Episode Details

A Country Doctor, Part 2 of 2

A = Assessment of Resistance

At the end of the moving and tearful empathy phase, we asked Jillian about her goals for the session, which included the ability to

• enjoy my work
• to give away all of my certificates
• set limits with my patients
• feel happy with what I do
• not have to fear my work anymore!

After Jillian said she would be willing to press the Magic Button to achieve all these goals instantly if we had one, we suggested Positive Reframing first. to see what might be lost of she suddenly achieved all these goals. You can creview the Positive Reframing that we did together.

Here's Jillian's Emotions table at the end of Positive Reframing, showing her goals for each emotion when we used the Magic Dial. The idea is to dial each feeling down to a lower level that would reduce your suffering while still allowing you to preserve all the awesome things about you!

Emotions % Now % Goal % After Emotions % Now % Goal % After Sad, blue, down, unhappy 80 15 Embarrassed, foolish, humiliated, self-conscious 50 10 Anxious, nervous 90 20 Hopeless, discouraged, pessimistic, despairing 100 0 Bad 70 0 Frustrated, stuck, thwarted, defeated 90 5 Inferior, inadequate, incompetent 95 5 Angry, mad, resentful, annoyed, irritated, upset, furious 100 10

Jillian said that the Positive Reframing really opened her up, especially when we read the list of positives out loud. It kind of shocked her in a good way so see that her negative feelings were not really problems, defects, or symptoms of one or more "mental disorders," but the expression of what was most beautiful and awesome about her as a human being, and as a physician.

This Positive Reframing is one of the unique aspects of TEAM-CBT. Although we are encouraging the patient to keep the symptoms, rather than pressing the Magic Button that makes them disappear, it paradoxically eliminates or drastically reduces the resistance to change, and opens the door to the possibility of ultra-rapid recovery.

M = Methods

We asked Jillian what Negative Thought she wanted to work on first, and she chose #9: "I'm not having a big enough impact." She believed this thought 100%.

First, we asked Jillian to identify and explain the cognitive distortions in this thought, and she focused on these: Should Statement; Self-Blame, All-or-Nothing Thinking, Mental Filtering, and Discounting the Positive.

In retrospect, I think I spotted two additional distortions: Emotional Reading (I feel I'm not having a positive impact, so I must not be having a positive impact) and Mind-Reading (my patients expect me to have the answers to all their problems and judge me when I don't have all the answers.)

Then we challenged the Negative Thought, and Jillian she was able, with a little help and a role reversal, to crush it, as you can see here.

Usually, crushing one Negative Thought is about all you really have to do, because once the patient blows one Negative Thought out of the water, there is usually a kind of "cognitive click," and the brain suddenly changes, and all the positive circuits suddenly get fired up. It's amazing to behold, and you will hear it for yourself!

The damn did suddenly break, and Jillian could clobber the rest of her Negative Thoughts fairly easily, using a combination of Self-Defense, Self-Acceptance, and a lot of the CAT technique. She suddenly appeared to be a radically and delightfully different person during the Externalization of Voices. You can see her final Daily Mood Log here.

You can see her feelings on the Emotions table at the end of the session.