Review: The Feeling Good Handbook

Review: The Feeling Good Handbook

The Feeling Good HandbookThe Feeling Good Handbook by David D. Burns

My rating: 4 of 5 stars

Unlike with previous Burns books, I read this one while I was feeling relatively normal and untroubled. I did this because I sensed myself relapsing. Cognitive therapy, as you might know, is based on the premise that your thoughts control your moods and emotions. Thus it works by changing your beliefs and even your values in order to alleviate depression, anxiety, and problems with relationships. In my own experience, this can have a remarkably liberating effect. The problem is that, when the relief passes and you once more get sucked into the humdrum world of daily troubles, the original beliefs and values come creeping back.

But why is this? Why are we so prone to adopting irrational and self-defeating patterns of thought? Why do we embrace unrealistic standards, make unjustified assumptions, jump to unwarranted conclusions—only to wallow in misery and fear and loneliness—when a few pen-and-paper exercises is sometimes all we need to feel better? It is peculiar. Robert Wright argues that our cognitive imperfections stem from our evolutionary heritage. A competitive and materialistic culture might also contribute. Burns, for his part, does not offer much in the way of explanation; his aim is therapy, not theory. Yet answering this question seems vital if we are to fight an offensive battle rather than a defensive one.

It seems to me that the most proactive strategy would be to intervene on the social rather than the psychological realm (if that were possible). To pick a simple example, if an obsession with being the best is really self-defeating—at least as far as happiness is concerned—then why the opposite message so passionately embraced in the culture at large?

Perhaps it is because these value systems, which equate happiness with accomplishment, do benefit the group even if they are not psychologically desirable. An office full of perfectionistic over-achievers might out-compete an office full of contented workers with nothing to prove. Advertisements may not have much effect in a world of high self-esteem. And political parties will have trouble getting elected in a world without anxiety. In these and a thousand other ways, society depends on the very thoughts and attitudes that books like this try to combat. No wonder that relapse is common once therapy ceases.

It is also true that there are hidden, and sometimes ugly, benefits to our bad habits. It feels satisfying to think oneself superior to others. Insulting and controlling other people brings a rush. Anxiety helps us to avoid discomfort. Intimacy requires painful vulnerability. And who wants to accept imperfections in oneself? Burns’ methods require that we see ourselves as flawed, that we acknowledge that other people have a point, that our anger is often unjustified, that we face our fears—and who wants to do that? Indeed, sometimes the beliefs that are most precious to us, the beliefs that form our identity and reality, are just what cognitive therapy encourages us to give up—the belief that, for example, your money makes you superior, or that life is rotten, or that your wife is crazy—and these beliefs can seem more important than happiness itself.

Well, I’m not sure I have a solution to this, other than meditating and occasionally dipping into some cognitive therapy books when I feel particularly troubled. For that purpose The Feeling Good Handbook is well suited, since it is a sort of omnibus of Burns’ general approach, with sections on depression, anxiety, and communication. Even though I was not looking for any special relief, I still found the book useful (specifically the section on procrastination, which prompted me to finally begin submitting my novel to agents). As usual, Burns is a heartening voice—compassionate, intelligent, and motivating—who is accessible without descending into tackiness. And it is always a relief to read his anecdotes, since they remind me that these problems, far from hopeless or strange, are part of the human condition.

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Review: When Panic Attacks

Review: When Panic Attacks

When Panic Attacks: The New, Drug-Free Anxiety Therapy That Can Change Your LifeWhen Panic Attacks: The New, Drug-Free Anxiety Therapy That Can Change Your Life by David D. Burns

My rating: 5 of 5 stars

I have always been an anxious person. I think I get it from my mother.

One time, we were in the car on our way to the supermarket when, for whatever reason, she asked if I had my license on me. “No,” I said. “Why do I need it? You’re driving.” “But what if we get into an accident?” she replied. At first, this response confused me. Then I realized that she was wondering how people would identify my body if we both died in a crash. “I think they’d figure it out,” I said finally, as scenes of bloody car crashes played in my mental theater.

This anxiety was part of my identity. It shaped how I interacted with strangers, my friends, my family, how I behaved in school, at work, and in my relationships. I thought it was a part of me. Sometimes I would have episodes when my worrying would flare up to the point that I was incapacitated; but for the most part it was manageable. Around last year, however, my panicking got decidedly worse. Terrible fantasies would flood my brain, making my chest tense up, my stomach tie itself into a knot, and adrenaline rush through my body. After another attack again this year, I decided that I didn’t want anxiety to be such a big part of my life anymore, and thus reached for this book.

Burns begins with his general views on anxiety. He doesn’t believe in anxiety disorders. The criteria for diagnosis are, he thinks, vague and arbitrary. There are people who tend to be more anxious than others; but anxiety-proneness falls onto a spectrum and does not map onto two neat categories, normal and pathological. Burns also has a negative opinion of anxiety medications. In his experience, they often don’t work and generally leave the underlying cause untouched. Thus he thinks it’s more effective when people don’t tell themselves that they’re “sick” and don’t treat anxiety like a disease to be cured. Rather, anxiety is a common state and it can be effectively managed through fairly simple techniques.

After explaining his general views, Burns launches into his techniques. These techniques occupy the bulk of the book, and are divided into three categories, Cognitive, Exposure, and Hidden-Emotion.

The Cognitive techniques were the most familiar to me, since this is the same approach used in his book on depression, Feeling Good. As the name implies, these techniques focus on your thoughts and beliefs. Anxiety, in this view, is the result of unrealistically negative thoughts which are traceable to certain deeply held beliefs. Burns calls these beliefs self-defeating, because they equate certain things with happiness, and yet inevitably lead to unhappiness. These self-defeating beliefs may be personal—such as perfectionism or achievement addiction—or interpersonal—such as entitlement or blame. The techniques thus focus on these beliefs and the thoughts they give rise to, with the goal of adopting a more realistic, forgiving, and easygoing attitude towards yourself and others.

Exposure techniques operate on a different principle. Instead of combating your anxiety, you seek it out and embrace it. For people with phobias, this means doing exactly the thing they’re afraid of. For people with traumatic memories, this means revisiting these experiences. For people who are shy, this means socializing. If you run away from what you fear, you only tell yourself that you ought to fear it; but if you confront it, you can find out that there’s nothing to be afraid of.

The Hidden-Emotion technique is based on still another principle. It holds that anxiety results when people sweep negative emotions—like frustration, anger, or hatred—under the rug. This most often results from “niceness”—the fear of upsetting anyone or even admitting to yourself that you’re upset. It is not that the negative feelings are consciously shunned, but that they are not consciously registered at all. Thus the technique consists in examining your life—not your childhood, but right now—and looking for things that bother you that you’ve been ignoring.

By the end of the book, Burns has explained 40 techniques. He includes so many because nobody can be sure which technique will work for which person. His treatment plan consists of trying these techniques one after the other until you find one that’s effective. In his experience, it can be very difficult to predict which one will work in any given case, so he encourages you to experiment.

I can’t summarize each of his techniques here, but I want to include just a couple examples of cognitive techniques.

One technique is thinking in shades of grey—that is, avoid essentialism in your self-talk. This sounds simple enough, but I’ve found that most people tend not to do this. For example, if a guy is trying to quit smoking, but he only lasts three months, he might conclude “I’m a failure.” Yet it would be more realistic for him to say “I was successful for three months, and then I relapsed. Maybe I can be successful for longer next time.” That’s both more accurate and more encouraging.

Also useful is the double-standard technique. If you’re having a problem and beating yourself up, ask yourself how you’d treat a friend who was having this same problem. Often you’ll find that you’re much more compassionate, understanding, and optimistic with your friend. Once you realize that, try talking to yourself the same way. If you do this, you can respect yourself in good times and bad, just like you respect your best friends, rather than beating yourself up for falling short, failing, being rejected, or getting criticized.

You may be thinking that these “techniques” are childishly simple. Indeed they are. And yet I was acting in the very opposite way, and without this book I don’t think I would have changed. Besides, simplicity is a good thing. The techniques don’t require you to believe anything untenable or subscribe to a new philosophy of life. They only require that you do some work with a pencil or paper, or try a new approach in conversation, or get over a fear that’s been holding you back. They allow you to understand and confront your emotions rather than be their victim.

That’s all for my overview. I could stop here with the note that I’ve found the book extremely helpful, indeed emancipating. But it is hard to write reviews of self-help books without lapsing into autobiography—at least for me it is. Well, here it goes.

The biggest realization I had while reading this book is that much of my anxiety resulted from being out of touch with my emotions. I think Burns would say I had emotional perfectionism, and thus swept a lot of negative feelings under the rug. But lately some kind of interior barrier broke. I suddenly realized that I was sad, and I cried for the first time in many years. It was a huge relief! Now even children’s movies are enough to set me off. I watched Inside Out on the plane ride back from Spain and ended up in tears. My girlfriend was absolutely shocked.

My other main lesson from this book is that fears have to be faced, not shunned. Instead of trying to push away my anxiety—resulting in endless struggle—now I just let it do its work. And the strange thing is that as soon as I stop resisting, the anxiety loses its grip.

To reinforce this lesson, I decided to confront one of my oldest fears—roller coasters. I went out to Coney Island and rode three of them.

When I was a kid, I went on a few roller coasters and hated it. Looking back, I think that’s because I mentally resisted the experience. I kept wishing to stop and get off, and simply wouldn’t accept the fact that I couldn’t do anything but sit there. This time around, I was scared, but instead of resisting it I told myself that there’s no getting off so I might as well try to enjoy it. That made all the difference. The ride itself was actually fun, and not terribly scary. The only difficult part was making myself get on.

And I realized that roller coasters provide a perfect metaphor for anxiety. If you resist the experience and try to wish it away, it’s only going to seem terrifying, pointless, and dangerous. But if you accept the experience and embrace it, you’ll find that it’s harmless fun.

So treat fear like a roller coaster that you can’t get off. Accept the things that scare you, accept your fear, and accept the insecurities, limitations, and imperfections that make you afraid. You can’t wish them away, so you might as well have some fun.

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Review: Feeling Good

Review: Feeling Good

Feeling Good: The New Mood TherapyFeeling Good: The New Mood Therapy by David D. Burns
My rating: 5 of 5 stars

If you can love and respect yourself in failure, worlds of adventure and new experiences will open up before you, and your fears will vanish.

It is an interesting statement on contemporary culture that practical, self-help books are often looked down on as lowbrow, unsophisticated, and unworthy of serious consideration. Just note how often in reviews of self-help books you come across the phrase, “I don’t normally read books like this,” or the like. Of course, skepticism regarding books of this kind is merited, especially when you take into account the amount of quackery, chicanery, demagoguery, and baloney in print. Indeed, I think it’s fair to say we have a veritable advice industry in our culture today, with a great deal of money to be made and thus lots of enterprising, unscrupulous people peddling various forms of nonsense, hoping to get rich. Self-help books now sell so well that they have to be excluded from non-fiction sales rankings, because if they weren’t the top 10 best sellers would be an endless parade of one self-help book after another.

But why are so many people willing to pay for and devour book after book, getting swept about by the ceaseless winds of doctrine, navigating their lives through fad after fad? Fashionable ways of running and ruining your life have always been with us; yet I think there is another aggravating factor at work in the present day.

Recently I read two history books, one about Ancient Greece and the other about Rome. As I learned about the philosophies of education in those societies, I noticed how central were the ideas of ethical and moral teaching. I don’t mean ethical in the narrow sense of right and wrong, but in the wider Greek sense, used by Aristotle, the Stoics, and the Epicureans—how to cultivate wisdom, how to live a well-regulated life, how to deal with the hardships and misfortunes that are so often thrown our way. These were primary concerns of pedagogy. By contrast, our current education system, as least here in the States, has deemphasized ethical teaching almost completely.

There are, of course, many reasons for this, and many of them are good ones; but I do think it leaves a certain gap in our culture that self-help books partially fill. Unfortunately, from what I can tell, many of these seem rather mediocre—or worse. But this book, by David D. Burns, is for me one of the exceptions. It is an interesting and, for me, an extremely useful book, based on a well-studied and much-tested therapeutic technique.

Burns’s aim in writing this book was to popularize the methods of Cognitive Behavioral Therapy (CBT), a therapeutic technique developed by the psychologist Aaron T. Beck, among others. The premise of CBT is very simple: your moods are caused by your thoughts, so by controlling your thoughts you can control your moods. At first sight, this may seem like complete nonsense; our moods come and go, and our thoughts simply take on the timbre of whatever mood we happened to be in, right? This seems to be what most people assume; certainly I did. Yet consider this scenario, which actually happened to me:

My boss scheduled a meeting with me out of the blue. I immediately started thinking that I hadn’t been doing a good job recently, so I began to panic, sure I was about to get fired. Eventually, this panic turned to indignation, as I convinced myself of the injustice of the situation, since I worked hard and tried my best. So, literally trembling with anxiety and outrage, I went to the meeting and sat down; and my boss said: “We’re giving you a bonus, because you’ve been doing so well. Congratulations!” Suddenly, all my negative feelings turned into joy.

This I think well illustrates the central idea behind CPT. All of my negative and positive emotions in this scenario were due to my interpretation of the event, not the event itself. I made the false assumption, based on no evidence, that I was going to be fired. I thought of every mistake and imperfection in my work over the last month or so, and convinced myself that I was doing poorly and that termination was imminent. Then, I persuaded myself that I wasn’t given adequate resources or support, and that the situation was unjust. And when I was finally given the bonus, I interpreted that to mean I was doing a good job and that I was getting all the support I needed—which were equally tenuous interpretations. Thus you can see how my mood was a direct product of my thoughts.

All of my negative assumption in the above paragraph contain what Burns calls “warped thoughts,” or cognitive distortions. These are irrational patterns of thinking which have been found to be common in depressed and overly anxious patients. The CBT interpretation of depression is that these thinking patterns are not caused by depression, but actually cause depression. In other words, depression results from persistent, unrealistic negative interpretations of one’s life and experience, leading one to focus solely on the bad and to feel hopeless about the future.

Burns gives a list of 10 types of warped thoughts, but in my opinion there is quite a bit of overlap in the categories. The distortions more or less boil down to the following:

—Making negative assumptions, whether about the future or about what someone else is thinking;
—Assuming that one’s emotions accurately reflect reality;
—Over-generalizing a small number of negative occurrences into an inevitable trend;
—Willfully ignoring all of the positives to focus solely on the negative;
—Thinking in black and white categories;
—Making unjustified “should” or “ought” statements about the world without considering other people’s perspectives;
—Feeling that you are responsible for things over which you have no control;
—Labeling oneself and others with vague pejoratives.

The first part of this book is dedicated to allowing the reader to recognize these types of thoughts and to combat them. This most often is just a matter of writing these thoughts down and exposing the distortions that lay beneath. Simple as this sounds, I’ve found this to be remarkably effective. As you might have guessed from the above example, I am rather prone to anxiety; and during this summer, my anxiety was getting to the point that I felt incapacitated. I was driving my friends and family nuts with my constant worrying; and nobody, including myself, knew how to deal with me.

Luckily, I heard about a site called MoodGYM, which is a website developed by the Australian National University for people dealing with anxiety and depression, using the techniques of CBT. Desperate for some relief, I completed the reading and activities on the website, and found that I felt much, much better. Impressed, I looked for books on CBT techniques, and of course came across this one.

What most intrigued me about CBT was the emphasis on accuracy. The techniques weren’t based on the premise that I was somehow damaged or filled with strange desires, nor did they include any amount of self-delusion or wishful thinking. Quite the reverse: the whole emphasis was on thinking clearly, basing beliefs on evidence, avoiding unreasonable assumptions, and seeing things from multiple points of view.

Take anger. Very often (though not always), our feelings of indignation simply result from seeing an event through a narrowly selfish lens. We don’t get the job we interviewed for, and we feel cheated; someone beat us to that parking spot, and we feel outraged. But when we consider these scenarios from the perspective of the boss or the other driver, the situation suddenly seems much more just and fair; they are pursuing their own interests, just like we are. So simply by looking at the situation from multiple points of view, and thus understanding it more fully, our feelings of anger are cooled.

When I began working through the techniques in the book, I was astounded by how often these types of distortions plagued my thinking. It would almost be funny if it wasn’t so unpleasant: I could twist any situation or piece of information into somehow reflecting negatively on my character. Everything bad in the world confirmed my negativity, and everything good only served to reproach me and to make me envious and resentful. The good news was that, when I began to recognize these illogical patterns of thought, it was extremely easy for me to correct them; and for the past month or so I’ve been feeling a great deal happier and calmer.

After teaching the reader several personal and interpersonal techniques—strategies for dealing with oneself and others more effectively—Burns moves on to examining some of the underlying assumptions that give rise to warped thinking. It turns out that these all involve equating one’s “value” or “worth” with some extrinsic good, whether it be approval, love, success, fame, or even skill. There is, of course, nothing wrong with enjoying the approval of others, the thrill of love, the sense of accomplishment, or the satisfaction of a job well done. The problem arises when, instead of enjoying something, we use it to measure ourselves.

To use a somewhat silly but germane example, how many people believe that those who read more books, bigger books, harder books, are somehow “superior” to people who don’t? I’ve certainly been guilty of this; but it is pretty clearly an absurd position when I think about it, and one that I couldn’t possibly defend on any valid moral or intellectual grounds. What on earth does it even mean to be a “superior” person?

Superiority only makes sense when we have some quality we can measure, such as wealth or strength; but when we say “superior” by itself, what quality do we mean? “Worth”? How do you measure that? You can try being clever and say “By the number of books you read” or something, but that’s clearly circular reasoning. If you are a humanist or religious, you might say that you have worth just from the fact of being alive; but then of course everyone is equally worthy and there’s no sense in feeling worthless.

In the non-Goodreads population, I suspect book addiction isn’t a big problem; more often, people feel down because they imagine that approval, love, money, or expertise is necessary to be a worthwhile and happy person. But the absurdity of this kind of thinking is revealed when you consider how many famous, beloved, rich, virtuosic, brilliant, successful people there have been, and still are, who are deeply depressed and feel worthless and hopeless. Short of torture, there are no circumstances in life that guarantee unhappiness; and the same goes for happiness. This is not to say that you shouldn’t try to change or improve your situation, only a reminder you that the way you interpret a situation is often as important as the situation itself, if not more so.

I cannot hope to sum up the entire book in the space of this review; but I hope what I have included has convinced you that it’s at least worth looking into. After all, by definition, nothing feels better than happiness.

Of course, the book isn’t perfect. Burns’s writing style is nothing remarkable, and it is occasionally tacky; but I think that it’s excusable considering that he’s a therapist, not a writer, and that he’s trying to reach a popular audience. One flaw that I thought was less easy to excuse was Burns’s exclusive focus on straight couples in his sections on love and relationships. Burns writes in a purely heteronormative vein, not even acknowledging same-sex couples, which is difficult to justify, considering the higher rates of depression and anxiety among gays and lesbians—not to mention others in the LGBTQ community. I hope this is changed in future additions.

A criticism I am tempted to make, but which I actually think is unfair, is that CBT makes people passive, accepting, and more content with the status quo. It sometimes seems as if Burns is telling people not to try to change their circumstances, but rather to accommodate themselves to them. I think this is unfair for a few reasons. No matter how powerful we may be, there will always be things in life which we cannot change and which we simply have to accept; so developing the tools to do so without frustration or anger is useful for everyone. What’s more, real depression and anxiety are not conducive to effective action. Quite the opposite: depression often makes people apathetic and anxiety makes people feel too overwhelmed to do anything. Besides, you can’t solve a problem unless you can see it clearly, and the thinking patterns associated with depression and anxiety lead to a total inability to see problems clearly and to deal with them rationally. So I think accusations that this book is somehow reactionary or that it leads to passivity are unfair.

To sum up this already overlong review, I just hope I’ve convinced you that this book might be extremely valuable to you or to someone you know. It certainly has been for me. Now I no longer feel that I am at the mercy of my moods or emotions, or that my sense of self-worth or confidence is dependent on my circumstances. And I’d say these benefits definitely outweigh the tacky cover and the corny title, don’t you?

(Oh, and if the book seems like too big a commitment, MoodGYM is pretty swell too, despite additional corniness of course.)

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