301: Why am I like this? Live Work with Nazli! Part 1 of 2

In the next two podcasts, you will hear the live therapy session that Dr. Jill Levitt and I did with Nazli, a young woman from Turkey, at our recent “David Burns Live” workshop on May 22, 2022. Nazli has been struggling with intense performance anxiety and generalized anxiety, and generously who volunteered to be a “patient.” Jill and I are very grateful for Nazli’s courage in sharing herself so courageously with all of you, and hope you enjoy the session and learn from it. Although the facts of your life are probably quite different from Nazli’s, you may be able to identify with the almost universal theme of feeling like you are not “good enough.” The ultimate antidote to this type of suffering is simple, but so basic that you may not “see it” at first, especially when it comes to your own negative thoughts and feelings. Although we all have many flaws and shortcomings, our inadequacies are rarely or never the cause of our emotional distress. Our emotional distress, in terms of anxiety, depression, inferiority, loneliness, hopelessness, and anger, nearly always results from our thoughts, and not so much from what’s actually happening in our lives. In addition, the thoughts that trigger those kinds of feelings are almost never valid. Instead, they are loaded with cognitive distortions. As you probably know very well, I have often said that depression and anxiety are the world’s oldest cons. And here’s the really good news. The very moment you change the way you THINK, you can change the way you FEEL! Sounds wonderful. But isn’t it just a little, or a lot, too good to be true? And can you really trigger real change at the gut level by changing the way you think? Let’s find out! In today’s podcast, you’ll hear the first half of Nazli’s session, including T = Testing and E = Empathy. Next week, you’ll hear the exciting conclusion of her session, including the A = Assessment of Resistance and M = Methods, followed, of course by the final of T = Testing so we can see if Nazli really changed, and if so, by how much. We’ll also see and how she rated Jill and David on Empathy, Helpfulness, and more. If you’ve followed the Feeling Good Podcasts, you know that doing live therapy to challenge your own demons is part of therapist training in TEAM-CBT This experience greatly deepens your understanding of team and allows you to give this message to your ow patients: “I know how you feel because I’ve been there myself. And it will give me great joy to show you how to CHANGE the way you FEEL, too!” I think of this personal step as the transition from technician to healer. But you cannot take this step with credibility if you haven’t yet done your own “work.” At the start of the session, Nazli explained that she’s struggled with anxiety ever since she was a child, and that’s what triggered her interest in a career as a clinical psychologist. In my experience, this is true of many if not most mental health professionals. Although the general public often have the impression that shrinks have it all together, nothing could be further from the truth. Most went into the field hoping to find a solution to their own suffering, and a great many—probably nearly all—are still searching and hoping to find a their “cure.” After completing her master’s degree in counseling 10 years ago, Nazli got a job at a counseling center, and in spite of the fact that she received consistently good feedback, she quit after 2 and 1/2 years and took a job in administration. This was because of the intense anxiety she experienced during sessions, resulting from the constant and relentless bombardment with negative thoughts that popped into her mind when treating  patients. However, she still yearned to do clinical work, so she decide to go back to clinical work several years ago and has been doing therapy for patients being treated for cancer. But the negative thoughts and feelings still continued to haunt her. You can review them on the Daily Mood Log that Nazli showed us at the start of her session. As you can see, when she’s treating patients, she feels severe depression, anxiety, shame and inadequacy. She also feels humiliated, hopeless, and discouraged, along with some moderate feelings of anger and resentment. Nazli explained that she has no fear of public speaking, but said that when she’s working with a client, she constantly criticizes herself for fear of making a mistake and tell herself:

• I’m not doing a good job.
• This job is not for me.
• Should I just quit?
• My friends are at a better place in life.
• I’m 38 years old and missing out on a lot.
• Why am I like this?

Recently, she went to visit one of her patients, a young woman struggling with lung cancer; but when Nazli entered the room, her patient said: “I don’t want to talk to you!” Nazli said, “I was devastated and felt like crying.” When you review Nazli’s Brief Mood Survey (BMS) at the start of the session, you’ll see that the only feeling that was elevated was anxiety, and that was minimal. However, her score on the Happiness Test was only 8 out of 20, indicating that she didn’t feel very worthwhile, happy, hopeful, motivated, or satisfied with her life. This meant that her negative thoughts and feelings when she was seeing patients were making a huge impact on her capacity for happiness and self-esteem. Her minimal scores on the depression, anxiety, and anger scales on the BMS also reflect the fluctuating nature of anxiety and other feelings for many people. For example, you may have little or no anxiety most of the time, and when you’re having a session with your shrink you may not feel especially anxious, either. But when you encounter the situation that triggers your anxiety, the feelings suddenly spike tremendously, along with a host of other negative feelings, and then the emotional discomfort can be overwhelming. End of Part 1 of the Nazli Session: T = Testing and E = Empathy. Next week, you will hear Part 2: A = Assessment of Resistance and M =  Methods. Thanks! Rhonda, Jill, Nazli, and David