419: Ask David: Changing an SDB; Intense Public Speaking Anxiety

Feeling Good Podcast | TEAM-CBT - The New Mood Therapy

Ask David How Can I Change an SDB (Self-Defeating Belief)? How Can I Cope with Intense Public Speaking Anxiety? Featuring Rhonda Barovsky, Psy.D., Matthew May, MD, Jason Meno and David Burns, MD (Jason is an AI Scientist on our Feeling Great App Team)

1. Anonymous asks: How can I change an SDB (Self-Defeating Belief)?
2. Hiranmay asks: How can I deal with my intense anxiety before public speaking.

Answers to Your Questions

Note: These answers below were written BEFORE the podcast, and the live discussion always adds new and different angles.

Today, Jason Meno, our beloved AI guy on our app team, also chimes in on the many super questions submitted by Andrew (#3 - #10.)

1. Anonymous asks: How can I change an SDB?

Dear Dr. Burns,

I’m an avid listener of the Feeling Good podcast and for the past few weeks, an avid user of the Feeling Great app. Thank you for your incredible work and dedication to making people everywhere feel better about themselves.

I have a question about self-defeating beliefs that I’m hoping you can address, either on the show or on your website. You have mentioned on several occasions that SDBs are the root cause of negative thoughts and consequently of negative feelings.

Yet, to me it doesn’t feel like SDBs are really addressed enough on the podcast. There seem to only be a handful of episodes covering the topic. It also seems there is a very limited toolbox of methods to use on SDBs, almost like dealing with them is considered an afterthought. If SDBs really are the cause of it all, shouldn’t the primary focus be on defeating them first and only then, on defeating negative thoughts?

I’m just a little bit lost when it comes to defeating SDBs, which seem to be way harder to deal with than negative thoughts. Any insights or thoughts on the subject will be greatly appreciated.

Sincerely,

Anonymous

David’s reply

Dear Anonymous,

Will start a new Ask David with your excellent question. Thanks,

david

First, you can look up Self-Defeating Beliefs in the search function on my website, and you'll find many great examples. Here's what I got just from "Self-Defeating Belief." You could also search for a specific type, like Perfectionism, Perceived Perfectionism, Achievement Addiction, Love Addiction, Approval Addiction, Submissiveness, etc.

In general, there are two approaches to any SDB. Four approaches can be used in this order:

1. 1. Do a Cost-Benefit Analysis of the SDB.
   2. If Disadvantages outweigh Advantages, use Semantic Technique to modify the SDB.
   3. Do an experiment to see if the SDB is actually valid.
   4. Use the Feared Fantasy Technique to put the lie to the SDB at the gut level.

Here's our latest thinking, which is a step beyond the four steps above. Do a Daily Mood Log on one specific moment when you were struggling with your SDB. We will discuss these ideas in greater depth on the show, of course!

You can also find a great deal on SDBs in my books, like Feeling Good, the Feeling Good Handbook, and more. But right now, I don't even know what SDB you might want help with / more information about.

Also, in the Feeling Great App, there's a terrific class called "Your PhD in Shoulds." It includes a lesson on perfectionism.

2. Hiranmay asks: How can I deal with my intense anxiety before public speaking without working on the negative thoughts I have afterwards, like

• “I am going to mess this up”
• “People are going to notice something obviously wrong in my presentation that I missed, and I will look like a fool.“
• “This talk is important, it must go well!

Here’s his email:

Dear Dr. Burns,

I love your books and the feeling good podcast. They have made such a huge difference in my life (in a good way of course).

I have an “ask David” question on acute anxiety:

If I have to play a badminton match or give a presentation, I usually get some or a lot of anxiety the day before the big event as well as the morning of. I then use all the methods you have taught, and the anxiety reduces. However, it usually comes back with a bang just before I give the talk or play a match. Cognitive techniques are not very helpful to me 30 minutes or 5 minutes before the presentation or match. I don’t have the time to sit down and write my thoughts or cannot focus at all on my thoughts. Are there any strategies to reduce this form of acute “relapse” or nerves.

Here are some more details:

Event: 30 minutes before my presentation. I just entered the seminar room, and the first speaker is about to start their talk. I am next. I can feel my heart starting to pound and I am getting the familiar sense of anxiety and nerves.

Thoughts: “I am going to mess this up”. “People are going to notice something obviously wrong in my presentation that I missed, and I will look like a fool“. “This talk is important, it must go well”.

Although to be honest, this is my analysis of what my thoughts were after the fact. 5-15 minutes before the presentation, I usually just notice my thoughts racing.

To reiterate: I am not looking for help with working on these thoughts after the presentation. Any strategies to acutely deal with anxiety or rather relapse of anxiety when I don’t have time to use all the wonderful TEAM tools would be very helpful.

Thanks so much.

Best,

Hiranmay (pronounced he-run-may) living in Basel, Switzerland.

David’s Reply

Sure, as a starting point I’d like to see your work with these thoughts on a Daily Mood Log. Do you have one that you could send me, with the percents filled in, etc.

That will allow me to see what your strategies are on challenging these thoughts, and whether you can knock them out of the park, or only challenge them “somewhat.”

Best, david

You can see Hiranmay's excellent DML if you check here.

David Continues

Hi Hiranmay,

It sounds like are not interested in help with the thoughts you recorded in your email below, since this, by definition, is “after the presentation.” If you like, you could perhaps “make up” some thoughts you might be having BEFORE you start to speak.

As someone who has had, and recovered from crippling public speaking anxiety, I have tons of powerful techniques, but would need some help from you so I’ll have something to go on.

By the way, I absolutely DO NOT BELIEVE you when you say those are not the thoughts you are having in the minutes before you begin to speak! So, your requirement that we are not allowed to work on them is a bit of a hindrance.

As an aside, I will include this in an Ask David podcast, if that is okay!

Sincerely, david

I asked H to send me a copy of his Daily Mood Log, which was really well done, and responded with a few suggestions.

Then I sent this note:

David’s Subsequent Response

One thing I noticed on your Daily Mood Log is your fear of making a mistake, or having a critical question from someone in the group, or not being able to impress your audience sufficiently. These fears are common in public speaking anxiety. We've all struggled with them at one time or another, I think!

I have changed my focus from needing to impress the audience with myself or my talk, and instead I try to remember to try to impress them with themselves, and how awesome they are.

Here's an example. I once gave a presentation on the serotonin theory of depression for about 1,000 psychiatrists at a prominent medical school in Texas. It was going well and suddenly a man at the rear stood up and started shouting something like this:

“I’m so sick of all you establishment researchers thinking you know so much and ignoring my work. I have discovered the cause and cure for depression in my laboratory. (He claimed it was some kind of vitamin deficiency.) But everyone is ignoring my work (and more ranting and raving.)

There was a chilled silence in the room. Here’s how I responded:

“I appreciate was you’re saying, and I agree. I think our current focus on deficiencies in brain serotonin is extremely misguided, and predict, as you say, that research will show that the chemical imbalance theory of depression is not valid. And often, the most important breakthroughs come from laboratories like yours, where someone who is unknown discovers the actual cause of an illness after being ignored for years and years. I’d be honored if you’d approach me at the end of my talk so I can learn more about your pioneering research!”

Notice I did not defend myself, but tried to make HIM feel good.

At the end of my talk, about 20 or more people came crowding up to the podium with questions and such. I saw him at the back of the group, pushing his way to the front. I braced for another attack. He said,

“Dr. Burns, that was the best presentation I’ve ever heard by far on the serotonin theory of depression. If you would give me permission, I would love to show your slides to my students and colleagues!”

I have very little fear of being attacked by people in the audience, and I now speak all the time in front of groups. I used to have paralyzing public speaking anxiety. But the monsters I feared were all in my brain!

Warmly, david

Andrew asks 8 cool questions! (#3 - #10) which are listed below, along with my answers. Jason Meno also sent some awesome answers, which you'll find below as well, right after my answers to the 8 questions.