David Burns

Dr. Burns graduated magna cum laude from Amherst College, received his M.D. from Stanford University School of Medicine, and completed his psychiatry residency at the University of Pennsylvania School of Medicine. He has served as Acting Chief of Psychiatry at the Presbyterian/ University of Pennsylvania Medical Center (1988) and Visiting Scholar at the Harvard Medical School (1998) and is certified by the National Board of Psychiatry and Neurology.

Currently Adjunct Clinical Professor Emeritus of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine, his awards include the Outstanding Contributions Award from the National Association of Cognitive-Behavioral Therapists, and Teacher of the Year three times from the class of graduating residents at Stanford University School of Medicine.

American mental health professionals rate his Feeling Good: The New Mood Therapy (over 4 million copies sold) as the #1 book on depression, out of 1,000 self-help books.

He conducts workshops for mental health professionals throughout the United States and Canada.

MB: How long have you been making public appearances?

DB: Since I was a research fellow. That’s when I did my first academic talk, at any rate. That would have been in the mid-1970s. After Feeling Good became well known, I had the chance to do quite a bit of talking both for the general public and for mental health professionals.

MB: Can you tell me about the first time that you were anxious or nervous appearing in front of a crowd?

DB: Well, I was giving a talk at Oxford University, when I was a fellow at the University of Pennsylvania Medical School. I had the chance to present some of my research at a very prestigious meeting to scientists who were involved in brain research. I was doing research on brain serotonin metabolism at the time.

MB: How did you feel?

DB: Well, I was very anxious because my research was challenging some findings that were coming out of one of the high profile laboratories at the National Institute of Mental Health [NIMH] on brain serotonin metabolism. I was convinced that the scientists at NIMH had been using incorrect methods. So I repeated one of their studies but analyzed the data quite differently, and came up with the opposite conclusion. This was exciting and potentially important, but there was one problem. I had heard that the fellow whose work I was challenging could sometimes be a little bit on the feisty side. He had a reputation for screaming at people at academic conferences. So I was very anxious.

To make it worse, I was one of the few junior investigators at the conference; there were only eighty scientists who were invited to attend—it was sponsored by the NATO Advanced Study Institute on Metabolic Compartmentalization in the Brain. Nearly all the people were senior, world famous researches, the top people in their fields. So I was very anxious because my presentation was scheduled toward the end. I kept fantasizing that I’d get up and mumble, and I was terrified that the man whose work I was challenging would be in the audience. In my fantasies, I imagined that he would scream at me at the end of my talk, and I’d be humiliated. I was in a state of high anxiety for four days, waiting for my turn to present. It was like waiting to be executed. The night before my presentation I couldn’t sleep at all. I just wandered around the Oxford campus. Even owls seemed to be scorning me and hooting at me. It was a nightmare.

So the next day my turn to speak finally came; I was the last speaker of the day. I walked up to the podium with my notes, and lo and behold, here was the fellow I had feared sitting in the front row right in front of me, staring at me in this icy way, just as I had fantasized. I was so nervous that I decided to kind of read and mumble my talk, rather than giving it in a spontaneous and dynamic way. At the end, there was silence for a few seconds, and no one said a thing. Then the scientist I feared jumped up out of his chair and started screaming at me. He said, in essence, that I didn’t know what I was talking about. Then he sat back down, and there was another prolonged silence in the room. Finally, the chairperson said, “Does anyone else have any questions for Dr. Burns?” And not a single hand went up.

Then the chairperson said, “Now we’re going to walk to dinner to a restaurant about two blocks from here.” And I remember when we were all walking no one would walk next to me. I felt so humiliated—it was my worst nightmare come true. I just felt like such a loser.

Then I got on the plane back to the United States, and I began to think about what the critical scientist said from a scientific point of view, and it dawned on me that his criticisms didn’t seem to be valid. So I went back and shared my concerns with my research colleagues, and we did a few more analyses using sophisticated computer simulation techniques. We proved very clearly that what he was claiming was the opposite of the truth. So I submitted my research to a journal called Biological Psychiatry. It was my first scientific article.

Four weeks later I got a call from the editor, and I thought, “Oh boy. Now I’m going to be criticized some more.” Usually, they just send you letters with the reviewers’ comments. Often, articles are rejected flat out. Occasionally, they ask you to revise the article and submit it again for another round of reviews. But they never call the authors, so this was unusual.

However, the editor said, “This article you sent is amazing. Your article has been accepted for publication and we’re going to publish it without any changes. In fact, the reviewers were so impressed with your work that we were wondering if we could submit it for the A. E. Bennett competition this year in the category of basic research?” That was quite a surprise. The A. E. Bennett Award was considered the world’s top award in the area of brain research for an investigator under 35 years of age. People all over the world compete, including the people from the lab at NIMH whose work I was challenging. I said, “Sure. Go ahead and submit it.”

Several weeks later, he called me again and said, “You’re the unanimous winner of this year’s A. E. Bennett Award for Basic Research. There was tremendous competition this year, but you received all the first place votes. Can you present your findings to the annual meeting of the Society for Biological Psychiatry in New York in a month?” I said that I’d love to.

But this time, I fantasized it very differently. I imagined that I would speak without my notes, and with great enthusiasm, and just talk to the people like they were my friends. I used a visual imaging technique to try to fantasize this as vividly as possible every night before I went to sleep. And even though it didn’t seem particularly believable, I figured that it couldn’t hurt. In my fantasy, I imagined that people would rush up to the podium at the end of my talk and congratulate me, and ask questions, and tell me they were thrilled with my presentation.

I bought a new suit, went to New York, got up, and delivered my presentation spontaneously, without any notes, and with a lot of enthusiasm. There were hundreds of scientists and psychiatrists in the audience, and at the end they all started clapping and cheering. Lots of people rushed up to the podium to congratulate me, just as I’d imagined. So that really kind of made a huge impact on my career. Although, as you know, I eventually went in a different direction with cognitive therapy. But that was the first real recognition I’d ever received as a psychiatrist.

Since then, I’ve done a lot of presentations. I now do approximately 25 two-day workshops to mental health professionals around the country every year. Of course, my public speaking techniques have evolved a lot. I’ve received standing ovations this fall in a great many of the workshops I’ve given recently. And I’ve really discovered what people are looking for, what’s the difference between a great presentation and a presentation that’s only so-so, and the attitudes and the mind sets that go along with that.

Recently I’ve been doing an anxiety workshop called “Scared Stiff”— it’s a two-day workshop. At the end of day one, I often treat someone with public-speaking anxiety live in front of the audience. It’s meant to illustrate all the negative thoughts that trigger public speaking anxiety and how to turn them around. It has been very dramatic, because someone gets right up on stage with me and their voice is trembling, and they have all these negative thoughts. I use cognitive therapy techniques, and nearly always see a profound shift in the person who volunteers for the demonstration. They usually defeat the problem right there on the spot. It only takes about thirty minutes to complete this live mini-“treatment” on stage. And that makes the audience believers, because you’ve actually shown your work rather than making claims about it.

MB: How could you have viewed that situation at Oxford differently so that you wouldn’t have been as anxious?

DB: From the cognitive therapy perspective, the thoughts and perceptions that cause anxiety and depression are distorted and unrealistic. But you don’t realize this when you’re feeling upset—you may be telling yourself, that “Everyone will see how nervous I am. My voice will tremble and my legs will shake. My mind will go blank. And I’m really going to blow it. The people in the audience will all look down on me.” But the funny thing is, these distorted thoughts can act as self-fulfilling prophecies. So you don’t know that you’re creating your own universe. You feel like a victim, a powerless victim, but you’re actually hypnotizing everybody to treat you in just the way you imagined.

Now, when I give a workshop, I view the situation quite differently; I view the audience almost like children—they’re burned out, they want some inspiration, they want to laugh, they want to cry, they want to have fun, and they want some magic to occur. They want someone to care about them. I expect them to be incredibly warm and responsive. So I get all excited now, and it nearly always turns out the way I expect.

If you perceive the people in the audience as enemies who are highly judgmental and critical, they will suddenly appear to be like that. And if you perceive them as warm, loving and responsive, and you react to them like that, they will usually be just like that. If you treat them with warmth and respect, they’ll give you their hearts and minds. It’s a magical thing; it’s more than just learning how to give a dynamic presentation. There’s a spiritual component to it.