Introducing Dr. David Burns

Dr. David BurnsIf you have ever been in to see me, you will have heard me talk highly of Dr. David Burns and his work in Cognitive Behavioral Therapy.  I have recommended his podcast about resistance to many people, as listening to how he has helped others is truly inspiring!  

Don’t want to take a listen, but still interested?

If podcasts just are not your cup of tea, (kind of akin to the Too Long; Didn’t Read variety, but with your ears), I thought I would break it down for you.

If you want to listen, here it is.

Podcast #1 – Resistance


Cognitive Behavioral Therapy (CBT) was popularized by Dr. Aaron Beck in the early 70’s.

At the time, David Burns found that pharmacology (prescribed drugs) was not helping his patients. As a result, Burns got interested in finding different methods to use and Dr. Beck’s Cognitive Behavioral Therapy was suggested.

Burns attended Aaron Beck’s weekly seminars and he found that his patients showed improvement when he tried the Cognitive Behavioral Therapy techniques.

However, some (about 1/3) clients stubbornly clung to “Yes, but…” and were not being helped.   

Why?  Why stuck?

They were stuck because of Therapeutic Resistance. They cling to the familiar. 

Cognitive Behavioral Therapy (or any treatment, for that matter) will not be helpful without addressing resistance. 

Once resistance is melted away, the strategy is very effective.

Types of Resistance

Resistance broken down into 8 most common categories. 

There are 4 targets  – Addictions, Relationship Problems, Anxiety and Depression.

Each target has two types of resistance: outcome and process.


Outcome resistance – this is when a positive outcome isn’t really wanted. 

For example,  if an alcoholic is offered an instant cure, the addict may truly believe that alcohol (or any other addiction) is the only source of escape, pleasure, relief, etc. in their life. Therefore, they don’t really want to become sober – outcome resistance.

Process Resistance – This is when you don’t want to do the required work to accomplish desired outcome.  For example, someone might want to lose weight, but is not willing to change behavior (exercise or diet) to accomplish weight goals .

Couples therapy – often doesn’t take resistance into account.  

Outcome resistance – The truth might be that one partner doesn’t want a close relationship with the other person anymore.  If the relationship has eroded to a terrible point, the partner may feel hurt or resentful and not want the other person in their life – outcome resistance. 

Process resistance – Sometimes, we blame our partner for the difficulties in the relationship and feel we are not responsible at all.  We are not willing to stop blaming, nor are we motivated to take any responsibility. Because of our position, we not willing to make any changes that might improve the relationship-process resistance.


Outcome resistance – magical thinking – if the anxiety disappears, something horrible will happen.  

For example, let’s say you are a chronic worrier and worry about everything. If I suggest to you that you can push a magic button and your anxiety will disappear.  Sometimes the worrier has a deeply rooted belief that if the button is pushed and the worrying goes away, something horrible will happen. 

To explain further, it is discovered that a person with Obsessive/Compulsive tendencies fears deeply that if they don’t wash their hands, they will contaminate their  children with a terrible disease.  Therefore, the person does not want to stop the behavior – outcome resistance.

Process resistance – Often when dealing with anxiety, we must face the things we are anxious about.  This is called Exposure and it can be terrifying – process resistance.


Outcome Resistance – The main resistance has to do with non-acceptance.  There is something about ourselves that we don’t want to accept leading to self doubt. We must accept who we are and lower standards. By doing this,  we might think that we are settling for the second best version of self- let go of the ego.  The impression of self is more powerful than the “real” self – outcome resistance. 

For example, a violent local drug dealer was suicidal. He had low self-esteem and considered himself a hopeless case.  Through prompting, he looked at the positives and negatives of continuing with his lifestyle. 

He thought the biggest cost was that he would be dead in 2 years. However, staying the same easy and familiar (benefit), he could get stoned all the time (benefit), he had a strong public identity and prestige (benefit), he was powerful (benefit), he got unlimited sex (benefit), he didn’t have to follow rules (benefit), and he was never disappointed in himself (benefit).

It was clear that being a “hopeless case” had many benefits. Why would he want to give it up?  The man realized that living was more important than all of the benefits his lifestyle afforded him.  

Process Resistance – homework – the effect of doing homework is huge. Improvement is directly related to doing, or not doing, homework.  Homework always involves working on some sort of change and many of us don’t like change.  It isn’t easy – process resistance

There is Podcast #1 in a nutshell.  Please feel free to check out Dr. Burns’ website.  His work is truly inspiring and can be a game changer for you!