The Feeling Good Handbook Read online

  FEELING GOOD FEELS WONDERFUL

  If you wake up in the morning dreading the day . . . if you have to force yourself to do anything . . . if you believe your work worthless . . . if you wilt under criticism . . . if you avoid intimate contact because you're convinced you're unattractive . . . if you consider yourself a born loser . . . you will probably benefit from the scientific and revolutionary way of brightening your mood and lifting your spirits without drugs or lengthy therapy.

  The only tools you need are your own common sense and the easy-to-follow methods clearly spelled out in this book. With them, you can stop seeing things in ways that bring you down. You can say good-bye to procrastination, to sapping away of energy and ambition, to so many other forms of nagging depression, as you at last experience the joy of—

  PEELING GOOD

  "A book to read and re-read!"---Los Angeles Times

  "I will recommend this book to my students, colleagues and patients."—Ari Kiev, M.D., Director,

  Social Psychiatry Research Institute

  ABOUT THE AUTHOR: DAVID D. BURNS, M.D. was graduated magna cum laude, from Amherst College, received his M.D. from Stanford University, and completed his psychiatric training at the University of Pennsylvania. There he has been one of the prime developers of Cognitive Therapy, upon which Feeling Good is based. In addition to treating patients, he teaches psychotherapy and drug therapy at the University of Pennsylvania and lectures to professional groups around the world. Among his many honors was the A. E. Bennett Award, the top psychiatric award to an investigator under thirty-five.

  His most recent book is Intimate Connections available in a Signet edition.

  Individuals wishing to contact the author may write to him at: David D. Burns, M.D. Presbyterian—University of Pennsylvania Medical Center 39th and Market Streets Philadelphia, Pennsylvania 19104

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  FEELING GOOD: The New Mood Therapy by David D. Burns, M.D.

  Preface by Aaron T. Beck, M.D. The clinically proven, drug-free treatment for depression, from the University of Pennsylvania School of Medicine.

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  FEELING

  GOOD

  The New Mood Therapy

  DAVID D. BURNS, M.D.

  Preface by

  AARON T. BECK, M.D.

  A SIGNET BOOK

  N E W A M E R I C A N L I B R A R Y

  A DIVISION OF PENGUIN BOOKS USA INC.

  PUBLISHER'S NOTE

  The ideas, procedures, and suggestions contained in this book are not intended as a substitute for consulting with your physician. All matters regarding your health require medical supervision.

  NAL BOOKS ARE AVAILABLE AT QUANTITY DISCOUNTS

  WHEN USED TO PROMOTE PRODUCTS OR SERVICES

  FOR INFORMATION PLEASE WRITE TO PREMIUM MARKETING DIVISION.

  NEW AMERICAN LIBRARY. 1633 BROADWAY.

  NEW YORK. NEW YORK 10019.

  Copyright

  1980 by David D. Burns, M.D.

  All rights reserved. No part of this book may be reproduced or

  'utilized in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without permission in writing from the Publisher. For information address

  William Morrow and Company, Inc., 105 Madison Avenue, New York, New York 10016.

  This is an authorized reprint of a hardcover edition published by William Morrow and Company, Inc.

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  SIGNET TRADEMARK REG U.S PAT OFF AND FOREIGN COUNTRIES

  REGISTERED TRADEMARK-MARCA REGISTRADA

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  SIGNET, SIGNET CLASSIC, MENTOR, ONYX, PLUME, MERIDIAN

  and NAL BOOKS are published by New American Library, a division of Penguin Books USA Inc., 1633 Broadway, New York, New York 10019

  First Signet Printing, August, 1981

  2 3 2 4 2 5 2 6 2 7 2 8 2 9 3 0

  PRINTED IN THE. UNITED STATES OF AMERICA

  This book is dedicated to my personal teacher, Aaron T.

  Beck, M.D., in admiration of his knowledge and courage

  and in appreciation of his patience, dedication and empathy.

  Preface

  I am pleased that David Burns is making available to the general public an approach to mood modification which has recently stimulated much interest and excitement among mental health professionals. Dr. Burns has condensed years of research conducted at the University of Pennsylvania on the causes and treatments of depression, and lucidly presents the essential self-help component of the specialized treatment that has derived from that research. The book is an important contribution to those who wish to give themselves a "top flight"

  education in understanding and mastering their moods.

  A few words about the evolution of cognitive therapy may interest readers of Feeling Good: The New Mood Therapy.

  Soon after I began my professional career as an enthusiastic student and practitioner of traditional psychoanalytic psychiatry, I began to investigate the empirical support for the Freudian theory and therapy of depression. While such support proved elusive, the data I obtained in my quest suggested a new, testable theory about the cau
ses of emotional disturbances. The research seemed to reveal that the depressed individual sees himself as a "loser," as an inadequate person doomed to frustration, deprivation, humiliation, and failure.

  Further experiments showed a marked difference between the depressed person's self-evaluation, expectations, the aspira-tions on the one hand and his actual achievements—often very striking—on the other. My conclusion was that depression must involve a disturbance in thinking: the depressed person thinks in idiosyncratic and negative ways about himself, his environment, and his future. The pessimistic mental set affects his mood, his motivation, and his relationships with others, and leads to the full spectrum of psychological and physical symptoms typical of depression.

  We now have a large body of research data and clinical experience which suggests that people can learn to control painful mood swings and self-defeating behavior through the application of a few relatively simple principles and techniques. The promising results of this investigation have triggered interest in cognitive theory among psychiatrists, psychologists, and other mental health professionals. Many writers have viewed our findings as a major development in the scientific study of psychotherapy and personal change.

  The developing theory of the emotional disorders that under-lie this research has become the subject of intensive investigations at academic centers around the world.

  Dr. Bums clearly describes this advance in our understanding of depression. He presents, in simple language, innovative and effective methods for altering painful depressed moods and reducing debilitating anxiety. I expect that readers of this book will be able to apply to their own problems the principles and techniques evolved in our work with patients. While those individuals with more severe emotional disturbances will need the help of a mental health professional, individuals with more manageable problems can benefit by using the newly developed "common sense" coping skills which Dr. Burns delineates. Thus Feeling Good should prove to be an immensely useful step-by-step guide for people who wish to help themselves.

  Finally, this book reflects the unique personal flair of its author, whose enthusiasm and creative energy have been his particular gifts to his patients and to his colleagues.

  AARON T. BECK, M.D.

  Professor of Psychiatry,

  University of Pennsylvania

  School of Medicine

  Acknowledgments

  I am grateful to my wife, Melanie, for her editorial assistance and patience and encouragement on the many long evenings and weekends that were spent in the preparation of this book.

  I would also like to thank Mary Lovell for her enthusiasm and for her technical assistance in typing the manuscript.

  The development of cognitive therapy has been a team effort involving many talented individuals who have made invaluable contributions in their work with the Mood Clinic and the Center for Cognitive Therapy. These include Drs.

  Aaron Beck, John Rush, Maria Kovacs, Brian Shaw, Gary Emery, Steve Hollon, Rich Bedrosian, and numerous others. I would also like to mention current staff members including Ruth Greenberg. and Drs. Ira Herman, Jeff Young, Art Freeman, and Ron Coleman for their many contributions.

  Several individuals have given me permission to refer to their work in detail in this book, including Drs. Raymond Novato, Arlene Weissman, and Mark K. Goldstein.

  I would like to make special mention of Maria Guarnas-chelli, the editor of this book, for her endless spark and vitality which have been a special inspiration to me.

  During the time I was engaged in the training and research which led to this book, I was a Fellow of the Foundations'

  Fund for Research in Psychiatry. I would like to thank them for their support which made this experience possible.

  And my thanks to Frederick K. Goodwin, M.D., Chief of the Clinical Psychology Branch of the National Institute of Mental Health, for his valuable consultation with regard to the role of biological factors and antidepressant drugs in treating mood disorders.

  I would also like to thank Arthur P. Schwartz for his encouragement and persistence in bringing about publication of this book.

  Contents

  Preface

  vii

  Introduction

  1

  PART

  I. THEORY AND RESEARCH

  7

  1. A Breakthrough in the Treatment of

  Mood Disorders

  9

  2. How to Diagnose Your Moods: The First

  Step in the Cure

  19

  3. Understanding Your Moods: You Feel

  the Way You Think

  28

  PART II. PRACTICAL APPLICATIONS

  49

  4. Start by Building Self-Esteem

  51

  5. Do-Nothingism: How to Beat It

  75

  6. Verbal Judo: Learn to Talk Back When

  You're Under the Fire of Criticism

  119

  7. Feeling Angry? What's Your IQ?

  135

  8. Ways of Defeating Guilt

  178

  PART M. "REALISTIC" DEPRESSIONS

  205

  9. Sadness Is Not Depression

  207

  PART IV. PREVENTION AND PERSONAL

  GROWTH

  231

  10. The Cause of It All

  233

  11. The Approval Addiction

  256

  12. The Love Addiction

  274

  13. Your Work Is Not Your Worth

  288

  14. Dare to Be Average!—Ways to

  Overcome Perfectionism

  309

  PART V. DEFEATING HOPELESSNESS AND

  SUICIDE

  335

  15. The Ultimate Victory: Choosing to Live 337

  PART VI. COPING WITH THE STRESSES

  AND STRAINS OF DAILY LIVING 357

  16. How I Practice What I Preach

  359

  PART VII. THE CHEMISTRY OF MOOD

  373

  17. The Consumer's Guide to Antidepressant

  Drug Therapy

  375

  Suggested Reading

  399

  Index

  401

  List of Charts

  SELF-ASSESSMENT TESTS

  Beck Depression Inventory

  20

  Novato Anger Scale

  136

  Dysfunctional Attitude Scale

  242

  SELF-HELP FORMS AND CHARTS

  Definitions of Cognitive Distortions

  40

  Triple-Column Technique

  60

  (Automatic Thought-Cognitive Distortion-Rational Response)

  Daily Record of Dysfunctional Thoughts

  62

  Double-Column Technique

  71

  (Automatic Thought-Rational Response)

  Daily Activity Schedule

  88

  Anti-Procrastination Sheet

  91

  Pleasure-Predicting Sheet

  96

  But-Rebuttal Form

  99

  Tic-Toc Technique

  101

  The Anger Cost-Benefit Analysis

  150

  Hot Thoughts-Cool Thoughts

  152

  Revising "Should Rules"

  159

  Advantages and Disadvantages of Self-Defeating

  Belief Systems

  263

  The Antiperfection Sheet

  313

  Response-Prevention Form

  317

  FEELING

  GOOD

  Introduction

  In this book I will share with you some of the latest scientifi-cally tested methods for overcoming blue moods and for feeling good about your life. The techniques are based on a new form of treatment known as cognitive therapy. The treatment is called "cognitive therapy" because you are trained to change the way you interpret and look at things when you feel upset so as to feel better
and act more productively.

  The mood-elevating techniques can be surprisingly effective. In fact, cognitive therapy is one of the first forms of psychotherapy that has been shown in clinical research studies to be as effective as and in some cases more effective than antidepressant drug therapy in the treatment of severe and mild depression. While antidepressants are often very useful, we now have an effective approach which has helped many people overcome their mood problems without having to take drugs. And even if you are being treated with medications, the self-help techniques described in this book can speed your recovery.

  Published investigations have also suggested that cognitive therapy may be superior to several other forms of psychotherapy, including behavior, group, and insight-oriented therapies, in the treatment of depression. These findings have intrigued many psychiatrists and psychologists and have caused a wave of basic and clinical research investigations.

  An article by Dr. Myrna Weissman of the Yale University School of Medicine in New Haven, which appeared in a leading psychiatric journal (the Archives of General Psychiatry), concluded that, in general, the completed studies show the superiority of cognitive therapy when compared with other specific therapies. As with all new developments in medicine and mental-health research, the final judgment must await the test of time and further studies, but the initial findings are highly promising.

  The new therapy emphasizes interventions based on common sense. Its rapid mode of action has caused skepticism among more than a few traditionally oriented analytic therap-1

  David D. Burns, M.D.

  ists. Conventional therapeutic approaches, however, often do not work for many mood disorders, and in fact sometimes result in a worsening of the conditions. In contrast, after only three months of treatment, the majority of severely depressed individuals treated by therapists with the techniques described in this book have reported a substantial reduction of the symptoms that brought them to treatment.

  I have written this book so that you can learn about the methods which have helped so many to overcome the blues and enhance their happiness and self-esteem. As you learn to master your moods, you will learn that personal growth can be an exhilarating experience. In the process you will develop a more meaningful set of personal values and adopt a philosophy of living that will make sense and bring you the results you want: increased effectiveness and greater joy.