• Intro (00:00 – 02:01)
• What exactly is depression, and what is healthy sadness? (02:01 – 05:27)
• Debunking the myth that depression is caused by a chemical imbalance (05:27 – 11:30)
• Why antidepressants such as SSRIs are no more effective than a placebo (11:30 – 13:37)
• Why antidepressants are still being prescribed (13:37 – 17:45) The IPS Academy (17:45 – 19:11)
• How the placebo effect works and improves mood (19:11 – 23:55)
• Real tools and techniques to help with depression (23:55 – 30:47)
• Learning to see the value behind ‘negative’ thoughts and feelings (30:47 – 41:18)
• What is T.E.A.M. therapy? (42:12 – 50:14)
• Why talk therapy without structure is often ineffective (50:14 – 52:09)
• How to help someone dealing with depression (52:09 – 59:26)
• Dr. Burns’ Tuesday groups at Stanford University (59:26 – 1:00:32)
• The Burns Depression Checklist (1:00:32 – 1:03:52)
• Final advice about depression from Dr. Burns (1:03:52 – 1:10:14)
• Outro (1:10:14 – 1:11:55)

The transcription is, for the most part, AI-transcribed and is currently 85% accurate. We are still weeding out some minor errors.

Jellis Vaes
Dr. Burns, a warm welcome to the podcast. It’s a true honor to have you on.

Dr. David Burns
Thanks for having me on. It’s an honor to meet you and to be on your wonderful podcast.

Jellis Vaes
Let’s maybe first start with laying a bit of a foundation because the word depression, it’s quite commonly used. know, everyone has heard that word, but I feel like not everyone really understands what it is, what depression looks like.

Dr. David Burns
Yeah, sure. Well, sure. What a great question. That is, depression is not the same as healthy sadness. you know, nobody’s supposed to be happy all the time and we all have tragedies in our lives. The loss of a loved one or a loved Pat. Pat, like I often talk about my… my best friend in the world, Obi, was a feral cat we adopted and he and I became incredibly close and then, but he had to go out hunting every night because he was a wild cat but he came to love us and he was very, very sweet and then he would go out at four in the morning and then he’d come back and scratch on our bedroom door at six so I could get up and let him back in.

Jellis Vaes
It’s a great alarm.

Dr. David Burns
And sometimes he’d bring back a gift for our other caps from his hunting. And one morning he never, he didn’t come back. And my wife, I slept in a little, my wife said, oh, he’s not back. And I knew he was gone. We have a mountain lion. We live near at the edge of the woods and there’s a mountain lion in the hills behind. And I think maybe the mountain lion got him. And so I grieve for him and I miss him and I loved him so much and we had so many beautiful moments together. But depression is quite different. It’s when you beat up on yourself with negative thoughts. That’s like, I’m not good enough and I shouldn’t have screwed up and what’s wrong with me? you know, there’s nothing special about me. I’ve never achieved anything. I’m just kind of an inferior human being and things will never change. And those thoughts create feelings of worthlessness, guilt, shame, hopelessness, loneliness, anxiety, and really the conviction that life is no good and I’m no good and my future is no good. And that’s what real depression is.

And it’s one of the worst feelings that a human being can have. And a lot of people listening right now are struggling with those feelings, as well as anxiety. Kind of thinking something terrible is going to happen. When I give that talk at church, my mind will go blank. And someone will ask a tough question I can’t answer. And I’ll make a fool of myself. And things like that. Or if I… talk to people in a social situation they’ll think I’m boring and uninteresting and these thoughts seem very true and it’s the belief in these thoughts that actually causes depression and anxiety and this theory goes back 1700 years to the time of Epictetus the Greek stoic philosopher and he said that we’re not disturbed by things but by our views of them.

Jellis Vaes
Hmm.

Dr. David Burns
In other words, it’s not the events of your life but your thoughts. And some people understand that and many people do not and argue and claim that’s not true. But that is the cause of depression. And we have a research article ready to submit for publication. We’re going to have two versions of it, one for a hardcore science journal and one for the popular psychology today, which is kind of a pop psychology version of it. But we’ve proven, we believe, for the first time in two large databases that negative thoughts actually are distorted negative thoughts, the cause of depression. And that’s very exciting because we now have a lot of a lot of techniques to challenge and crush those distorted thoughts.

When I was doing my postdoctoral research after my psychiatric residency at University of Pennsylvania, I did two or three years of brain research on the so-called chemical imbalance theory of depression. There’s some chemical imbalance in your brain and I never really believed that that theory was true because I was giving out antidepressants by the bucket full.

Jellis Vaes
Yeah. Right.

Dr. David Burns
And I never saw them doing anything for my patients. And then we did a research study at the VA hospital in Philadelphia. We had a depression research unit. And the theory was that depression is because you don’t have enough of this neurotransmitter called serotonin in your brain. And so to test that directly, we took veterans who were depressed and divided them into two groups and both groups got milkshakes, but one group, and it was a double-blind study, got milkshakes laced with 10 grams of L-tryptophan, which is the amino acid that your body cannot manufacture. You have to get it in your diet and goes from the stomach to the blood. It goes directly from the blood to the brain and gets synthesized into serotonin quickly. And so half of the veterans had massive doses of L-tryptophan every day, so their brains got flooded like 20 times, 50 times the normal amount of serotonin in their brains.

The patients didn’t know who was getting the L-tryptophan. The staff didn’t know. It was a double-blind experiment. then after several, but we studied their depression levels of both groups every day. And then we broke the code after three or four weeks to see which group did better and how much of an antidepressant effect did the L-triptophan have. And the answer was that there was no difference in either group and neither group got better whatsoever. And it was proof that this serotonin deficiency theory was false. And so we published it in the top psychiatric journal in 1975 and it was the first disconfirmation of this chemical imbalance theory and it has taken the field about 25 years to catch up to that article. People ignored it because they’d been told that this is true and so they couldn’t connect with research showing that it couldn’t be true. But now it’s finally been accepted that that’s a bogus theory.

Jellis Vaes
Wow, that’s crazy.

Dr. David Burns
And to that 1975, it took really 50 years for the field to come to that conclusion. But I knew it then. And I didn’t want to spend my life. I had grants from the federal government to a career development award to develop a serotonin research laboratory at the University of Medical School, University of Pennsylvania. And I had a tenure-track position. And I told my my supervisor, said, I don’t think I to pursue this career because why would I spend my life studying something I know is a fraud? And he says, come on, David, you’ve got a good thing going. You’re already known all over the world as one of the top experts on brain serotonin. stick it out. You can get tremendous grants. You’ll have tremendous financial support. I’ll show you how to test new antidepressants privately on your own for drug companies and you’ll make a ton of money. And I said, I don’t want to test antidepressants. I already test them informally because I give them to all my patients and they don’t do anything. That’s another bucket of rubbish. And he says, don’t leave the university. You’ll be burning bridges. And I said, no, my heart’s not in it.

I’m going to send the money back to the federal government for that laboratory and I’m going to pursue new and different approaches to the treatment of depression. And so I gave up my position at the university and started my private practice and that was when cognitive therapy was just coming in and I began studying it and using it and writing about it and then I started, I spent my career treating people and developing high-speed treatment techniques.

Jellis Vaes
That’s so interesting actually, because that theory of like the chemical imbalance, I even feel to this day, still a lot more people would say that their depression is because of that than because of their thinking.

Dr. David Burns
Right, that’s right.

Jellis Vaes
So like an antidepressant like an SSRI it does literally nothing?

Dr. David Burns
Right. Yeah, there was a fellow in the Midwest, Dr. Sheldon Prescorn, a research psychiatrist and really nice guy. And he tested antidepressants for drug companies and he also did research on how they were metabolized by the liver and by the body. And he had a database that he sent me as a courtesy of every known, the outcome data that drug companies had submitted to the Food and Drug Administration of every study on SSRIs ever conducted. Every dose, you know, where half the patients got the SSRI and half the patients got the placebo and at every single known dose of every single SSRI. So the studies involved roughly 20,000 people. And I was on vacation with my wife down in Carmel for a couple days. used to go down there overnight because it’s really, really beautiful and peaceful. And I was looking at the data and my wife’s a psychologist so she’s really smart and I said, Melanie look at this data. To me it looks like there’s no difference from the patients who got the SSRIs and the patients who got placebos. And look at it and tell me if I’m fooling myself and she looked she said you’re absolutely right there’s is no difference and I said that’s what I’ve suspected all along.

Jellis Vaes
Hmm.

Dr. David Burns
Because I, in the early days of my practice, I gave out SSRI antidepressants on at least 10,000 occasions. And because I reasoned, well, I’ve never seen them do much, but if I ever get sued, some attorney will say, you didn’t give an SSRI and so we’re going to sue the hell out of you. And that frightened me. So if a patient said, I want an antidepressant, I would give them one. But I kept track in my clinic of all the patients who got SSRIs and all the patients who just had cognitive therapy. And the data actually showed that the patients who got cognitive therapy plus SSRIs did more poorly than the patients who didn’t get the antidepressant. And I published that in the top psychology journal, Journal of Consulting and Clinical Psychology in the early 1990s.

But again, it was ignored by people because the drug companies were making billions of dollars. And so you turn on TV and you see all these advertisements for SSRIs. And then the psychiatrist who prescribed them can get paid up to $200 or $300 for a five or 10 minute session monitoring the patient’s SSRIs.

And so there’s a huge commercial incentive for young psychiatrists to promote this idea. They can make a million, two million dollars a year. Whereas when you’re selling psychotherapy, you know, you’re lucky to get a hundred dollars an hour. It’s a whole different kettle of fish. So there’s a lot of factors other than science and other than concern for healing and compassion that dominate the whole health industry. Now I don’t know what it’s like in Belgium, but in the United States it’s kind of a free enterprise kind of system. It’s kind of your money or your health. it’s disgusting to me. I used to, well, my wife and I were poor. We were homeless when I started out my residency training after medical school, we’d been homeless for some time. And so I appreciated the chance to develop a private practice and to get paid for psychotherapy. But I haven’t charged anyone for psychotherapy now for a good 30 years. And it’s so much more peaceful. And I have no ulterior motive to prolong the treatment. So when I see someone, I say,

The therapy is only going to last one session in all likelihood. And I’ll just sit down with you right now and we’ll continue until you’re cured. And that might probably will take two hours. And then we’ll then we’re done and we’ll do a little relapse prevention training. And then if you’re happy and contented, I’ll never see you again. not only do I treat you for free, but I offer a lifetime guarantee in my work. So if you ever have a tune up.

I’ll give you a free tune-up. And that’s the way I’ve been practicing. I think in part because I have no financial motive to prolong treatment, that and other factors have allowed me to figure out how to treat people really quickly. And that’s what our app, Feeling Great app is about. We’re training it to work just like I do. It’s what my book’s like feeling good and feeling greater about is teaching these techniques to therapists and to the general public. But that’s been the central drive and focus of my life.

Jellis Vaes
So one thing that I was just thinking of, like, I feel like someone who could be on an antidepressant right now, that it might be very confrontational also for them to perhaps hear that the drug that they’re taking might actually not really do much, but that it’s their thinking.

Dr. David Burns
They think it works like this, and I’m not giving any medical advice on this show, and you should never change any medication without working with your doctor who prescribes it, but there is this thing called the placebo effect that people do not understand, but it’s very real and it’s somewhat powerful and it’s just common sense that if someone gives you a pill, and tells you this is a powerful new antidepressant and you believe that there’s about a 35 % chance that you’ll recover in three, four, five, six weeks and you’ll attribute that to the drug. if you’re given it, but if it’s actually a placebo you got, the degree of improvement is exactly the same.

And that’s why that’s called a placebo effect. But the problem is that, let’s say I have announced to the media that I’ve synthesized a fantastic new antidepressant called placebo. And it has absolutely no side effects, but it’s extraordinarily powerful. And to prove my case, I’m going to give it free of charge to a million depressed Americans people in Belgium, wherever they are. And so I give this drug to a million severely depressed people. Well, a third of them, know, roughly 350,000 of them will say, hey, this cured me. I can feel it. My depression is gone. My energy is back. This is what a great thing it is. This corrected the chemical imbalance in my brain. But it’s simply a placebo effect. It’s not a real effect and had, and that’s what it was, my drug placebo, and it’s just a placebo. Do you see it? It has no active ingredients. But the people who believed it would help, that belief actually becomes a self-fulfilling prophecy. And that’s what confuses people and what the drug companies capitalize on to keep manufacturing new so-called antidepressants because they have that placebo effect.

And they always promise no side effects and a powerful antidepressant effect. And when I was doing research at the Philadelphia VA and at the University of Pennsylvania Medical School on antidepressants, we used to have a joke that you have to prescribe new antidepressants within the first six months of their release, because that’s when they’re still safe and effective.

And what that meant was that after six months, people start to figure out that they have lot of side effects that were being withheld by the drug companies and that they don’t have effectiveness for a good two-thirds of the people who take them. For example, one of the promises with Prozac, the first SSRI, was that it had no sexual side effects.

But after six months, the data came out and showed that it had sexual side effects in 100 % of the people who took it. And the side effects are a loss of libido, loss of drive, inability to have an orgasm, a lot of things of that nature. And many of the antidepressants have these kind of side effects. And then the SSRIs are potent drugs, it’s just they’re not antidepressants. I’m not aware of any condition in medicine or psychiatry that they have a genuine effect for. They’re just chemicals with side effects. But people say, I’m taking this and I’m getting speedy thoughts and a little loose stools and, you know, like they said, this must be a powerful drug.

And if they think it’s going to help them, it does. But it’s not the chemical, it’s just their thinking.

Jellis Vaes
Hmm.

Yeah. So you have developed over the years a lot of incredible tools to do help people with depression, right? And your book, Feeling Good, which if I’m correct, was first published in 1980, right? It has literally helped like millions of people overcome depression. Now, you also wrote another book called Feeling Great, which was published in 2020.

What’s the difference between the two books and is there anything out of the two books that you could share that could help someone right now listening with depression?

Dr. David Burns
Sure, absolutely. One thing listeners should know is if, I mean if you can get a copy of my first book, Feeling Good, that there’s been at least ten research studies published in scientific journals, peer-referee journals, that have shown that if you’re depressed and you get that book or someone gives it to you, Feeling Good, The New Mood Therapy, and you start reading it, and especially if you do the exercises in it, the written exercises like writing down your negative thoughts and finding the distortions in them and that type of thing. A good 50 to 65 % of the people improve so much within four weeks that they no longer want or need treatment. And that’s been shown over and over again. In fact, that’s why we developed the new Feeling Great app which we hope eventually to have in Europe right now, we only have it in the US. But it does the same thing, but it can cause the changes in as little as two hours of the first time people use the app. yeah, uh-huh. Yeah, there’s about a 50 to 60 % reduction, similar to what happened in four weeks with the book Feeling Good, but it’ll happen it happens to most people within two hours of using the Feeling Great app.

Jellis Vaes
Since we’re on it now on the topic, what actually inspired you in a way to start creating an app on mental health and how is it in a way unique? Like what does it do, right?

Dr. David Burns
Well, the thing that inspired me was the kind of therapy I’ve developed, the early cognitive therapy, and then the new thing I’ve created over the last 20 years or so called Team CBT, which is like cognitive therapy on steroids. But the kind of stuff I do is based on logic and common sense and doing things in a step-by-step way, simple procedures like writing down one of your negative thoughts like I’m a loser and then identify then there’s a list of 10 distortions that you can look at and see the distortions in that thought like it’s not really valid it’s it’s all or nothing thinking I’m a loser black and white thinking and it’s also over generalization generalizing from some negative feelings or some setback at work or whatever to your whole to your whole self and it’s also self blame beating up on yourself and it’s also a hidden should statement thinking I should be successful all the time I should never have to lose I should never lose at any anything and emotional reasoning I feel like a loser so I must be a loser and then once you see those distortions there’s techniques to crush that thought. And the moment you stop believing that thought, I’m a loser, in that very moment your feelings will change. That’s how it works. And that’s pretty much what was in my first book, Feeling Good. But since that book was written, you see that was like 50 years ago or 40, at least 40 or something like that.

Jellis Vaes
Yeah, a few decades.

Dr. David Burns
Well, I’ve been doing research and treating people the whole time and learning how people actually change and learning many new techniques that make even faster recovery possible. And that’s what’s in the book, Feeling Great, all the new developments as well as in our Feeling Great app.

Jellis Vaes
Yeah. Yeah. So you took actually from the two books for the app, right? You took all of the sort of essentials of tools and you placed that in a way in the app.

Dr. David Burns
Yeah, that’s right. All the tools in feeling good are still very valid and very effective. The only difference is that the original cognitive therapy, the research showed and my clinical practice showed it was amazingly helpful for about half of people with depression. And then I said, well, what’s with the other half? Wouldn’t it be nice if we could, you know, find out why they’re stuck? And then my research revealed why they were stuck that was really a matter of resistance. And then I developed, you know, that’s what Freud spent his life trying to figure out and he never did. then what are some tools that we could eliminate the patient’s resistance, say maybe in 30 minutes. And I’ve developed, I would say at least 15 really cool paradoxical tools to eliminate the patient’s resistance toward the beginning of when I when I see them first I empathize with them until they give me an a on empathy and that I’ve really understood them and and then I I do this this thing called paradoxical agenda setting where I kind of show them that all their negative feelings their rage their guilt their shame their panic, their worthlessness. All these things that they’re trying to get rid of are actually the expressions of some of their core values, what’s most beautiful about them as a person. I’m creating a video, an audio actually, with a new person who’s helping us with our app, but she’s one of these people who makes these awesome

audios that you can hear sometimes on the radio with very dramatic with sound effects and stuff and we’re taking a session that I issued as a podcast on my feeling good pass podcast several years ago of a woman who a colleague who had just been diagnosed with terminal lung cancer and it was a total total shock for her and she was the most severely upset person I’ve ever seen, even more severe than people on psychiatric inpatient units. I asked her her severity of nine different negative emotions on a scale of zero to 100. And she was 100 plus on all, you know, depression, panic, shame. She was ashamed. She was felt lonely and abandoned. She felt inferior and worthless.

hopeless, frustrated, stuck, angry, enraged. And we’re highlighting how her session went because she started out sobbing and terrified and ended up the session, not only all of those feelings went to like five or two or one or zero out of a hundred.

but she was in a state of euphoria, actually laughing uncontrollably. And how could you take a woman in two hours and bring her from the worst despair a human being can have to joy, to enlightenment? And it will illustrate exactly the methods that we used, how I was able to make that happen. But there are several steps to it but the important key you see with Marilyn was to the thing that opened her up to rapid change was getting her suddenly to see I have this thing called the magic button. Marilyn what would you like out of this session and you know after I had empathized and she said well if I could somehow and the time I have left the days I have left to be feeling joy, to look at the sunset or the moon and go be out walking with my dog and to feel awe and joy and not be flooded with intense despair and worthlessness. She was so ashamed and it was such a cool session because it wasn’t the cancer that was upsetting her. It was her negative thoughts and they were all as distorted as hell.

Jellis Vaes
Mm-hmm.

Dr. David Burns
But before we could show her how off her thoughts were, like she was beating up on herself saying, I’ve never found a loving partner in my life. So my life is a failure. I’m starting to doubt the existence of God. So I’m not spiritual enough. So I’m a spiritual failure. And you know, she had all of these ways of beating up on herself. But I showed her how beautiful those things were. Like Marilyn, what’s beautiful about your guilt and shame? You’re ashamed because you’re not spiritual enough and you’re ashamed because of this, that, and the other thing because you were an alcoholic for a while and because you’ve lost your faith in God. What does the shame show about you that’s positive and awesome? Because if you press that button and your shame disappears,

Maybe that’s not such a good idea. And then she was able to see, well, I guess my shame shows that I love people and I don’t want to disappoint people. It shows that I’m humble. It shows that I have high standards and on and on and with every negative emotion. And Marilyn, is this true what you’re saying? She said, yes, it’s true. Is it important? Yes, it’s important. Is it powerful? Yes, it’s powerful. We made a list of 43 beautiful things that her negative feelings showed about her. it was… Yeah, yeah, it just blew her mind. And then we went into challenging her negative thoughts and she was able to talk back to the thoughts and blow them out of the water. And her belief in them, you know, went from 100 plus to zero. And her negative feelings went from 100 plus to five and two and one. And that’s kind of how it works. But it’s a surprising type of therapy because the therapist doesn’t help the patient. Helping patients is the main cause of all therapeutic failure. Yeah, that’s right. And instead, you see, I’m trying to talk her into not changing.

But showing how beautiful and wonderful all of her negative feelings are. Why would you want to get rid of that? Because your anxiety, you want to press a magic button to make your anxiety go to zero, Marilyn? Well, we can do it. I have techniques. I can make your anxiety go to zero. Are you sure you want to do that? What are some good things about your anxiety? And she says, well, my anxiety keeps me on track in terms of following the cancer. I got anxious and angry with the insurance company. They said my first dose of cancer fighting drug, I’d have a copay of $3,000. And she said, I’m a poor person. And I’m already on verge of becoming homeless and living under the underpass in Oakland, within a homeless colony.

And I got angry and anxious and started shouting at the person at the drug company who was trying to tell me that. And I think they got ashamed and they decided to give me the medication for free that might prolong my life. So yes, maybe my anxiety is a good thing. Maybe it’s a form of self-love and protecting. And you know, once she saw all the positive side of her negative feelings, it was a shock to her system.

She couldn’t deny what we were saying was valid. You know, what’s good about your depression, Marilyn? The doctor just told you, you have stage four lung cancer and you’re gonna die of lung cancer and you’ve never smoked and you’re devastated with depression. If you press the magic button, your depression will disappear. Is that what you want, Marilyn?

You want to be dying of lung cancer and say people, yes, I’m dying of lung cancer and I’m, la, la, la, I’m happy as can be. That’s bullshit. And then she saw that, you know, the sadness shows that she’s being realistic and honest. And then when she tells herself that she’s lost her belief in religion, she’s being accountable. And, you know, and things like this and then I like to use humor too and I said, know, I’m not a very religious person. I’m a minister’s son and I’m kind of anti-religious, Marilyn, you know that. But I’ll tell you one thing, once when I was jogging home from the train station when we were living in Philadelphia, I was just about a mile from home. It’s about a three mile run.

And God came to me in a vision. Hold on just a second. That’s in the next room. hope there’s a phone ringing. As the Buddha said so often, what the shit, let it ring. But I said, God came to me in a vision. I said, he or she said to me, David, if you believed in me, I’d be incredibly disappointed. And then I said to God, don’t worry, big guy, I’ve got your back. And then God went away with satisfied. And when Marilyn heard that, she burst into laughter and we all started giggling. And I said, know, Mother Teresa doubted the existence of God. In fact, the mystics say that doubting the belief in God in the afterlife is a necessary step on the path to enlightenment. It’s called the dark night of the soul.

And that’s what you’re feeling right now, Marilyn. It’s a beautiful thing. What you’re feeling is a necessary step to spiritual enlightenment. And she saw it and understood it. And so this casting the emotions we’re trying to get rid of into actually something beautiful that you can be proud of to make it. And she suddenly became proud of all of her symptoms rather than being ashamed of herself.

And when that happens, then the person is opened up to the possibility of rapid change when we come in and challenge her with her negative thoughts, you know, start talking to her the way she’s talking to herself and seeing if she can defeat us. And she became very powerful. You can hear it in the audio that her voice changed from being very self-effacing and tearful and insecure.

to being powerful and triumphant. And that’s the experience I’m hoping to bring to many people through our Feeling Great app. I’ve taught about 50,000 mental health professionals in the United States and Canada in the last 30 years with my two-day intensive workshops and four-day intensive workshops as well as I teach a free class at Stanford every Tuesday. And if there’s any therapists listening now who would like to join us, you can just contact me, David, at feelinggood.com. yeah, yeah, that would be a good thing. But let’s see, where was I? What was I talking about? I’m elderly and demented now, you have to remind me.

Jellis Vaes
Hmm. I will put it in the show notes, by the way, for people listening. Well, what you just shared sounds like an incredible tool to cast light on, you know, what you feel as negative aspects of yourself to see them as qualities. So like that’s I mean, sounds like like someone listening right now who has depression that sounds like an incredible exercise for them to try to sort of question what they’re feeling.

Dr. David Burns
Yeah. The newer book Feeling Great makes it real easy to do that because there’s even charts you can look at. And what are the good things about depression? What are the good things about anxiety? What are the good things about guilt, about shame, about anger, about inadequacy, worthlessness and all of that?

Jellis Vaes
Yeah, I actually read the book a few days ago and it’s honestly one of the best mental health books that I’ve read in a long time. So I will also put it in the show notes for people to find the book. It’s an incredible book actually. It’s very practical, which is awesome actually. The theme therapy.

Dr. David Burns
Yeah, thank you.

Jellis Vaes
I think you were also going over the acronym what each letter stands for and like what does each letter stand for?

Dr. David Burns
Yeah. Well, that’s crucial because when I was, you see, for something to be scientific, you have to have measurement. And when you go to the doctor, you expect measurement. He’ll, he’ll, the doctor, he or she will take your blood pressure, take your temperature, do an EKG, do a chest x-ray. Marilyn was saying that’s how they found out she had cancer because one of her lungs was all blacked out.

And then they put a needle in her chest and took out two pints of blood from her around her her lung. And and if you tried to be a doctor or have an emergency room without measurement, you would you would be sued and and your license would be removed. But mental health professionals, to my way of thinking, are not only in incompetent, most of them in varying degrees, but also arrogant, thinking they don’t need to measure, that thinking that what they’re doing is just has to be helpful to people with absolutely no evidence. And that’s how I was trained as a psychiatric resident, both, you know, at Stanford and at University of Pennsylvania in Philadelphia. We never measured anything and we just had people come in and talk and gave them pills and assumed we were wonderful, which we weren’t because the patients never changed. And so I developed really accurate scales that ask people, how are you feeling right now? How depressed? How anxious? How suicidal? How angry? How happy are you right now?

And these are scales that have reliability or accuracies of about 0.95 or 0.96. They’re extraordinarily accurate and patients can fill them out in maybe 30 seconds. And I have them fill them out just before every session begins and then I see the scores. I can see how depressed or angry or anxious someone is. And then at the end they take it again. And that way I can see the change from the start to the end of the session.

And the message here is I’m expecting great changes today, not six months from now or two years from now or 10 years from now. And that puts pressure on me to learn techniques that will cause changes quickly for people. And that’s the team, the testing. And that was a crucial part of team therapy, which makes it different from pretty much every other form of psychotherapy or treatment in the world. And then the E is empathy. And I’ve developed some very powerful, innovative training methods so that mental health professionals or, you know, normal individuals for that matter, methods so you can improve the way you communicate with your patients and get to high empathy scores, a very deep connection. The very first time you meet with someone, some people say, how long does it take to empathize with someone you’ve never met, someone who’s very disturbed? And people think, that takes months, but it doesn’t. If it takes months, it’s going to take more than months because if it’s taking months, you’re probably never going to get there. But you can get to a perfect empathy rating from patients, almost any patient, within 30 minutes of the first time you meet them. And I’ve developed techniques that we train therapists in to develop essentially perfect empathy. That’s rated by the patient, not rated by the therapist, because therapist ratings are not accurate at all. And so at the end of the session, not only do they show how they’re feeling, but the give you your rating on empathy, your rating on helpfulness, and other variables like that. And that makes the therapy very scientific. And then some people resist because they’re afraid to measure.

Therapists, say, well, that’s stupid. You all Burns cares about is numbers. No, that’s not true. That’s like saying all a doctor in the emergency room cares about is numbers. No, we use numbers to develop compassionate, effective therapy that’s way vastly more powerful than in the days before we had a thermometer or an x-ray machine and blood tests and so forth. But that’s absolutely crucial and it takes courage for therapists to use the testing component because you’re going to see, you know, right away how effective or ineffective you’ve been. And I ask the people in my Tuesday class to bring in their ratings from patients so I could see how they were doing and make them accountable and one woman brought in the ratings from her best patient who she’d been seeing for a year and I looked on my brief mood survey how depressed she was a year ago and how depressed she was today how anxious how suicidal how angry and and and there were no changes in any of the scores she

Jellis Vaes
Interesting.

Dr. David Burns
And she was so proud. It really broke my heart because she was showing this to me to say, I’m so proud of the work that I’ve been doing with this patient. And the data showed you’ve had no effectiveness at all in anything with this patient. And it takes courage to look at ratings like that.

And I’ve had ratings like that too from single sessions when I thought I was hitting it out of the park. And then the end of session ratings, I found out, man, I suck terribly. But when you get the data and if you’re humble, then the next time you see the patient, you can talk it over with them and say, tell me what I missed and tell me about the anger you felt. then you can deepen the relationship. So that’s that’s that’s crucial. And I say the therapist who won’t use these tools are screwed. I have no patience with them at all. There’s something in the Bible about the unforgivable sin. And if I was to say, what’s the unforgivable sin in therapy? It’s the refusal to make yourself accountable and to get ratings from your patient at every session. But anyway, that’s the test and the empathy and then the A is the reducing resistance, the agenda setting, the helping them become proud of their symptoms rather than ashamed and then the T is the testing. I mean the T, is methods, T-E-A-M and I’ve developed about a hundred and forty or more methods to crush these distorted thoughts and the reason there are so many methods like externalization of voices or explain the distortions or paradoxical double standard technique or acceptance paradox is because different people respond to different tech techniques.

Jellis Vaes
Yeah. So you would say that talk therapy without structure isn’t really effective.

Dr. David Burns
Well, that’s my experience, yes, and I think that’s what the data shows as well. When I was a resident, they just come in and talk and then they would tend to cry and get angry and I would say, tell me more. And then I would go and talk to my supervisors who were frequently psychoanalysts. And they’d say, what happened this session? I’d say, the patient just came in and was very angry and you know, very depressed and sobbing and frustrated and kept telling me that I’m not helping them and and I and I was only allowed to say tell me more twice in the session and And then I said the patient would say that dr. Burns all you say is tell me more you wiggle your hands like this they the therapy the supervisor so you can go like this when you run out of your to tell me mores and then then

My supervisor said, you’re doing great therapy. And, you know, they’re getting all this bottled up anger out. And it’s all about, you know, expressing their feelings. And I said, OK, that’s good. Now, how long will it take for all of this frustration and anger and depression and sobbing? Will at some point in the therapy I’m doing, will that suddenly disappear and then they’ll have joy? Is the purpose of the therapy to show them how to have joy and make their symptoms disappear. And never once would a supervisor answer that question. And never once did I see it happen.

Jellis Vaes
So the bottom line in a way is everyone definitely check out the book Feeling Great. Because again, there is amazing, amazing tools in there and also to any therapist or, you know, psychologist or psychiatrist listening. It’s an awesome book actually for them to read too. I feel it’s a really good book.

Dr. David Burns
Sure. Yeah, absolutely. Thank you.

Jellis Vaes
I have a scenario for you that I’m very curious about to hear your thoughts on. Yes, so, know, the app filling the app that you developed, the books that you’ve written a podcast, episodes like this are all great, right. And they can potentially really help people. But what if the following scenario happens…

So I actually know someone whose dad is, I mean, he basically checks off every box you could say of depression. He doesn’t do anything anymore. Sits on the couch, smokes, drinks. Yeah, no energy. But he doesn’t, he just says that he’s okay and that there’s nothing wrong. But of course the whole family suffers also from that. But how do you…

How do you help someone like that? How can you be there for someone like that? Because that situation is, I don’t want to say common, but it happens, right? It happens.

Dr. David Burns
Yeah, right. Well, I love your question and I have a one of my Feeling Good podcasts, which I’m sure your users, some of them might have an interest in. We’ve done over 400 of them and you can search by topics on my website, feelinggood.com, where there’s a lot of free resources, free classes you can take on depression and anxiety and stuff like that. But we have a class called How to Help and How Not to Help.

And the idea behind it is something that people might have trouble grasping or accepting at first, but at least I can tell you what the answer is. If you’re a general citizen, the most helpful thing you can do is to learn to empathize and listen without trying to help. And trying to help is the cause of the no change because when you throw help at people who haven’t asked for help, they’ll resist and fight you. So you’re actually forcing them to remain depressed. And to give you just an example of this, I’ll just disguise the identity of this person a little bit, but let’s say a real close relative was, you know, pregnant and really dreading becoming a mom. And she was very actively involved in Aikido and exercising and various things that meant a lot to her. And she would say things to me like before the baby came and after the baby came. Which is interesting because we just got a new baby in our family this week, so we’re going to go up but and meet our grandson on Sunday. This is Friday in two days. But at any rate, and she would say things like that, like this to me, Dad, now that I’m a mom, I’m in prison for 18 years until he’s 18 and then I’ll be free again. And I just feel trapped and terrible.

And I learned not to help her. Instead, I would just empathize and say, you know, I won’t say her name, but you know how much I love you and you’re such an awesome mom. But it is true that you’re in prison now and you won’t be out of prison until, you know, he’s up and ready to leave home and go off to college.

And you see, so I’m agreeing with her. I’m not trying to help her. I’m just saying, you’re right. Your feelings are valid. And then she would say, well, well, dad, you know, I just really love the little guy and I’m as happy as can be. And it took about that much time. So by not helping, it was very helpful. And that always is effective. But if you go in trying to help someone, it will typically have the opposite effect. know, helping is very skillful thing to learn and most therapists don’t even know how to do it because, but one of the rules is don’t throw help at people. See, I never try to help my patients. I just let them know all I do is quick irreversible cures. But you’ve got to start with empathy.

And then if someone’s asking for help then you can see if you’re in a position to offer the help or or maybe suggest to them well, why don’t you read dr. Burns’s feeling good book or the feeling great book or things that really if he’s someone’s motivated to be helped then they can pick it up and You know and and and probably get real help from the book but sometimes you have to accept your limits as a human being and you might love somebody who’s stubbornly clinging to negativity. And the way to untie that knot is not by trying to untie the knot, but trying to understand the person. My book, Feeling Good Together, I found like an infomercial for my books, but that has the five secrets of effective communication in it.

And they’re hard to learn, but they will, if you do the written exercises while you’re reading that book, feeling good together, you can change radically the way you communicate and learn to become an expert empathizer. And empathy is something the world needs more of.

Jellis Vaes 
Yup. Yeah. Yeah. Yeah. It’s a skill that more, yeah, that we should all try to improve a little bit on because it’s, yeah, the world can use it a bit more. But that sounds in a way counterintuitive to many people, I feel, to just do nothing but just to empathize with the person. It’s actually crazy how hard that is for so many people to do that.

Dr. David Burns
Yeah. It’s how hard it is. And people think they’re being empathic and therapists think they’re being empathic when they’re not. My empathy scale the patients take at the end of every session is so sensitive that most therapists get a failing grade from every patient they see initially and this discourages them and they say, well I don’t want to use this test. This you know this sucks.

But if you’re willing to look at the fact that you’re failing with your patients, and then maybe join my Tuesday group at Stanford for free for couple of years and learn how to do it, these tools are not easy to develop because they go against human nature.

Jellis Vaes 
Yeah, yeah, yeah. interesting. Like, actually, so I’m studying clinical psychology. Started a little bit late, but you know, I’ll get there at some point. But actually one of…

Dr. David Burns
Well, if you get time on your hands, you can join our Tuesday group. I’d love to have you in our Tuesday group. 

Jellis Vaes 
Sure, I’ll fly over to the US then.

Dr. David Burns
No, you don’t have to. It’s all virtual.

Jellis Vaes 
Is it all virtual? That’s awesome.

Dr. David Burns 
Yeah. Uh-huh. Yeah, that’s what’s so cool about it. That changed about when the pandemic came. Then I went all virtual and I thought, this is really cool because now I can have the therapists from all over the world. We’ve got from Nepal therapists and from India and South America and all over the place. And we have a ball every Tuesday night.

Jellis Vaes
I’m going to check that. That’s cool. All right. But what I actually want to say is that in I think one of the subjects, I don’t know, clinical psychology, volume one or something, I saw some of the scales that you developed. the yeah, so the depression, the burns, the depression scale. I saw that actually, which is actually how I ended up discovering who you are and all that you do and have done. So. They’re legit scales.

Dr. David Burns 
Do you remember how many items it had?

Jellis Vaes
No, I don’t remember actually.

Dr. David Burns
The original scale had 15 items, then I’ve studied its statistical properties, I learned that you can get all of the relevant information in a five item version. that’s, I use in clinical work, five item versions of the scales. And in the app, we use a single seven item scale that measures seven different negative feelings that move together as if they were one.

Jellis Vaes 
Okay, so you compressed it a little bit.

Dr. David Burns
I didn’t, discovered a compression that I hadn’t realized was there. When I looked at, I developed a how are you feeling right now, a scale for our Feeling Great app so we could measure every few minutes how people are feeling and see where, what about the app really helps people and what does not. And it’s a seven item scale with sliders that go from zero to 100. You first is depressed.

Jellis Vaes
Yeah.

Dr. David Burns 
down unhappy, zero to 100, and then anxious, worried, nervous, panicky, zero to 100. And then you can do something statistically called factor analysis where you look at a scale to see how many dimensions there are in it. And over and over again we found that that scale has only one factor. There’s something in the brain that causes all of these negative feelings to occur simultaneously, which is quite different from the DSM or theoretically of all these different so-called mental disorders. And my data suggests a radically different model. We’re probably going to write an article on that, also for Psychology Today magazine, kind of a pop psychology article. But it’s kind of interesting that we’ve identified, and we’ve done this  replicated at about ten times in ten different databases and it’s always exactly the same and it boggled my mind and now most recently we found out that that unknown factor in the brain that causes all these seven emotions simultaneously also is responsible for causing the temptations in people who are struggling with with addictions.

And I’m also going to see if it also has causal effects on physical pain, because I have a really great two-item physical pain scale that has a 98 % accuracy. my prediction is we’re going to find out this also accounts for about half of physical pain, this unknown variable in the human brain.

Jellis Vaes 
It’s incredible to me to hear all this that you’re still doing so much today.

Dr. David Burns 
I’m busier today than I ever have been. You know, I’m working seven days a week and just because I’m excited about about what I’m doing.

Jellis Vaes 
Yeah, I mean, truly as an aspiring clinical psychologist, you are one of the people that I truly see as an inspiration that I look up to.

Dr. David Burns 
I forgot to put my glasses on. I look much better with my glasses on. Because I squint and these reflect the light.

Jellis Vaes
Let me ask a last question to you so we can wrap up the interview. Is there just any last message that you would like to share with someone listening who might potentially be depressed?

Dr. David Burns
Sure. Well, with regard to things like depression and anxiety, I would say I have three short sentences for people. First, you think the way you feel. And that means all of your feelings are caused by your thoughts. And as I say, we have a new research study proving that these distorted negative thoughts are the actual cause of your anger your anxiety, your depression, your inadequacy. So, and that’s something in the here and now. You don’t have to go into your past childhood and ruminate for years to find out why you’re depressed. You can find out within 10 seconds. Just say, what am I telling myself right now? What are my thoughts? And write them down. The second thing I want people to know, is depression and anxiety are the world’s oldest cons. Although you’ll believe your negative thoughts probably 100 % when you’re feeling down and I’ve had them myself and I believe them 100 % on myself. David, you’re a bad human being. You have no skill as a psychiatrist. You’re probably gonna lose your medical license, you know, during down moments. I’ve actually believed thoughts like that. But that these thoughts are virtually never valid. They’re filled with distortions and there’s ten classic cognitive distortions that I first listed in my book Feeling Good that came out in 1980 and they’re as valid today as they’ve ever been. All or nothing thinking and etc. And the third point which is the most important one and listeners won’t believe this but I’ll say it just so you’ve heard it is that the very moment you stop believing those thoughts, your feelings can change. And that means that they can, in theory, change today. Now, it’s not easy to do that. That’s why we’ve developed an app, and that’s why I’ve developed, you know, more than a hundred methods. But it is doable, and it is my belief that any human being has the capacity for not only joy, but also enlightenment coming back to our dear friend Marilyn Coffee, who I was talking about earlier, she didn’t have a lot going for herself. She was living in Oakland. She was barely had enough money to put food on the table every month. She had spent many years with alcoholism and eventually ended up an Alcoholics Anonymous, but at one point lost her license to practice psychology because she showed up at the hospital with alcohol on her breath one morning and they took legal action against her and then she’d just been given a diagnosis of terminal cancer, lung cancer and so you know I can’t imagine a person with more real problems than that and yet in a single therapy session.

And it’s recorded. You can go listen to it. We’re making a short version of it, but it’s one of the, know, like what on my Feeling Good podcast is probably number 49 or 50. And we actually broadcast without editing that that session with Marilyn. She went from incredible, the worst depression a human being can have to absolutely no depression and actually feelings of joy.

And I believe that that experience is possible for every human being. So it’s a message of hope. It does take work. And I demand work from my patients if you want to work with me. That’s what we’re going to do. We’re going to work. Sure, I’ll empathize and give you support, but we’re going to use tools to help you change the way you think and feel. And if you’re willing to use these tools on your own, as well as when you’re with me on a session, then we’re we’ve got a marriage in heaven, made in heaven.

Jellis Vaes
when you do like physical exercise, people get it that if you want to build muscle that you have to go more than once and you have to repeatedly, you know, do exercises. But with mental health, people are kind of like, yeah, I don’t know, not expecting the same there in a way.

Dr. David Burns 
Yeah, it’s the same thing. I’m like a coach. And if you go to a coach to learn tennis, the coach will ask you to practice the strokes between tennis lessons. And if you don’t want to do that, if you just want to come and talk to the coach about tennis, the coach will probably say, no, I want a student who’s ready to learn, ready to practice, ready to change your game. And what I do is exactly the same.

Jellis Vaes 
Dr. Burns, I can’t believe I had a conversation with you. You’re a true legend. Thank you so much for everything that you’ve done and everything that you’re still doing and yeah, for coming on the podcast.

Dr. David Burns
My pleasure and more power to you what you’re doing. I wish you the well and really well in your studies. You’re going to be a great therapist. You have so much compassion. You made me feel terrific. So you’ve got a lot to offer your patients.

Jellis Vaes
Thank you.

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