NEW YORK,NY – The until now untold story of how Cognitive Behavioral Therapy (CBT) – the current widely used non-drug treatment for people suffering from depression and anxiety by modifying negative, self-destructive thoughts – became widely known to the general American public back in January, 1982.
Then, a 38-year old relatively unknown psychiatrist from Philadelphia appeared as a guest on a local Cincinnati radio show to discuss his book, Feeling Good, which since its release by its publisher William Morrow and Company two years prior had sold in the respectable, but unspectacular range of 5,000 copies.
As the interview ensued, the psychiatrist stated that he had written his book as a way to inform mental health care professionals and the general public of CBT, which was mostly unknown at the time. The doctor elaborated that the book included several case studies documenting how over the then past five years he had used CBT with tremendous documented success to treat his patients suffering from depression and anxiety in both his Philadelphia private and hospital practices.
Explaining the theory behind CBT, the psychiatrist, a married father of two children, explained that brain research has shown that negative thoughts morph into negative mental behaviors, which adversely alter the chemistry of the brain, causing severe mental disorders, including depression and anxiety. The psychiatrist then elaborated that patients treated with CBT are taught how to first identify and then use a variety of mental processing techniques to overcome and reverse these negative cognitions.
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The show, which later received some but not a great deal of feedback from its home audience, ended there. But as the psychiatrist was minutes away from leaving the studio, he was approached by the show’s producer, a woman in her late 30’s.
Seeking his professional advice, the woman explained that her teenage son had made several attempts to run away from home, and blaming herself for his behavior, she had fallen into a deep state of depression. Promising he would soon get back to her, the psychiatrist left the studio to catch a train back to Philadelphia.
Several days later, the producer received a letter from the psychiatrist. In it, he pinpointed several techniques contained in his book that he thought would help her overcome her depression.
The following six years, the psychiatrist continued using CBT to effectively treat his by then significantly growing number of patients. And from time to time, he received letters and phone calls from the producer, thanking him for the advice he had provided in the 1982 letter, which she happily reported had helped cure her depression, and added that both she and her son were doing very well.
But in early 1988, the psychiatrist received another type of call from the producer. She informed him that she had just been hired as a producer on the widely popular afternoon television talk show, the eponymous Phil Donahue Show, and had booked him to be a guest on it to discuss Feeling Good. The book, she knew, had over the previous several years gained a steady flow of mainly word-of-mouth readers, but nevertheless, its total sales remained relatively small.
The psychiatrist was elated. The Phil Donahue Show was the most highly watched afternoon talk show in America. The first of its kind to include audience participation, the show since its first airing in 1976 had become famous for featuring an incomparable list of celebrity guests, including Mohammed Ali, Johnny Carson, Ayn Rand, Nelson Mandela and Kenny Rogers. But thanks to his friend the producer, the relatively unknown psychiatrist would be given his own chance to appear on that celebrated show.
It was an appearance, though, that began in the most ordinary fashion. Following his customary procedure, Donahue introduced and gave a brief bio of his new guest. The psychiatrist then offered a brief synopsis of Feeling Great – just as he had similarly summarized it on the Cincinnati radio show six years before.
But the similarities were soon to end there. As the show moved to its audience participation segment, a woman walked to the podium to address the psychiatrist. She told him that her son had been planning to commit suicide, but said that someone gave him a copy of Feeling Good, and it saved his life. She added that everyone in America should read the book.
With that the audience broke out in spontaneous applause, Donahue smiled in approval, and even before the one-hour show ended, Feeling Good had become the number one best-selling book in America.
The story does not end there. But before I continue, allow me to finally disclose the name of the afore described psychiatrist. His name is Doctor David Burns. And it was he who detailed the never before published story cited above during the first half of the 60-minute interview I conducted with him by telephone from my Long Island office to his San Francisco Bay Area California home last week.
If you already have heard the name David Burns, you would be one of many millions. The aforementioned Feeling Good went on to sell six million copies, won several major non-fiction book awards and became the self-help book on depression most frequently recommended by mental health care professionals.
And that was only the beginning of the success that Burns has achieved over the past 32 years: he has published dozens of peer acclaimed mental health studies; has presented CBT workshops to thousands of mental health care professionals throughout Canada and the U.S; and has been the subject of articles in more than 100 consumer magazines.
In addition, Burns has been interviewed in upwards of 1,000 radio and television shows and, in fact, hosts his own weekly podcast, not surprisingly named, Feeling Good, which has received more than three million cumulative downloads.
Still, a modest Burns told me that he owes all of his professional success and the accompanying widespread use of CBT by mental health care professionals to that appearance on the Donahue show.
“The enormous viewership and incredible publicity I received from being a guest on the show permanently put CBT on the map of psychotherapists and offered new hope to those viewers who themselves suffered or had loved ones suffering from depression and anxiety,” stated Burns.
Noting that while he was the first person to popularize CBT, the history of the treatment goes back nearly two millennium Burns elaborated,
“CBT is based on a concept, dating back to the Greek philosopher Epictetus almost 2,000 years ago. Epictetus wrote that people are not upset by negative events themselves but rather by the negative thoughts, also called cognitions, they engender. Thus, he theorized, that if people make positive changes in the way they think, they will experience positive changes in the way they feel.”
Citing the more contemporary history of CBT, Burns continued,
“Modern CBT was developed by the work of Dr. Albert Ellis during the 1950’s in New York and further developed in the 1960’s by Dr. Aaron T. Beck at the University of Pennsylvania, where I had completed my residency in psychiatry.”
As you might expect, I had enjoyed every minute of our interview up to that point. However, I realized that with only 30 minutes remaining, I had not asked Burns – though it was planned to be on the top of my agenda – about his new book, “Feeling Great,” published this past fall, which I had read earlier that week, and had become one of its greatest fans.
As Burns began to discuss Feeling Great, I remembered why the book had so impressed me.
“As I wrote [in Feeling Great], I have developed over the past 40 years more than 50 methods to eliminate negative thoughts that cause depression and anxiety and turn them into positive ones,” said Burns.
Referring to one of the six case studies contained in Feeling Great as an example of how this cognitive transformation could be accomplished, Burns stated,
“I assume you read the case of Melanie. Melanie, as you might recall from the book, had been in a totally honest and very loving marriage for ten years. However, because she previously had experienced two failed marriages, she viewed herself as a failure. In addition, she was plagued by the thought that if her friends learned of her failed marriages, they would judge her negatively and would no longer like or respect her. “To treat Melanie,” Burns continued, “we used what we call the role play version of the double standard technique. A colleague playing the role of a woman we called “Angela” told Melanie, who played herself in the skit, of her own troubled marital history and her own accompanying negative thoughts- both of which were almost identical to Melanie’s.
“During their role playing,” Burns elaborated, “Melanie said to “Angela” that although some people might view her negatively, most people will see the beautiful person she really is. And most importantly, Melanie emphasized, that “Angela’’ should focus on the very wonderful true thought that she now had a husband whom she truly loves and who truly loves her.
“As I record in the book,” Burns went on, “after the role playing ended, I explained to Melanie that the advice she gave to “Angela” actually applies to herself, since we had created her fictional clone in “Angela.” I can proudly state that in this single, two- hour therapy session Melanie made a full recovery. I also feel very proud to note that in addition to the 90% recovery rate of the depressed patients like Melanie I have treated in person, more than 50% of seriously depressed individuals who have simply read my books have recovered within four weeks, even without receiving any professional treatment, as confirmed by many research studies.”
Reflecting as the interview came to an end on his 50 year career as a psychiatrist, Burns, 78, added,
“Having the knowledge, skills and the unique opportunity to help so many people for so many years has given me the greatest feeling a psychiatrist could ever have.”
For Doctor Burns it is a feeling that probably can be traced back to the day he met a producer on a radio show in Cincinnati.