DAVID D, BURNS, ML. REVISED AND UPDATED MORE THAN THREE MILLION COPIES IN PRINT NOW WITH THE ALL-NEW CONSUMER'S GUIDE TO ANTIDEPRESSANT DRUGS AND A NEW INTRODUCTION FROM THE AUTHOR TUNG OOD THe New MOobD THERAPY The Clinically Proven Drug-free Treatment for DepressionHEALTH FEELING GOOD FEELS WONDERFUL The good news is that anxiety, guilt, pessimism, procrastination, low self-esteem, and other “black holes” of depression can be cured without drugs. In FEELING GOOD, eminent psychiatrist David D. Burns, M.D., outlines the remarkable, scientifically proven techniques that will immediately lift your spirits and help you develop a positive outlook on life: * Recognize what causes your mood swings + Nip negative feelings in the bud * Deal with guilt * Handle hostility and criticism * Overcome addiction to love and approval + Beat “do-nothingism” + Avoid the painful downward spiral of depression * Build self-esteem * Feel good every day BEGIN NOW, TO EXPERIENCE THE JOY OF FEELING GOOD “A BOOK TO READ AND RE-READ!”—Los Angeles Times TSBN 0-380 ii 2 Quill 9 | | | \ I i 51500> 2 b | is A An Imprint of HarperCollinsP ub 731763 780380! www.harpercollins.com USA $15.00 Canada $23.00Feeling Good: The New Mood Therapy has sold more than 3 million copies worldwide to date. In a recent national survey, Feeling Good was rated as the most helpful book on depression— from a list of over 1,000 self-help books—and was the most frequently recommended book for de- pressed individuals by American mental health professionals. Dr. Burns’ Feeling Good Handbook was rated #2 in the same survey. Although self- help books are quite controversial, five controlled outcome studies published in scientific journals over the past decade indicated that 70 percent of depressed individuals who read Feeling Good improved within four weeks even though they re- ceived no other treatment. In addition, these pa- tients have maintained their improvement during follow-up periods of up to three years. Surpris- ingly, the antidepressant effects of Feeling Good appear to be as strong as antidepressant medica- tions or individual psychotherapy for patients suffering from episodes of major depression! Although Dr. Burns does not recommend any self- help book as a substitute for professional therapy, Feeling Good should prove immensely illu- minating to anyone suffering from depression or anxiety. Feeling Good Feels Wonderful! You Owe It to Yourself to Feel Good! “I would personally evaluate David Burns’ Feeling Good as one of the most significant books to come out of the last third of the Twentieth Century.’’ Dr. David F. Maas, Professor of English, Ambassador UniversityAlso by David D. Burns, M.D. THE FEELING GOOD HANDBOOK INTIMATE CONNECTIONS TEN DAYS TO SELF ESTEEM THE LEADER’S MANUALFEELING (00D THe New Mood THERAPY DAVID D. BURNS, MD Va Quill of HarperCollinsPublishersThe ideas, procedures, and suggestions contained in this book are not intended as a substitute for consulting with your physician. All matters regarding your health require medical supervision. A hardcover edition of this book was published in 1980 by William Morrow and Company, Inc. FEELING GOOD. Copyright © 1980 by David Burns. All rights reserved. Printed in the United States of America. No part of this book may be used or reproduced in any manner whatsoever without written permission except in the case of brief quotations embodied in critical articles and reviews. For information address HarperCollins Publishers Inc., 10 East 53rd Street, New York, NY 10022. HarperCollins books may be purchased for educational, business, or sales promotional use. For information please write: Special Markets Department, HarperCollins Publishers Inc., 10 East 53rd Street, New York, NY 10022. First WholeCare edition published 1999. Reprinted in Quill 2000. Library of Congress Cataloging-in-Publication Data is available. ISBN 0-380-73176-2 09 08 07 06 RRD 30 29 28 27This book is dedicated to Aaron T. Beck, M.D., in admiration of his knowledge and courage and in ap- preciation of his patience, dedication and empathy.Acknowledgments I am grateful to my wife, Melanie, for her editorial assis- tance and patience and encouragement on the many long evenings and weekends that were spent in the preparation of this book. I would also like to thank Mary Lovell for her enthusiasm and for her technical assistance in typing the manuscript. The development of cognitive therapy has been a team effort involving many talented individuals. In the 1930s, Dr. Abraham Lowe, a physician, began a free-of-charge self-help movement for individuals with emotional diffi- culties, called ‘‘Recovery Incorporated,’’ which is still in existence today. Dr. Lowe was one of the first health pro- fessionals to emphasize the important role of our thoughts and attitudes on our feelings and behavior. Although many people are not aware of his work, Dr. Lowe deserves a great deal of credit for pioneering many of the ideas that are still in vogue today. In the 1950s, the noted New York psychologist, Dr. Al- bert Ellis, refined these concepts and created a new form of psychotherapy called Rational Emotive Therapy. Dr. El- lis published over fifty books that emphasize the role of negative self-talk (such as ‘‘shoulds’’ and ‘‘oughts’’) and irrational beliefs (such as ‘‘I must be perfect’’) in a wide viiviii Acknowledgments variety of emotional problems. Like Dr. Lowe, his brilliant contributions are sometimes not sufficiently acknowledged by academic researchers and scholars. In fact, when I wrote the first edition of Feeling Good, I was not especially fa- miliar with the work of Dr. Ellis and did not really appre- ciate the importance and magnitude of his contributions. I want to set the record straight here! Finally, in the 1960s, my colleague at the University of Pennsylvania School of Medicine, Dr. Aaron Beck, adapted these ideas and treatment techniques to the problem of clin- ical depression. He described the depressed patient’s neg- ative view of the self, the world, and the future, and proposed a new form of ‘‘thinking therapy’’ for depression, which he called ‘‘cognitive therapy.’’ The focus of cogni- tive therapy was helping the depressed patient change these negative thinking patterns. Dr. Beck’s contributions, like those of Drs. Lowe and Ellis, have been substantial. His Beck Depression Inventory, published in 1964, allowed cli- nicians and researchers to measure depression for the first time. The idea that we could measure how severe a pa- tient’s depression was, and track changes in response to treatment, was revolutionary. Dr. Beck also emphasized the importance of systematic, quantitative research so we could get objective information on how well the different kinds of psychotherapy actually worked, and how effective they are in comparison to antidepressant drug therapy. Since the time of those three early pioneers, many hun- dreds of gifted researchers and clinicians throughout the world have contributed to this new approach. In fact, there has probably been more published research on cognitive therapy than on any other form of psychotherapy ever de- veloped, with the possible exception of behavior therapy. Clearly, I cannot mention all the individuals who have made important contributions to the development of cog- nitive therapy. In the early days of cognitive therapy, during the 1970s, I worked with several colleagues at the Univer- sity of Pennsylvania School of Medicine who helped to create many of the treatment techniques still in use today.Acknowledgments ix They included Drs. John Rush, Maria Kovacs, Brian Shaw, Gary Emery, Steve Hollon, Rich Bedrosian, Ruth Green- berg, Ira Herman, Jeff Young, Art Freeman, Ron Coleman, Jackie Persons, and Robert Leahy. Several individuals have given me permission to refer to their work in detail in this book, including Drs. Raymond Novaco, Arlene Weissman, and Mark K. Goldstein. I would like to make special mention of Maria Guarnas- chelli, the editor of this book, for her endless spark and vitality which have been a special inspiration to me. During the time I was engaged in the training and re- search which led to this book, I was a Fellow of the Foun- dations’ Fund for Research in Psychiatry. I would like to thank them for their support which made this experience possible. And my thanks to Frederick K. Goodwin, M.D., a former chief at the National Institute of Mental Health, for his val- uable consultation with regard to the role of biological fac- tors and antidepressant drugs in treating mood disorders. Two Stanford colleagues, Drs. Greg Tarasoff and Joe Bel- lenoff, provided helpful feedback about the new drug chap- ters. I would like to thank Arthur P. Schwartz for his encour- agement and persistence. I would also like to thank Ann McKay Thoroman at Avon Books for editorial help on the new psychopharmacology chapters. Finally, I would like to thank my daughter, Signe Burns, for extraordinarily helpful suggestions and meticulous ed- iting of the new material in this 1999 edition.