Episode 415: Q & A with David — Positive Reframing & Delayed Reactions
Source: Feeling Good Podcast Episode 415
Hosts: Dr. David Burns, Dr. Rhonda Barovsky
Date: April 2026
Key Questions Discussed
Question 1: Can You Do TEAM on Your Own?
John from Ireland asks whether it’s possible to do TEAM-CBT self-therapy independently, especially given that even experienced TEAM therapists seem to require guidance from David and Jill.
Burns’ Answer:
- Most people can achieve real mood improvement through self-help (books, apps) and written exercises
- But it’s easy to get stuck; “two heads are often better than one”
- No shame in seeking a therapist when stuck
- Severe symptoms or suicidal ideation absolutely require professional help
- Even therapists have blind spots about their own thoughts; everyone benefits from external guidance
- Ronda’s anecdote: Positive reframing with Jill sparked an insight she couldn’t have reached alone because Jill asked poignant questions
Question 2: Positive Reframing — How to Do It On Your Own
John from Ireland, a trainee integrating CBT/REBT, reports hitting resistance during positive reframing. He finds himself discounting positives, as if negatives vastly outweigh positives. He suspects he’s falling into “cheerleading” rather than genuine reframing.
What Positive Reframing Is NOT
Not Cheerleading. The most common mistake is trying to build up your positive qualities or points. Everyone resists this. Burns has never seen it help.
Instead, positive reframing works with your negative thoughts and feelings.
The Core Process
Start with a Daily Mood Log:
- Identify a situation where you’re upset
- List all negative feelings (depressed 80%, anxious 100%, ashamed 80%, inferior 90%, etc.)
- List negative thoughts (“I’m a loser,” “I should be better,” etc.)
Then ask yourself these four questions about the negative thoughts/feelings:
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Is there some truth in these negative thoughts? Are they appropriate given your situation? What’s the kernel of truth?
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What are the values or benefits of having these thoughts and feelings? Could they be motivating? Does anxiety protect you from danger? Does it keep you vigilant? Does self-criticism show you have high standards?
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What do these negative thoughts and feelings show about me that’s positive? If you’re very self-critical, does this show you’re perfectionistic with high standards? Connect the “negative” feeling to an underlying positive value.
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Are there bad things that would happen if I stopped beating up on myself? What would be lost if you gave up these feelings? (This is the newest addition to positive reframing; Burns added it more recently.)
The Goal: Not Self-Improvement, But Self-Acceptance
The aha moment is not thinking you’re some kind of wonderful person. Instead, it’s beginning to see the beauty in your negative self-critical thoughts and feelings. Most people feel ashamed of how they feel; the shift is to stop ashaming yourself for your shame.
Why It’s Powerful
Ronda observes that when Burns and Jill do positive reframing skillfully with clients, clients feel “almost recovered” after this single step. Burns confirms: much of the improvement in negative feelings happens during positive reframing—not just later.
The key: Burns and Jill don’t try to convince the patient. Instead, they ask poignant questions that guide the patient to their own insights. This is far more powerful than telling them what to think.
Example from the session: Jill asked Ronda: “Do you think you’re a conceited person?” Ronda said no. Jill: “What do you think about conceited people?” Ronda: “I don’t like them.” Jill: “How would you describe yourself?” Ronda: “I guess I’m humble.”
Through dialogue, Ronda discovered her own humility—far more powerful than being told she’s humble.
Practical Implementation
Burns emphasizes the skill is subtle. It looks simple, like taking a knife to wood, but some people carve masterpieces while others just hack. There’s a nuance and complexity to it.
Ronda describes it as: there’s a discovery that happens, often unexpected. If you do it formulaically, it doesn’t work.
Resistance During Positive Reframing
A new AI development: Burns’ team (led by Jason Mino) built a “multi-level” positive reframing AI that listens for the client’s resistance and pivots to address it. If positive reframing isn’t landing, the AI asks questions about the resistance itself, turning that resistance into instant understanding of positive reframing on a deeper level.
Burns sees this as bottling the gift: taking what skilled therapists do (detect and work with resistance) and scaling it via AI.
Question 3: Blushing and Self-Acceptance
A 49-year-old woman has blushed and sweated profusely since age 5. Her blushing causes intense anxiety. She’s tried controlling it, is on Xanax to control the facial redness, and sweats profusely in social situations.
Burns’ Core Point: Your problem results 100% from non-self-acceptance. You’re trying to hide or control the blushing. Your anxiety doesn’t come from blushing or sweating—it comes from distorted thoughts about the blushing.
Solution: Self-acceptance. Accept that you blush. This is one of the things your body does. Crushing distorted thoughts about it will reduce anxiety.
The Paradox: People think acceptance means giving in or giving up. Burns: “Self-acceptance is the greatest change a human being can make.”
Feared Fantasy Roleplay (Demonstration): Burns demonstrates the technique by playing “the stranger from hell”—someone who voices all the woman’s feared judgments. By having her practice responses in a fantasy where her worst fears come true, she can desensitize.
Key moment: When attacked (“Your blushing is disgusting”), Burns models self-acceptance responses:
- “I’ve been sweating like this proudly since I was five. If you’re disgusted, tell me what’s disgusting about it. Once you know me better, you’ll see this is one of my lesser flaws.”
- “Blushing is just one of my many flaws, but if you get to know me, you’ll find I have far more than that.”
The shift: not “blushing is my strength” (which she doesn’t believe), but accepting it as a flaw while normalizing and depersonalizing it.
Question 4: Delayed Reactions to CBT Exercises
Dylan asks: Is it common for people to not feel immediate mood reduction after an exercise, but then experience results days later?
Burns’ Answer:
- It often happens during exercise development or refinement. He’d wake up with answers to questions he couldn’t solve the day before.
- The positive thought has to be 100% true and drastically reduce belief in the negative thought. Half-truths never work.
- A couple-days-delayed improvement suggests deep discovery and understanding—your brain is working it over subconsciously.
- The moment you see that the negative thought is garbage (belief drops to 5%, 10%, or 0%), your feelings change instantly.
- This delayed insight is normal and shows a healthy subconscious mind working for you.
Example: A clinical social worker believed she was “just average.” It took four hours of roleplay (spread over four weeks) before the insight hit halfway through the fifth session. When it hit, she “became enlightened” instantly.
Clinical Observations from the Panel
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Paradox of Acceptance: People resist the very thing that will liberate them—they confuse acceptance with defeat.
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The Blind Spot: Even experienced therapists have blind spots about their own distortions. An external guide (human or AI) helps you see what you can’t see alone.
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Skill vs. Formula: Positive reframing looks simple but requires deep listening, asking the right questions at the right time, and guiding discovery rather than imposing answers.
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Shame About Shame: The deeper work is often about shame about negative feelings, not the negative feelings themselves. Acceptance includes accepting that you feel ashamed, anxious, depressed.
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Self-Love as Decision: Burns references Christian theology: happiness comes from self-love, which is a decision you make, not something you earn.
Resources Mentioned
- Books: Feeling Good (1980), Feeling Great (latest)
- App: Feeling Great (available on Apple App Store and Google Play Store)
- Related Podcasts:
- Episode 88: “Roleplay Techniques & Feared Fantasy Revisited”
- Episode 168: “The Blushing Cure”
- Website: feelinggreat.com, drburnsfeelin.com