advanced empathy training

Handouts for Workshop 21 on Thursday, December 10, 2009

8:30 – 11:30 AM

Advanced Empathy Training Helping the Angry, Mistrustful

Client*

By David D. Burns, M.D.

Adjunct Clinical Professor Emeritus, Department of Psychiatry, Stanford University School of Medicine

Dr. Burns' email: [email protected]

Website: www.feelinggood.com

* Copyright 2009 by David D. Burns, M.D. The materials in this handout are intended for your use during the

workshop. Dr. Burns must grant written permission for all other uses or reproduction of any materials.

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Therapeutic Empathy / Burns

Five Secrets of Effective Communication*

E = Empathy

1. The Disarming Technique (DT). Find some truth in what the other person is saying, even if it seems totally unreasonable or unfair.

2. Empathy. Put yourself in the other person's shoes and try to see the world through his or her eyes.

Thought Empathy (TE). Paraphrase the other person's words.

Feeling Empathy (FE). Acknowledge how the other person is probably feeling, based on what she or he said.

3. Inquiry (IN). Ask gentle, probing questions to learn more about how the other person is thinking and feeling.

A = Assertiveness

4. "I Feel" Statements (IF). Express your own ideas and feelings in a direct, tactful manner. Use "I feel" statements, such as "I feel upset," rather than "you" statements, such as "You're wrong!" or "You're making me furious!"

R = Respect

5. Stroking (ST). Convey an attitude of respect, even if you feel frustrated or angry with the other person. Find something genuinely positive to say to the other person, even in the heat of battle.

* Copyright 1991 by David D. Burns, MD. Revised 2004.





Advanced Techniques*

Changing the Focus

You focus on the process rather than the content of the argument. In other words, you might gently point out that the two of you are arguing and not working together as a team. You bring the conflict to conscious awareness in a kindly way, so you can both talk about your feelings, rather than trying to figure out who's right and who's wrong. In a sense, there's an elephant in the room, but everyone's ignoring the tension pretending it isn't there. When you change the focus, you point to the elephant and say, "Do you see what I see?"

Multiple-Choice Empathy

When you have no idea where someone is coming from, and they're reluctant to tell you, you can suggest several possibilities and ask if any of them ring a bell. It's like priming the pump. You might say, “I can imagine you might be feeling X, Y, or Z. Do any of those words ring a bell?” X, Y and Z could be words from the Feeling Words chart. Multiple-Choice Empathy can be especially helpful when the other person refuses to open up and tell you how they're feeling. You'll have to be disarming rather than blaming when you list the possible reasons why the other person doesn’t want to talk to you. You'll also have to do this in a way that sounds caring, respectful, and concerned, and not demanding or condescending.

Positive Reframing

You put a positive spin on the situation. For example, you can reframe an angry conflict as a golden opportunity to develop a better relationship with the person you’re at odds with, rather than viewing the problem as a prelude to Armageddon. You can also reframe the other person's motives or behavior in a positive way. For example, if someone seems stubborn, dogmatic, and argumentative, you could think of them as having intense conviction and desperately wanting you to understand them. You can also consider the almost possibility that you haven’t been disarming them in a genuine way, and that’s the precise reason they keep arguing. Or, if a loved one is acting nasty, you could reframe their behavior as an expression of the hurt, loneliness, or frustration she or he is feeling.

* Copyright 2007 by David D. Burns, MD. Revised 2004.





The Law of Opposites*

If you disagree with a criticism that is totally untrue and unfair, you will immediately prove that the criticism is entirely valid.

This is a paradox.

In contrast, if you genuinely agree with a criticism that is totally untrue and unfair, you will instantly put the lie to it.

This is also a paradox.

* Copyright 1991 by David D. Burns, MD. Revised, 2003.





Feeling Words Chart*

Blue Down Unhappy Disheartened

Sad Disappointed Despairing Low Depressed

Hurt Lost Dejected Miserable

Guilty Ashamed At fault Bad Responsible

Hopeless Discouraged Pessimistic Desperate Defeated

Inadequate Worthless Flawed Second-rate Inferior Useless Undesirable Incompetent Defective

Exhausted Weary Fatigued Sleepy Tired Drained Worn out Lethargic Wiped out

Unmotivated Uninterested Bored Turned off Burdened

Abandoned Alone Rejected Unloved

Dep

ress

ion

Lonely Unwanted Isolated Lonesome Friendless

Worried Afraid Scared Nervous

Apprehensive Uptight Tense Terrified Anxious

Panicky Fearful Frightened Alarmed

Foolish Self-conscious Flustered Awkward Shy Humiliated Mortified Embarrassed Timid

Overworked Burned out Tense Frazzled

Anx

iety

Stressed Pressured Strained Besieged Overwhelmed

Mad P. O.'d Ticked off Irate

Resentful Irritated Incensed Annoyed Angry

Upset Furious Enraged Aggravated

Picked on Put down Insulted Judged Criticized Blamed Intimidated Defensive Condemned

Frustrated Stuck Thwarted Stymied

Ang

er

Jealous Envious Mistrustful Suspicious Paranoid

* Copyright 1989 by David D. Burns, M.D. Revised 1992, 2000, 2003.




Fees and ordering information on reverse. A license cannot be sold or transferred. Electronic, internet or publication rights not included. US funds only. The EASY Diagnostic System is sold separately.

Order Form: Therapist’s Toolkit (Includes the Massive 2009 Upgrade)*

The Initial Assessment Relationship Assessment Other Useful Tools Clinician’s History Form Brief & Full-Length Relationship Satisfaction Scale Self-Defeating Beliefs Concept of Self-Help Memo Anger Therapist’s Report Card How to Make Therapy Rewarding Memo 1. toward self Scales for Use in Supervision & Teaching Administrative Memo 2. toward others Individual Therapy Tools

Session-by-Session Assessment Dangerousness Assessment Daily Mood Log Brief Mood Survey— Violent Fantasies Daily Mood Log Continuation Sheet

1. Depression Violent Plans and Urges Checklist of Cognitive Distortions 2. Suicidal Urges Suicide Assessment 50 Ways to Untwist Your Thinking 3. Anxiety 1. Self-report scales Cost-Benefit Analyses with instructions 4. Anger 2. Structured Suicidal Urges Interview Pleasure Predicting Sheet with instructions 5. Relationship Satisfaction Scale Hopelessness Scale The Anti-Procrastination Sheet

Evaluation of Therapy Session Motivational Assessment Decision-Making Form with instructions 1. Therapeutic Empathy Willingness Scale The Anti-Hopelessness Memo 2. Helpfulness of Therapy Session Why Our Patient’s Resist Change 23 Common Self-Defeating Beliefs 3. Satisfaction with Therapy Session Self-Help Report Interpersonal Therapy Tools 4. Commitment to Doing Homework Scales for Use in Medical Settings Relationship Cost-Benefit Analysis 5. Negative Feelings during session Brief Mood Survey Relationship Journal 6. Positive Feelings about session Satisfaction with Doctor’s Bedside Manner EAR Checklist 7. What did you like, or dislike, the most? Satisfaction with Diagnosis and Treatment The Bad Communication Checklist

Powerful before-and-end of session scales Brief Positive Feelings Survey Five Secrets of Effective Communication Group Scales Medication Record Feeling Words Chart

1. Mood scales Side Effects Checklist 12 GOOD Reasons— 2. Evaluation of Therapy Group Brief Pain Scale 1. NOT To Listen

Brief Mood Survey in— 1. Pain Right Now 2. NOT To Express Your Feelings 1. French 2. Recent Pain 3. NOT to Treat the Other Person with Respect 2. Spanish Scales for Positive Emotions Attitudes that Inhibit Intimacy 3. Russian 1. Self-Esteem Record-Keeping

Chart Records 2. Feeling Good About Others Progress Note (brief and detailed versions) New Children's Scales 3. Happiness Mood Records

Sad Feelings (depression and suicidal urges) 4. Productivity The Final Evaluation Anxious Feelings 5. Playfulness Termination Summary Angry Feelings 6. Freedom from Fear Patient’s Evaluation of Therapy Shy Feelings 7. Hope Hyperactive Feelings 8. Spiritual Awareness And Much More Therapist Niceness (Therapist Empathy) License for Unlimited Photocopying Therapist Helpfulness (Therapist Effectiveness) No Royalty Fees

* Currently, the 2008 Upgrade is available via email attachment only




Order Form page 2

Yes! I want the Therapist's Toolkit!

Item Cost # Ordered Total 1. Initial Toolkit. Comes with one license, includes 2008 Upgrade. Please add P&H below! $229

2. Postage and handling for each Toolkit mailed to US $15 US $25 Can

NA

3. Additional Toolkits at same agency. Each comes with one license. $165 4. Licenses for additional Therapist Toolkits. Additional individuals may be licensed for $100 per

person, assuming you are all practicing at the same location. Multiply the number of therapists in your practice / facility / institution times $100. Does not include Toolkit. You must have at least one Toolkit to order additional licenses.

$100

5. EASY Diagnostic System (Screening for 56 Axis I and 10 Axis II Disorders) $149 6. Additional Licenses for EASY Diagnostic System. Additional therapists must practice at same

location as the therapist with the primary license. $75

Subtotal

Please add California sales tax if you are in California 8% of total

Total

Your name & degree: Phone: Street: Suite: City: State: Zip: Email address

If you are ordering multiple licenses, include the name, address & phone # of every therapist who will be licensed to use the Toolkit.

Send your order with a check to David Burns, M.D., 11987 Murietta Lane, Los Altos Hills, CA 94022. No purchase orders or credit cards. Please allow 3 - 4 weeks for TK delivery. Canadians send money order in US $. After you receive your Toolkit, send an email requesting the free 2007 Upgrade to [email protected]. The free upgrade comes as an email attachment. Use an email address that can receive attachments!

The Therapist’s Toolkit is intended for use only by qualified mental health professionals.


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advanced empathy training

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