A (2:41)

If you had to describe what you do for a living, how would you describe your work?

B (2:46)

Well, I'm trained as a clinical psychiatrist, but what I do is very different from what most psychiatrists do. I'm not anymore a drug prescriber, although for a while I was doing research on this chemical imbalance in the brain and giving out pills by the bucketful. But what, what I really like to do is bring about high speed change to people who are struggling, often for years or decades with severe depression and anxiety and transform their pain into joy in a short period of time. And by a short period I'm talking about usually in, in a single therapy session lasting maybe two hours. And I like to complete treatment in a single session if, if I can. And usually that is possible. But when I was a psychiatric resident, we, we just had, just had people come in and talk and then we would give them pills and then they'd come in and talk some more and give them more pills. And there never seemed to be any conclusion to the process. I, I can't remember anyone ever recovering when I was a psychiatric resident at Stanford or University of Pennsylvania medical school. And I always had the dream, you know, aren't we supposed to be able to cure people or bring them out of depression and into joy? And that's what I finally learned how to do after, you know, 40 years of treating people and doing a lot of research on people, how people actually change.

A (4:22)

What you're describing, I think is the way that most people are treated. The sitting in front of an individual for years talking about their problems, getting some sort of prescription maybe, maybe just help people understand where this system or where this style of help even came from.

B (4:42)

I had first seen it when I was a medical student. I was, I went to Stanford Medical School and I shouldn't have. One of my college advisors said, oh, you should go to medical school. I said, well, I'm not a pre medical student and I never wanted to be a doctor. And he said, I said, I think I'll be a psychologist because I'd like to do psychotherapy and, you know, help people change. And he said, oh no, no, you have to go to medical school because drugs are going to become so important and psychologists can't prescribe drugs, so you should go to medical school. I said, well, how could I get in? I'm not a Premedical student. I've never had a biology class and they wouldn't want me. And he said, oh, you can talk your way into anything. They won't even notice. So I talked my way into Stanford Medical School, but I was like a fish out of water. I cut most of my classes. I, I didn't enjoy what I was, was doing and I just wanted to get in a situation where I could, you know, work with people and, and free people. But I, I, I cut a lot of my medical school classes, but I went to this thing in Palo Alto called the Human Institute and this crazy Chinaman named Hussein Chung was the head of it and he was kind of a guru type of, and they would have these marathons, 48 hour marathons where they'd get maybe 35 people in a house and they'd pay 35 bucks for this two day experience. And one by one they'd go in the center and be confronted and they'd kind of crash and they'd rip away their, their defenses, you know, kind of see through them how phony everyone was. And then when they crashed and cried, then all of a sudden, you know, they would throw them in the air and they'd go into a state of joy and you know, it was like becoming vulnerable and becoming real. And, and I saw rapid change pretty much every time. And then I would go back to the Stanford Medical School for my medical school classes and it was all this kind of pompous psych psychiatrist in the department of psychiatry and, and you just talk to people end, you know, that people weren't measuring anything, that I didn't see anything changing for, for, for people. And, and, and I, I dropped out for a year on two different occasions. And, and then finally I ended up homeless with my now wife living down near Carmel Valley. And, and my wife was pregnant. We would just, I would just was counseling people for free. And if I met them in a coffee house or on the beach or whatever, whatever, you know, and, but we didn't have any money. And then it occurred to me, wow, if I went back and, and did my internship and residency, I still wouldn't know anything. But people wouldn't know that and they think I know something. So they would pay me to come and talk to me and then we could have a place to live and food and stuff like that. So I, I, I went back and I did my internship and residency at a big county hospital in Oakland, California, Highland Hospital. And that was a fantastic experience for me. And then ended up at UPenn Medical School and I started studying really hard and I won awards for my research and had a tenure track position on the faculty, but I still wasn't seeing anyone being cured of anything. And in our research, I was doing research on this chemical imbalance theory of, you know, brain chemistry is the cause of depression. And our, our research proved it was a false theory. And I published that in the top Psychiatry Journal in 1975. And it took the field 30 years to catch on to the fact that, you know, depression is not due to a deficiency of brain serotonin. There's never been any proof of that. There's never been any evidence of that. It was just a stupid theory that someone made up to get grants. And meanwhile.

A (8:53)

But what is that? Is that not. What is that not. Sorry, that's. That's fascinating. I mean, do people still not believe. I thought people still believe that in 2024.

B (9:02)

Well, sure they believe it because the drug companies promote that theory. So they can sell these placebos that are called antidepressants, which are nothing but chemicals with side effects, but they're not true antibodies antidepressants, and they don't really outperform placebos by any significant clinically meaningful effect. But to test it, we did a simple experiment that I think a fourth grader could understand. At the VA hospital, we had a depression research unit. And I did a two year postdoctoral research fellowship in depression research after I finished my psychiatric residency. And we reasoned if, if depression is due to a deficiency of serotonin in the brain, which the claim was then to raise, brain serotonin will eliminate depression. And so we divided the depressed veterans on the research unit into two groups and, and half of the, they both got milkshakes each day. But half of them, the milkshakes released with massive doses of L tryptophan, which is an essential amino acid that the body can't produce, you have to get it in your diet. And it goes from the stomach into the blood and into the brain where it's instantly enzymatically transformed into serotonin, the so called happy molecule. And so we had both groups for a number of weeks with half, but it was double blind. So nobody knew who was getting the massive doses of L tryptophan. And then we broke the code. We measured their depression levels every day. And after four or five weeks of this, there was no difference. Neither group had shown any improvement. And there was no difference in the depression levels in either group. And so we published it in the Archives of General Psychiatry. Serotonin Precursors in the treatment of Depression was the name of the article. And we reported well that since massive influences increases in brain serotonin did nothing for depression, how can it be that depression is due to a deficiency of it? But people didn't care. It was a correct conclusion. But the drug companies make billions marketing these things called antidepressants, which aren't really antidepressants. If you believe something's going to help you. If someone says this pill is an antidepressant, a third, you've got a 1/3 chance of improving. And that's what you see with them. But you also see that if you give them a sugar pill and say it's a powerful new antidepressant. And so I said, I don't want this job at the university. I got a big grant from the government to build a serotonin research laboratory because we were doing cutting edge research. But I told my advisor, I said I don't want to spend my life doing this because the theory is a fraudulent theory and no one's being helped. You know, we've been giving these veterans on our research and massive doses of antidepressants. I've never seen one of them recover. We had Prozac in the 1970s before, years before it came to market. It was called Lily 110140 that we got all the new experimental antidepressants. But I, I could see it was wrong and that it just. And so I left the university. They pressured me to stay on the faculty and they said, this is stupid. You're burning bridges. You're known all over the world for your expertise on brain serotonin. I said, well, that expertise isn't worth anything and I want to find out how to cure people, how to help people who are depressed. So I started going to Dr. Aaron Beck's cognitive therapy seminar just because the colleague said he's got a new theory that depression is caused by negative thoughts. And I said, well that, that sounds right. All my depressed patients have negative thoughts. But you can't cure depression by changing negative thoughts. And he said, well, why don't you go to his seminar then and prove it to yourself. Get, try it on some of your patients and then as part of your research fellowship and then you'll know that it doesn't work, that it's a fraud. Because Beck looked like a fraud to me. He was a fast talker, guy wore these goofy looking bow ties and, and so I went to his, his seminars and I started trying it on my patients just to prove to myself that it wouldn't work. And the first, for the first time they started turning the corner on their depressions and I, I couldn't believe it. And I said, maybe there's something to this thing after all. And I treated more and more, more people and got really impressive results. And the patient said, keep going to that seminar, keep learning these techniques. And then I, that's when I left the university and said, I'll just develop my private practice and help develop this, what was then new cognitive therapy. And I wrote my book Feeling Good. And it just changed the whole trajectory of my life. And in those days, we cut the treatment time down from maybe a year or two for depression to maybe a month or two. And that seemed like a fantastic acceleration. But since then I've done further refinements over the last 40 years and now can, can do it for most people in just a two hour period of time.

A (14:46)

So the way that, what you're saying is the way that most people understand depression, it's, it's, it's a con. It's not true.

B (14:54)

Exactly. Yeah, that's right. It's a con. It's not tr. True. And it's worse than a false theory because the false therapy theory is generally discarded by scientists. But a false theory that supports economic gain, people stick with.

A (15:11)

So then help me understand if this, if the traditional definition of, of depression is not true, what actually causes it outside, like negative thoughts? It's hard to put a finger on. Like how do you describe, how do you quantify a negative thought?

B (15:27)

Well, because I have a paper about to come out on that because, you know, 2,000 years ago Epictetus said people are disturbed not by things, but by our views of them. Our thoughts, our interpretations of events. And that's been debated for 2000 years. And of course the cognitive therapists believe it's true. And other therapists say our theory is fraud. It's shabby, it's not, not true. And so I, I recently did an experiment with about 2000 people and proved for the first time that negative thoughts do cause depression. And the way we measure that is that we ask people in therapy or in an experiment, you know, what, what are some of your self critical thoughts? Like, you know, I'm not as good as I should be. That's a common one. How much do you believe that? Oh, I believe that 100%. Or I'm defective. A lot of depressed people have that, that thought. I believe that a hundred percent. And then with our app, we, we use a lot of techniques that I've developed or learned to help people challenge the distortions in these negative thoughts and, and to lower their belief in them. And as they stop believing them, we can measure negative moods with 96% ACCUR scales. And sure enough, as their negative thoughts go down, the negative feelings go down. And when they stop believing those negative thoughts, the negative feelings disappear completely.

A (17:03)

Is there anything that happens hormonally in this process or. No.

B (17:07)

We are organic beings. And so the brain is constantly. It uses more energy than any other organ in the body, even more than muscles. And so there's, you know, billions of nerves and billions of circuits firing all the time in the brain. We're going to meet tomorrow with a group from Utah who have a clinic who have some of these multimillion dollar functional MRI brain imaging machines. And we're going to do some studies of people using our app and have their brains image simultaneously so we can see the very moment when the change in feelings comes exactly what's happening in the wiring in the brain. It's an experiment I've been wanting to do for 35 years, and I finally talked someone into doing it, and we're very excited about that. But in the therapy, it's a very practical thing. It's using a variety of techniques. There's really over a hundred of them now to help people crush these, these negative thoughts. Because the thing about the negative thoughts is they're really distorted, they're, they're not true. And, and the moment you, you realize that, your feelings will change. And I can give you an example of it if you want.

A (18:34)

Yeah.

B (18:34)

Make it clear.

A (18:35)

Sure.

B (18:36)

One of the first patients that I tested this on when I was going to Beck's clinic, and I was still, you know, didn't know what I was doing really from a psychotherapy point of view. But she was referred to me from the intensive care unit of University of Pennsylvania Hospital because she had tried to kill herself, an elderly woman. And I thought, well, this would be a good one to, to test this new. What was new cognitive therapy in those days? And I'd been giving her pills and having her talk the way I was trained to do, and nothing had changed. I measured her depression every week and, and she was stuck. And I, I said, there's this new thing I'm learning. Would you mind if I present your case at the conference? We have a weekly conference with about six or eight of us, and maybe I'll get some tips on, you know, we could try this new cognitive therapy. And she said, sure. You know, I'D love it if you do that. So I said, Dr. Beck, here's this elderly woman, and she tried to kill herself and almost succeeded. And what. How would I treat her with this based on negative thinking? And he says, well, that's easy. Just ask her what she was thinking the moment she tried to kill herself. I said, oh, that makes sense. That's easy enough. So I went and I said, told her. I said, Dr. Beck said, I'm supposed to ask you what you were telling yourself the moment you tried to kill yourself. And she said, oh, yeah, well, I was just telling myself I was a worthless human being because I've never accomplished anything in my life. I've never done anything worthwhile. And I said, well, why is that? What. What have you done in your life? She says, I've. I've done nothing but, you know, clean people's floors and clean their houses and scrub their floors. And I've done that my entire life with my children, ever since I was a young woman, so I don't have any fancy accomplishments. And so she said, so what am I supposed to do? And I said, I don't know. Let me go back to the class again and find out what I'm supposed to do next. So she said, fine, you know, tell me next week. And So I told Dr. Beck, he says, well, just ask her to use a technique called examine the evidence. Tell her to make a list of three things she has accomplished. And I said, oh, that makes perfect sense. So I went back, and she said, what did Dr. Beck say? And, and, and I said, well, he said that you're supposed to make a list of three things you have accomplished. And she said, well, that's what I told you last week. I've never accomplished anything, so what am I supposed to do? And I. I couldn't think of anything to say. So I said, well, maybe you could take it as a homework assignment and see if you could think of something, and, you know, you could give me your list next week. So the next week I came back and I forgot about the homework assignment, and I did my things. You need any more pills and how are your symptoms and. And that type of thing? And halfway through the session, she said, aren't you going to ask me about my homework? And I said, oh, I forgot. Were you able to think of anything? And she gave me a piece of paper with about 10 things on it. And number one, she said, I forgot that when I was a young woman, you know, my husband and all of our family died in the concentration camps. But I managed to smuggle our two boys out of Nazi Germany, and we made it back to the United States and New York, and I got a job cleaning people's houses. So we put a roof over our heads, and I was able to put food on the table. And I thought, well, maybe that was an accomplishment of sorts. And my son just graduated number one in his class at the Harvard Business School. And I thought, well, maybe that was a good thing, too. And then I forgot about the fact that I speak four foreign languages fluently. She had listed that. And then number five was, I'm a gourmet chef. And she had all this stuff listed. And I said, well, how do you reconcile this with your claim that you're a worthless human being who never accomplished anything worthwhile? And she says, Dr. Burns, I can't. It doesn't make sense. I have no idea how I got that idea in my head. I don't believe it anymore. And I said, how are you feeling now? She says, I'm suddenly feeling a whole lot better. She said, do you have some more of these techniques? And I said, we have to wait another week. That's the only one I've learned so far. But that was kind of how it went. And it. And it lifted my heart so much to finally, after spending seven years, really, in medical school, another seven years in residency, and never learning one thing that would help people, finally to have found ways of helping people and connecting with people and seeing people go from suicide or tears or total belief that they're worthless to joy and laughter. And that's kind of been the story of my life. And the reason we've created the. The app, the Feeling Great app, is because, you know, I've probably trained 40 or 50,000 therapists in. In my life. I've done workshops all over the United States and Canada, and. And I've. I've discovered it's very difficult for human therapists to learn what I've developed. The techniques are great, but there's only a handful of therapists who can really do it at a high level of skill. And so I thought, well, I bet the computer would do it what I tell it to do, and could learn how to do this. And so we've got AI doing it, and the AI is doing it almost as well, you know, maybe even better than what I can do. And that's been my life, my dream, to develop a scalable way of getting this out to everyone, because I can't treat everyone by my. By myself or, you know, that. Anyway, that that that's kind of the story of my life.

A (25:08)

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To get your jobs more visibility, just go to indeed.comclary right now and support our show by saying you heard about Indeed on this podcast. Indeed.com Clary terms and conditions apply. If you're hiring, Indeed is all you need. Have you thought about what she said when she. When she sort of came to the realization that she didn't understand how all these negative thoughts creeped in, because that was that moment when all these negative thoughts creeped in, when she felt worthless, almost ended her life. So have you thought about for people listening, first of all, how do they stop this feeling of worthlessness and hopelessness even start to creep in? Where does that come from?

B (30:03)

Well, we don't know that, you know, it comes from negative thoughts. But we don't know why some people have more negative thoughts than others. And is it genetic? All the theories of causality are just pure speculation. And we don't know the cause. But we do know that negative thoughts in the here and now are the cause. And we do know now have, you know, over a hundred techniques to help people crush the negative thoughts. But one way to think about it. When I was a teenager, I used to love magic. And I go to magic stores and learn card tricks. And it was really fun. And once I saw this, this book, it cost 25 cents. It was 25 Ways to Hypnotize your friends. Well, that'd be cool. So I bought this book and I took it home and I read it and I did exactly what it said with one of my friends. And lo and behold, the guy went into a hypnotic trance. And I found about a third of my friends were extremely hypnotizable. And we would do all these goofy things that kids do. And it was a lot of fun. It was probably irresponsible, but it was funny. And, you know, it was like, endlessly entertaining. But it. I've come to see depression and anxiety as well as, like, hypnotic trances. You're giving yourself messages that are not true and believing them with all of your heart, like, I'm a loser. I'm not as good as I should be. I shouldn't have screwed up. I shouldn't have made this mistake when I was young. I shouldn't have this social anxiety. I must. There's something wrong with me. And they're. You're believing that with all of your heart. And what you don't realize is that those thoughts are all frauds. They're distorted. They. They've got what I put in my first book, feeling good. 10 cognitive distortions, like all or nothing. Thinking overgeneralization. Like a young woman, a lovely young woman, broke. Broke up with her boyfriend. That they've been going together for two years. And then. Then she says, do Dr. Burns, does this mean I'm unlovable? And she was really devastated. And that's like an overgeneralization going from this relationship broke up, then myself must be worthless, myself must be unlovable, and I'll be alone forever. And, and why human beings succumb to this kind of distorted thinking is totally weird and hard to understand. You know, I mean, you might think about the book of Genesis in the Old Testament, the Hebrew scriptures, how Adam and Eve were allowed to live in this garden of Eden where everything was provided, and then they had to screw up and get themselves banned from that Garden of Eden into place where there's thorns and suffering. And to me, it's always been about as strange as that because the thoughts that cause the depression are always totally off base. That's the weird thing about it. If a loved one dies or a pep dies and you say, I really love that person and you grieve, but that's not depression. That's a healthy, healthy grief. But when people are depressed, you're telling yourself you're no good. Or when people are anxious, they're telling themselves, oh man, if I say something stupid in a group of people, they'll all reject me. The word will spread. And you know, all of these things, fortune telling and mind reading and emotional reasoning and hidden should statements and self blame and. But I, I don't know all, all the answers, just enough of the answers to, to be able to, to have a lot of help available for people maybe who are listening to the show right now and who are struggling and, and saying, you know, I, I feel like what Dr. Burns is saying, I feel like I'm not good enough and I, I'm unhappy a lot. And I, I see myself as inferior and inadequate and, and kind of screwed up or, or I'm anxious all the time or I have all these phobias and fears or, or whatever it is.

A (34:27)

Well, I think a lot of people feel that, and there's various degrees, I think that's very important to highlight. So you have people that are on the verge of suicide and people that feel like they have no value on this earth, but to a lesser degree, I think almost everybody who I know has some version of imposter syndrome.

B (34:46)

Oh yeah, right. Yeah, yeah. We must hang out with the same crowd.

A (34:53)

Unfortunately, I think we do. But it's true, it's very true. It doesn't have to be such an extreme example.

B (35:00)

I teach a free counseling class for psychotherapists at Stanford every week, and we have it virtual now so therapists can come for free from all over the world and get training in these new techniques and you know, did you ever see those New Yorker cartoons about how neurotic psychiatrists are?

A (35:20)

Yes.

B (35:20)

Yeah, yeah, well, it's true. And, and I've asked the people and we do live therapy with them, you know, as part of their training. And we, I, I post a lot of them on my podcast, the Feeling Good podcast. You can hear live, you know, examples of being people being treated and two hours and going from tears to joy. But I would say over 90% of the therapists in our Tuesday training group are convinced that they're not good enough and they struggle with insecurity and depression and, and anxiety. And so like you, I see it everywhere now. I think there are some people who are immune. My, my mother in law I don't think has had an unhappy day in her life and she's one of those people just born happy and she's joyful and positive all the time. But I, I, to me that's, that's pretty rare. I, I see people struggling and suffering.

A (36:22)

So you've actually written Feeling Good, which they sold over 4 million copies. But there's been research that has shown that just reading your book alone to a degree can treat depression. Is that correct?

B (36:34)

Yeah, that's, that, that's right. And I didn't intend it to be a self help book. I just wrote it when I was opening up my practice because the story like the woman to commit suicide. I had so many of those. I just wanted to write a book to tell people there's a new approach and share my excitement. And I imagine patients could read it for homework when they're going to therapy and then the therapist wouldn't have to teach them all the stuff in the book. They could just individualize the therapy. But the book was published in 1980 and in 1988 somebody said have you seen the headline in the New York Times? And I says no, I don't read the New York Times. What's the headline says? Well, apparently they've been doing research on your book and they found out that just by reading the book, people overcome depression. And this guy from the University of Alabama was named what was Forrest Gogan. He was a research psychologist and he did experiments where when people would come seeking treatment for depression, he said we're going to have to put you on a waiting list for four weeks. But in the meanwhile he gave half of them my book Feeling Good. It was a random assignment type of study. And, and they said read this, this book while you're on the waiting list. And Then they, he reported that after four weeks, most of the people on the waiting list had improved so much that they said they no longer wanted or needed treatment. And, and, and so then he submitted that and some people from the National Institute of Mental Health Health said, well, this might have been a placebo effect. You have to do another study and randomly assign them to some other book and, and see if it's the same. So he did a second study and he gave half of the patients my book Feeling Good, and half of them. That book by Viktor Frankl, Man's Search for Meaning, which is some kind of classic book about someone who survived the concentration camps. And, and then again for, for four weeks. And then after four weeks again, about 2/3 of the people who read Feeling Good had improved dramatically, but none of the people who read the other book had improved. So they proved it wasn't a placebo effect. And then he did eight more studies that were published in top psychology or medical journals, peer reviewed, and he just confirmed that over and over again. But nobody too much cared because no one could make money off of that finding because the book.

A (39:20)

No, you, you lose people money. Yeah, you lose people money.

B (39:24)

Right?

A (39:24)

Because now if people are fixed, they don't have to pay for a therapist, they don't have to pay the drug companies. People are just fixed.

B (39:31)

Right. And at the time you could buy the book feeling good for $2.40 wholesale. So. And you can now too, by the way. I've heard that people are buying it used copies on Amazon for about that amount of money and some of them are getting first edition hardcovers for that and which are rare. They found, somebody found a load of undiscovered first edition hardcover feeling goods. But, but anyway, that was part of what inspired me to create the Feeling Good app. And now we call it the Feeling Great app to, to be able to get that effect out the same that was in my book Feeling Good, but more powerfully and to make it available to more people because we can do so much more now with, you know, video and interactions with the patient and AI and, and things like that. But it was a shock to me that, because I never thought that people would be reading the book and the book itself would have such profound antidepressant effects.

A (40:32)

But did you've worked with a lot of different systems and, and strategies now to have, to help people have this massive change in their life, Massive, massive shift from depressed to feeling happy, feeling good about themselves. Obviously in the book, in the app, there's lots of different things that people can explore and learn about. But in your mind at least, what are some of the most impactful or life changing strategies that you've thought through, that you've tested on some of your patients that have worked exceptionally well?

B (41:14)

Well, the original thing, and Feeling Good is still very helpful to people. And that's you just, and it seems so simple. A lot of people, patients refuse to do it because it doesn't seem fancy enough. But you just write your negative thoughts down on a piece of paper and then you look at my list of 10 distortions from my book Feeling Good or any of my books or the app and find out what, what are the distortions in them? And, and it helps you see that the thought isn't really true in the way you thought it was. And I can give you a personal example of, of that. When I was first, you know, working with Dr. Beck and you know, I didn't know much and I would present cases to him and one day he criticized the way I dealt with a patient who hadn't been paying his bill in the clinic. And, and, and I can't remember what I did, but I said the wrong thing or whatever. And, and then I got on the train going home and I, I felt horribly depressed. And, and, and I, and, and I said, well, you know, why, why are you depressed? I said, well, I'm thinking that I'm a worthless human being. They'll probably take away my medical license. I, I, I have nothing to offer. I have no talent as a, as a psychiatrist. I'm a bad human being. And those thoughts seem terribly, and I was telling myself, David, you should just write them down like you have your patients write down the thoughts and, and then look, see if there's distortions in them. And then I told myself, oh no, this is real. My thoughts are true. And it was so such a strange experience. It was like I had finally just discovered that I was a terrible, bad human being. And it seemed like it was unarguable, like it was just a fact of, of the universe. And, and I just felt terrible. And I had a six mile jogging trail over hills that I would run on. So I said, david, write down your negative thoughts. I said, no, that's a waste of time. I'll go out and jog and get my brain endorphins up. So I went out and ran this six mile loop and the farther I ran, the more depressed I became and it didn't do me a bit of good. And I finally went home and, and, and, and I said, yeah, And I told myself to say, david, you're being stubborn like your patients. Just take an effing piece of paper and write down your thoughts and see if there's any distortions in them. So I said, okay, but I know it won't do any good. So I wrote them down. I'm a bad human being. I'm going to lose my medical license. I have no aptitude in psychiatry. I have no future in psychiatry. You know, things like that. And then I looked at those thoughts and I said, wait a minute. Is that true? And isn't that an example of all or nothing thinking? I said, one wrong thing to one patient, now I'm going to lose.

A (44:23)

That's one of the distortions. That's one of the distortions, yeah.

B (44:25)

That's one of the distortions, yeah. All or nothing thinking. And I said, yeah, David, you've got a little all or nothing thinking going here, don't you? And then how about emotional reasoning? You know, I feel worthless, so I must be worthless. My feelings must reflect reality. And then fortune telling, they're going to take away my medical license. David, how many times do they take away a medical license? For somebody who talks to a patient about not paying their bill, that doesn't seem entirely realistic. And then I said, well, what could you sell? Tell yourself instead, write down positive thoughts on the right edge of the paper. On the left, I had written down my negative thoughts. And I said, well, I could think about it like this. I could say, david, you're a beginner and you're entitled to make mistakes and learn from your mistakes. In fact, it's impossible to learn anything worthwhile without making mistakes. And it's maybe not even a bad deal because you can. You're going to see this patient tomorrow and you can talk it over with them and tell them that you felt ashamed and felt like you let them down and let's talk it over. Maybe he'll forgive you. And immediately my heart just jumped. I felt wonderful. I thought, my God, that really is a con. I've been conning myself. And the next day I saw the patient. I said, you know, Bill, yesterday we talked about your bill. And my supervisor told me I didn't handle it sensitively or correctly at all. And I've been feeling ashamed and like I really let you down because I like you and I'm. I believe that I hurt you, and I just wanted to tell you that. And I. You. You might be feeling really hurt and angry and disappointed and. And I want to hear what you have to Say, and he talked and opened up and at the end he says, Dr. Burns, this is by far the best session we ever had. This is just, you're fantastic. And I couldn't, I couldn't believe my ears. But that, that was, you know, like one, one powerful thing that's still true today is if you, you know, when you're upset and you're beating up on yourself, write down your thoughts on a piece of paper and then take a look at the list of 10 distortions, all or nothing, thinking over generalization, mental filtering, discounting the pot of positive mind reading, fortune telling, magnification, should statements, and on and on. And that's a good first step. Now another thing that, that's, that's really powerful. That's kind of new with my book Feeling Great. And the Feeling Great app is that I was taught as a doctor that negative feelings are bad, they're mental disorders. So if, if you've been feeling down and guilty and ashamed and inadequate and worthless, that means you have a mental disorder called major depressive disorder. And I, as an expert, am supposed to fix your broken disorder. That's the whole way psychiatry is set up and clinical psychology as well. And what I've discovered is that all of your negative feelings do not result from what's wrong with you, but from, from what's right with you. And, and so I've developed a technique called positive reframing, where I have once I've had people record all their negative thoughts and feelings, I ask them, what are these negative thoughts and feelings show about you that's positive and awesome? How do these negative thoughts and feelings help you? And that patients have never heard that before. That's like some alien language or something. And then we began to come up with this list. We come up with 10 or 15 really beautiful things about them. And, and the genuine, genuine things. And, and then, and then we say, well say, like, you know, I, sure, I've got techniques. I could probably cure you in today's session. I have no, no doubt that would be possible. Probably is going to happen, but given all these positives, I, I don't think we should do that. And then people say, well, please, please do that. You know, I, I, I know that shows beautiful things, but I'm hurting. But that is called positive reframing. And, and that, it opens them up because they, they suddenly become proud of their suffering rather than ashamed. And that seems to open up the, the door to rapid recovery. Because after I do the positive reframing, it's usually usually just maybe 15 minutes to the finish line. Then. And then I use a technique called externalization of voices. That's. They say, I'm going to become the negative you, and I want to see if you can defeat me. And one of the things you're. You're telling yourself is that you're. You're no, no good, and you're not good enough. And I'm going to be your negative self, and I've got the same name as you. I'm just, just like you, but I'm this voice in your head. And. And then I start saying that you, you know, you're no good. And. And now see if you can defeat me. And they try. And then if they can't win a huge victory, say, let's do a role reversal. I'll say, I'll show you how to crush that thought. And we do role reversals back and forth for two or three minutes until they get it and they suddenly see through the thought and whammo. Their negative thoughts typically, typically go to zero at that point. And those are so. So those are three of the dimensions of how I work.

A (50:09)

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B (53:40)

Well, the one thing in traditional therapy is they generally have this one thing that's supposed to be the answer. And so they keep doing that over and over again. It keeps not working. Whereas one of my philosophies is fail as fast as you can because the technique that works for Scott won't work for Sarah. And I've developed roughly 140 techniques for smashing negative thoughts and helping people change the way they think and feel. And so if something doesn't work, I just go on to the next thing. Another thing that traditional therapy has wrong is that they're trying to help people who are broken, as I mentioned, with the positive reframing. And that's the basic error of just about all of the so called schools of therapy, that when you try to help people, it kind of puts people on the defensive. And so I go in the opposite direction. I try to persuade people not to change. I become the voice of their subconscious mind. And, and that, that, that really helps me empathize with people at a deeper level. But I would say the main thing is when I, when I was a resident, we never measured anything. We just talked to people endlessly and assumed that in 6 months or 18 months something good would happen. And it was because not I never saw anything good happen. But when I then I doing during my research years, we had to measure depression. And I saw how important that was to have an objective scale. And now I've developed really quick, highly accurate scales to measure not only depression, but suicidal urges, anxiety, anger, and even happiness in the here and now. And I measure that at the start and end of every therapy session. How depressed are you at this instant? And These tests are 95, 96% accurate. How suicidal are you? How anxious are you? How angry are you? How happy are you? And, and so I measured at the start and end of every session. And that makes me accountable for getting change in today's session. And you know, we're going to measure it and we're going to see right away, did you do any good, David, or are you just bullshitting with this, with this patient? And another thing is I also have them measure rate me on empathy, how warm and caring was I did I understand how they were feeling inside. And the scale I've developed that they take at the end of the session is very, very sensitive to the tiniest errors. And most therapists, when they use the scale initially, they get failing grades from every patient at every session and they discover that their empathy skills really are not good. And then that's What I do in my training group, my free training group is teach them how to correct these, these errors. But it's, it's data driven. It's the, it's science based, based on research that I've done on how people change and data driven. But three quarters of the therapists, or more refuse to use measurement scales. And as The Buddha said 2,000 years ago, they're screwed because they're human. Therapists do not know how your patients feel. They think they know. I've done research in the Stanford Hospital to see how depressed does, does your therapist think you are and then how depressed do you think you are? And there's virtually no correlation. They're complete lack of knowledge. But the therapists don't even know that their impressions aren't correct. And so you have to start measuring. And, and it's, it's like, suppose I told you I want to start a new emergency room and I want you to invest, but we're not going to use any of the X rays or, or blood pressure cuff or blood tests or anything like that. Would you invest?

A (57:51)

No, I definitely would not invest.

B (57:54)

Yeah. And that's the same thing. Would you spend money on a therapist who's not measuring anything? I, I wouldn't.

A (58:00)

So all the, I mean, so then, I mean you must have massive issue with all these like telemedicine companies offering therapy and whatnot, because that can't.

B (58:10)

Yeah. And, and I've wanted to do a head to head comparison with our app, but, but I, I don't think they would permit it. But to, to, you know, you can use our app for free and if anyone wants to try it, it's not expensive and if you can't afford it, we'll give it to you for free.

A (58:27)

But I'll link it in the, I'll link it in the show notes too. I'll link the app and the.

B (58:31)

Yeah, yeah, yeah, great. But the. We were going to go against, it's called Better Health, I think because one of my colleagues checked it out and said it was just horrible. And I think you pay 300amonth or something, they assign a therapist to you. And I said, well, we could randomly assign patients there or to our app and then publish the results. But then I realized that the betterhelp, if they caught on to what we were doing, they would forbid it. And I think to be ethical we'd have to tell the therapists there that were doing research on them. And I kind of cooled off to that idea. But I would love to do that. Kind of comparison, because the app, I recently did some research on the AI and the app is getting like a 50 to 60% reduction in seven negative feelings in new users the first time they sit down with the AI chat. And if you look at all the world's published outcome studies with psychotherapy or antidepressants, they don't get that in six to 12 months or even two year studies. So it's literally thousands of times more powerful.

A (59:48)

Do you have a sense of when you do these rapid change strategies, how well do they last? What's the longevity of these strategies?

B (59:59)

When someone has recovered, I tell them the good news is the next few days will be the happiest days of your life. There's nothing better than recovering from depression. And here's the even better news, within three days or three minutes or three hours or three weeks, all those negative thoughts and feelings are going to come back and you're going to crash horribly. And that's what we're hoping for. And then they say, why should we hope for that? I say, because nobody's allowed to be happy all the time. That's impossible. But let's practice now what you're going to do when those negative thoughts come back. And I call it relapse prevention training. And here's what you're going to be telling yourself, and here's your negative thoughts. And then let's practice crushing those negative thoughts right now, ahead of time. And I tape record that. So I tell them all the things they're going to tell themselves when they have a relapse. They'll say, oh, this proves that the app didn't work, or this proves that the therapy didn't work and this proves that I'm hopeless after all. And this proves I really am worthless and I knew this would happen and I'm sorry, screwed, and, and that type of thing. And then we, we just do role reversals, blasting those thoughts out of the water. And in my clinical practice, when I was in private practice, I did this with every patient before I discharged them. And then I told them the last thing is I, and I said, I, I hope and pray that you will relapse. And they said, well, why is that? I said, because if you don't, I'm never going to see you again. And I've just gotten to know you and I really feel close you to, to you and I'm proud of you. But if you ever relapse and need my help, you just, you just call me and, and I offer unlimited free tune ups for the rest of your life.

A (61:48)

That's how confident you are in the product, that's how confident you are in the system.

B (61:52)

But, but relapse is an issue and it's not to be underestimated. And the Buddha knew that 2500 years ago. And one of the things he said is we all drift in and out of enlightenment. And when I first heard that, it sounded nonsensical, but now I know what it means because when you recover totally, it is enlightenment. It's just you feel close to people, you have no territory to defend, you have no self, you just feel tremendous joy. And then drifting out of enlightenment is when you go back into your own pattern of self, self critical thinking. So the question that you raised is vitally important.

A (62:35)

Do you think there's, I mean, you've mentioned a few times there's all these different forms of negative self talk that people, that people use. Is there one that is the most nefarious, the most malicious, that you wish people would be aware of that?

B (62:53)

Yeah, absolutely. And by the way, our AI guy just, just studied 27,000 negative thoughts of app users and categorized them in different categories and surprisingly the most common. And we're going to have a meeting on this tomorrow and probably do a podcast on it. But this relationships is the most common one. Like I'm a bad father, I'm a failure as a husband, I'm a bad mother, things like that, or, you know, so and so rejected me, so I'll be alone forever. But the most dangerous one of all is hopelessness. And that's the, the idea that things will never change. And that, that's a hallmark of, of depression. And a lot of anxious patients feel that way too. And my mentor, Aaron Beck used to say that we can put up with anything as long as we see hope, that the other light at the end of the tunnel. But when you think there's no escape from your suffering, that's when people turn to suicide. And, and, and, and so when people start saying I'm, I'm worthless and I'll always be worthless and I'm hopeless and there's no treatment, no one's been able to help me and nothing will be able to help me, that, that, that's the most dangerous one of all because that's when people turn to suicide. And I've treated so many people who, who were hopeless. And if you hang in there and work with these new techniques, you can always transform the way you think and feel. The hopelessness is the worst, but it's also the Cruelest fraud. Fraud of all. But again, you know, I could tell you stories. We're probably running out of time of hopeless people and the technique that, that work for them. But, but there's always a, there's always a way to, to get people back to joy and self esteem. I asked Dr. Beck about it early in my career. I said, Dr. Beck, you know, all my patients, they come to me, they tell me they're worthless and hopeless. And some of them, I'm beginning to think maybe it's true. What do you think? Because they're so persuasive, depressed people, they make a real case for.

A (65:04)

Well, they believe it. They believe it.

B (65:05)

Yeah. And they get you believing it. And Dr. Beck says, well, David, you'll have to make your own decision about that. But I have never bought into the idea that anybody's hopeless and, and nobody's worthless and that those. That has really paid off for me, but you'll have to make your own decision. So I came to the same decision. It's almost paid off for, for me too. But it's a, it's a great question because the, these thoughts, as I say, the hypnotic, hypnotic trance of horror that we're in when we're depressed or panicky or anxious is, is very, very real. And, and people can't imagine that their thoughts are not valid. And when I was feeling down, I thought, man, I've just made a discovery about myself. How could it have taken me to, you know, to be 30 years old before I realized I was a horrible human being? It was like a discovery and it just seemed true, but it was pure malarkey.

A (66:04)

It's fascinating what we can convince ourselves of. Yeah, yeah, very scary. Yeah, very, very scary.

B (66:09)

Oh yeah.

A (66:10)

I'm going to put a whole bunch of links in the show notes, but where should people go and check out your work? Is there one website or.

B (66:18)

Yeah, there's two websites they might be interested in. Well, first, you know, I have my own Feeling Good podcasts and you can find them on my web page, which is feelinggood.com and that's filled with free resources. I have a free depression class, a free anxiety class, a free relationship class. I've got 400 and some free podcasts and, and all kinds of free, free resources in my books, which are pretty inexpensive. You know, you can link to Amazon, pick them up. The other thing would be the Feeling Great website, which is the website for our Feeling Great app. And that's, that's kind of a new exciting tool for anyone who's struggling with depression or anxiety. And you can go to Just Feeling Great dot com. It's easy to remember. And you can check out the app and either of the app stores. You can download it and take a. Get a free ride for a week or two on it and see if you like it because it works really fast. And if you like it, you can get a year subscription to it and you can use it, you know, whenever you're feeling down or if, if you really like it but can't afford it, just email us, contact me and we'll give it. Gladly give it to you for free. And so those are some. And then also I've got a lot of new things I'm posting on the Internet on both on. On the Feeling Great. I'm also doing new videos now. I'm. I'm. We have a little video studio. So every week I go in and post cool little videos on different topics. I know.

A (68:00)

I saw, I saw a few. They're good. They're very good.

B (68:03)

Thank you.

A (68:03)

They're very good. Yes.

B (68:05)

Yeah. So we're having fun with that. With that too. I'm just trying to do my legacy, get as much stuff out there as I can in the time I've still got.

A (68:15)

I always like to see how you've looked at your own life, your own career, your own successes, because you've had an incredible career. And if you're going to go back and all the lessons that you've learned about success, about mindset, about happiness, about depression, what would be one lesson that you'd want to leave your children with?

B (68:34)

I think for anyone that to look at your negative thoughts when you're feeling down and anxious and panicky and take a piece of paper and write them down and see what you're telling yourself, you may be surprised. That can be the first step on a journey to enlightenment. And then another thing that I've learned. I used to think like that attorney, that I had to be perfect to have anyone love me or care about me or impress people. And what I found is that the. The world is far gentler and more loving than I had thought. And that when you're just yourself and you're vulnerable and show people how wonderful they are, that's a greater and better path to love and intimacy than trying to impress people with yourself.