In response to a debate regarding an orthopedist’s role in dealing with mental health issues David Burns wrote me this letter. I have seen consistent and profound results with just having my patients use his book in addition to the free writing of thoughts. It is self-directed by the patients. My role has been making my patients accountable to fully engage in using his tools. Whenever possible I do work with pain psychologists who have added wonderful dimensions to my patient’s care.

David Burn’s Letter

Thanks so much. There is evidence based on quite a bit of research that reading Feeling Good: The New Mood Therapy can have significant antidepressant effects. Dr. Forrest Scogin has reported (based on numerous controlled outcome studies published in Journal of Consulting and Clinical Psychology and other journals) that approximately 2/3rds of individuals seeking treatment for a major depressive episodes will be substantially improved or recovered within four weeks if they are given a copy of Feeling Good, with no other treatment offered during this time. Those patients did not need any further treatment, and maintained their gains during 3-year follow-up studies.

It is certainly not a panacea or cure-all, but does seem to help many people who are struggling with depression and anxiety. Some, of course, will need more than just a self-help book.

There are many techniques and ideas in Feeling Good, and there has not been much research on what the effective therapeutic “ingredients” might be. Research indicates that this is not a placebo effect, since a placebo book was not effective in a controlled study.

In my own research in clinical settings, we have seen that doing psychotherapy “homework” (such as reading Feeling Good between sessions, recording automatic negative thoughts, and so forth) does seem to have profound antidepressant effects.

All the best,

David D. Burns, M.D.

Adjunct Clinical Professor,

Department of Psychiatry and Behavioral Sciences,

Stanford University School of Medicine

The post David Burn’s Letter first appeared on Back in Control.

The post David Burn’s Letter appeared first on Back in Control.

I personally used the book extensively for many years, and the three-column technique was a major factor in pulling me out of my free fall. In 1997, I realized that it was a tool I could use in my own practice, and I liked using it because it was so much faster than trying to get someone to see a pain psychologist. They could engage almost instantly and often aggressively. This book was the entire component of the stress management  for the DOC Project for many years. I originally told my patients that if they could obtain some stress management skills, they would cope with it better. I was surprised to see many patients report both a better quality of life and a significant decrease in pain. However, it was puzzling to me why some patients would respond so much better than others. It eventually became clear that the patients who did well were the ones who participated in the writing process. The results have been consistent. Patients who commit to a daily writing process, based on the suggestions in the book always have a significant response.

His book is a wonderful book, but I have them initially read only the first third of the book to get started in the “three-column technique.” He outlines ten “errors in thinking.” They cover the range of cognitive distortions. We all use them a lot, as that is how we were raised. Some of the categories he describes are:

• “Should” thinking
• Catastrophizing
• Labeling
• Minimizing the positive
• Emphasizing the negative
• Emotional reasoning

In the first column you write down your “ANT”.  That stands for “automatic negative thought. This step represents the first step of stimulating neuroplasticity, which is increasing the awareness of the disruptive thought.

Then you write down the “error in thinking” that the thought represents in the second column. As you categorize the thought and understand the effect it has on your peace of mind, it separates you from it.

In the third column you write down the more rational thought. The more specific you are the better. This is the phase of burning a new circuit.

For example, your son may have just flunked a test. Your first response might be, “He is lazy and stupid.” You would  write those thoughts down in the first column. In the second column you would note that represents “labeling”. In the third column you might write, “My son just flunked a test. I wonder why. Is he being bullied at school? Could he be depressed? I am going to try to find out what is going on.” Positive thinking would be represented by, “He isn’t lazy.  He is my son and I love him.” That might be it. Except, without writing the more specific rational response, your thoughts might start spinning around. By the time you actually talk to him, you might not be in a great frame of mind.

The technique is effective for most people and it certainly was for me. The key to keep in mind is that the writing is only a starting point in the healing journey.

The post The Three Column Technique first appeared on Back in Control.

The post The Three Column Technique appeared first on Back in Control.