Feeling Good: The New Mood Therapy

by Burns, David D.

  Before I show you the way out of the trap of crumbling inwardly when criticized, let me show you why criticism is more upsetting to some people than to others. In the first place, you must realize that it is not other people, or the critical comments they make, that upset you. To repeat, there has never been a single time in your life when the critical comments of some other person upset you—even to a small extent. No matter how vicious, heartless, or cruel these comments may be, they have no power to disturb you or to create even a little bit of discomfort.

  After reading that paragraph you may get the impression that I am cracking up, mistaken, highly unrealistic, or some combination thereof. But I assure you I am not when I say: Only one person in this world has the power to put you down—and you are that person, no one else!

  Here’s how it works. When another person criticizes you, certain negative thoughts are automatically triggered in your head. Your emotional reaction will be created by these thoughts and not by what the other person says. The thoughts which upset you will invariably contain the same types of mental errors described in Chapter 3: overgeneralization, all-or-nothing thinking, the mental filter, labeling, etc.

  For example, let’s take a look at Art’s thoughts. His panic was the result of his catastrophic interpretation: “This criticism shows how worthless I am.” What mental errors is he making? In the first place, Art is jumping to conclusions when he arbitrarily concludes the patient’s criticism is valid and reasonable. This may or may not be the case. Furthermore, he is exaggerating the importance of whatever he actually said to the patient that may have been undiplomatic (magnification), and he is assuming he could do nothing to correct any errors in his behavior (the fortune teller error). He unrealistically predicted he would be rejected and ruined professionally because he would repeat endlessly whatever error he made with this one patient (overgeneralization). He focused exclusively on his error (the mental filter) and over-looked his numerous other therapeutic successes (disqualifying or overlooking the positive). He identified with his erroneous behavior and concluded he was a “worthless and insensitive human being” (labeling).

  The first step in overcoming your fear of criticism concerns your own mental processes: Learn to identify the negative thoughts you have when you are being criticized. It will be most helpful to write them down using the double-column technique described in the two previous chapters. This will enable you to analyze your thoughts and recognize where your thinking is illogical or wrong. Finally, write down rational responses that are more reasonable and less upsetting.

  An excerpt from Art’s written homework using the double-column technique is included (Figure 6–1). As he learned to think about the situation in a more realistic manner, he stopped wasting mental and emotional effort in catastrophizing, and was able to channel his energy into creative, goal-oriented problem solving. After evaluating precisely what he had said that was offensive or hurtful, he was able to take steps to modify his clinical style with patients so as to minimize future similar mistakes. As a result, he learned from the situation, and his clinical skills and maturity increased. This gave his self-confidence a boost and helped him overcome his fear of being imperfect.

  To put it succinctly, if people criticize you the comments they make will be right or wrong. If the comments are wrong, there is really nothing for you to be upset about. Think about that for a minute! Many patients have come to me in tears, angry and upset because a loved one made a critical comment to them that was thoughtless and inaccurate. Such a reaction is unnecessary. Why should you be disturbed if someone else makes the mistake of criticizing you in an unjust manner? That’s the other guy’s error, not yours. Why upset yourself? Did you expect that other people would be perfect? On the other hand, if the criticism is accurate, there is still no reason for you to feel overwhelmed. You’re not expected to be perfect. Just acknowledge your error and take whatever steps you can to correct it. It sounds simple (and it is!), but it may take some effort to transform this insight into an emotional reality.

  * * *

  Figure 6–1. Excerpt from Art’s written homework, using the double-column technique. He initially experienced a wave of panic when he received critical feedback from his supervisor about the way he handled a difficult patient. After writing down his negative thoughts, he realized they were quite unrealistic. Consequently, he felt substantial relief.

  * * *

  Of course, you may fear criticism because you feel you need the love and approval of other people in order to be worthwhile and happy. The problem with this point of view is that you’ll have to devote all your energies to trying to please people, and you won’t have much left for creative, productive living. Paradoxically, many people may find you less interesting and desirable than your more self-assured friends.

  Thus far, what I have told you is a review of the cognitive techniques introduced in the previous chapter. The crux of the matter is that only your thoughts can upset you and if you learn to think more realistically, you will feel less upset. Right now, write down the negative thoughts that ordinarily go through your head when someone criticizes you. Then identify the distortions and substitute more objective rational responses. This will help you feel less angry and threatened.

  Now I would like to teach you some simple verbal techniques which may have considerable practical relevance. What can you say when someone is attacking you? How can you handle these difficult situations in a way that will enhance your sense of mastery and self-confidence?

  Step One—Empathy. When someone is criticizing or attacking you, his (or her) motives may be to help you or to hurt you. What the critic says may be right or wrong, or somewhere in between. But it is not wise to focus on these issues initially. Instead, ask the person a series of specific questions designed to find out exactly what he or she means. Try to avoid being judgmental or defensive as you ask the questions. Constantly ask for more and more specific information. Attempt to see the world through the critic’s eyes. If the person attacks you with vague, insulting labels, ask him or her to be more specific and to point out exactly what it is about you the person dislikes. This initial maneuver can itself go a long way to getting the critic off your back, and will help transform an attack-defense interaction into one of collaboration and mutual respect.

  I often illustrate how to do this in a therapy session by role-playing an imaginary situation with the patient so that I can model this particular skill. I’ll show you how to role-play; it’s a useful skill to develop. In the dialogue that follows, I want you to imagine you are an angry critic. Say the most brutal and upsetting thing to me you can think of. What you say can be true, false, or partly both. I will respond to each of your assaults with the empathy technique.

  YOU

  (playing the role of angry critic): Dr. Burns, you’re a no-good shit.

  DAVID:

  What about me is shitty?

  YOU:

  Everything you say and do. You’re insensitive, self-centered, and incompetent.

  DAVID:

  Let’s take each of these. I want you to try to be specific. Apparently I’ve done or said a number of things that upset you. Just what did I say that sounded insensitive? What gave you the impression I was self-centered? What did I do that seemed incompetent?

  YOU:

  When I called to change my appointment the other day, you sounded rushed and irritable, as if you were in a big hurry and didn’t give a damn about me.

  DAVID:

  Okay, I came across in a rushed, uncaring way on the phone. What else have I done that irritated you?

  YOU:

  You always seem to hurry me out at the end of the session—just like this was a big production line to make money.

  DAVID:

  Okay, you feel I’ve been too rushed during sessions as well. I may have given you the impression I’m more interested in your money than in you. What else have I done? Can you think of other ways I might have goofed up or offended you?


  What I am doing is simple. By asking you specific questions I minimize the possibility that you will reject me completely. You—and I—become aware of some specific concrete problems that we can deal with. Furthermore, I am giving you your day in court by listening to you so as to understand the situation as you see it. This tends to defuse any anger and hostility and introduces a problem-solving orientation in the place of blame casting or debate. Remember the first rule—even if you feel the criticism is totally unjust, respond with empathy by asking specific questions. Find out precisely what your critic means. If the person is very hot under the collar, he or she may be hurling labels at you, perhaps even obscenities. Nevertheless, ask for more information. What do those words mean? Why does the person call you a “no-good shit”? How did you offend this individual? What did you do? When did you do it? How often have you done it? What else does the person dislike about you? Find out what your action means to him or her. Try to see the world through your critic’s eyes. This approach will frequently calm the roaring lion and lay the groundwork for a more sensible discussion.

  Step Two—Disarming the Critic. If someone is shooting at you, you have three choices: You can stand and shoot back—this usually leads to warfare and mutual destruction; you can run away or try to dodge the bullets—this often results in humiliation and a loss of self-esteem; or you can stay put and skillfully disarm your opponent. I have found that this third solution is by far the most satisfying. When you take the wind out of the other person’s sails, you end up the winner, and your opponent more often than not will also feel like a winner.

  How is this accomplished? It’s simple: Whether your critic is right or wrong, initially find some way to agree with him or her. Let me illustrate the easiest situation first. Let’s assume the critic is primarily correct. In the previous example when you angrily accused me of sounding rushed and indifferent on several occasions, I might go on to say: “You’re absolutely right. I was rushed when you called, and I probably did sound impersonal. Other people have also pointed this out to me at times. I want to emphasize that I didn’t intend to hurt your feelings. You’re also right that we have been rushed during several of our sessions. You might recall that sessions can be any length you like, as long as we decide this ahead of time so that the scheduling can be appropriately adjusted. Perhaps you’d like to schedule sessions that are fifteen or thirty minutes longer, and see if that’s more comfortable.”

  Now, suppose the person who’s attacking you is making criticisms you feel are unfair and not valid. What if it would be unrealistic for you to change? How can you agree with someone when you feel certain that what is being said is utter nonsense? It’s easy—you can agree in principle with the criticism, or you can find some grain of truth in the statement and agree with that, or you can acknowledge that the person’s upset is understandable because it is based on how he or she views the situation. I can best illustrate this by continuing the role-playing; you attack me, but this time say things that are primarily false. According to the rules of the game, I must (1) find some way to agree with whatever you say; (2) avoid sarcasm or defensiveness; (3) always speak the truth. Your statements can be as bizarre and as ruthless as you like, and I guarantee I will stick by these rules! Let’s go!

  YOU

  (continuing to play the role of angry critic): Dr. Burns, you’re a shit.

  DAVID:

  I feel that way at times. I often goof up at things.

  YOU:

  This cognitive therapy is no damn good!

  DAVID:

  There’s certainly plenty of room for improvement.

  YOU:

  And you’re stupid.

  DAVID:

  There are lots of people who are brighter than I am. I’m sure not the smartest person in the world.

  YOU:

  You have no real feelings for your patients. Your approach to therapy is superficial and gimmicky.

  DAVID:

  I’m not always as warm and open as I’d like to be. Some of my methods might seem gimmicky at first.

  YOU:

  You’re not a real psychiatrist. This book is pure trash. You’re not trustworthy or competent to manage my case.

  DAVID:

  I’m terribly sorry I seem incompetent to you. It must be quite disturbing to you. You seem to find it difficult to trust me, and you are genuinely skeptical about whether we can work together effectively. You’re absolutely right—we can’t work together successfully unless we have a sense of mutual respect and teamwork.

  By this time (or sooner) the angry critic will usually lose steam. Because I do not fight back but instead find a way to agree with my opponent, the person quickly seems to run out of ammunition, having been successfully disarmed. You might think of this as winning by avoiding battle. As the critic begins to calm down, he or she will be in a better mood to communicate.

  Once I have demonstrated these first two steps to a patient in my office, I usually propose we reverse roles to give the patient the chance to master the method. Let’s do this. I will criticize and attack you, and you will practice the empathy and make up your own answers. Then see how closely they are accurate or nonsensical. To make the following dialogue a more useful exercise, cover up the responses called “You” and make up your own answers. Then see how closely they correspond with what I have written. Remember to ask questions using the empathy method and find valid ways to agree with me using the disarming technique.

  DAVID

  (playing the role of angry critic): You’re not here to get better. You’re just looking for sympathy.

  YOU

  (playing the role of the one under attack): What gives you the impression I’m just looking for sympathy?

  DAVID:

  You don’t do anything to help yourself between sessions. All you want to do is come here and complain.

  YOU:

  It’s true that I haven’t been doing some of the written homework you suggested. Do you feel I shouldn’t complain during sessions?

  DAVID:

  You can do whatever you want. Just admit you don’t give a damn.

  YOU:

  You mean you think I don’t want to get better, or what?

  DAVID:

  You’re no good! You’re just a piece of garbage!

  YOU:

  I’ve been feeling that way for years! Do you have some ideas about what I can do to feel differently?

  DAVID:

  I give up. You win.

  YOU:

  You’re right. I did win!

  I strongly suggest you practice this with a friend. The role-playing format will help you master the necessary skills needed when a real situation arises. If there is no one you feel comfortable with who could role-play with you effectively, a good alternative would be to write out imaginary dialogues between you and a hostile critic, similar to the ones you’ve been reading. After each harangue write down how you might answer using the empathy and disarming technique. It may seem difficult at first, but I think you’ll catch on quite readily. It’s really quite easy once you get the gist of it.

  You will notice you have a profound, almost irresistible tendency to defend yourself when you are unjustly accused. This is a MAJOR mistake! If you give in to this tendency, you will find that the intensity of your opponent’s attack increases! You will paradoxically be adding bullets to that person’s arsenal every time you defend yourself. For example, you be the critic again, and this time I’ll defend myself against your absurd accusations. You’ll see how quickly our interaction will escalate to full-scale warfare.

  YOU

  (in the role of critic again): Dr. Burns, you don’t care about your patients.

  DAVID

  (responding in a defensive manner): That’s untrue and unfair. You don’t know what you’re talking about! My patients respect all the hard work I put in.

  YOU:

  Well, here’s one who doesn’t! Good-bye! (You exit, having decided to fire me. My defensiveness
leads to a total loss.)

  In contrast, if I respond with empathy and disarm your hostility, more often than not you will feel I am listening to you and respecting you. As a result you lose your ardor to do battle and quiet down. This paves the way for step three—feedback and negotiation.

  You may find initially that in spite of your determination to apply these techniques, when a real situation arises in which you are criticized, you will be caught up by your emotions and your old behavior patterns. You may find yourself sulking, arguing, defending yourself vehemently, etc. This is understandable. You’re not expected to learn it all overnight, and you don’t have to win every battle. It is important, however, to analyze your mistakes afterward so that you can review how you might have handled the situation differently along the lines suggested. It can be immensely helpful to find a friend to role-play the difficult situation with you afterward so that you can practice a variety of responses until you have mastered an approach you are comfortable with.

  Step Three—Feedback and Negotiation. Once you have listened to your critic, using the empathy method, and disarmed him by finding some way to agree with him, you will then be in a position to explain your position and emotions tactfully but assertively, and to negotiate any real differences.

  Let’s assume that the critic is just plain wrong. How can you express this in a nondestructive manner? This is simple: You can express your point of view objectively with an acknowledgment you might be wrong. Make the conflict one based on fact rather than personality or pride. Avoid directing destructive labels at your critic. Remember, his error does not make him stupid, worthless, or inferior.