Episode 11

Feeling Good in Uncertain Times

With Dr. David Burns
Episode 11

Feeling Good in Uncertain Times

With Dr. David Burns

Best-Selling Author. Professor at Stanford University. A. E. Bennett Awardee. Founder of the Feeling Good Institute.

Dr. Burns is a pioneer in Cognitive Behavior Therapy - a highly effective, scientifically validated approach to mastering emotions and strengthening mental well-being. He teaches at Stanford University and is the founder of the Feeling Good Institute. He has received numerous awards, including the A. E. Bennett Award for his research on brain chemistry, the Distinguished Contribution to Psychology through the Media Award, and the Outstanding Contributions Award from the National Association of Cognitive-Behavioral Therapists.

David has also served as Acting Chief of Psychiatry at the Presbyterian / University of Pennsylvania Medical Center (1988) and Visiting Scholar at the Harvard Medical School (1998), and is certified by the National Board of Psychiatry and Neurology. His book, Feeling Good: The New Mood Therapy, has sold over four million copies worldwide, and is the most frequently 'prescribed' book for patients of depression by psychiatrists and psychologists in the US and Canada.

  • Your programs are memorable, and I keep revisiting them for nuggets I might have missed. Thank you once again. Jagdish Chinappa
  • Absolutely amazing and what an absolute honor and treat to hear Dr. Burns speak live. Thank you Hitendra! Vikram Gupta
  • David's compassionate approach guides us into embracing our shadow, so that we can see our light in its totality. Asha Dutia

In this episode of Intersections, Prof. Hitendra Wadhwa has a conversation with David Burns on the topic “Feeling Good in Uncertain Times”.

It is not just our outer world that is in turmoil today - but our inner world as well. Recent polls show that anxiety and depression rates in America have surged dramatically - from 10% in 2019 to 33% today. Does our mental well-being have to depend on our outer circumstances? How can we take more control over our moods and emotions in today's challenging conditions?

“When two people respect each other, the ability to be vulnerable and to reveal hurt feelings can create a powerful emotional connection that is the source of real intimacy and friendship.”
David Burns

The episode “Feeling Good in Uncertain Times” offers key insights on:

  • How to eliminate our resistance to change
  • How to create a joyful sense of connection with ourselves
  • How to use self-acceptance as a tool for personal transformation
Hitendra Wadhwa

Hello and warm greetings from Hitendra and a warm welcome to Intersections. At the intersections, our main goal is to allow us to see the full potential for us to not just survive, but thrive and flourish through good times and bad. To be able to go through on the journey in life and leadership in the pursuit of our fullest potential. Now, one of those forms of intersections that I have been very invested in over the last several years, has been to take the fields that I am pursuing, such as, for example, business, and make them intersect and connect with disciplines that are the frontiers of the science of human nature.

As I was doing that over my first few years of research in the last 14, 15 years, I ended up recognizing that it is very important for us to study those disciplines that are truly helping people become better versions of themselves. That led me to look at the fields of psychotherapy. As I was doing that, I was flummoxed by the wide disparity of the different fields that psychotherapy represents. There were a whole wide range of ideologies, methodologies, treatments, groups, movements. So, I decided for myself that I wanted to zoom in on those parts of psychotherapy that were going to satisfy two criteria. One, that they were scientifically very solid in terms of the evidence that science had picked up over the years, that they really work in a measurable and trackable way. The second was that they were incredibly practical. Therefore, could be tools that any or all of us can use from time to time. Through that, I discovered the power of a discipline called cognitive behavioral therapy.

So, I started to ask myself, who are some of the experts in that discipline? I was really blessed at that point to encounter the work of Dr. David Burns, who is going to be our guest today. So let me introduce you to Dr. Burns and then we will welcome him.

David, as he is popularly known, is not just one of the leading lights in the discipline, but really in many ways a living legend. He has an M.D. from the Stanford School of Medicine. That itself is a really rich and powerful story, which hopefully we will get into when we talk to David. He is now serving there at Stanford as a professor, as a researcher and a trainer. He has, of course, done incredible work in the field of therapy, bringing about so much transformation to so many people's lives. In addition to that, he has also been incredibly invested, a contributor to the advancement of his discipline with all of the training that he has done of therapists over the years.

I myself have sat in on some of those sessions and had the distinct pleasure and privilege. It is an incredible dynamic to watch him working with these experienced and at times leading practitioners of his craft, of his discipline, and just holding that audience to a state of tremendous respect and awe for the manner in which he is able to bring to life its most advanced tools. His research and his practice of therapy specializes in relationships, depression, anxiety and trauma. I've also seen David work on things like anger and addictions. He is the author of a classic in this discipline called Feeling Good, The New Mood Therapy. If you have not until now encountered this book, I encourage you to race through your online bookstore and get access to it now since we are all in this lockdown phase. One of the most successful psychotherapy books ever published, 4 million copies sold in the United States, many more around the world, an incredible force unto itself.

Feeling Great is a new book that is going to come out soon. He has won numerous awards in the discipline that reveal how much wide and deep regard there is in the field for the range of contributions that he has made over the years.

So, it is my distinct pleasure to welcome into our midst, Dr. David Burns. David, welcome.

David Burns

Thank you. I appreciate your words.

Hitendra Wadhwa

Our pleasure. David, it's a great joy to have you with us, and I thought maybe we can start by just sharing a little bit about your personal journey? You have been so deeply invested in reinventing and advancing the field of mental health. What got you interested in mental health?

David Burns

Well, when I was in college, I was a philosophy major. I would have majored in physics. But I realized I wasn't smart enough. My roommate is a major in physics, and I was so far beyond my own. But I did have an aptitude for philosophy. So, I majored in philosophy and thought I would go to philosophy graduate school. But one of my roommates in my senior year said, "You should read this book by Ludwig Wittgenstein called Philosophical Investigations." The downside is, it's rumored that only seven people in the world can understand it. But on the upside, he said, "Some people claim it contains the solution to all the problems of philosophy." I thought that was pretty fascinating. I was fascinated by problems like the free will problem. How can humans have free will if we are following the laws of the universe, things like that. So, I started reading this book, but I couldn't understand it. I could see why people couldn't understand it. It was just about simple things, like a piece of string or a bricklayer laying bricks on a wall and he has an apprentice. Then when he shouts out Brackley, an apprentice brings them new stones to put on the wall. He'll just say something like that and say, "Now, do you see where Aristotle missed the boat?" And I would say, no, not really, I don't understand what you're talking about. It sounds nonsensical.

I kept reading that book. Then in the spring of my senior year, I was walking across the Amherst campus and it kind of came to me in a flash what he was trying to say. At that moment, I saw the solution to all the problems of philosophy that had intrigued me. I thought, gosh, I don't need to go on with a philosophy that was very consigns hope for all of his students. He saw philosophy as a kind of mental illness, and he saw his book as a treatment for it. It really worked. It was incredible. So, I went to my supervisor and said, "I don't think I'm going to go to philosophy graduate school, maybe I'll try psychology, that seems more practical." And then he said, "No, you've got to go to medical school." I said, "I'm not a premedical student. I haven't had any of the prerequisites. Why would I want to do that?" He says, "Oh, well, if you go to medical school, you can prescribe drugs. That's what psychiatrists do. Psychologists can't do that. And they're going to be so important in the future." I said, "How would I ever get into medical school?" He says, "Oh, you can talk your way into anything." So I got into Stanford Medical School and I was one of the worst medical students I think they ever had. I skipped most of my classes. I never should have been there. I had nothing in common with pre-medical students and I had never had a desire to be a doctor, but that was how I ended up going to medical school and ending up in psychiatry.

Hitendra Wadhwa

You know, I'm always amazed at your storytelling and your humor in the way you look at life and also at your humility, David. I can only imagine how you must already from that point, been creating many lasting impressions in the lives of people around you. So, you started off in a discipline that in many ways is very physiological. In a sense, the physical aspect of who we are. Then you migrate into the mental health side of it. It is quite remarkable because of who I know you to be, over the decades, at that early stage, you were so deeply invested in studying this theory of chemical imbalance as a factor in mental health in triggering things like depression. What happened to you when you were going down that path, which is so medicational and pharmaceutical, what happened that ultimately led you down the path of pursuing mental health from a different world?

David Burns

There were three things. All I ever wanted to do was to treat people and see people get cured from despair to joy. After my residency at the University of Pennsylvania Medical School, I did three years of research and everything was on brain chemistry. We were told that and people are still being told that depression is due to some chemical imbalance in the brain and so I was doing research on brain serotonin, the so-called happy chemical that's lacking in people who were depressed. I reviewed the entire world literature, and I couldn't figure out where this theory came from because I couldn't see any evidence for that theory. Then we began to test it directly. One of those studies, just the one I won the A. E. Bennett award for, was on brain serotonin metabolism. But we did a very simple study.

We had a research unit at the VA hospital in Philadelphia, and we gave half of the veterans' massive daily doses of L-tryptophan that goes directly from the stomach into the blood and then it diffuses in the brain and it's quickly manufactured into serotonin. That is the thing that's supposedly lacking in depression. Half of the veterans didn't get any of this L-tryptophan. They got milkshakes without the L-tryptophan, half of them got milkshakes with L-tryptophan. So, no one could tell who got what. The nurses didn't know. The psychiatrist didn't know. The patients didn't know. Then we collected data on changes in depression for three or four weeks. And then wrote the code to see how much improvement there was from the massive boost in brain serotonin. There was absolutely no change in either group. There was not a shred of evidence that this massive increase in brain serotonin, that didn't help anybody whatsoever. We published that in the top psychiatry journal, and said that this isn't consistent with this theory, there's no evidence for it.

Then I got frustrated and said, "Well, maybe we didn't give them enough L-tryptophan. So, I bought with my research grant two pounds of L-tryptophan from the Ajinomoto company of New York, Inc. and went to the hospital. They taught me how to create sterile intravenous infusions with unbelievable amounts of L-tryptophan, the most biochemically possible to get into a human being. And I started injecting this into the veins of the veterans. Such massive doses, their brain serotonin was probably going up by a thousand times. All it did was put them to sleep. It didn't help anybody's mood, and I said, "This theory sucks." And I told my supervisor, "I don't know if I want to spend my life doing research on this because I had not got a grant from the federal government to create a brain serotonin laboratory." I told my supervisor, who was one of the original biological psychiatrists. I said, "Why are we studying serotonin? There's no evidence that it has anything to do with anything." And he says, "Well, we've got a good deal going here. I can show you how to test these serotonin drugs for drug companies so you can make millions. You are already just out of your residency. You already have a worldwide reputation and research. Don't shake the boat."

I thought, I don't care about shaking boats or not shaking boats. I want to help people. I want to cure people. Then the other thing was I was giving all kinds of antidepressants to people and doing conventional talk therapy. I was not seeing this mythical 85% cure rate the drug companies were claiming. I hardly ever had anyone who recovered. Some did a little, many didn't change at all. Some got worse. This whole approach, it just, it just isn't working. That's when I heard about Aaron Beck's development of this new theory, a drug free treatment for depression that sounded goofy, cognitive therapy, that your depression results from your thoughts, your cognitions.

When people are depressed, they think negatively. I am no good. I'm a loser. Or if they're anxious, something terrible is going to happen. When I get up and get to my car, my mind will go blank. I'll make a fool of myself. People will judge me. I knew my patients had these thoughts, but it seemed ridiculous that you could train people to change the way they think and change the way they feel. But I decided to try it out because I was just desperate to find something to help my patients. I was shocked that I went to his weekly seminar and started trying the techniques on my patients. Almost all of whom were really recovering. All of a sudden, they started recovering and I said, this is really interesting. I was wrong to be so cynical about it, but it just sounded so silly and simplistic that you could treat depression by changing negative thoughts.

But I couldn't deny that my patients were recovering and they wanted more. I finally decided just to send my grant back to the federal government and said I don't want this money. I can't stand the idea of spending my life studying brain serotonin because it's never going to amount to anything. It's a fraudulent, false theory. It's a waste of time. And I want to cure people.

So, I left the university. I had a full-time academic appointment, a tenure track, and went into private practice and stayed on the faculty as a voluntary faculty member. Just as now, I'm on the voluntary faculty at Stanford. But I decided I wanted to help develop this and other new approaches and psychotherapy. I'm just so glad I did it. But it was the hardest decision of my life, because they put tremendous pressure on me to stay on the faculty. They said, "Oh, you're throwing your life away. You're going to do all this great research. You can't do research when you're in private practice." And that didn't turn out to be true. I collected data on all my patients when I was in private practice, but I focused on how psychotherapy works rather than brain chemistry. I published articles in the top psychology journals and developed radical new insights about causes and cures for depression and anxiety. That eventually morphed into the new team cognitive therapy that I developed at Stanford, which is incredibly powerful. I never would have dreamed at the beginning of my career that a form of psychotherapy could be developed that is this powerful.

But now when I work with people, I generally see a complete elimination of symptoms the first time I meet with them. It has to be a 2-hour session. But I now see psychotherapy as a procedure, more like open heart surgery that you do all at one time in a single day or a half a day or just a couple of hours. The most exciting time of my career is when my patients go from despair to joy. The Buddha said we're all one. I don't know what it means but it's really true because when my patients go into a state of euphoria, it thrust me into a state of euphoria.

I treat everybody for free. The idea of charging for health care or battle health care, is just disturbing to me. It's the most rewarding thing I do and in the world is treating people and seeing them recover so fast. It's like participating in a miracle over and over again.

Hitendra Wadhwa

That's beautiful David. I love that last phrase and that you just shared, participating in a miracle over and over again. I want to just draw out some of the things that you have shared that I want to make sure really get recognized by the audience.

So, we're going to come back to the practice of team therapy, cognitive behavioral therapy, etc., in a couple of minutes to give our listeners some practical advice and practical guidance on what each of us can do today to navigate through these turbulent times. Before I do that, I just want to recognize that chapter that you shared with us when you made that sort of shift in your career at a point when you were at the top of your game, at a point where you had this coveted research grant that could have just like funded your career for the next several years, as I understand, I also understand that you were already winning some major accolade, major awards and recognition for the work that you were doing. Again, you put it in a very playful and humble way, but it was being recognized as being very pioneering.

But somehow, in a sense, your conscience, your higher wisdom, your logical mind of someone who is striving to see truth for what it is, not for the varnished version that maybe thrown at us from our community or the orthodoxies of thinking of our people, that part of you seemed to get stirred by something beyond what you were doing in that moment. And you had that clarity and you had the courage to actually leave behind that very successful world, take a plunge into the unknown, even with all the cautions that people in your immediate environment were throwing at you. You took that plunge. You followed your own inner calling; not just have you blazed a really remarkable trail since but the incredible countless number of people who benefited from it is testimony to how that is the right path. Not just looking backward for you, David, but is the right path for any and all of us to really learn to anchor ourselves in that inner voice and seek to strive for that clarity and step back a little bit with the healthy skepticism from the things we are hearing from time to time, integrate all the facts and then go on and follow our heart. Well, what a beautiful story right there, David.

I know you write a lot of books. At some point someone should write a book about your story.

There is a quote from David's book which says, "I have always wanted to see people's lives transformed from depression and anxiety to joy and peace." What a beautiful thought and a purpose. Let's move into that direction now.

Let's get into the main stream of work that you've been doing over the years. One of the things you just shared is that you have very recently been invested in and inspired by a single session of transformation that you help people go through, sometimes over two hours, sometimes half a day, sometimes a day. Is it actually really possible? If I think about people and the struggle that many are going through today with how they feel beaten up, they feel beaten up at times by institutions and leaders that they can no longer trust. They feel beaten up by a lack of clarity as to where health and safety is going in a coronavirus age. They feel kind of shaken by all these realizations that we are so far and more in need to advance right now on issues like racism, there is a lot of job loss and economic uncertainty, etc. So, in a global crisis and moments like this, when so many are facing a lot of struggle with regard to moods, anxiety, depression, is this something that will only get fixed when these outer conditions are fixed? Is it something that will only get fixed over long periods of time when people take medication because they just happen to be someone who's been diagnosed as a clinically depressed person? Or there's something powerful in what you're saying, but can you double click on that and tell us how that works? This idea of the ability to transcend and transform and go from depression and anxiety to joy and peace through certain interventions and actions that you're helping people take.

David Burns

Thanks for the great question. The times are indeed very threatening right now from many different perspectives for folks. But one of the great ideas that's at the core of cognitive therapy and the new team therapy that I've developed since I've been at Stanford goes back 2,000 years to the time of Epictetus, a Greek stoic philosopher and really beyond before that to the Buddha who said the same thing, that human beings are disturbed not by things, but by the views they take of them. In other words, it's not the events of our lives that make us unhappy, but the thoughts that we have. This is such a basic idea, it's almost a little like Wittgenstein, what he was saying was so basic, people couldn't understand it. This is really saying that all of your emotions, even at this minute while you're watching the show, are not created by what Hitendra is saying, or what David is saying, but by your thoughts about it. This is tremendously liberating in theory and a practical reality, because we often can't change the circumstances of our lives, but we can change the way we think about it. That's the first huge idea.

By the way, on my second podcast each week for seven weeks or so called the Corona Cast. I actually treated people live on the Corona Cast who were upset by things related to Corona. One, was a beautiful psychologist whose husband is an emergency room and ICU doctor in New York. He's working all day long with Covid patients. He's afraid 2 of his colleagues died who he worked with, and he's horrified that he's going to get the Covid and die. So, he has moved out from his wife and three children to protect them. And she's worried that he's going to die. She asked for a session to help with her moods.

She said at the start of the session that she cries herself to sleep every night and is my husband going to die. This is unfair, that he should have to be out in the battlefield fighting. I mean, I can earn enough money for our family to survive, why can't he come home and be with me. And so, I had her write down her thoughts, just as I do in every session. What are you telling yourself? And then what you find is even when there's an actual crisis, each person's upset is not caused by the crisis, but by their own thoughts. And those thoughts are typically distorted. When you challenge those thoughts and look at things in a more positive and realistic way, your feelings can change. Actually, the thought that was upsetting her was, I should be strong, I shouldn't be upset, and I shouldn't share my feelings with my husband, because that will be too much of a burden for him and I shouldn't feel the way I do. So, she was kind of beating up on herself with all of these unrealistic statements and high expectations for herself. Then once she identified all the distortions in their thought, like I shouldn't be upset, I shouldn't share my feelings with my husband. She saw that it's like all or nothing thinking, a should statements, it is self-blame. It's emotional reasoning and it's mind reading. And then when we began to examine the evidence for that, she realized, well, maybe it's OK to share some of my thoughts and maybe sharing my thoughts with him will bring us closer together.

When we've done that in the past, it's led to a more loving, a loving relationship. It may have taken an hour and a half to complete the whole treatment, which you can actually hear live happening if you want to look up that recent podcast of mine. She just smashed the thought and once she smashed the first thought and saw how unrealistic it was and she said to herself, it's OK to share my feelings with my husband and it's OK to be upset. I don't have to be in control all the time. She felt such joy, then she was able to blow all of her other thoughts away and she felt great. Then the oddest thing happened a couple of days after we completed the podcast, her worst fear came to pass. Her husband developed a fever and was diagnosed with Covid. Then I like to ask people. What do you think happened when her worst fear came to pass or what happened? Obviously, she's going to be all upset. But remember, reality never causes our feelings. It's only our thoughts. What happened is she said, "Well, gosh, he's got a mild case, he's not going to die." And she went on to a state of euphoria and she just emailed me recently that she and her husband are now reunited. They rented a little house out in the country just to have some beautiful time to be together. And she just got on top of the world.

But that's her story. Every person listening right now has their own negative thoughts. One of the beautiful things about this approach is I don't have general advice to give to people. I always say to people, when you're upset, write down your thoughts on a piece of paper, see what you're telling yourself. You'll often see that those thoughts are just stored in with the 10 distortions from my book, Feeling Good. When you challenge those thoughts, you can change the way you feel, and it can happen rapidly. This is so different from the way people are trained, the way I was trained as a psychiatrist. Even the Stanford psychiatrist today are trained to think that depression builds up over years and takes years of treatment to make it go away. But that's not my experience with it. Usually, people recover from depression in maybe about 60 seconds or 90 seconds. It takes a little while to build up to that moment, but the very moment they start believing these distorted thoughts, in that instant, your feelings will change.

This is fantastic. On the one hand, because it's true, it's a powerful tool. But at the same time, when I say these things, it creates a certain antagonism among some mental health professionals and the general public who are used to thinking this way and are kind of committed to therapy or some long term thing that happens over a course of years where change is slow and gradual. I found that change can be rapid. For me, that's a blessing. If my daughter were depressed and she went to a therapist who calls her to recover in one single 2-hour therapy session, I would kiss that person's feet and say thank you. That's how we treat pneumonia with intravenous penicillin. The idea isn't to have pneumonia for years, that there's something wonderful or honorable about that. The idea is to have a curative intervention. That's how I think psychiatry and psychology could be. The field is beginning to evolve and change, but it is going slowly and against quite a bit of resistance. There are so many things in this new therapy model that are radically different from the way most mental health professionals treat people.

Hitendra Wadhwa

What a beautiful story that you've shared of this lady and her transformation and what transpires after that and how she continues to benefit from this awareness of just shifting her thoughts into a certain place, and then she accepts reality for what it is and can continue to flourish. What a powerful story. Thank you for sharing that.

David, as a way to illustrate for us the power of the thesis you are sharing, which if I get the very central part of it, it's not these outer conditions, it is the thoughts that they trigger that lead us into unhealthy mental states. Therefore, we can be the engineers of moving our feelings into a better place by controlling those thoughts and smashing some of them and moving us beyond. Now, there's a phrase that you used, which I have found very powerful and liberating about how these are not traits, but these are states. The idea that the discipline of mental health sometimes has defined individuals to be possessed of a certain trait, but actually those things can be viewed as states and you can drift in and out of them. Could you just talk about that for a second?

David Burns

Yeah, that's true on so many levels. The Buddha said we drift in and out of enlightenment. When I first heard that, I didn't know what it meant. You hear these goofy Buddha statements that seem nonsensical and then suddenly it comes to you what they actually mean. What it means is, that probably no one is allowed to be happy all the time. I often say we're entitled to five happy days per week and two miserable days. And if you don't have your five happy days, you need a little mental tune-up. If you don't have your two miserable days, you're getting a little too happy then maybe we need to put you on lithium, which is not meant to be disrespectful, but a joke. There's wisdom in it, because I'm a pretty happy person. I'm so thrilled with life and so grateful for my life and my colleagues, having a chance to hang out with you right now is like a miracle, really to me. It's amazing. You're so talented and so skillful and you've done such a beautiful job with your colleagues in creating this show today. Things happen to me and all of us that really demoralize us. We can go in an instant from joy to feelings of shame or guilt, anger, rage, depression, panic, or hopelessness and discouragement. So, what I do is, give a person tools that work for them.

I've developed over a hundred tools for crushing depression, crushing anxiety. But once you find the tool that works for you, it'll work for the rest of your life. So that once I've worked with someone and they've recovered and they're enlightened and euphoric, I just do relapse prevention training, which takes maybe 25 minutes and let them know that these negative thoughts, these insecurities, these inadequacies will return over and over again throughout your life. That's mandatory. It's a part of the human condition. But I want you to know what tools to use when that happens, because it's OK to be upset for an hour or it's OK to be upset for a day or even a few days. But if you've got the tools to pop out of that and then drift back into enlightenment, that's the whole secret.

Another dimension on what you said of states versus traits, the American Psychiatric Association views negative moods as mental disorders. They have this DSM-5, the Diagnostic and Statistical Manual of Mental Disorders, and they try to change all negative emotions into different mental disorders. Now, if I could see a show of hands from the people listening and say how many of you sometimes get anxious in social situations or have public speaking anxiety and fear, judgment of others or feel insecure in groups of people, nearly all the hands would go up. That's just the way human beings feel, I used to have what the psychiatrist would say, five different forms of social anxiety myself. I have public speaking anxiety, social anxiety, and I had a phobia of cameras. I can smile now for my camera; I could not do that for 50 years. But these are just feelings that people have and they're easily treatable and they're easily changeable. But they would say, "Oh, you aren't shy. You have social anxiety disorder," like you have a brain disorder. They do that with everything. You're not sad and down. You have major depressive disorder. "Oh, you worry a lot. Well, you have a generalized anxiety disorder." They're trying to disrupt everything. There's a dichotomous yes or no thing. But these are just feelings that human beings have.

But when you view it as a disorder or a state, rather than just a trait or a feeling that you have, then you think, "Oh, I'm defective," you're ashamed. Then they say it's because of a chemical imbalance in your brain or a bad childhood or some personality defect. One of the things that makes the new team therapy so powerful is we've come to see that these symptoms, as well as people's resistance to change, do not result from a chemical imbalance in your brain or that you have a brain disorder or some kind of mental defect. Your symptoms, your negative feelings result from what's most beautiful and awesome about you. They're not expressions of brokenness. They are expressions of your deepest core values as a human being. The moment you see that your negative feelings are not bad, but good, really beautiful things. I really try to talk my patients into preserving them, not getting rid of them. I do that in a very gentle and positive and respectful way. The moment the patient sees this paradoxically, the resistance to change disappears and generally, recovery is just 10 or 15 minutes away.

It takes a little while to do that procedure of melting away the resistance. It might take 45 minutes of a session. But it's a pretty remarkable thing, and it's a radically different way of viewing negative feelings from this illness model.

Now, there are 3 or 4 true mental disorders. Schizophrenia is one, bipolar is one, the full-blown manic-depressive illness. These are due to some abnormalities of brain tissue, a real mental disorder. But 90-95% of what causes happiness for the people watching the show right now is not mental disorders, but just negative feelings that are a part of life. But there are things you can do to pinpoint those negative thoughts, the distorted thoughts that are causing those feelings and to transform them. That's not to say we should never be unhappy. Some negative feelings are healthy. If a loved one dies or a pet that you love dies, it's natural to cry, to have grief, to be sad, because your sadness is an expression of your love for life. But when you get depression or excessive anxiety or telling yourself things that aren't true, like I am a loser, I'm no good and I'll be hopeless, things will never change and that's what can be changed now in many cases very rapidly.

Hitendra Wadhwa

David, in so many ways you've just summarized such a powerful body of work that, of course we can only do so much justice to the very precious hour that we have together.

David, you've been sharing a lot of things here that are giving glimpses into a much richer kind of machinery that is so beautifully documented, shared and taught in your books. We are going to spark some of these ideas here today in your presence. But I'm going to encourage everyone listening to the show to go into the written work of David's books to be able to get more of the practice of what it is that we are sharing here. David has talked about the realization that thoughts are behind a lot of our feelings. It's not the events on the outside that, David, you tend to ask people not just to help them just broadly, but to start writing down the thoughts and diagnosing what's wrong with them, which leads to your point about these 10 mental distortions that you've compiled, which is there in your books.

Then there are several techniques that you offer in order to really be able to then ultimately smash those thoughts to get rid of those distortions, but also to hold the space for those thoughts that might be, in some ways, a valid representation of the world that we are facing when somebody does get sick or in some cases somebody does pass away and to validate some of those feelings as being very noble and coming from a place of deep values. There is a lot that you shared already, which I think represents that full arc of going from pain to healing, which can only be done full justice to by any of us if we really put in that effort and the time to go through.

Yet, it's not a very effortful effort, because when I read your books, David, one thing that really struck me about them is that they are very different from so many others, is that it almost feels like you are there with me talking to me. It doesn't look like I'm reading words from the passive agency of a book. It looks like I'm having a dialogue with you. You're just incredible at taking this craft of what you have done in the therapy suite and translating it into even just the form of a book.

Can you talk for a minute about this incredible way in which the psychotherapy profession has also recognized the power of the teaching that is there in feeling good? I recognize you are coming up with a new book now which might further advance the craft. But I was very inspired by this notion of bibliotherapy, getting therapy by reading a book. There are some incredible studies that have been done on that with Feeling Good. Could you just talk about that for a second?

David Burns

Well, yes. I first read about these studies in The New York Times. I didn't know that they were going on. A psychologist at the University of Alabama named Forrest Scogin, began doing research on my book, Feeling Good because he was trying to say what is the cheapest and most effective way to treat people with depression? He said, "What would happen if we took people who were coming to the medical center for treatment for moderate to severe depression and told them they had to be on a waiting list for four weeks before they could see their doctor. But in the meantime, read this book, Feeling Good." And half the patients they just put on the waiting list, half of them for four weeks and the other half was a random outcome study, half of them, they gave the book Feeling Good. Then they studied their moods every week for the four weeks and they found that the people on the waiting list haven't changed. But 2/3 of the patients who they gave the book Feeling Good to improve so much were recovered to the extent that they no longer wanted or needed therapy.

That was fantastic, because I didn't think of the book as a self-help book. I was excited about how it might help people in therapy recover faster. But I didn't think it would itself have an anti-depression effect. Then they took the ones who hadn't improved, who were on the waiting list, and they said, "Oh, you have to wait four more weeks. But in the meanwhile, read this book." Then in the next four weeks, 2/3 of them also improved or recovered to the extent that they no longer needed treatment. They've also done follow-up studies on those patients for up to three years and they have the feeling that they have gotten improved even more and did not have any relapses needing treatment. They often got upset, just as I do, and just as you do. But they said when they got upset, they just pulled the book off the shelf and read those pages again.

Then there have been multiple independent studies with different teenagers, older people, different ethnicities and seems to have that effect that has been replicated over and over again.

My new book, Feeling Right, will address, how about the 1/3 of people who didn't improve when they read Feeling Good? And how about the 50% of patients in all these psychotherapy or studies of depression or antidepressant studies who don't improve in those studies. What's the difference with the ones who don't improve or why do they stop? I think my research led me to the discovery of why some people get stuck in depression. And that's what led to the new team therapy that has even new and more amazing tools. All the original cognitive therapy stuff I had in Feeling Good, all that stuff is still pure gold. But we now have new innovative techniques to reduce this therapeutic resistance that keeps some of us who get stuck or sucked in by depression. These new techniques are the secret of the ultra-rapid recovery I'm now seeing in the vast majority of people I treat.

Hitendra Wadhwa

What will be one example of a practical insight, a tool or a technique from these advancements that you've done in the last few years that could benefit our listeners? There's a question, are there certain people who are more able to step back and become aware of their thoughts and work on them and others who may not be able to do that? You've talked about how you are now working to help bring breakthroughs to that percentage who weren't showing a lot of impact in the past. Is there a tool or insights that could be of value to our listeners?

David Burns

Well, there's certainly a tendency that varies among people toward negative thinking and getting sucked in by negative thinking. We don't know the cause of that. There could be genetic factors or environmental factors, but certainly everything is on a bell-shaped curve. But what is really cool is that with the new techniques, we can help almost anybody who is feeling depressed or anxious.

At my hospital in Philadelphia at Presbyterian Medical Center, we developed a huge cognitive therapy program for the people in our area, we treated mainly homeless people, and quarter of our patients couldn't read or write. They were from all ethnicities and we treated them with cognitive therapy groups based on my book, 10 Days to Self-esteem. The groups were just led by people in the neighborhood who were taught and trained by a clinical psychologist. That program was very inexpensive. So, our Department of Psychiatry grew from two employees when I started the department to over 200 full time employees within a year. We ran thousands of patients through that program and most of them were symptom free within three days. It was just an entirely new model, a new way of treating people. But we had people from all walks of life and all orientations.

The compassion of the people in the program in helping these individuals. We didn't treat them like one group a week. We treated people all day long, every day. You come into the program and you're going to be in cognitive therapy groups from early morning to late at night every day until you are recovered and ready to get discharged. I think it can be helpful for virtually anyone. But another thing I learned in my research and something you alluded to was that the act of practice is absolutely mandatory. You can't just read my book Feeling Good and expect to recover. You have to do the written exercises, write down your thoughts, identify the distortions like all or nothing thinking, overgeneralization, emotional reasoning, should statements and self-blame and things like that and then practice, how am I going to challenge that thought. There is something about that written exercise that seems important.

At my clinic in Philadelphia, I did research on hundreds of patients who came to us and what I discovered was that virtually every patient who did a little bit of psychotherapy homework consistently throughout the therapy improved or recovered completely in the first 12 weeks of treatment. Virtually every patient who refused to do the homework assignments failed to improve. Many of them deteriorated and just dropped out of therapy. I published that in the top psychology journals. That variable, which I call willingness, is still, I think, the only variable in world literature that has been shown to have a massive causal effect on changes in depression. That's what actually led to the team therapy, because I always thought, "Well, since some people are unwilling to do this, what techniques could we do to melt away their resistance?" And that's been the feature of the new team therapy that'll be in the new book, Feeling Great, all those new techniques, as well as the original cognitive therapy techniques.

Hitendra Wadhwa

I'm so looking forward to that book, David. It sounds like it is really advancing the craft in a very important way and all based on real grounded work that you've been doing over the years. As you were speaking about this need for that effort for repeated practice in a disciplined way, it just reminded me of an experience very recently in my own career where I was really struggling with one outcome that was not coming my way, I was going down a certain gentle spiral towards depression or just feeling really low about the fact that this was not happening. I have these two modes in which I operate, one where I get very obsessed and attached to that goal, and the other where I just get myself anchored in my core belief that there is a power in this universe that is all loving and caring and attentive and ever present, omnipotent, and that the only duty I have in life is to be able to step away from my ego to allow that power to flow through and do its bidding, because it knows better than I do, as to essentially what it is that we need to make happen in humanity.

I had to really slow my work down, slow my life down, go into a reflective mode, do almost the kind of work that you're talking about of recognizing my goal obsessed thought in that moment, challenging the thought, bringing it back to my core belief, putting a lot of energy into that belief in that moment. And to your point, you just experience this complete sense of release and liberation from that negative thought. You go into this place of grace, serenity and joy. It's a daily journey to make. You have to keep striving for that illumination, the enlightenment and balance, as you said, to drift back into that more enlightened state.

David Burns

Well, you've done a beautiful job, not only in translating a lot of these concepts into the business world and for people in general to make them understandable. But you've also done your own personal work, your meditation, your own spiritual effort. This has had a powerful transforming effect on you, which is beautiful to see.

The kinds of things I'm doing from a secular perspective, from a research perspective, from practical tools, are really accomplishing the same kinds of goals to get people to the state of self-acceptance. I have often said self-acceptance is the greatest change a human being can make to get to a stage of what you might call spiritual enlightenment. Because to me, I'm no longer treating people's defects to try to make them less depressed or less broken. That was the model when I was a psychiatric resident. But my goal now is to bring people not only to a complete abolishment of their feelings of depression and anxiety, but also to thrust them into a state of joy, of enlightenment, of inner peace, something that's a little difficult to explain in words.

If you see it happening, like in a live therapy session, you can see the moment when the person gets it. If you have experienced it yourself, then you grasp it. But at first, it's a little hard to grasp and a lot of people just believe it's not even possible. They just think it's a lot of B.S. But it's something very real and something very beautiful.

Hitendra Wadhwa

Thank you for sharing that. David, in that last piece that you just talked about, it's beautiful to see how you have continued to reinvent yourself and to advance human consciousness in very practical ways, in very toolkit-based ways. You were talking about the need for really helping people feel great fulfillment and worth for who they are. And I remember your book, 10 Days to Self-esteem, which to me should also be considered a classic. The book is incredible in terms of a structured way in helping people advance the cause of healthy, sustainable form of self-esteem.

Am I hearing from you that in more recent times you have further pushed the envelope and further advanced that into a much deeper place of people feeling this joyful sense of connection with themselves? Is that something that Feeling Great, your new book is going to help give them more?

David Burns

Yeah, that's why I wrote Feeling Great, although I've written spinoffs from Feeling Good. This is the first true sequel because it will have massive new technology for change while preserving all the great stuff that was in Feeling Good. All that stuff is still great, but there's a whole second technology that is as powerful but radically different from that. When you put those two together, it's like one plus one equals three types of thing.

Essentially, the new book is not only working on cognition, but also on motivation and resistance and also transforming the field from a field that's based on viewing people as broken to quite the opposite, that our suffering is revealing things about us not that are broken and shameful, but that are beautiful and awesome. The moment a person sees the beauty of depression, the beating up on yourself, the self-criticism, I'm not good enough. And instead of seeing those things as shameful defects that you shouldn't do, to see those as expressing truly remarkable, beautiful, mind blowing things about you, suddenly your shame disappears and you become proud of your symptoms rather than ashamed of that.

The moment you do, you don't need the symptoms anymore and it is really easy then to cause people to recover. It is so easy now for me to treat people. It almost feels shameful, like it's supposed to be way harder. But I think we have something that's truly remarkable and truly a breakthrough. It'll take a while to catch on, just like cognitive therapy when I wrote it. There were only 12 or 15 cognitive therapists in the world. Most people consider us Quacks. Now, it's kind of the same thing. After Feeling Good came out, cognitive therapy has now become the most popular form of psychotherapy in the world and the most researched form of psychotherapy in human history.

Now I have to do the same thing with the new book Feeling Great, and the new ideas, which I believe represent a potential major advance beyond cognitive therapy, which was huge. It deserves to be honored. The techniques are still effective, but there's something even more powerful now.

Hitendra Wadhwa

David, to wrap this up, you are somebody who strikes me as so deeply invested in your cause. Moment by moment, day by day, year by year, decade by decade. I am always struck whenever I spend time with you, how invested you are, how focused you are, how passionate you are, how productive you are, how prolific you are in all that you're thinking, in all that you are doing, in all that you're documenting, in all that you're teaching, in all that you're researching and in all that you're going to heal people. Where do you get that energy and how do you stay rejuvenated, given that it must take a lot from you to be able to wake up in the morning, do all this incredible work and get back to bed. Where does your energy come from?

David Burns

Well, just to go a full circle, comes back to what we started out on the show. The decision I made not to stay in a field that I knew was not valid and wasn't really going to bear fruit and to do what I loved and what I believed in. That decision has really paid off for me because I absolutely love what I'm doing. I have this fantastic new database on how psychotherapy works, I have got data over 9,000 psychotherapy sessions. I'm building a mathematical model that's creating amazing new insights that are radically different from the way the field thinks psychotherapy works.

Well, this morning I slept down. I slept until 6. Usually, I'm so excited I'll wake up at 4 and come down and start analyzing that data. It's like being in a candy store, discoveries come out. There are several. I'm just lucky to be doing what I love doing. Then when I work with people for free, my training group at Stanford is free for therapists in the Bay Area that they can come and get unlimited training and unlimited therapy for the rest of their life for free every week, 2 hours on Tuesday nights, and then before the Covid, we also did have a 6-hour hike on Sundays. People are grateful and they want to give back. So that has created a whole community of people, a community of creativity.

Now I'm working with Jeremy Karmel on a Feeling Great app and we're put in a tremendous time on that. We'll be recording today the idea of developing an electronic flavor that I think can be as good or better than the real David, because when I got the data on my book Feeling Good and saw that 65% people read it were cured in four weeks, I said, "Oh, that's better than I'm doing." My book is better than mine because I can get irritable. But the persona I created in that book is always loving and wonderful. But I'm hopeful that the app we're working on can have some of those same effects, too, so that people all over the world, people listening to the show now can participate. If anyone wants to be a beta tester, just go to my website feelinggood.com/app and you can sign up there and you can help us develop this app by telling us what turned you off? Turn you on. What do you like? What do you not like?

Hitendra Wadhwa

Well, that's wonderful, I'm super excited to hear about the app. We are living in a very amplified world and why not use this channel as well.

David Burns

You were the one who told me to do it. Remember, you brought me into the Appstore 5 or 8 years ago. I still don't even have a cell phone, but it finally dawned on me that what you were saying was right. I have to thank you for that.

Hitendra Wadhwa

You still don't have a cell phone?

David Burns

No, but the guy I'm working on the app will say, I've got to get one. So, I think I'll get an iPhone 11 or something like that. They say use the app you're creating and see how it looks. So, I will probably get one. But it just never appealed to me to have a cell phone.

Hitendra Wadhwa

That's an incredible revelation, David. You don't have a cell phone and that is what most of us today are married to. But on the other hand, you have this wonderful spouse. That article in the Stanford magazine talks about it in a very beautiful way. the time of your meeting, dating and ultimately getting married. Melanie is a clinical psychologist herself and I know has been a tremendous force in your life. Could you close this out by just reflecting with us on that relationship? What has it meant to you to have her with you all through this journey?

David Burns

Well, I just love her tremendously. I am so grateful to have Melanie as my wife. She's really the brains in our family. When I met her, she was just a high school dropout and kind of a hippie. We were hippies. I offered her a ride on my motorcycle and she accepted. And we fell on a great journey ever since. Then she went ahead and went to college after the kids were born. She got her Ph.D. in clinical psychology at Penn. She's just incredibly brilliant. I'll struggle for something for six months that I don't understand, trying to figure it out, then I'll mention it to her and in 15 seconds, she'll blurt out the answer. She always knows how I'm thinking. She knows how I'm feeling. She's kind of my guide and she supports me and makes it possible to do what I'm doing.

It's kind of hard for her now with the Covid thing. It's not hard for me, because I'm like with you now, having fun and I do Zoom and stuff with my colleagues all day long. But, she can't play tennis now with her friends and she's feeling a little sad and down. We met last Saturday with our son Eric and his new girlfriend Sammy. She's just awesome. He's on top of the world. We went on a distant hike and then ate in a dining room, but it's like 8 feet from each other. So, we had a little family contact there, which means so much to her. I'm just really lucky to have Melanie.

Hitendra Wadhwa

Do convey my warm regards to her. I think all of us feel a great sense of thankfulness for what she has meant to you and what you must mean to her.

David, you had mentioned some time ago that if your daughter was suffering from this thing and there was this person who could help her in this way, you would kiss his feet. I think that is an appropriate way for me to close out at this moment with you in that beyond what you meant for the world, you have been a tremendous force in my own career. While it is true that, as you recognize, I am very grateful for teaching a path, a spiritual direction that I have been deeply invested in, you should also know that the work that you are doing has been a critical complement to that, not just for myself, but sometimes I brought these tools and these ideas into that community as well. It's so synergistic, it's so harmonized with really the teaching that is there any great spiritual tradition on any great spiritual path but what you've done is to give it a certain form, give it a certain practical toolkit, and infuse it with these stories of modern-day healing miracles, which I think are incredible in many ways.

It is a moment where I should kiss your feet because you have been a tremendous teacher and guide and illuminator for me, as much as for the world. Thank you so much, David. On behalf of the community here, all the best in all that you are doing in the months and years ahead and looking forward very much to feeling great as well, and I look forward to having you back on the show if you would be open to gracing us again.

David Burns

Sure. I would love that. It's fun to shoot the breeze with you. I'm just so proud of what you've accomplished personally and professionally. I'm just honored to be on your show and to interact with you today. Thank you so much.

Hitendra Wadhwa

There is the Stanford article we sent you, there is the Feeling Good website that David talks about from where you can get access to David's podcast and also, sign up to be a beta user of his app. There's the book, Feeling Good and some of the other books around self-esteem and anxiety. Then more recently, this book called Feeling Great, that is meant to come out. Those are all the resources that David and I can point you to as a way to really take to heart the ideas and thoughts and tools that are so transformational in what David is offering us. I'm so grateful.

We're going to be having some really meaningful dialogues in the weeks ahead, including on this topic of race that has really hit the world radar, that has stirred our consciousness so much in the last few weeks. We will have a couple of key voices coming in, reflecting and sharing more with us on that. But for now, thank you for staying the course much beyond our usual hour. But I thought it was well worth it to have David here for as long as it took to get us to a good closure place. Godspeed. You take care. We'll see you next week.

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