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Feeling Good: The New Mood Therapy

Tags: #psychology #self-help #mental health #cognitive therapy #depression #anxiety

Authors: David D. Burns

Overview

In Feeling Good: The New Mood Therapy, I present a revolutionary approach to understanding and treating depression, anxiety, and other mood disorders. Based on years of research and clinical experience at the University of Pennsylvania, this method, known as ‘cognitive therapy’, asserts that our feelings are not dictated by external events but by the way we think about them. In other words, our moods are created by our ‘cognitions’ or thoughts. \\n\\nThis book challenges traditional approaches to psychotherapy that focus primarily on delving into the past or venting emotions. Instead, cognitive therapy provides a practical, down-to-earth set of techniques for identifying and changing the distorted negative thoughts that cause our emotional turmoil. I believe that anyone can learn to apply these techniques, regardless of the severity of their problems. For those facing serious challenges, such as suicidal thoughts, professional help is crucial. \\n\\nCognitive therapy isn’t just about feeling better; it’s about getting better. It’s about understanding the root causes of your negative thought patterns, developing self-esteem and self-reliance, and gaining the ability to maintain your emotional well-being over the long term. This book, I hope, can be your personal blueprint for achieving lasting happiness and emotional enlightenment.

Book Outline

1. A Breakthrough in the Treatment of Mood Disorders

This chapter introduces the concept of cognitive therapy, a revolutionary approach to treating depression and other mood disorders. This therapy, developed and researched by experts at the University of Pennsylvania, suggests that you can overcome depression by learning simple methods for mood elevation.

Key concept: Cognitive therapy is a fast-acting technology of mood modification that you can learn to apply on your own. It can help you eliminate the symptoms and experience personal growth so you can minimize future upsets and cope with depression more effectively in the future.

2. How to Diagnose Your Moods: The First Step in the Cure

This chapter introduces a self-assessment tool called the Burns Depression Checklist (BDC), a reliable mood-measuring device. It helps readers determine if they are suffering from depression and if so, its severity. The chapter also provides guidance on whether to seek professional help or use self-help methods based on the BDC score.

Key concept: The Burns Depression Checklist (BDC) is a reliable mood-measuring device that detects the presence of depression and accurately rates its severity.

3. Understanding Your Moods: You Feel the Way You Think

This chapter focuses on understanding moods and how they are directly related to thoughts or cognitions. It emphasizes that depression is not an emotional disorder but results from distorted negative thinking. This chapter introduces the concept of ‘automatic thoughts’, the negative thoughts that run through our minds involuntarily and create negative feelings.

Key concept: The first principle of cognitive therapy is that all your moods are created by your “cognitions,” or thoughts.

4. Start by Building Self-Esteem

This chapter introduces the concept of self-esteem and its connection to negative emotional reactions. It argues that low self-esteem is often the root cause of negative emotions and provides specific methods for boosting self-esteem. This includes challenging the idea of ‘worthlessness’ often associated with depression and understanding that human worth is not contingent upon external factors like achievements or approval.

Key concept: 1. All-or-Nothing Thinking - You see things in black-and-white categories. If your performance falls short of perfect, you see yourself as a total failure.

1. Overgeneralization - You see a single negative event as a never-ending pattern of defeat.
2. Mental Filter - You pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened, like the drop of ink that colors the entire beaker of water.
3. Disqualifying the Positive - You reject positive experiences by insisting they “don’t count” for some reason or other. In this way, you can maintain a negative belief that is contradicted by your everyday experiences.
4. Jumping to Conclusions - You make a negative interpretation even though there are no definite facts that convincingly support your conclusion. a. Mind reading. You arbitrarily conclude that someone is reacting negatively to you, and you don’t bother to check this out. b. The Fortune Teller Error. You anticipate that things will turn out badly, and you feel convinced that your prediction is an already-established fact.
5. Magnification (Catastrophizing) OR Minimization - You exaggerate the importance of things (such as your goof-up or someone else’s achievement), or you inappropriately shrink things until they appear tiny (your own desirable qualities or the other fellow’s imperfections). This is also called the “binocular trick.”
6. Emotional Reasoning - You assume that your negative emotions necessarily reflect the way things really are: “I feel it, therefore it must be true.”
7. Should Statements - You try to motivate yourself with shoulds and shouldn’ts, as if you had to be whipped and punished before you could be expected to do anything. “Musts” and “oughts” are also offenders. The emotional consequence is guilt. When you direct should statements toward others, you feel anger, frustration, and resentment.
8. Labeling and Mislabeling - This is an extreme form of overgeneralization. Instead of describing your error, you attach a negative label to yourself: “I’m a loser.” When someone else’s behavior rubs you the wrong way, you attach a negative label to him: “He’s a goddam louse.” Mislabeling involves describing an event with language that is highly colored and emotionally loaded.
9. Personalization - You see yourself as the cause of some negative external event which in fact you were not primarily responsible for.

5. Do-Nothingism: How to Beat It

This chapter focuses on ‘Do-Nothingism,’ a common symptom of depression characterized by a lack of motivation and willpower. It challenges traditional theories about laziness and self-sabotage, arguing that these behaviors often stem from negative thought patterns. This chapter provides various cognitive techniques to overcome procrastination, including the Daily Activity Schedule, the Antiprocrastination Sheet, and the concept of ‘Motivation Without Coercion’, among others.

Key concept: The Lethargy Cycle: Your self-defeating negative thoughts make you feel miserable. Your painful emotions, in turn, convince you that your distorted, pessimistic thoughts are actually valid. Similarly, self-defeating thoughts and actions reinforce each other in a circular manner. The unpleasant consequences of do-nothingism make your problems even worse.

6. Verbal Judo: Learn to Talk Back When You’re Under the Fire of Criticism

This chapter provides strategies for dealing with criticism effectively, emphasizing the importance of maintaining self-esteem in the face of disapproval. This chapter introduces the concept of ‘Verbal Judo,’ a technique for handling verbal abuse and disapproval non-defensively. The key steps involved include empathy, disarming the critic, and feedback & negotiation.

Key concept: Empathy: the ability to comprehend with accuracy the precise thoughts and motivations of other people in such a way that they would say, “Yes, that is exactly where I’m coming from!”

7. Feeling Angry? What’s Your IQ?

This chapter examines anger, its causes, and how to manage it effectively. It emphasizes that anger, like any other emotion, is generated by our thoughts and not by external events or people. This chapter provides tools for measuring your “Irritability Quotient” (IQ) and outlines techniques for managing anger, including the double-column method and imagining techniques.

Key concept: Anger, like all emotions, is created by your cognitions.

8. Ways of Defeating Guilt

This chapter delves into the complexities of guilt and how it contributes to depression. It distinguishes between ‘remorse’ and ‘guilt’, highlighting that guilt stems from the belief that our actions make us a ‘bad person’. This chapter outlines the ‘Guilt Cycle’ and how negative thoughts, feelings, and behaviors reinforce each other, leading to self-defeating patterns. The chapter offers several techniques for managing guilt, including the ‘Daily Record of Dysfunctional Thoughts’, ‘Should Removal Techniques’, and the ‘Irresponsibility of Guilt’.

Key concept: Guilt is the emotion you will experience when you have the following thoughts:

1. I have done something I shouldn’t have (or I have failed to do something that I should have) because my actions fall short of my moral standards and violate my concept of fairness.
2. This “bad behavior” shows that I am a bad person (or that I have an evil streak, or a tainted character, or a rotten core, etc.).

9. Sadness Is Not Depression

This chapter addresses the concept of “realistic” depressions triggered by seemingly insurmountable life events such as financial loss, serious illness, or the loss of a loved one. This chapter argues that while these events can cause sadness, they do not directly cause depression. The pain and suffering associated with such events are often amplified by distorted negative thoughts. It further emphasizes the difference between healthy sadness and depression.

Key concept: The distinction is simple. Sadness is a normal emotion created by realistic perceptions that describe a negative event involving loss or disappointment in an undistorted way. Depression is an illness that always results from thoughts that are distorted in some way.

10. The Cause of It All

This chapter delves into the root causes of depression and explores the role of ‘silent assumptions’ in shaping our vulnerability to mood swings. It explains how these underlying beliefs about self-worth, often formed in childhood, can predispose us to depression and anxiety. This chapter highlights the need to identify and challenge these negative thought patterns in order to achieve lasting emotional well-being.

Key concept: Although your distorted negative thoughts will be substantially reduced or entirely eliminated after you have recovered from a bout of depression, there are certain “silent assumptions” that probably still lurk in your mind.

11. The Approval Addiction

This chapter explores the ‘Approval Addiction,’ a common self-defeating belief that our worth is determined by the opinions of others. It argues that this addiction can lead to anxiety and depression as our mood becomes dependent on external validation. This chapter offers techniques for breaking free from this addiction, emphasizing the importance of self-validation and self-respect.

Key concept: It’s a fact that approval feels good. There’s nothing wrong with that; it’s natural and healthy. It is also a fact that disapproval and rejection usually taste bitter and unpleasant. This is human and understandable. But you are swimming in deep, turbulent waters if you continue to believe that approval and disapproval are the proper and ultimate yardsticks with which to measure your worth.

12. The Love Addiction

This chapter examines the concept of ‘Love Addiction’ and the belief that romantic love is an absolute necessity for happiness. It argues that this dependency on love for self-worth can lead to loneliness and unhappiness, as individuals become overly focused on external validation. This chapter encourages readers to find happiness within themselves and to challenge the notion that being alone is equivalent to being lonely.

Key concept: The demand or need for love before you can feel happy is called “dependency.” Dependency means that you are unable to assume responsibility for your emotional life.

13. Your Work Is Not Your Worth

This chapter challenges the belief that our worth is proportional to our achievements, a common misconception often ingrained in Western culture. This chapter argues that equating self-worth with achievements can be self-defeating, as it leads to a constant fear of failure and an inability to enjoy life’s simple pleasures. It encourages readers to redefine their value system and to find satisfaction in the process of living, not just in the outcomes.

Key concept: The first step in changing any personal value is to determine if it works more to your advantage or disadvantage.

14. Dare to Be Average: Ways to Overcome Perfectionism

This chapter focuses on perfectionism, exploring its harmful effects on our well-being. It challenges the idea that we should strive for perfection, arguing that this pursuit is unrealistic and often leads to disappointment and anxiety. This chapter encourages readers to embrace ‘averageness’, emphasizing that it’s a more realistic and fulfilling approach to life.

Key concept: “Perfection” is man’s ultimate illusion. It simply doesn’t exist in the universe. There is no perfection. It’s really the world’s greatest con game; it promises riches and delivers misery.

15. The Ultimate Victory: Choosing to Live

This chapter provides a compassionate and insightful look at suicide, a topic often considered taboo. It acknowledges the prevalence of suicidal thoughts in individuals struggling with severe depression, but emphasizes that suicide is never the answer. This chapter delves into the illogical thinking that leads to suicidal impulses, highlighting the distortion of reality often experienced by depressed individuals. This chapter offers practical advice for assessing suicidal impulses and emphasizes the importance of seeking professional help.

Key concept: You Are Wrong in Your Belief That Suicide Is the Only Solution or the Best Solution to Your Problem.

16. How I Practice What I Preach

This chapter provides a personal account of how the author, a psychiatrist, applies the principles of cognitive therapy to his own life and work. It offers real-life examples of how he copes with challenging situations involving hostile patients, ungrateful patients, and those experiencing suicidal thoughts. This chapter highlights the effectiveness of cognitive techniques in managing a wide range of emotional challenges.

Key concept: I also used the double-column technique for recording and talking back to my automatic thoughts after one of Hank’s midnight calls (see Figure 16– 1, page 415).

17. The Search for “Black Bile”

This chapter delves into the biological underpinnings of mood, exploring the ongoing search for the biological causes of depression, often referred to as the ‘black bile.’ It discusses the history of this research, the challenges involved in determining the cause-and-effect relationship between brain chemistry and depression, and the potential for future breakthroughs in this field.

Key concept: Some day, scientists may provide us with frightening technology that will allow us to change our moods at will. This technology may be in the form of a safe, fast-acting medication that relieves depression in a matter of hours with few or no side effects.

18. The Mind-Body Problem

This chapter delves into the age-old ‘mind-body problem’ and explores how this philosophical concept influences our understanding and treatment of depression. It examines the different perspectives of ‘biological’ and ‘psychological’ treatment approaches, highlighting the debate between proponents of drug therapy and talking therapy. This chapter discusses recent research suggesting that these two approaches may not be as distinct as traditionally believed and that they might, in fact, work in similar ways on the brain.

Key concept: The belief that our minds and bodies are separate is reflected in our treatments for problems such as depression. We have biological treatments, which work on the “body,” and psychological treatments, which work on the “mind.”

19. What You Need to Know about Commonly Prescribed Antidepressants

This chapter provides practical guidance about commonly prescribed antidepressants. It explores the effectiveness of these drugs, factors influencing response to medication, common side effects, and the importance of monitoring progress. This chapter also dispels common myths about antidepressants and emphasizes the significance of an informed and collaborative approach to treatment.

Key concept: Myth Number 1. “If I take this drug, I won’t be my true self. I’ll act strange and feel unusual.” Nothing could be further from the truth. Although these drugs can sometimes eliminate depression, they do not usually create abnormal mood elevations and, except in rare cases, they will not make you feel abnormal, strange, or “high.”

20. The Complete Consumer’s Guide to Antidepressant Drug Therapy

This chapter provides a comprehensive guide to antidepressant drug therapy, presenting detailed information on costs, doses, side effects, and drug interactions of all currently available antidepressants and mood-stabilizing agents. This chapter serves as a reference guide for those taking antidepressants, offering practical advice for managing medication, understanding potential risks, and making informed decisions about treatment.

Key concept: Table 20-1. Names, Doses, and Costs of Antidepressant Medications

21. Suggested Resources

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22. Index

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23. Acknowledgments

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24. About the Author

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25. About the Book

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26. Notes and References (Chapters 17 to 20)

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Essential Questions

1. What is the fundamental principle of cognitive therapy?

The foundation of cognitive therapy lies in the understanding that our feelings stem from our thoughts. When we experience negative emotions like sadness, anxiety, or anger, it’s because of the distorted, negative thoughts we are having at that moment. Feeling Good emphasizes that these thoughts, often called ‘automatic thoughts,’ are not necessarily true reflections of reality. By learning to identify and challenge these thoughts, we can change our emotional responses.

2. What are cognitive distortions, and how do they contribute to depression?

Feeling Good outlines ten common cognitive distortions, including all-or-nothing thinking, overgeneralization, mental filtering, disqualifying the positive, jumping to conclusions, magnification, emotional reasoning, should statements, labeling, and personalization. These distortions are habitual ways of thinking that lead to negative and inaccurate interpretations of reality, contributing to our emotional distress.

3. What are some key techniques for managing negative emotions and overcoming depression?

The book provides a range of techniques for managing negative emotions. Some key techniques include the ‘triple-column technique’ for challenging automatic thoughts, the Daily Activity Schedule for combating ‘do-nothingism’, the ‘Verbal Judo’ technique for handling criticism, and the ‘Anger Cost-Benefit Analysis’ for managing anger. By diligently practicing these techniques, individuals can gain control over their moods and improve their emotional well-being.

4. What is the relationship between external factors and our emotional well-being?

Feeling Good challenges the notion that external factors, such as achievements, approval, love, or serious life events, are the primary causes of happiness or unhappiness. While acknowledging the impact of these factors, the book emphasizes the role of our internal belief systems and thinking patterns in shaping our emotional responses. It suggests that true self-esteem arises from within and is not contingent upon external validation.

5. How does the mind-body problem relate to the treatment of depression?

The book challenges the traditional ‘mind-body’ dichotomy and presents evidence suggesting that psychological treatments like cognitive therapy may actually work by changing the chemistry and structure of the brain. This aligns with emerging research on neuroplasticity, the brain’s ability to change and adapt throughout our lives. It highlights the interconnectedness of our thoughts, feelings, and physical well-being.

Key Takeaways

1. Our feelings are created by our thoughts, not external events.

Feeling Good emphasizes the power of our thoughts in shaping our emotional reality. Our interpretations of events, rather than the events themselves, determine how we feel. This is crucial because it means we have the power to change our emotional responses by changing the way we think.

Practical Application:

In the context of AI product design, understanding this principle can help prioritize user experience. Instead of focusing solely on technical capabilities, product engineers can focus on how users perceive and interact with the technology. By understanding and addressing potential negative thoughts or anxieties that users might experience, the product can be designed to foster positive emotional responses and enhance user satisfaction. For instance, a user-friendly interface and clear instructions can reduce frustration and enhance feelings of competence and mastery.

2. Challenge your ‘should statements’ to reduce self-imposed pressure and guilt.

Feeling Good challenges the ‘should statements’ that create pressure, guilt, and resentment. These moralistic judgments often set unrealistic standards and lead to self-criticism and disappointment. By rewriting these ‘shoulds’ in more flexible and realistic terms, we can reduce self-imposed pressure and foster a more accepting and compassionate attitude towards ourselves and others.

Practical Application:

In the context of AI safety, acknowledging that even advanced systems are not infallible is critical. By identifying and challenging our own ‘should statements’ about AI’s capabilities, we can avoid setting unrealistic expectations and fostering a false sense of security. For instance, instead of assuming that a self-driving car is absolutely foolproof, we need to recognize the potential for errors and design systems with appropriate safeguards and fail-safes.

3. Master the art of ‘Verbal Judo’ to handle criticism effectively.

The book introduces the concept of ‘Verbal Judo’ as a powerful technique for handling criticism and disapproval without losing self-esteem. This involves learning to listen empathetically, disarm the critic by finding points of agreement, and provide feedback in a tactful and assertive manner. This approach helps navigate challenging interpersonal situations and maintain self-respect.

Practical Application:

In the context of effective meetings, practicing ‘Verbal Judo’ can help navigate challenging conversations and disagreements. By listening empathetically, finding points of agreement, and communicating assertively, individuals can de-escalate conflict, maintain relationships, and work towards mutually agreeable solutions.

4. Shift your focus from outcomes to the process.

Feeling Good encourages a ‘process orientation’ rather than an ‘outcome orientation.’ This means shifting our focus from achieving a specific result to enjoying and valuing the process of engaging in an activity. This approach can reduce anxiety, enhance enjoyment, and lead to greater satisfaction and productivity.

Practical Application:

In the context of AI development, embracing a ‘process orientation’ can help teams stay motivated and productive even when facing setbacks or delays. By focusing on the steps involved in developing the technology, celebrating small wins, and learning from mistakes, teams can maintain momentum and avoid becoming discouraged by the pursuit of a distant, and potentially elusive, end goal.

5. Embrace the inevitability of making mistakes.

The book encourages readers to embrace the inevitability of making mistakes. Instead of viewing errors as catastrophic failures, it promotes seeing them as opportunities for learning and growth. This perspective helps reduce the fear of failure, enhance self-acceptance, and foster a more experimental and growth-oriented approach to life.

Practical Application:

In the context of AI research, embracing the inevitability of mistakes can foster a more experimental and innovative mindset. By viewing errors as opportunities for learning and growth, researchers can be more willing to take risks, explore new approaches, and push the boundaries of what’s possible.

Suggested Deep Dive

Chapter: Chapter 3: Understanding Your Moods: You Feel the Way You Think

This chapter is particularly relevant for an AI product engineer as it dives into the core principle of cognitive therapy: the relationship between thoughts and feelings. Understanding how our interpretations of events shape our emotional responses can be invaluable in designing AI systems that interact with users in a way that fosters positive emotional experiences and avoids triggering negative ones.

Memorable Quotes

Introduction. 10

For as he thinks within himself, so he is.

A Breakthrough in the Treatment of Mood Disorders. 25

Cognitive therapy is a fast-acting technology of mood modification that you can learn to apply on your own.

Understanding Your Moods: You Feel the Way You Think. 40

Depression is not an emotional disorder at all!

Understanding Your Moods: You Feel the Way You Think. 58

Your feelings are not facts!

Do-Nothingism: How to Beat It. 83

One of the most destructive aspects of depression is the way it paralyzes your willpower.

Comparative Analysis

Feeling Good: The New Mood Therapy, while a seminal work in the field of cognitive behavioral therapy (CBT), shares common ground with other notable works exploring the interplay of thoughts, feelings, and behaviors. Albert Ellis’s Rational Emotive Behavior Therapy (REBT), for example, also emphasizes the role of irrational beliefs in creating emotional disturbance. Both CBT and REBT provide structured, action-oriented techniques for challenging and modifying these beliefs. However, Feeling Good distinguishes itself with its clear, engaging style and wealth of practical examples, making it accessible to a broader audience. \\n\\nIn contrast to psychodynamic approaches, such as those popularized by Sigmund Freud, which delve into past experiences and unconscious conflicts, CBT focuses on present-day thinking patterns and their impact on our current emotional state. While acknowledging the influence of past experiences, Feeling Good emphasizes that we have the power to change the way we think about these experiences and thereby change our emotional responses. \\n\\nFeeling Good aligns with the burgeoning field of positive psychology, which emphasizes building strengths and fostering well-being. While addressing negative thought patterns, the book also emphasizes self-acceptance, self-love, and the pursuit of meaningful activities as essential pathways to happiness. This holistic approach distinguishes it from some CBT manuals that may focus solely on symptom reduction.

Reflection

Feeling Good: The New Mood Therapy, first published in 1980 and revised in 1999, presents a compelling case for cognitive therapy as a powerful tool for combating depression and anxiety. While some might view the book’s emphasis on the power of positive thinking as overly simplistic, the wealth of research and clinical experience presented provides compelling evidence for its effectiveness. \\n\\nIt’s important to note that the book predates the significant advances in neuroscience and genetics that have occurred in recent decades. While acknowledging the potential role of biological factors in mood disorders, the book’s primary focus is on the psychological and behavioral aspects of treatment. However, even with the advancements in our understanding of the brain, cognitive therapy remains a valuable tool, and its principles align with the emerging field of neuroplasticity, the brain’s ability to change and adapt in response to our thoughts and experiences. \\n\\nDespite its strengths, the book could benefit from updates reflecting current research and a more nuanced discussion of the interplay between biological and psychological factors in mood disorders. Nevertheless, Feeling Good remains a seminal work in the field of cognitive therapy, and its practical, accessible approach has helped millions of individuals find relief from depression and anxiety.

Flashcards

What causes our feelings?

Our thoughts. Feeling Good emphasizes that our emotions are created by our interpretations of events, not the events themselves. For example, being late for a meeting might trigger the thought ‘I never do anything right’, leading to feelings of panic and inadequacy.

List the ten common cognitive distortions outlined in Feeling Good.

All-or-nothing thinking, overgeneralization, mental filter, disqualifying the positive, jumping to conclusions, magnification, emotional reasoning, should statements, labeling and personalization.

What is the ‘triple-column technique’ used in cognitive therapy?

This is a three-column technique where you write down your negative thoughts, identify the cognitive distortion present, and then formulate a rational response to challenge the negative thought.

What is the ‘Pleasure-Predicting Sheet’, and how can it help overcome dependency?

This technique involves scheduling pleasurable and fulfilling activities, both alone and with others, and then predicting and recording your actual satisfaction levels. This helps challenge the belief that you can only be happy in the presence of others or in specific circumstances.

What is the ‘disarming technique’ used in ‘Verbal Judo’?

This involves agreeing with some aspect of the criticism, even if it seems absurd, in order to disarm the critic and pave the way for a more productive discussion.

What is the ‘Don’t Put the Cart Before the Horse’ principle?

It suggests that action often precedes motivation. By taking action, even if we don’t feel like it, we can prime the pump for motivation and start feeling better.

What is ‘process orientation’?

This refers to shifting your focus from outcomes to the process of engaging in an activity. This approach can reduce anxiety and enhance enjoyment, as you no longer feel pressure to achieve a specific result.

What does it mean to ‘treat yourself like a beloved friend’?

This means acknowledging and accepting your strengths and imperfections without judgment or self-criticism. It’s about treating yourself with the same kindness and respect you would offer a close friend.