Podcast: Your Thoughts Are Lying to You: How to Take Back Control

Dr. David Burns graduated magna cum laude from Amherst College, received his M.D. from Stanford University School of Medicine, and completed his psychiatry residency at the University of Pennsylvania School of Medicine. He has 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.

Dr. Burns is currently Adjunct Clinical Professor Emeritus of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine, where he is involved in research and teaching. 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. He has been named Teacher of the Year three times from the class of graduating residents at Stanford University School of Medicine, and feels especially proud of this award.

In addition to his academic research, Dr. Burns has written a number of popular books on mood and relationship problems. His best-selling book, Feeling Good: The New Mood Therapy, has sold over 4 million copies in the United States, and many more worldwide. Feeling Good is the book most frequently “prescribed” for depressed patients by psychiatrists and psychologists in the United States and Canada. Surveys indicate that American mental health professionals rate Feeling Good as the #1 book on depression, out of a list of 1,000 self-help books.

Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, “Mental Illness is an Asshole and other Observations,” available from Amazon; signed copies are also available directly from the author. Gabe is also the host of the “Inside Bipolar” podcast with Dr. Nicole Washington.

Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com.

Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: You’re listening to Inside Mental Health: A Psych Central Podcast where experts share experiences and the latest thinking on mental health and psychology. Here’s your host, Gabe Howard.

Gabe Howard: Welcome to the podcast everyone, I’m your host, Gabe Howard. Calling into the show today we have Dr. David Burns. Dr. Burns is currently adjunct clinical professor emeritus of psychiatry and behavioral sciences at the Stanford University School of Medicine. Back in the 1980s, Dr. Burns was instrumental in making society aware of CBT therapy. And currently his new app, Feeling Great, is available on the App Store or Google Play. Dr. Burns, welcome to the podcast.

David Burns, MD: Thank you. I’m thrilled to be here and very honored and grateful and eager to to shoot the breeze. Thanks.

Gabe Howard: You are very, very welcome. Thank you so much for being here, because today we’re going to be discussing how to break free from negative thoughts and get back to feeling joy. And I want to confess to you, Dr. Burns. It seems like it should just be simple. Just stop focusing on the negative and start focusing on the positive. But that’s of course easier said than done, right?

David Burns, MD: Absolutely. Yeah. It’s the hardest thing in the world. But when you get the knack of it and find out what works for you, It’s the greatest feeling in the world to go from, you know, tears and despair and hopelessness and low self-esteem to suddenly exploding into feelings of joy and optimism and closeness to other people. That’s why I love my my work. Because in the old days, we used to think, boy, if we could make that happen in ten to 12 to 15 sessions, that would be a miracle. And that’s what the original cognitive therapy did. It was a step forward at the time. And that is such a joy for me, because whenever I work with people, I, I don’t charge people for therapy. I haven’t for 30 years. And so I have no motive to have long term therapy. My only reward is seeing someone get better. But I wanted to see people change so they could wake up in the morning and say, it’s great to be alive. And, you know, I’m filled with joy. That’s that’s what people want. And that’s what people deserve.

Gabe Howard: You use the phrase once you get the knack, it’s easy, and I want to challenge you on that for a little bit, because the knack of being happy, I mean, is it something that you can just learn? Is it like a habit we can embrace? And if so, what’s the what’s the secret? Can you share it on the podcast? And all the listeners will just be perfect. Wouldn’t that be great?

David Burns, MD: Well, yeah. Yeah, but there’s every one person ends up with their own secret. I’ve developed over 140, 150 techniques to crush the negative thoughts that cause depression and anxiety. Like, I’m not as good as I should be. I’m a loser. I’ll make a fool of myself. Everyone will laugh. People will judge me. Or I’m a hopeless case. Nothing. Nothing will will change for me. And those are the thoughts that that cause depression and anxiety and anxiety. And when you learn how to blast those thoughts out of the water, suddenly your feelings change. People say, Dr. Burns, how long does it take to change the way you feel? To to overcome depression. And I say it takes generally between 30 and 60 seconds, but working up to that 30 or 60 seconds may may take some time. I think of it as like lock picking. You have to find the combination to the lock. And you may have to try different things until you find the combination. Because we all have our own way of way of being depressed or feeling worthless or inadequate or angry or pissed off or whatever. So, I might try one with you, and you have the idea that you should be more successful and that you’re kind of a failure or something. You know, people have thoughts like that all the time.

Gabe Howard: Yeah, that sounds exactly like me. Actually, I’m a little concerned that you hit the nail right on the head, right? Right out of the gate. I just

David Burns, MD: Yeah, right.

Gabe Howard: Sincerely, it’s not even the setup of a joke. I mean, I think

David Burns, MD: Yeah, yeah.

Gabe Howard: I’m right in line with your assessment so far.

David Burns, MD: Yeah. Okay. Well, sure that we all fall into these traps. I do fall into them myself. But once you find the method that works for you, because. Because, like, we all have our own unique way of suffering and our own unique path to enlightenment. And that’s what the therapy is about, is trying to find the path for, for, for each person. And I have the philosophy of failing as fast as I can when I’m working with someone. And you say, well, that’s not helping and that’s not helping. Then and finally find you one that blows your mind.

Gabe Howard: I know we don’t have time to cover all 150 techniques. What’s like the most popular one?

David Burns, MD: The most powerful one of all the cognitive therapy techniques in the world is the first one I created years ago, when I was going to Doctor Beck’s weekly seminars in Philadelphia. He had decent techniques like examine the evidence or logic-based techniques. But but they were kind of dry and sometimes somewhat boring. So I developed this externalization of voices technique because when I was a medical student at Stanford, I was a crappy medical student. I hated being there. I skipped half of my classes, but I found this place in Palo Alto called the Human Institute with this crazy guy, Husain Chung was the head of it, and he did like 72-hour marathons with people like a group of 40 people in a house or 48-hour marathons. And it was very intense, and I saw people going from tears to joy. You know, everyone who would go to the marathon, they’d get in the circle and everyone would be ripping away at them and they’d cry, and then they’d suddenly go into a state of enlightenment. It was scary, but amazing. And I thought, this is what I want to be able to do for people. And so I created Externalization of Voices at that seminar, and I said, I have a new way of helping people with their negative thoughts.

David Burns, MD: I play the negative part of their brain and they play the positive. And then we do role reversals until they see how to blow the thing out of the water. And that’s called externalization of voices. And it’s still by far the most powerful of all of the cognitive therapy techniques, because when you’re doing it, you can model the acceptance paradox, the self-defense paradigm, the counterattack technique. Be specific. It’s just a very intense and powerful method. And initially, the patient can’t defeat the negative thoughts. When I’m the negative thoughts because they’re so used to believing they’re no good. They think it’s a truth. Not not a thought. And they think it’s a valid thought, not a distorted thought. And but then when we do a role reversal and they attack me, I show them, here’s, here’s one way to beat that thought and here’s another way to beat that thought. And we go back and forth and that takes and often will catapult the person into enlightenment. It’s actually a kind of a technique for achieving enlightenment as much as it is a technique for defeating depression and anxiety.

Gabe Howard: Why do people believe their thoughts so intensely? I mean, there’s there’s a really big difference between what we think and what is factual. And I’ve heard

David Burns, MD: Yeah.

Gabe Howard: The phrase feelings aren’t facts before, but I’ve never really heard the phrase your thoughts aren’t the truth before. Why do people believe that what they feel and what they think is absolute reality?

David Burns, MD: Then the answer to that isn’t known. A lot of people will try to answer questions that aren’t known that you’re saying, what’s the cause of depression? And we don’t know. Some people might be born with a tendency toward believing these negative, distorted thoughts about ourselves, but it’s one of the great mysteries, and I suppose a religious spiritual mystery. Why? It’s like the Garden of Eden story. Why do we make ourselves miserable when we could be feeling such joy? What Epictetus said 2000 years ago, that humans are disturbed not by things or events, but by our thoughts about them. And all the gurus throughout history are not all of them, but many of them have said this is true. You know, even Shakespeare said something about, you know, nothing’s either good or bad, but thinking makes it so. And, you know, a lot of Albert Ellis thought that Albert Aaron Beck thought that a lot of people have popularized that. That your negative thoughts have a massive effect on how you feel and the moment you crush those thoughts and stop believing them in that very moment, your feelings will change. And we have tremendous techniques for helping people challenge these negative thoughts and change them.

David Burns, MD: To me, there’s never been greater hope and promise and power to help people who are suffering from depression or anxiety than than this very day. We’ve documented that the change in negative thoughts has massive causal effects on changes in negative feelings. And a lot of people, they hate it when I say that they get enraged. Other people, when they hear that, they say, that’s amazing. I want to give this a try. Could this be true? When I first heard it, I thought it was hogwash and somebody had said I was doing a post-doctoral research fellowship. And somebody said, well, go, go to Beck’s, Aaron Beck’s weekly seminar. He’s got this kooky new thing, cognitive therapy. And he claims it’s actually thoughts that cause depression. And you can change your thoughts and change your feelings. And I said, that is the biggest horseshit I ever heard. I knew my patients had a lot of negative thoughts, but I didn’t believe that the change could be they could be changed or that could lead to a reduction in depression. So the department chairman says, well, why don’t you just go and try his techniques on your toughest patients and go to his weekly seminar, and you can satisfy yourself that it’s not valid, he said. It can be part of your research. I said, sure, I’ll do that. And and so I went to his weekly seminars.

David Burns, MD: And, you know, he was kind of a friendly guy, a little kooky, wore these bow ties. And I said, this guy sounds a little like a con artist to me, but I’ll give him a chance. And they referred a patient to me from the intensive care unit at the University of Pennsylvania Hospital. She had attempted suicide and it was nearly completed. But she survived, and they referred her to me for for treatment. And I said to her, could I do you mind if I present your case in this weekly seminar I’m going to? Because it’s a new approach based on the way you think, and it might have some promise. And she was very nice. She was an elderly woman from Latvia. So I said, well, I have someone who attempted suicide and what should I do? And he said, well, ask her what she was telling herself, what she was thinking the moment she tried to kill herself. Because your thoughts create your moods. It’s all in your thoughts. So I went back and I asked her and call her Martha to protect people anyway. But I said, Martha, Dr. Beck said I was supposed to ask you what you were thinking the moment you tried to kill yourself. And she said, oh yeah, you see, all I’ve done my life is I have cleaned people’s houses. I scrubbed their floors, and that’s all I’ve ever accomplished. And so I was telling myself I was a worthless human being.

Gabe Howard: That’s so sad. I mean, yeah, just repeating that to yourself over and over again. That

David Burns, MD: Yeah,

Gabe Howard: Would be terrible.

David Burns, MD: Yeah, yeah. And she had the evidence. Here’s my hands and here’s my knees. And, you know, I’ve been scrubbing floors for 60 years.

Sponsor Break

David Burns, MD: And so she said, what should I do? How does it work? And I said, well, if you could wait another week, I’ll ask them at the seminar and I’ll tell you what he said. So she was fine with that. And I went back and she said, well, what did he say? And he said, oh, he said it was simple. You just make a list of several things you have accomplished. And she said, well, that’s the problem, Dr. Burns. I’ve never accomplished anything except, you know, cleaning people’s houses and cleaning and washing their floors, and that’s all I’ve ever done. So what should I do? And I said, well, if you can think of something between now and next week, maybe you can jot it down on a piece of paper, something you have accomplished. And, and and you can tell me. And then the next week, I forgot about the assignment. And halfway through the session she said, well, doctor, did you want to see my homework? And I said, oh yeah, I forgot. Did you think of anything? And she handed me this piece of paper and when I looked at it, I, I started to cry because the first thing she says I overlooked the fact that I, my husband and all of our family died in the Nazi concentration camps.

Gabe Howard: Oh, wow.

David Burns, MD: But I managed to smuggle my two boys out of Nazi territory and make our way to the United States. And once we got to the United States, I was able to get a job cleaning people’s houses so we would have a bed to sleep on and a roof over our heads and food. And I thought, well, maybe, maybe that was a worthwhile accomplishment. And my oldest son just graduated number one in his class from the Harvard Business School. And maybe that was, you know, something I could be proud of as a kind of accomplishment. And I overlooked the fact that I speak five foreign languages fluently, and I’m a gourmet chef.

Gabe Howard: Wow. That’s a very accomplished person.

David Burns, MD: And all of this stuff. And I was just looking at it and tears were going down my cheeks. And I said to her. How do you reconcile this with your belief that you’re a worthless human being who’s never accomplished anything of value? And she says, doctor, it doesn’t make sense. I don’t know. I don’t know how I could have believed those that. But but but it was. And I was believing it. And that’s what I mean. It’s like being in a hypnotic trance when you’re hypnotized. You’re. And that’s a sad and tragic thing about it. And then I said, well, how are you feeling now? She says, doctor, I’m suddenly feeling so much better. Do you have some more of these techniques? And I said, well, that’s the first one I’ve learned. You have to wait another week and I’ll learn another one at the seminar.

Gabe Howard: [Laughter]

David Burns, MD: And that that’s the thing that made me think, My God, there’s something to this, and I want to devote my life to this. And I left the university. I had a tenure track position. And my colleague said, don’t leave, you’re burning bridges. You’ll never do research again. You’re throwing your career away, you’re just barely out of your residency. I said, I don’t care, this is what I want to do. I want to heal people. And that’s that’s kind of what happened. And I’m really glad that I left. It was the hardest decision I ever had to make because I was under so much pressure. But it’s my life has been so rewarding and there have been so many miraculous developments in how to treat depression and anxiety. And I’m just so proud and grateful to have been a small part of that that movement toward powerful, fast acting forms of psychotherapy.

Gabe Howard: Dr. Burns, we’re almost out of time, but I know that your new app tracks people’s feelings. Why is that so important? Why is it important to track our feelings?

David Burns, MD: Well, I did research in the Stanford hospital on how accurate shrinks are in knowing how how people are feeling because most shrinks don’t measure things. I’ve measured things in every session I’ve had since 1978, and now we measure at the start and end of every session so we can see right now, today how effective we are. And that’s accountability and that’s science. And that’s where the field must go. But most therapists refuse to use measurements because they don’t want to be held accountable. It’s like running an emergency room without an x ray machine, and you have to intuit how your patients are feeling. But in my research at the Stanford Hospital, I found that the top experts I let them spend 2 or 3 hours with newly admitted patients and at the end of that time, estimate how depressed the patient is, how suicidal the patient is, and then during the 2 or 3 hours, they’re just doing an interview about symptoms. And then the I had the had the patient and the therapist turned their back on each other and had the patient fill out. How? How depressed are you at this moment? How suicidal, how anxious, how angry, how happy are you? And how empathic was this therapist? And then the therapist filled out the same scale, estimating how the patient was feeling and how empathic they thought they were. And to make a long story short, the accuracy of everything was less than 10%.

Gabe Howard: Oh, that’s not good at all. They’re not even. They’re not even on the same page. How can you hope to get good therapy if?

David Burns, MD: No. Yeah, you could ask a taxi driver, how did I do in this session? And the taxi driver would have as good a estimate as you do.

Gabe Howard: Wow.

David Burns, MD: There’s the estimate of detecting changes in depression was 3%. The accuracy at picking up suicidal urges was 0%. The accuracy on estimating how angry the patient was feeling was 0%. The accuracy on knowing how empathic I was was 9%. That’s why measurement is vitally important, not only in therapy but in the app. And you have to have measure accurate measures to have science. And science is the only way forward. Right now psychotherapy is all these competing cults with gurus at the head.

Gabe Howard: Yes. Yes. Very very often. Yes.

David Burns, MD: Who claim they know all the answers and they’ve got the best techniques and they all say the same thing. And when Copernicus came in and they developed the first telescope and began to make measurements. The Catholic Church is arguing that everything goes around the Earth, the whole universe, the sun revolves around the Earth. The stars revolve around the Earth. The Earth is the center of the universe. And it was this silly, narcissistic idea. And they said, our mathematical models prove that this is not the case. The Earth revolves around the sun. The sun does not revolve around the Earth. And there was 100 years of persecution because they didn’t want science to come in. They wanted to have it a faith based. But you see what’s happened with physics and astrophysics. It’s mind boggling the stuff that’s happening now, giant telescopes that are going back to the origin of the universe. And that’s the same thing can happen in the behavioral sciences and psychotherapy to develop incredibly powerful new forms of psychotherapy. But it cannot happen without measurement, and a lot of therapists will not measure. And when I say you should be measuring, they get angry with me because it’s like sacred territory. We know we’re the experts, but they don’t know. And they don’t even know that they don’t know.

David Burns, MD: They don’t even know how inaccurate their perceptions are. And without the truth, without having therapy or self-help tool based on truth, you’re just bullshitting yourself and other people. And it angers me. And people get angry at me for saying this, but this is what I believe, and this is what I’ve devoted my life to. And this is the way. It’s the way of science. And it’s a way of compassion, too. Because the app uses measurements, the Feeling Great App. And it is. It’s just fantastic. But it’s measuring itself. And and so I think there’s a revolution that will transform the face of mental health care and basic research on discovering how people really change. And that’s the whole goal and purpose of my life. And I’m 82 now, and I’m glad I’m still kicking because I’m working harder than ever. I’m learning more than ever. It’s the most exciting time of my life.

Gabe Howard: I love that. I love that, Dr. Burns. Where can folks find the app so that they can get it themselves?

David Burns, MD: You just go to either of the app stores and it’s only in the US at the moment. And once we get things nailed down in the US, we’ll try to make it available in other countries as well. But and you can try it for free, you can get a, you know, a free week or so on it and see if you like it. There’s, there’s the bot that talks to you and works with you. And then there’s all these classes and lessons that I’ve created that are kind of self-paced. There’s tremendous amount of material there. And if you think you like it and want to buy it, great. But if you think you like it and can’t afford it, just contact us and we’ll give it to you for free. Gladly. And but but check it out because it works for many people. Most people in as little as the first hour and a half sitting down with it. If you just sit down with it for an hour and a half or two hours. You may be shocked by the change in your feelings because we’re measuring that. And the changes for many people are very dramatic and very quick.

Gabe Howard: Dr. Burns. Where can folks learn more about you?

David Burns, MD: Well, you can go to my website which is just filled with resources, FeelingGood.com and I’ve got my weekly Feeling Good podcast. We’re approaching our 9,000,000th download. There’s free classes on my website. My website is FeelingGood.com and it’s all free stuff. And then the app is FeelingGreat.com. And that’s all about the app. So thank you so much for having me on your show. It’s what a pleasure and what an honor. I’m very grateful. And all of you who are listening, thank you so much.

Gabe Howard: This has been amazing. Dr. Burns, thank you so much for being here. My name is Gabe Howard, and I’m an award-winning public speaker who could be available for your next event. I also wrote the book “Mental Illness Is an Asshole and Other Observations,” which you can get on Amazon. However, you can get a signed copy with free show swag or learn more about me just by heading over to my website, gabehoward.com. Wherever you downloaded this episode, please follow or subscribe to the show. It is absolutely free and you don’t want to miss a thing. And hey, can you do me a favor? Share the show. Share your favorite episode on social media. Send somebody an email. Send somebody a text message. Mention it in a support group. Sharing the show with the people we know is how we’re going to grow. I will see everybody next time on Inside Mental Health.

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