiety prison and and you've let yourself out and and then these things will come creepling back. So some relapse prevention training would be important. But one key that you can decide about we can't do this today but to see if you'd want to do some cognitive flooding and desensitize yourself entirely or in part to to this horror so you're not triggered again the horror that you have when reading articles and and and that can be done although it seems terrifying and impossible right now but the likelihood of success with that should you choose to do it is about 100%. And let let me give you the last words here and then we'll give Madeleine last words and then see what our audience has to say.

 

Jill Levitt: Yeah. I was going to say that I think in part I'll just first first make a comment about the yeah the conceptualization and then what to do with that and then also just want to say thank you to Madeleine but yeah I think that I conceptualize kind of two different things that are going on for you and they're both related. And one of them has to do with this anxiety that gets triggered when you see or hear about terrible things going on in the world and obviously it's especially triggering for you having daughters and worrying about their safety. And from that perspective you know we did some work on that piece but I think the next piece would be doing cognitive exposure. If the goal truly is to be able to read this, hear this, think about this and not be distressed by it, I think the only cure to that, you know like is kind of inoculating yourself against it. And that's terrifying for most but completely achievable. And that would mean actually committing to being willing to let's say read an article that was really upsetting over and over and over again even daily until that article is no longer upsetting to you. And interestingly it will likely generalize to other kinds of upsetting you know news. And so that would be a piece of it right? Like you could do that for homework and we could follow up with you on on how to do that for homework but you'd kind of commit to doing that with no distraction, no avoidance, no reassurance just kind of doing that repeatedly. And that would help with that piece. But I think this other piece that we did target more with externalization of voices, double standard and the identify the distortions is this kind of intense responsibility that you feel for your daughter. And again I think these two are related. It's why these things are so upsetting to you. But I think that's what we did a pretty good job of targeting today is you letting yourself off the hook. You realizing that you have done a lot and even just by caring the immense amount that you do. You're clearly so thoughtful and proactive in the way that you parent and being willing to give yourself credit for that and stop you know kind of beating yourself up. So we want you to keep doing that for homework too though to keep working on that sort of self-compassion right? That kind of combating all that negative self-blame self-talk.

 

Dr. David Burns: Yeah. And and one last comment I have is and and then I saw a transformation in you like a metamorphosis of a caterpillar into a butterfly today because I saw the the strong woman that you're aspiring to for yourself and your daughters emerge during the session. You started becoming very strong and confident. I'm sure you experienced that but it was visually apparent too. And the last thing that I would would want to say is your main goal is to help your daughter or your daughters. And do you know now the that fantastic thing that you can do that will help your daughters tremendously?

 

Madeleine: Yeah.

 

Dr. David Burns: Yeah. Okay. What is it?

 

Madeleine: To not be beating myself up all the time.

 

Dr. David Burns: Yeah. And once you get really good at that your daughters will suddenly learn how to do it too. If they don't already. But anyway that that you're very beautiful woman and I can't thank you enough for your incredible contribution to to today. We'll give you the last word and then we'll get some audience questions and comments.

 

Madeleine: Thank you both so much. You are you know I'm glad to do this because like I said in the beginning the two of you are so generous with your teachings and you're incredible teachers and you've been told that a million times but I just can't say it enough. And I just you all are fantastic role models for all of us for the world. And I just I've learned so much from you all and I want to continue learning and I'm so happy to do this and I I hope it's helpful. Just wanted to put that out there and say thank you. Thank you. Thank you. You're just your in generosity for both of you is just so exemplary and can't say enough.

 

Dr. David Burns: You're welcome. You're welcome. You're welcome.

 

Madeleine: Yes. Yes. Really really. You just don't see this in the world and or in this field even. So.

 

Dr. David Burns: Okay. Now we'll turn it over to our.

 

Madeleine: No I want to say one more thing. I want to say one one thing that's important and that is when you had me do when I volunteered and you said "Okay do a DML." And I did it right away. I mean just feeling out the DML writing down my negative thoughts circling my feelings provided a huge sense of relief for me that right that in that next day. Awesome. Yeah. Yeah. I just want to put that out there that it's it's everybody these these things are so powerful just just to do them without going where we did today. Yeah. 

 

Dr. David Burns: I'm glad you put it out there because people don't believe it. They dismiss it. They Well we're not doing that. We're telling you how to change your life. Take a piece of paper damn it and write your negative thoughts down. That's what the Buddha said 2500 years ago. You can find that if you don't believe me in in that book he wrote the Tibetan Book of the Dead which was interestingly published 700 years after he died.

 

Madeleine: And attempt at humor.Yeah. And I don't I don't know if you have experienced this other therapist man but sometimes patients they just No no it's too much work. I don't want to do that.

 

Dr. David Burns: Yeah. Yeah. Right.

 

Jill Levitt: Exactly. I also wanted to highlight and then we will turn to I want to say one thing to the audience which is make sure you stay until the end. We're not done by any means. We have 50 minutes still left in this workshop and you do need to stay for the whole time to get your CE credit but also there's a lot of learning that's going to come through the Q&A and through our sort of analysis of what just happened in this session. So that part's really important. And also we're going to share with you some other learning opportunities for therapists and the general public. But I also wanted to say we didn't really as a teaching point we didn't touch on the positive reframing and I just wanted to say I think that you know the time that we spent with you Madeleine really thinking about the benefits of these negative thoughts and feelings and what they show about you that's beautiful and awesome I think was huge and especially because Madeleine you do have some mixed feelings. You know you're not like I want everything to go to zero. You really want to hang on to some of your anxiety and you believe that it it works for you and that it shows some beautiful things about you. And I just think the audience needs to understand if we were I believe Dr. David Burns if we had just gone straight to methods with Madeleine everything would have failed because I think that's right Madeleine would not want to be less self-critical. Madeleine would not want to be less this would have would have been a gruesome session.

 

Dr. David Burns: Right. Terrible push pull tug-of-war.

 

Jill Levitt: Yeah. Right. Right. And the the reason we sidestepped that was because of positive reframing. Okay. Now let's get on to the Q&A and those final slides on additional resources and let's fly through the slides so we can spend as much time on Q&A.

 

Dr. David Burns: Well we can start with Q&A and then we'll come start.

 

Q&A Session