Feeling Good: David Burns at TEDxReno (Full Transcript)

David Burns is an adjunct professor emeritus in the Department of Psychiatry and Behavioral Sciences at the Stanford University.

Here is the full text of David’s talk titled “Feeling Good” at TEDxReno conference.

David Burns – TEDx Talk TRANSCRIPT

Well, my talk is on depression and anxiety.

Sometimes some of us fall into black holes of self doubt, anxiety, inferiority, feeling like we are not good enough, beating up on ourselves. How many of you sometimes feel that way? Put your hands up if you’ve ever struggled with depression or anxiety or self doubt?

It is one of the worst forms of human suffering.

I’ve had patients who told me that they pray to God at night, that they could develop cancer so they could die in dignity, without committing suicide. How many of you have ever felt maybe that your life was not worth living or have known a friend or loved one or a colleague who made a suicide attempt? Put your hands up if it had ever touched you. It’s one of the most horrible, horrible things.

I started out at University of Pennsylvania medical school, I finished my residency. And I did a research fellowship on depression, and I was always curious what makes us depressed, why do we fall into these black holes, what’s the cause of it, what can we do to turn these moods around?

And I started out like many young psychiatrists. It’s what you call a biological psychiatrist. I was doing research on brain chemistry, this idea that depression and anxiety are due to some kind of chemical imbalance in the brain. I was treating patients with antidepressants and other medications.

But there were only two problems from my point of view. The first is our own research — research we did, didn’t seem to confirm that depression or anxiety were actually due to a chemical imbalance in the brain. In fact, our research indicated that this probably is not the cause of depression and anxiety.

In addition, I was giving antidepressants by the bucketful to patients. I had hundreds of patients, only a few of them were being helped. Most of them were not. They were going on week after week, saying I want to die, I feel worthless.

And, I said, “Gosh, there’s got to be a better way.” If the pills had worked I would have been perfectly, perfectly happy. And I thought maybe there’s some type of psychotherapy I could combine with the medications, because I wanted people to be able to wake up and say “It’s great to be alive”, and “I have joy, and full of love, I am full of life” and I was rarely seeing that.

And I tried different kinds of psychotherapy. They didn’t seem to work, and then a colleague said “You know, there is something new, fellow here at Penn is developing, Aaron Beck, and he calls it cognitive therapy and it is kind of simple in its theory. And maybe you could try this out with some of your patients.”

COGNITIVE THERAPY

And cognition is a thought, it is just a fancy word for a thought, and there is three basic ideas behind cognitive therapy.

The first, is that our thoughts create all of our moods. And that when you’re depressed and anxious, you’re giving yourself negative messages. You’re blaming yourself, you’re telling yourself something terrible is going to happen.

Now, this idea is not new. It goes back to the Greek philosopher Epictetus. Nearly 2000 years ago, he said people are disturbed not by things, in another words, not by the events of our life; but by the views we take of them. That, we create all of our emotions, positive and negative, at every moment of every day through our interpretations of what’s going on.

And that goes back even before Epictetus to the Buddha, who was saying the same thing 2500 years ago.

Well, the second idea is that when you’re depressed and anxious, those negative thoughts: I am no good, I am a loser, what’s wrong with me, I shouldn’t have screwed up, I should be better than I am — those thoughts are not realistic thoughts. They’re distorted. That depression and anxiety are the world’s oldest cause.

And that there is ten distortions that you always see in the negative thoughts of individuals who are depressed and anxious, like all or nothing thinking, if I am not a great success today, I will be a total failure. Shapes of gray don’t exist or over-generalization, seeing a negative event has a never ending pattern of defeat or should statements or self blame.

And the third idea was that you could train people to change the way they think, and then suddenly change the way they feel.

Well, I heard that theory and I said: “That sounds like so much bullshit.” I know my patients have negative thoughts. That’s certainly the case, but you can’t help serious suicidal, depression with some kind of power of positive thinking. And I told the colleague that.

He says, “Well, David, why don’t you go to Beck’s weekly seminar and as part of your research try this with a few of your toughest patients and then you can prove to yourself that it doesn’t work.”

And I said that’s, that’s a great idea. I think I will check it out.

Well, the first patient I tried it out was a woman, referred from the intensive care unit of the University hospital. She had made a nearly successful suicide attempt. An elderly Latvian immigrant. They referred her to me for a follow-up.

And I said “Martha, there is this new form of therapy and I am doing some investigating and would it be okay if I present your case at this weekly seminar? And then, I can tell you what they say and maybe we can find some new techniques. And she was fine with that, she gave me permission.

So I presented her case to Dr. Beck. I said: “How would you use this cognitive therapy with someone who is suicidal?”

And he said: “Well, our thoughts create all of our emotions, so just ask her what were you telling yourself the moment you try to commit suicide.”

So, I went back to her and I said to her. She said: “What did you find out at the seminar?”

I said “Well, I am suppose to ask what were you telling yourself the moment you attempted suicide, what were your negative thoughts.’

And she said “Oh, I was telling myself that I am a worthless human being, because I’ve never accomplished anything meaningful or significant in my life.”

And she said “What am I supposed to do about that?”

And I said: “I am not sure, you have to wait a week until I go back and ask at the seminar.”

So I went back and said: “Here’s what I found out and, what should I do?”

Dr. Beck said: “Well, one technique we use is called ‘examine the evidence, see if what you are telling yourself is true or not. Ask her to make a list of the several things she has accomplished.”

I thought, that makes sense, so I went back and I said.

She said: “What’d you find out at the seminar?”

I said: “Well, you are supposed to make a list of the several things you have accomplished.”

She said “That’s just the problem, I can’t think of anything.”

And I don’t know maybe some of you folks felt that way, sometimes looking back on your life and say ‘What have I done that was really meaningful, really significant, what did my life really amount to’.