Shyness Workshop / Burns

T.E.A.M. Therapy—High Speed
Treatment for Social Anxiety
Disorder

David D. Burns, M.D.
Adjunct Clinical Professor of
Psychiatry and Behavioral
Sciences, Stanford Medical
School

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Copyright © 2014 by David Burns,
M.D. Page

Shyness Workshop / Burns

Therapist’s Toolkit*
Comprehensive Assessment and
Treatment Tools for
the Mental Health Professional

Part 1: Assessment Tools
Part 2: Treatment Tools

by David D. Burns, M.D.
*Copyright 1989, 1991, 1994 by David D. Burns, M.D.

Do not reproduce without the written permission of Dr. Burns.

Copyright © 2014 by David Burns,
M.D. Page

Shyness Workshop / Burns

What is Social Anxiety Disorder?

 Shyness
 Public Speaking Anxiety
 Performance Anxiety
 Shy Bladder Syndrome
 Test Anxiety

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Treatment Targets

 Anxiety / shyness
 Shame
 Co-existing symptoms

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Copyright © 2014 by David Burns,
M.D. Page

Shyness Workshop / Burns

The Cognitive Model

 Social Anxiety ALWAYS Results from Distorted
Negative Thoughts

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Common Distortions—
Social Anxiety

 All-or-Nothing  Magnification
Thinking and Minimization
 Overgeneralization  Emotional
 Mental Filter Reasoning
 Discounting  Labeling
the Positive  Should Statements
 Jumping to Conclusions  Self-Blame
– Mind-Reading
– Fortune Telling

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Copyright © 2014 by David Burns,
M.D. Page

Shyness Workshop / Burns

Common Self-Defeating Beliefs
in Social Anxiety

 Perfectionism  Love Addiction
 Perceived Perfectionism  Conflict Phobia
 Achievement Addiction  Spotlight Fallacy
 Approval Addiction  Brushfire Fallacy

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T.E.A.M. Therapy

 T= Testing
 E = Empathy
 A = Agenda Setting
 M = Methods

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Copyright © 2014 by David Burns,
M.D. Page

anxiety.A.E. suicidal urges. articulate.M. lonely. Therapy Example  Frank. accurate tests at the start and end of every session with every patient – Depression. a young man with severe social anxiety  Attractive.Shyness Workshop / Burns T. good sense of humor – Avoids talking to girls – Avoids talking in groups – Tries to hide his shyness – Depressed. M.D. Page . anger – Shyness – Relationship satisfaction – Positive Feelings 12 Copyright © 2014 by David Burns. anxious. angry 11 T = Testing  Use brief.

Frustrated  2. Loss of motivation to do things  5. Sad or down in the dumps  2. Low self-esteem or worthlessness  4. 1. M.D. Discouraged or hopeless  3. Page . Annoyed  3. Loss of pleasure or satisfaction in life  Total  15 Total  Before After Session Session Anger 2—Moderately 2—Moderately 1—Somewhat 1—Somewhat 4—Extremely 4—Extremely 0—Not at all 0—Not at all 3—A lot 3—A lot Use checks () to indicate how you're feeling right now. 1. Irritated  Total  14 Total  Copyright © 2014 by David Burns.Shyness Workshop / Burns Before After Session Session Depression 2—Moderately 2—Moderately 1—Somewhat 1—Somewhat 4—Extremely 4—Extremely 0—Not at all 0—Not at all 3—A lot 3—A lot Use checks () to indicate how you're feeling right now. Angry  5. Resentful  4.

 Total  11 Total  Copyright © 2014 by David Burns.  7.  2. I feel hopeful.  6. self-conscious or embarrassed in social situations.D. I feel close to people. I avoid social situations because I feel so awkward or anxious.  4. I often feel nervous.Very dissatisfied 0 . I feel encouraged and optimistic.  8.  3. M. I often feel shy or anxious in social situations. I feel motivated to do things.  5.Very dissatisfied 4— Very satisfied 4— Very satisfied 2—Neutral 2—Neutral 1. I feel worthwhile. I feel good about myself.Shyness Workshop / Burns 4 – Completely true 2 – Moderately true 0 – Not at all true 1 – Slightly true 3 – Very True Shyness 1.  2.  Total Score  18 Before After Session Session Positive Feelings 1—Somewhat dissatisfied 1—Somewhat dissatisfied 3— Somewhat satisfied 3— Somewhat satisfied Survey 0 . I often feel uncomfortable or insecure around other people. I feel a spiritual connection to others.  10. I feel calm and relaxed.  5. I feel I am accomplishing something. I worry that people might notice how anxious or embarrassed I feel.  9.  4. My life is satisfying. Page .  3.

D.A.E. shy – Almost no positive feelings  Will assess again at the end of the session 17 T.M. Therapy  T= Testing  E = Empathy  A = Agenda Setting  M = Methods 18 Copyright © 2014 by David Burns. M.Shyness Workshop / Burns Before-Session Testing  Frank is – Severely depressed – Not suicidal – Very angry – Extremely anxious. Page .

probing questions.D. Convey liking or respect. M. support  Do NOT try to – Help – Rescue – Reassure – Normalize 19 Five Secrets of Effective Communication  The Disarming Technique. directly.Shyness Workshop / Burns E = Empathy  Necessary but not sufficient for effective treatment  Provide warmth. Find the truth in the criticism.  Empathy. Copyright © 2014 by David Burns. Express your feelings openly. understanding. – Feeling Empathy. Ask gentle. Page . – Thought Empathy. Acknowledge his or her feelings. Paraphrase the other person’s words. and tactfully using “I feel X.”  Stroking.  "I Feel" Statements.  Inquiry.

Substitute more positive and realistic thoughts (later in session) 22 Copyright © 2014 by David Burns. Record your negative emotions 3. M. Page . Record your negative thoughts 4.D. Describe a specific moment when you felt upset 2.Shyness Workshop / Burns E = Empathy  Can use Daily Mood Log (DML) to gather accurate data – About the patient’s negative thoughts. Identify the distortions (later in session) 5. feelings and beliefs at one moment in time 21 Five Steps in the Daily Mood Log 1.

defective. Copyright © 2014 by David Burns.D. irritated % % % NT Before After Dist PT Belief 1. worried. discouraged Guilty. nervous Hopeless. Page . stuck. 2. thwarted Inadequate. 2. down. humiliated Anxious. panicky. % % % % % % Emotions Before Goal After Emotions Before Goal After Sad. panicky. worried. incompetent Mad. thwarted Inadequate. defective. nervous Hopeless. 3. M. annoyed. stuck. foolish. ashamed Frustrated. resentful. ashamed Frustrated.Shyness Workshop / Burns Daily Mood Log Upsetting Situation: % % % % % % Emotions Before Goal After Emotions Before Goal After Sad. depressed Embarrassed. resentful. humiliated Anxious. depressed Embarrassed. foolish. discouraged Guilty. incompetent Mad. down. irritated % % % NT Before After Dist PT Belief 1. Frank’s Daily Mood Log Upsetting Situation: Standing in line at the supermarket. annoyed. 3.

2. 3. discouraged Guilty. Page . incompetent Mad. 2. incompetent Mad. humiliated Anxious. panicky. panicky. depressed Embarrassed. Copyright © 2014 by David Burns. resentful.Shyness Workshop / Burns Frank’s Daily Mood Log Upsetting Situation: Standing in line at the supermarket. M. stuck. thwarted Inadequate. % % % % % % Emotions Before Goal After Emotions Before Goal After Sad. defective. annoyed. stuck. ashamed Frustrated. % % % % % % Emotions Before Goal After Emotions Before Goal After Sad. nervous Hopeless. defective. resentful. humiliated Anxious. annoyed. irritated % % % NT Before After Dist PT Belief 1. ashamed Frustrated. nervous Hopeless. worried. foolish. depressed 50% Embarrassed. thwarted Inadequate. irritated % % % NT Before After Dist PT Belief 1. down. down. worried. Frank’s Daily Mood Log Upsetting Situation: Standing in line at the supermarket. foolish. discouraged Guilty.D. 3.

down. panicky. thwarted Inadequate. nervous 100% Hopeless.D. foolish. annoyed. ashamed 100% Frustrated. nervous Hopeless. worried. resentful. defective. 3. foolish. resentful. depressed 50% Embarrassed. thwarted 100% Inadequate. discouraged Guilty. humiliated Anxious. irritated % % % NT Before After Dist PT Belief 1. % % % % % % Emotions Before Goal After Emotions Before Goal After Sad. discouraged 90% Guilty. irritated 80% % % % NT Before After Dist PT Belief 1. panicky. incompetent 95% Mad. 3. down. humiliated 100% Anxious. depressed 50% Embarrassed. 2. stuck. stuck. defective.Shyness Workshop / Burns Frank’s Daily Mood Log Upsetting Situation: Standing in line at the supermarket. annoyed. worried. 2. Page . ashamed Frustrated. Frank’s Daily Mood Log Upsetting Situation: Standing in line at the supermarket. % % % % % % Emotions Before Goal After Emotions Before Goal After Sad. Copyright © 2014 by David Burns. incompetent Mad. M.

% % % % % % Emotions Before Goal After Emotions Before Goal After Sad. % % % % % % Emotions Before Goal After Emotions Before Goal After Sad. incompetent 95% Mad. annoyed. discouraged 90% Guilty. nervous 100% Hopeless. incompetent 95% Mad. ashamed 100% Frustrated. 3. foolish. M. stuck. 3. resentful. irritated 80% % % % NT Before After Dist PT Belief 1. worried. panicky. Copyright © 2014 by David Burns. defective. down. thwarted 100% Inadequate. I don’t have anything interesting 100% to say. humiliated 100% Anxious. irritated 80% % % % NT Before After Dist PT Belief 1. panicky. nervous 100% Hopeless. foolish. depressed 50% Embarrassed. thwarted 100% Inadequate. depressed 50% Embarrassed. Page . 2.Shyness Workshop / Burns Frank’s Daily Mood Log Upsetting Situation: Standing in line at the supermarket. humiliated 100% Anxious. resentful.D. annoyed. I don’t have anything interesting to say. down. ashamed 100% Frustrated. defective. 2. worried. Frank’s Daily Mood Log Upsetting Situation: Standing in line at the supermarket. stuck. discouraged 90% Guilty.

irritated 80% % % % NT Before After Dist PT Belief 1. I wouldn’t have time to deal with a relationship right now. M.Shyness Workshop / Burns Frank’s Daily Mood Log Upsetting Situation: Standing in line at the supermarket. 2. I never succeed with the good. even if I 85% did have a good relationship with her. 7. incompetent 95% Mad.. If I'm humble and quiet. stuck. 3. depressed 50% Embarrassed. ashamed 100% Frustrated.D. thwarted 100% Inadequate. Page . down. worried. I better just keep my 100 mouth shut. People will think I'm a 100 self-centered jerk if I try to flirt with her. I have no personality. since I might say something stupid. 6. I don’t have anything interesting 100% to say. panicky. so 5. foolish. defective. 100% looking girls. they'll like me more. annoyed. % % % % % % Emotions Before Goal After Emotions Before Goal After Sad. 100 Copyright © 2014 by David Burns. I shouldn't be so loud 100 and obnoxious. nervous 100% Hopeless. Daily Mood Log (cont'd) NT % Dist PT % 4. discouraged 90% Guilty. resentful. humiliated 100% Anxious.

I'd probably get shot down. If I tried to flirt with 100 her. 9. T.D. she'll eventually find out what a loser I am. 10.E.Shyness Workshop / Burns Daily Mood Log (cont'd) NT % Dist PT % 8. Page . That would show that 100 what a loser I am. Therapy  T= Testing  E = Empathy  A = Agenda Setting  M = Methods 34 Copyright © 2014 by David Burns.M. Even if I do get a date 100 with her. M. I must be a terrible 100 person because I'm so concerned with superficial things like success and looks.A. 11.

Page .Shyness Workshop / Burns A = Paradoxical Agenda Setting (PAS)  What does the patient want help with?  What will she or he bring to the table if you agree to work with them? 35 Paradoxical Agenda Setting (PAS)  Outcome Resistance  Process Resistance 36 Copyright © 2014 by David Burns.D. M.

Shyness Workshop / Burns Outcome Resistance—Anxiety Disorders  Most patients are ambivalent about recovery  Few therapists take this into account – Cause of nearly all therapeutic failure 37 Outcome Resistance—Anxiety Disorders  Magical Thinking – “Something terrible will happen if I give up my anxiety.” 38 Copyright © 2014 by David Burns. M.D. Page .

 Test Anxiety – If I stop worrying.Shyness Workshop / Burns Magical Thinking—Social Anxiety  Shyness – I’ll make a fool of myself if I interact with others.  Public Speaking Anxiety – I’ll really blow it! It’s not worth the risk.D. exposure. M. exposure 40 Copyright © 2014 by David Burns. Page . 39 Process Resistance—Anxiety Disorders  Exposure.  Performance Anxiety – My worrying is the price I have to pay to do really great work. I’ll flunk the test.

Shyness Workshop / Burns Types of Exposure  Classical  Cognitive  Interpersonal Interpersonal Exposure Techniques  Self-Disclosure  Flirting Training  Smile and Hello Practice  Rejection Practice  David Letterman  Shame Attacking Technique Exercises  Feared Fantasy 42 Copyright © 2014 by David Burns.D. M. Page .

I am the victim.D. 44 Copyright © 2014 by David Burns.  Relationship Problem Hypnosis – It’s not my fault.  Anxiety Hypnosis – I am too fragile (or not ready) to confront my fears. Page .Shyness Workshop / Burns Beware of Reverse Hypnosis!  Do your patients put you in a trance? 43 Three Forms of Reverse Hypnosis  Depressive Hypnosis – I really AM defective and hopeless. M.

Page . and you walked out saying it was just fantastic. what would happen? What would you be asking for? 45 Outcome Resistance (cont’d)  Magic Button  Positive Reframing – What do these negative thoughts and feelings show about you that’s awesome and positive? 46 Copyright © 2014 by David Burns. M.Shyness Workshop / Burns Melting Away Outcome Resistance  Miracle Cure Question – If a miracle happened during today’s session.D.

M.Shyness Workshop / Burns Outcome Resistance (cont’d)  Respect for other people  Honest about my flaws and failures  High standards  Anxiety protects me—I don’t have to risk looking foolish or being humiliated 47 Outcome Resistance (cont’d)  Care deeply about relationships  Want meaningful relationships  Some anger can be healthy—people can be judgmental  Some sadness and loneliness are appropriate and may motivate me to break out of my shell 48 Copyright © 2014 by David Burns.D. Page .

down. nervous 100% 30% Hopeless. M. 100% looking girls. I never succeed with the good. annoyed.D. irritated 80% 0% % % % NT Before After Dist PT Belief 1. depressed 50% 10% Embarrassed.. I don’t have anything interesting 100% to say. discouraged 90% 0% Guilty. ashamed 100% 5% Frustrated. incompetent 95% 10% Mad. stuck.Shyness Workshop / Burns Outcome Resistance (cont’d)  Magic Dial – How would you like to feel? What would be the ideal / optimal intensity for each negative feeling? 49 Frank’s Daily Mood Log Upsetting Situation: Standing in line at the supermarket. Copyright © 2014 by David Burns. foolish. Page . % % % % % % Emotions Before Goal After Emotions Before Goal After Sad. humiliated 100% 20% Anxious. 3. panicky. worried. I wouldn’t have time to deal with a relationship right now. defective. 2. even if I 85% did have a good relationship with her. thwarted 100% 0% Inadequate. resentful.

Page .Shyness Workshop / Burns Melting Away Process Resistance  Gentle Ultimatum  Sitting with Open Hands 51 M = Methods  The Daily Mood Log (DML) – Which Negative Thought (NT) do you want to work on first? 52 Copyright © 2014 by David Burns.D. M.

D. 10 Cognitive Distortions  All-or-Nothing Thinking  Magnification  Overgeneralization and Minimization  Mental Filter  Emotional Reasoning  Discounting  Labeling the Positive  Should Statements  Jumping to Conclusions  Self-Blame and Other- Blame 54 Copyright © 2014 by David Burns. Page .Shyness Workshop / Burns Daily Mood Log (cont'd) NT % Dist PT % 5. People will think I'm 100 a self-centered jerk if I try to flirt with her. M.

a self-centered jerk MR.D. if I try to flirt with MAG. LAB. ER. FT. SH. M. Page . People will think I'm 100 AON. SB 12 11 1 10 2 People will think I’m a 9 self-centered jerk if I try to flirt with her. her. OG.Shyness Workshop / Burns Daily Mood Log (cont'd) NT % Dist PT % 5. 100% 3 8 4 7 5 6 Copyright © 2014 by David Burns.

D. M.Shyness Workshop / Burns Recovery Circle  Select at least 15 -20 techniques for challenging the Negative Thought (NT)  Fail as Fast as You Can 57 Four Types of Methods on the Recovery Circle  Motivational Techniques – Melt away resistance  Cognitive Techniques – Modify distorted thoughts  Behavioral / Exposure Techniques – Confront the monster  The Hidden Emotion Technique – Bring hidden conflicts and feelings to conscious awareness 58 Copyright © 2014 by David Burns. Page .

D.Shyness Workshop / Burns Recovery Circle (cont’d)  Help Patient Develop Effective Positive Thoughts (PTs)  Recovery Circle is the “Engine” of the DML 59 Philosophy Behind Recovery Circle  Highly Individualized Treatment  Methods drawn from many schools of therapy 60 Copyright © 2014 by David Burns. M. Page .

100% 8 4 Straightforward Technique 7 5 6 Experimental Technique Downward Empathy Arrow 12 11 Double 1 10 Agenda Setting Standard 2 People will think I’m a Thinking in 9 Identify the self-centered jerk if I try Shades of Gray 3 Distortions to flirt with her. 100% 8 Semantic 4 Straightforward Method Technique 7 5 6 Examine the Cost-Benefit Analysis Evidence Feared Fantasy Copyright © 2014 by David Burns.D. M.Shyness Workshop / Burns Empathy 12 11 1 10 Agenda Setting 2 9 People will think I’m a Identify the self-centered jerk if I try 3 Distortions to flirt with her. Page .

100% 20 David Letterman 16 Survey Technique 19 Technique 17 18 Flirting Acceptance Training Paradox Paradoxical Magnification Requirements for an Effective PT  Must be 100% true. Page .D. M.Shyness Workshop / Burns Self- Disclosure Rejection Let’s Define Practice Terms 24 23 Shame. or nearly 100% – Necessary but not sufficient condition for emotional change  Must drastically reduce the belief in the NT – Sufficient condition 64 Copyright © 2014 by David Burns. 13 Reattribution Attacking 22 14 Smile and 21 People will think I’m a Five Hello Practice self-centered jerk if I try Secrets 15 to flirt with her.

Shyness Workshop / Burns Many Techniques Will NOT Be Effective  “People will think I’m a self-centered jerk if I try to flirt with her.D.” 66 Copyright © 2014 by David Burns.”  Using the Straightforward Technique. Page . can you think of another way to look at it? What could you tell yourself instead?” 65 Frank Came Up with this Positive Thought  “If people look down on me for flirting with her. you might say: – “Frank. M. it's probably because they're jealous and have unfulfilled desires to be more flirtatious and outgoing.

Page . M.Shyness Workshop / Burns Was Frank’s Positive Thought Effective?  Did it fulfill the necessary and sufficient conditions for emotional change?  What does it tell us about Frank?  What will you do when a technique fails? 67 Paradoxical Cost-Benefit Analysis  What are some advantages of feeling anxious and ashamed and giving yourself these messages? 68 Copyright © 2014 by David Burns.D.

Copyright © 2014 by David Burns. Advantages Disadvantages I won’t have to risk embarrassment or get shot down. I can blame people for my impoverished social life. I’ll feel morally superior because I’ll sacrifice my own needs to make other people happy. I won’t upset people.D. Page .Shyness Workshop / Burns Belief: People will think I’m a self-centered jerk if I try to flirt with her. I can feel sorry for myself. M. Advantages Disadvantages Belief: People will think I’m a self-centered jerk if I try to flirt with her.

If I do try to talk to her. embarrassment or get I won’t grow because I’ll shot down. I won’t upset people. I’ll end up alone. Advantages Disadvantages I won’t have to risk I won’t do what I want. I’ll feel morally superior I’ll get really uptight because I’ll sacrifice my because I’ll think own needs to make other everyone is mad at me. be so afraid of rejection. be so afraid of rejection. I’ll feel morally superior I’ll get really uptight because I’ll sacrifice my because I’ll think own needs to make other everyone is mad at me. Page .Shyness Workshop / Burns Belief: People will think I’m a self-centered jerk if I try to flirt with her. I won’t upset people. 35 65 Copyright © 2014 by David Burns. embarrassment or get I won’t grow because I’ll shot down. Advantages Disadvantages I won’t have to risk I won’t do what I want. I’ll be angry and blame I can blame people for my other people for my impoverished social life. inhibitions.D. I can feel sorry for myself. I can feel sorry for myself. I’ll be angry and blame I can blame people for my other people for my impoverished social life. people happy. people happy. If I do try to talk to her. inhibitions. Belief: People will think I’m a self-centered jerk if I try to flirt with her. I’ll end up alone. M.

what would it mean to you? Why would it be upsetting to you? 74 Copyright © 2014 by David Burns. Page .Shyness Workshop / Burns What to Say— Individual Downward Arrow  “If that were true. M.D. what would it mean to you? Why would it be upsetting to you?” 73 Downward Arrow Technique People will think I’m a self-centered jerk if I try to flirt with her. If that were true.

what would it mean to you? Why would it be upsetting to you? 76 Copyright © 2014 by David Burns. If that were true. Page . M.D. If that were true. what would it mean to you? Why would it be upsetting to you? 75 Downward Arrow (cont’d) That would mean that I might be punished and go to Hell.Shyness Workshop / Burns Downward Arrow (cont’d) That would mean I was a terrible person.

M. 77 What are Frank’s Self- Defeating Beliefs (SDBs)? 1. 3. 78 Copyright © 2014 by David Burns.Shyness Workshop / Burns Downward Arrow (cont’d) That would mean I'd be miserable for all eternity. Page . 2.D. 5. 4.

Page . Spotlight Fallacy 5. Approval Addiction 4.D. Perfectionism 2. M.Shyness Workshop / Burns Frank’s Self-Defeating Beliefs 1. Perceived Perfectionism 3. Brushfire Fallacy 79 Examine the Evidence  “How did you come to the conclusion that people would look down on you if you tried to flirt with someone you were attracted to?”  “Do you look down on people who are outgoing?” 80 Copyright © 2014 by David Burns.

humility and self- sacrifice? – They ever had to struggle with feelings of shyness or fears of rejection when they were dating? 82 Copyright © 2014 by David Burns.D. Page . M. aside from flirting with her in some clever way and sweeping her off her feet?” 81 Survey Technique  Could you ask friends if – They look down on people who flirt with strangers? – They admire your quietness.Shyness Workshop / Burns Thinking in Shades of Gray  “Is their a more modest goal you could set for yourself.

Shyness Workshop / Burns Double Standard Technique  What would you say to a dear friend who was in a similar situation? 83 Reattribution  “If I try to flirt with her and get shot down. that will show that I’m a total loser.D. M.” 84 Copyright © 2014 by David Burns. Page .

Page . I LAB. I don't to her. SB Most people probably don't care that much about what I do. or if he made a fool out of himself. In fact. that this is true. MR. ER. look down on other SH. 85 % % % NT Before After Dist PT Belief 5 People will think I’m a self. M. people who are friendly MAG. I don't know for a fact centered jerk if I try to talk OG. and outgoing. Flirting or talking with strangers isn't terribly unusual. Copyright © 2014 by David Burns.D. admire them.Shyness Workshop / Burns Feared Fantasy Technique / Acceptance Paradox  Frank is desperately afraid that the people in line would look down on him if they say him flirting. People don't all react in the same way. 100 AON. FT.

I don't to her. People don't all react in 100 the same way. M. 100 AON. admire them. FT. I don't know for a fact 70 centered jerk if I try to talk OG. I don't know for a fact 70 centered jerk if I try to talk OG.D. 100 30 AON. In fact. look down on other SH. and outgoing. people who are friendly MAG. Copyright © 2014 by David Burns. ER. Page . Flirting or talking with 100 strangers isn't terribly unusual. admire them. Flirting or talking with 100 strangers isn't terribly unusual. ER.Shyness Workshop / Burns % % % NT Before After Dist PT Belief 5 People will think I’m a self. people who are friendly MAG. I don't to her. I LAB. MR. SB Most people probably 100 don't care that much about what I do. I LAB. People don't all react in 100 the same way. In fact. FT. look down on other SH. and outgoing. that this is true. that this is true. % % % NT Before After Dist PT Belief 5 People will think I’m a self. MR. SB Most people probably 100 don't care that much about what I do.

You can flirt without 100 being loud and obnoxious. like me more. anything terribly clever or SH. MR.Shyness Workshop / Burns % % % NT Before After Dist PT Belief 6 I shouldn't be so loud 100 15 AON. SB people in grocery store lines will like me if I'm quiet and humble. I don't especially like 100 and obnoxious. Page . quiet and humble. DP.D. There's no evidence that 100 ER. I probably don't need to say 70 interesting to say. MAG. But would it be the end of the world if I got shot down or made a fool of myself? % % % NT Before After Dist PT Belief 1. M. people who are overly humble and quiet. LAB. SB interesting. I don’t have anything 100 25 AON. I could just start by smiling 100 and saying hello. FT. If I'm MR. and that would be a good first step Copyright © 2014 by David Burns. they'll SH.

ashamed 100% 5% 0% Frustrated. thwarted 100% 0% 0% Inadequate. 1.D. % % % % % % Emotions Before Goal After Emotions Before Goal After Sad. depressed 50% 10% 0% Embarrassed. annoyed. worried. MR. Page . irritated 80% 0% 0% % % % NT Before After Dist PT Belief 1. I probably don't need to say 70 interesting to say. SB interesting. down. incompetent 95% 10% 0% Mad. panicky. discouraged 90% 0% 0% Guilty. humiliated 100% 20% 10% Anxious. I could just start by smiling 100 and saying hello. stuck. I don’t have anything 100 25 AON. DP. anything terribly clever or SH. defective. resentful. nervous 100% 30% 30% Hopeless. and that would be a good first step Arm Chair Work Will Not Be Enough  Interpersonal Exposure – Smile and Hello Practice – David Letterman Technique – Flirting Training – Rejection Practice – Self-Disclosure – Shame-Attacking Exercises 92 Copyright © 2014 by David Burns.Shyness Workshop / Burns Frank’s Daily Mood Log Upsetting Situation: Standing in line at the supermarket. foolish. M.

Page .Shyness Workshop / Burns Examples of Interpersonal Exposure  Shame-Attacking Exercises – Dinner with the Ellis group  Self-Disclosure – David at neighbor’s house 93 Before After Session Session Depression 2—Moderately 2—Moderately 1—Somewhat 1—Somewhat 4—Extremely 4—Extremely 0—Not at all 0—Not at all 3—A lot 3—A lot Use checks () to indicate how you're feeling right now. Loss of pleasure or satisfaction in life   Total  15 Total  0 Copyright © 2014 by David Burns. Low self-esteem or worthlessness   4.D. Sad or down in the dumps   2. Loss of motivation to do things   5. 1. M. Discouraged or hopeless   3.

1. I avoid social situations because I feel so awkward or anxious. self-conscious or embarrassed in social situations.Shyness Workshop / Burns Before After Session Session Anger 2—Moderately 2—Moderately 1—Somewhat 1—Somewhat 4—Extremely 4—Extremely 0—Not at all 0—Not at all 3—A lot 3—A lot Use checks () to indicate how you're feeling right now. Page .  2.D.  5. Frustrated   2. Irritated   Total  14 Total  0 0 – Not at all true 1 – Slightly true 4 – Completely 2 – Moderately 3 – Very True Shyness (end of session) true true 1.  3.  Total Score  3 Copyright © 2014 by David Burns. I often feel nervous. I often feel shy or anxious in social situations. Resentful   4. Angry   5. I worry that people might notice how anxious or embarrassed I feel. Annoyed   3.  4. I often feel uncomfortable or insecure around other people. M.

My therapist did a good job of listening. and concerned.Moderately true 1 . M.   7.   3.   6. I feel I am accomplishing something.   5.Somewhat true 0 .   9.Very true Empathy 1.   Total  11 Total  30 4 .Very dissatisfied 0 . I feel motivated to do things.  2. I feel calm and relaxed. My therapist understood how I felt inside.Not at all true 3 . I feel a spiritual connection to others. I feel encouraged and optimistic.   10.   8.  4. My therapist seemed trustworthy.Very dissatisfied 4— Very satisfied 4— Very satisfied 2—Neutral 2—Neutral 1.Shyness Workshop / Burns Before After Session Session Positive Feelings 1—Somewhat dissatisfied 1—Somewhat dissatisfied 3— Somewhat satisfied 3— Somewhat satisfied Survey 0 . sympathetic. I feel worthwhile. My life is satisfying. My therapist was warm. My therapist treated me with respect.  Total Score  20 Copyright © 2014 by David Burns.   2.  3. Page .  5.Completely true 2 . I feel close to people.   4.D. I feel hopeful. I feel good about myself.

The approach my therapist used made sense.  Total Score  20 0 – Not at all true 1 – Slightly true 4 – Completely 2 – Moderately 3 – Very True Shyness true true (2 weeks later) 1.D.Somewhat true 0 . I was able to express my feelings during the session. I worry that people might notice how anxious or embarrassed I feel. I talked about the problems that are bothering me. The techniques we used were helpful. Page .  3.Very true Helpfulness 1.Completely true 2 .  3. I often feel shy or anxious in social situations.Moderately true 1 . I learned some new ways to deal with my problems.  2. I avoid social situations because I feel so awkward or anxious.Shyness Workshop / Burns 4 .  5.  Total Score  1 Copyright © 2014 by David Burns.  5. M.  2.Not at all true 3 . I often feel nervous. self-conscious or embarrassed in social situations.  4. I often feel uncomfortable or insecure around other people.  4.

Shyness Workshop / Burns Before After Session Session Positive Feelings 1—Somewhat dissatisfied 1—Somewhat dissatisfied Survey 3— Somewhat satisfied 3— Somewhat satisfied 0 .   7.   2. I feel encouraged and optimistic. I feel good about myself.Very dissatisfied 0 . My life is satisfying.Very dissatisfied (two weeks later) 4— Very satisfied 4— Very satisfied 2—Neutral 2—Neutral 1.   4.   Total  40 Total  40 You’re Invited—Join the TEAM!  T= Testing  E = Empathy  A = Agenda Setting  M = Methods 102 Copyright © 2014 by David Burns. I feel motivated to do things.   10.   6.D.   8. Page .   9.   5. I feel worthwhile. I feel hopeful. M. I feel close to people. I feel I am accomplishing something.   3. I feel calm and relaxed. I feel a spiritual connection to others.

Shyness Workshop / Burns Additional Resources  David’s Psychotherapy eBook – Tools. Therapy Certification Program – Many outstanding weekly online training groups 104 Copyright © 2014 by David Burns.com – www.M. Page .A.com – T. of Therapy 103 Additional Resources (cont’d)  Unlimited free Bay Area training – david@feelinggood. Not Schools.com  www.FeelingGoodInstitute.feelinggood.D. M.E.

D. institutions 106 Copyright © 2014 by David Burns. M.Shyness Workshop / Burns Therapist Toolkit  Treatment Tools – Cognitive Behavioral Therapy (CBT) – Interpersonal therapy (IT) – Motivational Therapy  Tools for individual therapy. group therapy 105 Toolkit (cont’d)  Psychometric Information – Scoring keys – Instructions  License for Unlimited Reproduction – Individuals. couples and family therapy. Page . groups.

Time-Limited Offer Dr.com Copyright © 2014 by David Burns.Shyness Workshop / Burns Free 2014 Toolkit Upgrade If you obtained a Toolkit at the workshop. You can download and open them in Microsoft Word. Burns' email— david@feelinggood. You'll receive numerous new tools via email (zipped files). send an email to Dr. M. Page .D. Burns for a free upgrade.