429: Ask David: Daily Mood Logs; Somatic Complaints; Passive Aggression

12/30/24 • 68 min

Feeling Good Podcast | TEAM-CBT - The New Mood Therapy

Ask David With Special Guest Expert, Dr. Matthew May Daily Mood Log: Does it have to be done perfectly? Somatic Complaints: How does TEAM Help? Passive Aggression: What distortions cause it?

Roger, from Australia, asks: Do daily mood logs still work if you complete them ‘imperfectly’?
Roger also asks: Based on your clinical experience, what causes a reduction or complete elimination of in symptoms for people who present with somatic complaints or chronic pain?
TOZ asks: Does passive aggressive behavior result from All-or-Nothing Thinking?

The answers below were written prior to the show, based on correspondence with those who asked the questions. The live answers on the show will be different in many cases.

1, Roger, from Australia, asks: Do daily mood logs still work if you complete them ‘imperfectly’?

2. Roger also asks: Based on your clinical experience, what causes a reduction or complete elimination of symptoms for people who present with somatic complaints or chronic pain?

Dear David,

Sure, I would love to have my questions be on an Ask David! It would be okay for you to use my real name and my location as being in Australia for the podcast and show notes.

I’ve reworded the questions so that they get across what I was actually trying to ask in my previous email. You might now have a slightly different response based on the new questions. I have to apologise as my wording in my previous email was confusing, even for me.

Here’s a shorter version of the first question:

“Dear David, I’ve got a question about doing daily mood logs as part of my psychotherapy homework. I tend to start a lot of new daily mood logs where I write my negative emotions and thoughts, as well as do positive reframing, but then get stuck when it comes to doing methods for challenging my negative thoughts, as I get caught up on trying to do the exercise perfectly. I get worried that I won’t see as much benefit from the exercise if I don’t do the steps perfectly or in order. Did you see improvements in patients who filled out their daily mood logs imperfectly? Perhaps they may have skipped steps or maybe they couldn’t crush their negative thoughts completely, but continued to move on to working with new thoughts and seeing if they could crush those.”

An even shorter version of the question would be:

“Do daily mood logs still work if you complete them ‘imperfectly’?”

A shorter version of the question about somatic complaints and pain is:

“I’ve also got a question on treating somatic symptoms and chronic pain. Some clinicians have seen people improve by doing journalling or expressive writing about life stressors such as past stressors, current stressors, and self-limiting behaviours or beliefs.

Other activities which seem to be useful include writing unsent letters to people who’ve hurt you, or doing behavioural changes for self-limiting beliefs like learning how to designate free time for yourself if you have a tendency to take on too much or feel guilty about spending time relaxing and not doing work. I was wondering what you’ve seen in your clinical experience and what you’ve seen patients do which helps them reduce or eliminate their somatic symptoms and chronic pain?"

An even shorter version of that question would be:

“Based on your clinical experience, what causes a reduction or complete elimination of in symptoms for people who present with somatic complaints or chronic pain?"

Regards,

Roger He

David’s reply

Thanks, these short versions are a big improvement. Here are the quick answers:

The critical thing is to come up with one or more positive thoughts that are 100% true, and that reduce your belief in the negative thought. If you send a specific example, it would help. There are several rules about getting workable negative thoughts as well. Perfection is never possible in the universe of daily mood logs, but excellence certainly is. A change in belief in neg thoughts is the goal.
In my experience, somatic complaints, such as undiagnosed pain, dizziness, fatigue, and more, are often created or magnified by (or the expression of) negative emotions, as well as hidden emotions / problems. The average reduction of pain, for example, will be 50% if there is a dramatic reduction in negative feelings, or if the patient identifies and tackles some unexpressed problem, like anger, or unexpressed grief, or loneliness when the kids go off to college, and so forth. An average of 50% means that some people will experience a complete elimination of the negative symptoms, like pain. Some will experience no improvement. And some will experience some improvement.

With regard to how or why this works, I don’t really know, and don’t think that anyone knows. But it seems like negative feelings, like depression, anxiety, anger and so forth h...

Ask David With Special Guest Expert, Dr. Matthew May Daily Mood Log: Does it have to be done perfectly? Somatic Complaints: How does TEAM Help? Passive Aggression: What distortions cause it?

Roger, from Australia, asks: Do daily mood logs still work if you complete them ‘imperfectly’?
Roger also asks: Based on your clinical experience, what causes a reduction or complete elimination of in symptoms for people who present with somatic complaints or chronic pain?
TOZ asks: Does passive aggressive behavior result from All-or-Nothing Thinking?

The answers below were written prior to the show, based on correspondence with those who asked the questions. The live answers on the show will be different in many cases.

1, Roger, from Australia, asks: Do daily mood logs still work if you complete them ‘imperfectly’?

2. Roger also asks: Based on your clinical experience, what causes a reduction or complete elimination of symptoms for people who present with somatic complaints or chronic pain?

Dear David,

Sure, I would love to have my questions be on an Ask David! It would be okay for you to use my real name and my location as being in Australia for the podcast and show notes.

Here’s a shorter version of the first question:

An even shorter version of the question would be:

“Do daily mood logs still work if you complete them ‘imperfectly’?”

A shorter version of the question about somatic complaints and pain is:

An even shorter version of that question would be:

“Based on your clinical experience, what causes a reduction or complete elimination of in symptoms for people who present with somatic complaints or chronic pain?"

Regards,

Roger He

David’s reply

Thanks, these short versions are a big improvement. Here are the quick answers:

The critical thing is to come up with one or more positive thoughts that are 100% true, and that reduce your belief in the negative thought. If you send a specific example, it would help. There are several rules about getting workable negative thoughts as well. Perfection is never possible in the universe of daily mood logs, but excellence certainly is. A change in belief in neg thoughts is the goal.
In my experience, somatic complaints, such as undiagnosed pain, dizziness, fatigue, and more, are often created or magnified by (or the expression of) negative emotions, as well as hidden emotions / problems. The average reduction of pain, for example, will be 50% if there is a dramatic reduction in negative feelings, or if the patient identifies and tackles some unexpressed problem, like anger, or unexpressed grief, or loneliness when the kids go off to college, and so forth. An average of 50% means that some people will experience a complete elimination of the negative symptoms, like pain. Some will experience no improvement. And some will experience some improvement.

With regard to how or why this works, I don’t really know, and don’t think that anyone knows. But it seems like negative feelings, like depression, anxiety, anger and so forth h...

Previous Episode

428: Tahn Wanders . . . and Wonders

Tahn Wanders . . . and Wonders A Young Monk's Search for Peace and Happiness

Today we are honored by a second visit from Tahn Pamutto, who first appeared as a podcast guest on November 4, 2024, where he described his transition from a soldier in Iraq to an ordained Buddhist monk. He also gave us a taste of Buddhist teachings, and compared them to what we to in TEAM-CBT.

There were certainly a number of areas of overlap. For example, as a psychiatrist, my goal is often to help bring patients as rapidly as possible from a state of unhappiness and depression to a state of joy and enlightenment, using a number of specific psychological techniques we call TEAM-CBT. But part of this is spiritual in nature as well.

Tahn’s role as an ordained Buddhist monk is similar, in part. His goal is help people who ask for guidance how to discover the cause of unhappiness, and the path to happiness, using a number of spiritual exercises, including meditation. But part of these exercises are psychological as well.

Today, Tahn began by contrasting a spiritual vs a materialistic view of life, and emphasized that the materialist view cannot solve the problem of unhappiness or provide us with happiness. This is, in part, because material things are impermanent, and will all ultimately disappear.

Negative feelings, like unhappiness, actually result from our thoughts--how we view the world. The world is the world, and you can accept that, or you can protest and shout angrily that things “should” be different or “shouldn’t” be the way they are, but your feelings will always result from the way you think about the world.

He said that when he was growing up, all his needs were taken care of, and happiness was fleeting, so he embarked on a search for answers. Who was I, and why was I struggling with so much unhappiness?

He said,

“To explore and really find out who I was, I’d have to depart from my comfort. When I joined the army, it sounded great. It was all about patriotism, loyalty, honor, service, and all kinds of positive values. . .

But then at some point, they say that’s time to invade this or that country, and you have to try to make that work, since you can’t challenge the mission. The Iraq war was going on, and I spend 13 months there.

But if your mission is wrong, you will keep suffering, no matter how hard you try. Did the people in Iraq really want us there? Are we really doing anything that’s positive or good?

And what is it that I really want to do with my life?

One thing we have to recognize is two things that cannot be denied: our mortality and the existence of unhappiness. As I began to accept these two inevitable facts, I also realized that there is no quick solution, and that the reality is that our unhappiness may not end on its own. We may go to sleep, and escape for a while, but when we wake up, we will still be unhappy. We could even imagine being reincarnated and having a different body, a different religion, or living in a different time, but our suffering still won’t change. I may be a different person, but I will still be unhappy.

I asked myself if and how I could train myself to accept what life brings me. . . and wondered whether is would be possible to pursue unending happiness? And if so, how would I go about it? What I do?

When I was in Iraq, I applied for conscientious objector status and eventually got out on an early retirement. Then, I began looking for an experienced, humble teacher who could share their knowledge with me.

I bought a backpack and some hiking shoes, and began to search so I could learn what I needed to learn. I didn’t have much knowledge of Buddhism at all at that time.

I left my mother’s house in New Jersey and started walking. I walked 20 miles, but realized I was going in the wrong direction, and had to walk 20 miles back and start over, walking in the opposite direction.

The first night of my journey, I got exhausted and slept on a park bench. In the middle of the night, I thought I heard loud explosions, and woke up feeling terrified, but it was just acorns falling down from the oak tree I was sleeping under.

In the Army I had learned the wrong way, and that’s why I decided to search, but any old street in New Jersey probably didn’t have what I was looking for. I decided to search for the answer in Asia instead, and wandered in India, Thailand, Korea, Japan, and Taiwan.

I went into Temples and Mosques. I had the romantic notion that some wise bearded man would come out of nowhere and tap on my shoulder and say, “We’ve been waiting for you, Tahn! You have finally arrived!”

But it doesn’t work like that.

In Thailand, there is a monastic level to society, as well as a commercial level. Thailand and Burma are certainly not perfect as countries, but have a higher than average level of happiness because the people are gene...

Next Episode

430: Was Epictetus Right? Finally--an Answer!

Do Negative Thoughts REALLY Cause Depression? An Answer--At Last!--from Research Featuring David Burns, Jeremy Karmel, Diane Spangler and Rhonda Barovsky

Today, David and two dear colleagues--Jeremy Karmel, CEO of the Feeling Great Corporation, and Dr. Diane Spangler--share the amazing results of two types of research on the Feeling Great app that focus on two related and vitally important questions:

How effective is the Feeling Great app? Research confirms it triggers incredibly fast and dramatic reductions in seven negative feelings: depression, anxiety, guil7, inadequacy, loneliness, hopelessness and anger. The speed and depth of these effects may substantially outstrip human therapists as well as antidepressant medications.
How does it work? What is the mechanism of action? People have argued intensely about the chicken vs the egg problem for more than 2,000 years. Do negative thoughts REALLY cause negative feelings? Or do negative feelings cause negative thoughts? Or both? Or neither?

The answers are exciting!

Warmly,.

Rhonda, Jeremy, Diane, and David