287: Ask David, Featuring Matt May, MD: Acceptance. Irritating Questions. And More! Today, Rhonda, Matt and David answer several challenging questions submitted by fans like you. William asks: How would the TEAM-CBT model look with an addiction or a habit like procrastination? Robin asks: What’s the difference between a habit and an addiction? Edwin asks: What’s the best treatment for internet surfing? It feels like my actions operate below the level of consciousness! Matt asks: What’s the full list of questions that David finds irritating? Matt also asks: How do we help patients who don’t “get” the Acceptance Paradox? Phil asks: Hey David, Rhonda and Mark, Can’t thank you enough for all your hard work and effort! Where do you guys get all your energy?! Note: The answers below were generated prior to the podcast, and the information provided on the live podcast may be richer and different in a number of ways. 1: William asks: “How would the T.E.A.M. model look with addiction and procrastination?” I have a question about your recent podcast on weight loss with Dr. Angela Krumm. She is doing a great job … but did not need any help from others. About the T = Testing part of TEAM, you could say that Angela had lost her kilo’s. But I am not recognizing the testing in the form of a depression / anxiety test or something alike. With the E = Empathy part, it is even more strange. Where is the Empathy section? How would the T.E.A.M. model look with addiction and procrastination? Anyway, I assume you can’t expect that addiction and procrastination issues will be solved in a single therapy session? I realize that Dr. Burns empathized in the podcast, but then the ‘work’ already was done. Thanks a lot, William David’s reply Thanks, William, for your thoughtful questions. I will probably make this an Ask David, but here's the short answer. Yes, empathy must always come first. As you point out, Angela was simply discussing the methods she used for weight loss. This was not a live therapy session. And yes, in therapy sessions I always start with T = Testing, but often add the Temptations Scale as well. And yes, procrastination can usually be cured in a single (two-hour for me) session, and sometimes addictions too, but severe addictions might need ongoing support, as with AA for example. Rhonda and I did a free two-hour workshop on Habits and Addictions on January 26th, 2022, sponsored by PESI. To view it, you can click on the link and download the entire video. Then you can watch it locally on your devise. On the bottom of my homepage on www.feelinggood.com, you’ll find an offer for two free unpublished chapters on habits and addictions. D 2: Robin asks: What’s the difference between a habit and an addiction? No email, just the question. David’s reply You could check with a dictionary. I think Shakespeare said that a rose by any other name is still a rose! Technically, an addiction is associated with physiologic dependence and withdrawal symptoms during discontinuation. But once again, if “yearning” is a withdrawal symptoms, then habits, too, could be seen as addictions of sorts. You might also think of habits and addictions as two points on a continuum, with addictions being on the more severe side of the bell-shaped normal distribution curve. But all these definitions are, to some extent, arbitrary. Does “alcoholism” exist? Or just people who are drinking excessively? 3: Edwin asks: What’s the best treatment for internet surfing? It feels like my actions operate below the level of consciousness! Dr. Burns, I am a huge fan of your books and podcast, and I enjoyed your talk today on Habits and Addictions as well as your “Feeling Great” bonus chapter on the same. I struggle with a habit of internet surfing (news, social media, etc.) when I’m avoiding boring or unpleasant tasks at work. Do you feel that motivational and cognitive techniques are sufficient for addressing this habit when it often feels like my actions operate below the level