Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
Health & Fitness:Mental Health
The Night My Childhood Ended, Part 2
In today’s podcast, we present the second half of the therapy session with Todd, who did personal work focused on the impact of a traumatic event that ended his childhood when he was eight. Last week, we presented the T = Testing and E = Empathy phase of the session. Today we present the A = Assessment of Resistance, M = Methods, final testing, and teaching points.
A = Assessment of Resistance
Todd’s goal was to be able to feel more vulnerability by the end of the session.
During the Positive Reframing, we listed the positives that were embedded in Todd’s negative thoughts and feelings.
As you listen, you’ll see that it was incredibly difficult for Todd to see anything positive in the fact that he was that calling himself a coward. He kept thinking that he “should” have gone in earlier to try to help and save his mother, and that this might have changed the entire trajectory of his life. At the same time, he conceded that he was just a little guy, and that his father was an incredibly frightening and intimidating figure.
You can see Todd’s Daily Mood Log at the end of A = Assessment of Resistance (link). As you can see, he wanted to reduce all of his negative feelings quite dramatically, but he wanted his sadness to remain at 100%, because he wanted to be able to feel this emotion and grieve.
M = Methods
Jill and I tried a variety of techniques during the Methods phase of the session, including a new version of the Double Standard Technique. I played the role of the 8-year old Todd, and he played the role of himself. I verbalized all of his Negative Thoughts, “But isn’t it true that I rally was a frickin’ coward?” and challenged him to crush them.
This helped Todd get in touch with his compassionate and realistic self.
You can see his final Daily Mood Log. As you can see, there was a dramatic reduction in all of his negative thoughts except sadness, which fell to 80%. You will recall that his goal for sadness was 100%.
There were lots of positive messages for Todd throughout the session in the chat box. There were many outpourings of love and admiration for Todd's courage and vulnerability. We sent those messages to him after the end of the session, and that was when the tears finally came.
Here’s an email we received from him after the session.
What an evening! I just saw the video again and I was so blown away from the amazing love and support I felt from all of you last night. I also was able to tear up a bit when I was reading all of the heart felt chats that Alex had shared with me. I would give all of you an A+ on empathy for sure. Finally, I'm so grateful to JIll and David for their compassion, and for helping me reconnect with little Todd and feel much closer to all of you. What an awesome night and group!
Brandon Vance MD sent a link to a song one of his students created, and Todd responded to it:
Last night, it was so awesome to listen to the musical recording that your student so beautifully shared with us. I'm not one to cry very easily, but I was so moved by the lyrics and the emotions in that song. I've been so amazed at how you continuously evolve TEAM in so many wonderful and creative ways. Kudos!
Here's the link to the song if you'd like to listen! I also found it moving and beautiful.
Cassie Kellogg is the performer and songwriter, and her song is called Double Standard, which is the method that proved so helpful for Todd. Some interesting information about Brandon and Cassie, as well as the words to her song, appear at the bottom of the show notes.
There were also tons of positive comments about the session in the teaching evaluation at the end of the session, with overwhelming outpourings of love and appreciation for Todd. Time after time, the personal work we sometimes do while teaching seems to make the most positive emotional impact on our students. And, of course, the teaching value can be tremendous.
Teaching Points
1. T = Testing is crucial.
If you met Todd, you would have no idea how he feels inside, and if you were his therapist, and you did not use the Brief Mood Survey at the start and end of every session, and the Evaluation of Therapy Session at the end of every session, you would also be partially “blind” to how Todd was feeling, and how dramatically his feelings changed at the end of the session.
Most therapists still are not using session by session assessment, and they are at a severe disadvantage that they are not even aware of. I am convinced that it is impossible to do great, or even excellent therapy with these, or similar, instruments.
2. Sometimes you have to slow down to speed up.
During the empathy portion I made and corrected an error, with Jill's help, of jumping in prematurely with a method that fell flat. It is easy to give in to hunches and try methods prematurely, prior to doing careful and skillful E = Empathy and A = Assessment of Resistance.
One good thing about TEAM is you can easily "right the boat" when it tips, and get back on track. TEAM works way better as a systematic package. Some therapists who learn about TEAM may try to "borrow" this or that M = Method, and incorporate it into their current approach, but that is generally far less effective.
3. A = Assessment of Resistance can be challenging.
Positive Reframing can be quite difficult because you have to "see" something obvious that is almost invisible to the naked eye. Initially, Todd had tremendous trouble seeing any value in his self-critical thought that he was "an effing coward” when he and his older brother hid out during his parents’ brutal and terrifying fight.
TEAM is not a cookbook, formulaic, treatment manual type of therapy. It requires “insight” on the part of the therapist, and the skills to lead the patient into seeing what you. therapit, (hopefully) have seen.
4. Childhood traumas can often be reversed--quickly.
Another important teaching point might be that even traumatic childhood events that have totally rocked someone's world and self-esteem for decades can often be "undone" quickly using TEAM. Joy and self-esteem are possible for every human being.
5. Hopelessness is a cruel illusion.
If you’re depressed, you have a deep (and misguided) incredibly painful belief that things are hopeless when they aren't. These feelings of hopelessness are common, but demoralizing at best and dangerous at worst.
More about Brandon and Cassie:
Dr. Brandon Vance writes:
Cassie was an outstanding student of mine when I was teaching CBT last fall at CIIS in San Francisco (California Institute of Integral Studies). My final project was on sharing CBT with the public and suggested that the students could do a creative project or a paper.
Cassie was inspired by the Double Standard technique personally and professionally, as she's studying to be a Marriage and Family Therapist. She wrote this song for her final project.
Although she has had some experience singing, this was the first song she ever wrote (and she taught herself piano recently). I played the song just before the Feeling Great Book Club one week. and then read the words out loud in the book club. My voice cracked as I was tearing up reading them.
As a musician, I am blown away at the power of the words, how well-crafted the song is, and Cassie’s singing and performance. Even the old record-like quality of the recording, with the slightly out-of-tune piano, and faint sounds of kids in the background, adds to the atmosphere!
Here are the beautiful words to Cassie's song, Double Standard:
You get so down on yourself
Convinced you don’t need help
What would you say
If the reflection in the mirror
Was someone you loved
Would you say, babe, you’re worth it
It’s okay not to be okay
Would you help her up and remind her
Of her strength
And don’t you deserve the same grace
So when you’re down on yourself
Convinced you don’t need help
Remember what you’d say
if the reflection in the mirror
was someone you love
tell yourself that you’re worth it
it’s okay not to be okay
hold yourself up and remember
all your strength
you deserve all the grace
so when you’re down on yourself
convinced you don’t need help
remember what you’d say if the reflection
in the mirror
was someone you love
because the reflection in the mirror
is someone
who deserves
love
Thanks Todd! Thanks Cassie! Thanks Brandon! You have touched all of us!
If you would like to contact Todd, you can reach him at: todd.daly@gmail.com
Warmly,
david and rhonda
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