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Ask David, Rhonda and Matt

Assertiveness,

Suppressing your Feelings,

and the "Miracle Cure" question

Questions for today\\u2019s Ask David podcast.

1. Chris asks if I have a book about assertiveness.

2. Brian asks: Is there anything to the theory that "suppressing emotions" is harmful or is that just Freudian mumbo jumbo?

3. Matt asks about the \\u201cMiracle Cure\\u201d question in the Assessment of Resistance portion of a TEAM therapy session.

Rhonda began with a lovely endorsement and a cool reminder of the classic book, Robinson Crusoe, who created cognitive therapy (the double column technique) when he was stranded on a deserted island! I believe I wrote about it in one of my books, possibly Feeling Good. It\\u2019s pretty cool! You will hear Matt playing the role of the \\u201cevil\\u201d thoughts, like, \\u201cI am stranded alone on a deserted island,\\u201d and Rhonda will play the role of the \\u201cgood\\u201d thoughts, like, \\u201cYes, but my life was spared, and all of my shipmates died.\\u201d

Here\'s what it looks like in the novel:

I know this novel is a couple hundred years old, so it certainly deserves nomination of the earliest cognitive therapy!

Now, for the answers to today\\u2019s Ask David questions. Keep in mind that these answers were written BEFORE today\\u2019s recording, so the actual live answers will differ in some regards from the written answers below.

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1. Chris asks if I have a book about assertiveness.

Hi Dr. Burns,

I hope you\'re doing well. Do you have a book on assertiveness training?

I\'ve used your books to help me with my hidden "should" statements, which has enabled me to be less angry or anxious whenever someone treats me less than satisfactorily.

While this has helped immensely, I realize it\'s still in my interest to reduce the behavior I disagree with. For example, my sibling scheduled an early morning shift after I had a long day of work. Because they can\'t drive, they expect me to take them to work, which means I\'ll only get about 5 hours of sleep; this in itself isn\'t a bad thing... except this is the 3^rd\\xa0time in a row they\'ve done this.

After using your techniques, I\'m less angry and anxious, but I still want to address the behavior to reduce the likelihood that they do something like this again, which is why I\'m reaching out.

Thanks for your help.

Kind regards,

Chris

David\\u2019s Reply

Sure. I like my own book, Feeling Good Together, and have often recommended Manuel Smith\\u2019s When I Say NO I Feel Guilty.

There is a LOT to be said about assertiveness training, including the fact that it doesn\\u2019t always work! I can give a great personal account of that!

Sometimes, or always, skillful listening is also effective. Assertiveness without listening makes it sound like only your own feelings are important, which is obviously pretty self-centered.

One of the most helpful things to me is the difference between healthy and unhealthy anger, and how to express tough messages in a loving, respectful way.

Can discuss more on the show. For example, what are the problems with the assertiveness movement? And where can it be helpful?

And what mistakes do unassertive individuals make when trying to be more assertive? Do they sometimes overdo it?

Warmly, david

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2. Brian asks: Is there anything to the theory that "suppressing emotions" is harmful or is that just Freudian mumbo jumbo? Thanks!!

David\\u2019s reply.

Thanks, Brian. Great question!

You can listen to the podcasts on the Hidden Emotion Technique, or read about it in my book, When Panic Attacks.

Will make this an Ask David question if that\\u2019s okay!

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3. Matt asks about the \\u201cMiracle Cure\\u201d question in the Assessment of Resistance portion of a TEAM therapy session.

Hi David,

I\'ve noticed that when I ask the \'miracle cure\' question or \'magic wand\' question, I\'ll sometimes get a response that isn\'t all that useful and I might waste time trying to figure out what the person is really asking for.

An example might be, \'I want to be able to support and understand my husband, who is addicted to video games and spends a lot of our money on games\'.

I\'ve found it helpful, in such situations, to ask, \'let\'s imagine you could achieve that goal, you were perfectly understanding and supportive, at all times, of your husband, who is addicted to video games and spends a lot of your money on games...what would change, in your life, if all your dreams came true?\'

I think this might help in a lot of cases where the agenda is a bit fuzzy and unclear.

Wishing you the best!

Matt

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David\\u2019s response

Matt and I exchanged several emails we\\u2019ll discuss on the podcast. Essentially, I don\\u2019t think this woman is asking for understanding why her husband is addicted to video games and spends money on them. Instead, she is secretly blaming him and is probably angry with him for not spending time with her! She wants to change him.

Matt agreed with this and has proposed a new tool therapists can use when setting the agenda.

I, David, also raised the problem of \\u201chearing the music\\u201d behind the patient\\u2019s words. This is incredibly important\\u2014but hard for therapists to learn\\u2014when using the Disarming Technique. They have a tendency to agree with the patient\\u2019s words in a literal way without \\u201chearing\\u201d what the patient is really trying to say.

If you use any form of therapy literally, with really grasping the patient\\u2019s feelings, your treatment will not be effective or helpful. There is a human art to therapy, and following rigid formulas simply won\\u2019t come across as compassionate or genuine most of the time.

That\\u2019s why I am dubious about testing different therapies with outcome studies with human therapists. You are actually testing the impact of a miscellaneous group of therapists with potentially widely divergent skill sets. This is one of the many reasons why psychotherapy outcome studies for depression all come out about the same\\u2014somewhat better than placebos, but not much better.

And there\\u2019s been no one winner when using human therapists.

Dr. Paul Crits-Christoph from the University of Pennsylvania Department of Psychology once published a study showing that the differences between therapists within each arm of an outcome study were grater than the differences between the two schools of therapy!

That\\u2019s why I\\u2019ve been so excited about analyzing data from our beta tests with the Feeling Great App. Each \\u201cpatient\\u201d gets the exact same shrink! This makes the \\u201cdose\\u201d of the TEAM done by the computer the same for each patient, much like an outcome study of a medication.

TEAM is a actually series of metaphors! If you don\\u2019t \\u201cget\\u201d the metaphors, and try to apply TEAM in an overly literal way, you\\u2019ll have a lot of trouble learning TEAM!

David

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Matt\\u2019s Musings:

David is incredibly gifted when it comes to \\u2018hearing the music\\u2019 behind what folks are saying, verbally. I suspect this is partially an innate gift, like someone who\\u2019s a prodigy at math, only for emotional states and understanding people.

After years of practice, I\\u2019m not quite as good as David. However, I think there were specific forms of experience that helped me improve my skill \\u2018hearing the music\\u2019.

In addition to using measurement and processing feedback with my patients, one thing that helped me a lot was using a lot of \\u2018uncovering techniques\\u2019. These include the \\u2018What If\\u2019 technique, to expose hidden fears, the \\u2018Individual Downward Arrow\\u2019, to expose hidden insecurities, the \\u2018Interpersonal Downward Arrow\\u2019, to expose hidden assumptions about how we \\u2018should\\u2019 act in our relationships.

Seeing several thousand of these has helped me with \\u2018pattern recognition\\u2019, which I think is related to \\u2018hearing the music\\u2019. I\\u2019m proposing that beginning therapists might also benefit from an \\u2018Uncovering Technique\\u2019 for agenda-setting, following the \\u2018Miracle Cure Question\\u2019, which keeps asking, ok, let\\u2019s say you got that, what would you hope for, if you got absolutely everything you wanted? Ok, and let\\u2019s say you also got that, what would you hope for, in your wildest dreams?

This might expose hidden agendas which can be super important if we want to be able to anticipate resistance and identify the \\u2018cost of recovery\\u2019.

Thanks for listening today!

Rhonda, Matt, and David