TEAM-CBT with children and teens, featuring Jeffrey Lazarus, MD Tics, Irritable Bowel Syndrome, Chronic Pain, Bedwetting, Fears, Phobias, Performance Anxiety, and more In TEAM, we usually conceptualize four categories of problems: depression, anxiety disorders, relationship problems, and habits and addictions. Although there are similarities in the treatment of each of these targets, there are also important differences. Today’s guest, Jeffrey Lazarus, MD, is a pediatrician who specializes in a fifth category, somatic complaints, which can include physical symptoms like chronic pain, dizziness and fatigue without any known medical cause. This category also includes as irritable bowel syndrome, headaches, tics with and without Tourette syndrome, bed wetting, and a wide range of other problems which are common in kids and sometimes in adults as well. Dr. Lazarus also works with anxiety disorders, such as test anxiety, sports performance anxiety, public speaking anxiety, school phobia and more. Although Dr. Lazarus worked as a general pediatrician for the first 27 years of his career, he switched to hypnotherapy when the painful plantar warts on his feet were unexpectedly cured following a single hypnotherapy session from a colleague. Dr. Lazarus was so impressed that he began studying hypnosis and incorporating it into his work with children, teens, and adults. He now works from a TEAM perspective, incorporating Testing, Empathy, Paradoxical Agenda Setting (also called Assessment of Resistance), and a variety of cognitive methods, along with hypnosis. He began today’s podcast with a case of a young man he was treating for persistent bed wetting, and was surprised when his patient slammed him in the written feedback on the Evaluation of Therapy Session form following the session, labeling Dr. Lazarus as a bit “narcissistic.” At the start of the next session, Dr. Lazarus responded non-defensively with the Five Secrets of Effective Communication. This won the boy over, leading to a successful outcome. Jeff said that the Evaluation of Therapy Session form and the Five Secrets have “saved him” on several occasions with disgruntled patients. Jeff then presented several fascinating cases where motivational factors and resistance played a major role in the treatment, and emphasized that treatment failure would probably have been inevitable if these factors had not been brought to conscious awareness. For example, a teenager who frequently had to go home from school because of somatic symptoms listed, at Dr. Lazarus’ suggested, the many advantages of his symptoms, such as “I don’t have to go to school,” “I get extra attention this way,” and more. After this intervention, the boy decided that it just wasn’t worth it, because there were lots of fun things he was missing out on at school, and his symptoms rapidly subsided. In another case of bed-wetting, Jeff discovered that a 10-year old knew that he wouldn’t be permitted to go on sleep overs at his cousin’s house until he outgrew his bed-wetting problem. But when he “listened” and encouraged the boy to talk about his distress, the boy explained that his cousin had a “creepy dog” that frightened him, so he actually didn’t want to go on sleepovers. Jeff encouraged the boy to tell his parents what was really going on, and when his mother said he wouldn’t have to go on any sleepovers unless he wanted to, his bed-wetting suddenly disappeared. He described many additional cases where motivational factors dominated his patient’s problems, including a promising teenage tennis star who suddenly developed a fear of flying which made it impossible to go with her parents to important weekend tournaments. But with Dr. Lazarus’ support, she confessed that her life was dominated by school, study, and going to tennis tournaments, with no free time to be a “normal teenager.” She finally confided that she was just “tennissed out” and wanted to have more fun in life, to have dates, and so forth. By subconsc