Episode 3-Chronic Worrying with Indrani Mookerjee

• Transcript

  Kevin: Today we have Indrani Mookerjee. Hello, Indrani, nice to have you join us on the podcast.

  Indrani: Hi, Kevin. It's good to be here.

  Kevin: Yeah, thank you so much. I'm really excited to talk to you. Of course, Indrani, I know you because I've had the pleasure of being in a couple of different training groups with you weekly and spend a lot of hours learning from you and with you. And for the people who are listening to our Tools for Change podcast today, I would love to give them a chance to get to know a little bit about you. So, maybe you could tell us all a little bit about you, your background as a therapist your practice and the patients that you're finding yourself working with most often.

  Indrani: Absolutely. I would love to do that. Yeah, so I've been a therapist for a long time. I practice in Columbia, Maryland. I have a group practice, just a group of very wonderful clinicians with different specialties. I went to school in Washington University in St. Louis. And then I got additional training in cognitive behavioral therapy, and that's when I heard about Dr. Burns. And because I live in the outskirts of the Washington DC area, I've seen Dr. Burns several times in for workshops and seminars and conferences. But I didn't really get serious about TEAM until about 2017 or so. So 2018, I went to my first intensive in San Francisco with Dr. Burns. I went back again in 2019 and this wonderful journey started ever since. And I'm pretty sure I saw you there, Kevin. Yeah, you were one of my heroes. You still are. And you're just so eloquent and articulate and so smooth. And so, got TEAM certified at different levels, and so now I'm certified at level four. And guess that's exclusively what I do now in my practice here in Columbia.

  Kevin: Wow. and I just love hearing about your journey, especially studying CBT and then being introduced to Dr. David Burns because he's such a pioneer in cognitive behavioral therapy, and the creator of TEAM CBT, which is what this podcast is really about. We're talking about the tools of TEAM CBT and how we use them with our patients. And there's something about meeting Dr. Burns and learning from him that really interested you, and so you attended these intensive trainings. So the intensives are a week long, all day series of workshops that David does basically by himself. I think he does do live therapy work with a co-therapist, usually Jill Levitt. I think I was at both of those weeklong intensives that you were at, and it's just this wonderful time to learn from him and it's such a great model of therapy. And maybe you could tell us a little bit about the areas that you specialize in and the kind of patients you usually find yourself working with, and how you've been able to use TEAM in your work with them.

  Indrani: Yeah, absolutely. So I see a lot of patients with mood issues, mostly anxiety. I also see people who might have habits or addictions problem, usually eating, compulsive eating procrastination and now increasingly, technology, the different kinds of technology. And then a lot of my patients, of course, have relationship problems, mostly marriage problems. So, it's a mix. And thanks to this very kind of targeted measurement driven approach that you and I have access to, Kevin, you know, we really have a model to work with all these people, all kinds of issues across the board.

  Kevin: As I was listening to you talk, I was just immediately picturing the conceptualization of the problems and imagining the different methods that you would be using for helping people who brought in those problems. So, it makes sense to me that you see people with a variety of problems, because the TEAM model really helps us work with someone with whatever it is that they're struggling with. Because we're still going to be using testing to notice what are the problems and how strong are they? Empathy, you're going to really listen to somebody really well and try to see the world through their eyes and understand them as much as another person can, and also give them lots of warmth and support and concern, right? And then that assessment of resistance, there's lots of good reasons for them to keep the symptoms that they've been having, to keep their negative thoughts and feelings and behaviors. And then the wonderful effective methods that help someone make change.

  And you and I spoke a little bit before we recorded the podcast today, and I think we thought that maybe a great area of focus that would be helpful to a lot of the people listening to this today would be anxiety, specifically what's sometimes called generalized anxiety disorder, or just in plain speaking would be excessive worrying. So I'm wondering, can you maybe help paint a picture for us, Like maybe tell us about, you can think of a, a patient that's come in with excessive worrying and how they were struggling before they worked with you. Would that be okay?

  Indrani: Absolutely. I was hoping you would ask me that because that's one of my favorite kinds of people to work with because I'm a recovering warrior that that's long gone in my past, but I know how difficult that can be and how painful it can be. But I'm always excited to share the tools that worked for me because it got me out of it and it's not a problem anymore. So yes, I would love to give you an example of a person that I've been working - it did even take me that long. I've seen her probably for six sessions and she's well on her way to recovery. A school teacher, she's in a leadership position in the public school here. A woman in her early fifties, had some health problems, but has helped overcome them, but has this kind of frequent and recurrent worry that things are not going to work out. So something might happen - when she goes to school, something might happen to her kids, something will happen to her husband when he's traveling, her mother might get sick. There is this constant and recurrent worry that has really been pretty damaging to her because it's not only stopped her from enjoying life which she has a good life, but it's also impacting her focus, her concentration, it's taking her longer to do things, making her irritable and anxious, and also she's having trouble with insomnia and other symptoms because of the worrying.

  Kevin: Okay. I'm just taking some notes as you and I are talking here, and I'm imagining other people who are listening to this who may have struggled with worrying. It struck me that as you were describing her, I think a lot of people, myself included, could relate to what it is that she's struggled with. There's just something about us as human beings. It's kind of the way our brain works, that we start to really worry about what could go wrong. And that could lead to so much discomfort and pain and fear that it starts to get in the way of us being able to function and live the life that we want to live, free of all that pain and fear. I mean, you mentioned this patient was having problems focusing at work, and also losing a lot of sleep, having problems with insomnia which then leads to its own list of problems with energy and focus.

  And you tell me if you agreed, Indrani, that one of the things that happens when we lose sleep because of anxiety is that these two problems kind of feed on each other and make each other worse. Not to get too technical, but when we're really struggling with fear and anxiety, there's a part of our brain that becomes overactive. The amygdala, it gets overactive, and it makes us think that we're in danger when we're not, so the body responds as if there's a threat. Everybody's probably heard of this like fight, flight or freeze response, which is why we're all alive. It's why people exist still because we have that system that protects our safety. But when we haven't gotten enough sleep, the problem is, is that then that part of the brain can become overactive. It's not functioning as well. Am I on the right track?

  Indrani: Yeah, you're absolutely on the right track. Are's a perseverative quality to it, so we can't shake it. And the reason why it's a problem, and you're absolutely right that worry or anxiety is an adaptive emotion. It keeps us safe, it keeps us alert, it kind of keeps us vigilant. We are alerted to dangerous things around us at the same time, and that's healthy. But if I'm doing it when there is absolutely no danger to my life or limb in any way, then that becomes an unhealthy response. And then because as you said, it feeds up on itself, now it's become a vicious cycle. And so the things that I worry about actually starts coming true. I forget things. I'm becoming irritable. I'm behind on my tasks. And so now it sort of takes on a life of its own, and that's when it becomes a problem. And that's exactly where I found this person.

  Kevin: And something you just said reminded me of something that helped me with understanding how to help people with anxiety a little bit more too, which is that part of our brain, like the amygdala, it doesn't know the difference between an actual legitimate threat to our safety and a negative thought that causes fear. It responds to both of them similarly. And so, that's why a big part of treating anxiety involves exposure. We don't want to avoid the things that we're afraid of happening; we want to face them and experience the anxiety, so that that part of the brain can relearn and understand that I can feel really anxious, and that doesn't mean that my life is in danger. And the reason why that's really important too, is because in our modern times, we don't get chased by predators. That's not a problem that most of us face, so our threats have become of a psychological nature. It's our worries, the things that we're afraid of that might come true. And I was just thinking about how sad that is when you described that vicious cycle that a person can get trapped into. And it sounds like the woman that you have in mind that you were telling us about has been stuck in kind of a vicious cycle like that.

  Indrani: Yeah. And what you're saying, Kevin, is so important because I think TEAM has so many elements that some other models of therapy may or may not have, mostly don't have. One of them is of course the structure, and the very targeted approach to the anxious thoughts. So in this case because it's anxiety, we are looking at what this woman is telling herself to cause her to feel the feelings that she's feeling, and TEAM model is very targeted to that. And then of course because we are measuring empathy, we are measuring all of the interventions as well and measuring our impact, the impact of treatment, and we are measuring the resistance. And in our world, as Kevin, in the TEAM world, resistance is a good thing. Resistance is protective resistance shows many wonderful things about the person.

  And then when you, when you were talking about exposure, to me, that's another genius of TEAM, is we put exposure front and center for the treatment of anxiety, because like you were saying, the body cannot tell whether this is real danger or not. And the only way that we can teach our body and our brain to know the difference is by exposing ourselves to the perceived danger. And it's an incredibly powerful tool, as you know Kevin, that actually really helped this person that I'm talking about. Exposure helped her a lot. She didn't want it. She was scared of it, understandably, but it worked really, really well for her.

  Kevin: Indrani, I'd love to, and of course we won't reveal anything about this person that would identify them in any way, because we always protect confidentiality of patients. I'm wondering if you could help us understand, let's say that we were, of course we would've gone through a testing phase in the beginning, and actually before and after every session. But let's say you did some testing and discovered that there was a problem with chronic worrying for this person, right? And then when you meet with her and just to learn like what are the worries on this person's mind and the kinds of thoughts that are bothering them in a moment in time when worry is really high. Like, what are the kinds of thoughts that we would be talking about here that are causing this worry?

  Indrani: Yeah, I mean, that's exactly what I mean. That's like the first step after we get a good baseline understanding of what her anxiety is, depression, anger, positive feelings, relationship feelings, all of that. In that moment, then I would ask her something like, you know, I would of course allow her to talk about what she was there for, what she wanted help with. Just as an aside, I think it would be useful for our listeners to know that before Kevin or I, or any TEAM therapist sees a patient, we actually do a phone screening, where we kind of tell patients about this approach. We try to understand a little bit about what they need help with and then explain our approach. And for everybody with anxiety, we also talk about exposure as a method that we would be using.

  So it starts early, so by the time the patient comes to us, they have a little bit of a background. And so, I generally allow my patients to just tell me, sort of get it off their chest, and then I invite them to get to work. And if they're ready to kind of dive in and get to work, then I will ask my patients something like, "Well, tell me a specific moment in time when you found yourself extremely worried and overwhelmed by it." And then we would generate what we call a daily mood log. And on that daily mood log from that specific moment in time, we identify - well the patient will identify all of her feeling, and we rate those feelings on a scale of zero to hundred. And then we generate the negative thoughts that are driving those feelings.

  And I just want tell you, Kevin, at this point, I'm sure you can relate to that as well, sometimes patients - and it's hard for them to connect the thoughts to the feeling because they feel so bad and they feel so many kind of distressing sensations in their bodies that it's hard for them to connect to that. But we eventually get to those thoughts, and those thoughts are something like, and I can tell you some of my patient's thoughts were, "Something bad is going to happen today. The people at work will be angry with me. My kid will be angry because I didn't pick her up from her soccer game. I'm going to mess up. I will hurt someone's feelings." So those were sort of the thoughts that were coming up for her, and so that's kind of how we sort of go - it's a back and forth and generate some really robust juicy 13 or 14 thoughts on that daily mood log.

  And I just wanted to, just a quick addition there if I might; I don't want the listeners to think that this will take three or four years. This takes, the whole thing from start to this point, it probably take 15 to 20 minutes in the session, 25 minutes at the most.

  Kevin: Yeah. That is really important to point out because our therapy is a brief model. I think you said earlier, these patients are finding recovery and their work with you in six to eight hours it sounds like. And I like the way you described the process of looking at one moment when this is a problem, and then what was the person feeling in that moment and how strong were their feelings, and what thoughts caused those feelings.

  Indrani: They believe those thoughts in that moment.

  Kevin: That's right. And exactly how much do you believe the thoughts that cause the negative feelings. Because when we're treating an anxiety problem, it's important to understand that events don't cause our feelings; it's our thoughts that do. And the kinds of thoughts that lead to really excessive worrying as an example; usually have something about them that's not true. And so we're not at the part of methods yet in your description, but eventually we're going to get to a point where we're going to use methods that prove that those thoughts aren't true. And that's when the change happens and how we feel. And I'm thinking about in our model of TEAM, we've talked about T=Testing and E=empathy, where you're really understanding this person and what she's experiencing and also given her lots of support and building trust with her. So that then the next logical part of the model would then be the A=Assessment of resistance.

  When we're looking at, well, there's outcome resistance and there's process resistance, and a tool of outcome resistance would maybe be initially checking in - I could imagine asking this woman that you were talking about, if everything went well in our work together on this problem, what would be different? Let's say a miracle occurred and you got exactly what you need. Like, what would that be? What's the miracle you're looking for? Is that something that the two of you explored it all?

  Indrani: Absolutely. And that I think it could be a stylistic thing. I generally ask that question after I get a specific moment in time.

  Kevin: Great. Yeah, right away.

  Indrani: Yeah. That, "Oh, I felt so anxious this morning when I was getting ready to go to work." And then I get some preliminary thoughts, I get all the feelings and miracle happened by the end of our session, so that I give the message to my patient that you don't have to wait 20 years for the miracle. There is a finite period of time when you're actually going to see improvements. So, if there's a miracle happened by the end of the session, what would that look like? What would change? And then I could actually go on to ask a few more questions. Like, so why would that be important to you? And what she said was or what I would want is, I would want to get up in the morning feeling excited about going to school and why that would be important to her is because she loves teaching. She said, "This is what I love doing. I trained many years for it. I love doing what I'm doing." And then I ask another question is that, "What would you be doing differently if you woke up thinking that I love teaching?" And then she would say, "Oh, I wouldn't spend so much time worrying. I would get ready quicker. I might go for a walk." And now I have her vision and now she and I are now looking at what that life without worry could look like and would look like. So, that's to answer the question.

  And then there is another place as well, Kevin, where we can check, so that is a miracle cure. But then again, once we generate, when we identified all the feeling, I will offer her the magic button. And then I asked her, "Well if magically all of these feelings went away, here's a button that you can push and these feelings will go away magically, would you push the button?" And then let her give me a yes or no answer. Regardless of the her answer, we're still going to go on to the next step of checking the benefits of these feelings that come to her. There's some clear advantages to have those feelings and what it says about her that is beautiful, which is basically her core value. I mean, that takes a little bit of time, takes a little bit of priming, because most patients are not used to thinking of their negative feeling in this kind of positive way, so we basically positively reframe their negative feeling.

  Kevin: It's a really beautiful and powerful part of the therapy, and probably what sets TEAM apart the most from other kinds of therapy. And I was just thinking a way that we could bring this to life for people who are new to TEAM and listening to this, I'm imagining your patient has shared with you that they were feeling anxious and worried and afraid at like a level of like 90%, when they got up in the morning and thinking about, I'm getting ready for going into school today. And then they were having this thought that led to those feelings, like, something bad is going to happen today, and people at work are going to be angry with me. And so, imagine that I'm this person, I'm this patient, and I've said that I actually would love to push a magic button and have those thoughts and feelings go away so that I could go to work and actually enjoy my day teaching because I love teaching so much. And I want to be free of this problem, and I want to not be trapped by anxiety. Could you maybe show us how would you introduce positive reframing? And maybe you could have me positively reframe my feelings and thoughts that we were just talking about.

  Indrani: Oh, absolutely. So I would pick the main set of feelings here, which are the feelings on the anxious line, which would be anxious, worried, panicky, frightened, and nervous. And she picked a few other feelings, but this was the one that stood out - this was the one that was causing her most distress, and that was actually at 100. We can certainly demo the positive reframe, kind of do a quick roll play on that. And I might say something, like just assuming that you said yes to pushing the magic button, which is what she said, "Absolutely, give me the button." And so then I would say something to you like, "Yeah, I mean, that would make sense, Kevin, why you would want push the magic button because it's painful for you. These feelings are pretty intense. At the same time I just want to make sure that you're not going to lose anything by pushing this button, because a lot of times there's some really good reasons why you have these feelings, even though they're painful and fairly intense. Would you be willing to look at some of the benefits that these feelings have for you? And also what it says about you that is so positive and beautiful?"

  Kevin: Sure, of course.

  Indrani: Just getting out of the role play for a second here, Kevin. I always ask people to write, because I can never do anything in my head. And so, at that point say something like, "Great here's a piece of paper. Let's draw a line down the middle on one side, let's put emotions and thoughts; on the other side let's put benefits and values. And let's start with the anxious - your anxious feelings. So let's write anxious, worried, all of that, the ones that she checked off on that line," which were all, in this person's case. "Let's write that down. And Kevin, can you tell me what are some benefits or advantages? What were some benefits for you to have those feelings this morning when you were getting ready for school? How did it help you?"

  Kevin: That's, that's, that's an interesting question. And it's kind of hard to answer to because I keep thinking of the anxiety as a bad thing, right? Well, I'm there I'm getting ready to go in and teach, and I'm feeling really worried and anxious and panicking and nervous and frightened, how is that helping me? I think it would make me really careful about preparing myself for my day.

  Indrani: Exactly. So it might have helped you kind of prepare and maybe plan your day.

  Kevin: Yeah, plan and prepare because I don't want to make mistakes that would make my coworkers angry.

  Indrani: So it might prevent me from making mistakes as much as I can. Can you think of any other benefits that these feelings of anxiety have for you?

  Kevin: Well, I'm going to choose my words really carefully when I'm communicating with my students and my coworkers, if I'm worried about offending them or causing conflict with them.

  Indrani: Exactly. So you would choose your words carefully, you would be alert to using any kind of language or words that might potentially offend them. Kind of would keep you alert for that, help you choose words carefully. And I mean, you're doing great. And Kevin, what does it say about you? What would say anxiety say about you that is so beautiful? Can you think of some core values that might be reflected in these anxious emotions?

  Kevin: Well, when I look at those benefits that it's giving me, it kind of shows me that I value planning ahead and being prepared for things. And that's true, I am very careful and I don't like to do things kind of halfway or I'm a pretty thorough detail-oriented person. Would that be a value you are looking for?

  Indrani: Absolutely. That's great. And would that show that you have high standards, you want to do things thoroughly, you want to do things well and be detail-oriented?

  Kevin: Boy, do I! And in fact, that's sometimes it's to an extreme, but I guess to a certain degree it could be helpful, that I have my high standards.

  Indrani: Yeah. You're doing good. What else does it show about you, Kevin, that is so beautiful?

  Kevin: Well, I guess, yeah. Well, I guess because I was extra concerned about disappointing people or making them angry, maybe that shows me that my relationships with my coworkers are really important to me. Like, I want to have good, professional, respectful relationships with my colleagues, and I don't want to let them down. Does that sound?

  Indrani: It's very good. And now when I look through this list of benefits and values, Kevin, are these true, these benefits and values that you listed, that it helps you prepare and plan, it prevents you from making mistakes, shows that you don't want to hurt anyone's feelings, be vigilant, care about what your coworkers think of yo, you want be professional, have high standards, are these true?

  Kevin: Totally. Yes.

  Indrani: How much is it important to you?

  Kevin: Very, very important.

  Indrani: And are these powerful?

  Kevin: Yes.

  Indrani: Yeah, I would agree with that. And so I'm going to pause here, Kevin, and I can move on to the [unclear35:02] question, or if you want explain, I would be happy to kind of...

  Kevin: Yeah. I love, I love that we're pausing here for a moment because if you were in a session with a real patient, you would do all of the feelings on the mood log, probably. And and we don't have time to do that today. So we can imagine - well, imagine that I said that the thing I most want to change is the anxious feelings. I think that's what this patient said. So maybe we can kind of go through this next part of what you would do next with the model, with just this set of feelings and what we positively reframed and learned from that exercise. Can you show us what you would do next then?

  Indrani: Absolutely. You're right, I mean, I would go through all of the feelings. And while there are a few overlaps, each set of feelings really have their own benefits and reflect distinct values. So, I would like to kind of make sure that I we capture as many of those that are possible. This step is generally hard for my patients because they never think of any of this as being anything but negative. Because the feeling feels so painful that how can there be anything good about it? And sometimes our patients will even say that, "What do you mean their benefits to this? It feels horrible." And I think you also said it, which was great because that's exactly what happens.

  And so sometimes I might have to kind of prime the pump a little bit. And what I noticed is that once we do a few and the patient starts to kind of come up with their own benefits and values, and I always kind of focus it back to that specific moment in time so all the benefits and that specific moment in time, not their entire life, not generalities to keeps them kind of focused. And then once they come up with this and they agree that these are true and they are important and they're powerful, now I'm kind of getting their buy-in. Yes, these are good reasons for them to have the anxiety. And then I will ask what is called the pivot question, right? And that is that, "Wow, given all of these benefits and values that there are in these negative feelings of anxiety, worry, et cetera, you still want to push the magic button." Let me ask you that question, Kevin.

  Kevin: Well, that's, that's a hard question because I don't like the way that those feelings felt, but I also, I don't want to lose those benefits and those values, so yeah, I'm not sure now.

  Indrani: Yeah. So if you're not sure about pushing the magic button, which I would agree with because there's like too many good reasons for you to have these feelings. Perhaps I can offer you the magic dial, which puts you in charge of these feelings, and you can dial it as low as you want to, or as high as you want to, depending on how much you need then. So if I offered you the magic dial right now, where would you want these feelings to be? And Kevin, I sometimes think of the dial as the dial on the radio because if you're listening to Beethoven cranked up all the way, it's painful. But when we dial it just at the right spot, that's when the music sounds just divine. And so, what would be that right spot for you, sweet spot, where you can keep all the benefits, but kind of get rid of the pain?

  Kevin: I think that I'd want those to be dialed down to about 20%.

  Indrani: 20%. That's great. So you want to feel about 20% anxious and worried and panicky and nervous and frightened.

  Kevin: Yeah, and I think that that would be enough.

  Indrani: And then what would that do for you?

  Kevin: Well, I would still keep that helpfulness, right? Like, I would be mindful of what it is that I say to people and communicating well. It's certainly good to be concerned about what other people think of my work and not disappointing them. And I would still do careful work so that I wouldn't make lots of mistakes. But I wouldn't be feeling all those terrible things like the butterflies in my stomach and actually the knots in my stomach and losing sleep at night over it and dreading going into work, instead of looking forward to it. So if it was dialed down enough, like to 20, maybe I would really look forward to going into work.

  Indrani: Yeah, that makes sense if that's what you want. And so Kevin, let's get started, now that you've dialed it down to 20, let's look at your thoughts and see what we can do that will make your anxiety go down to 20 instead of this that it's at right now. And then you would go onto the distortion.

  Kevin: Sure. Yeah. And so I'd love to pause for a moment and kind of catch people up on all the great things that you just did. Indrani, for people who are listening is very skillfully using tools of TEAM CBT, and what she was just doing right now was assessing resistance. Because all of us actually do have resistance to change, and like you said in TEAM CBT, we don't view that as a bad thing, but as a good thing. And what we do is, we look at the negative feelings and thoughts that this patient is having in that moment, not as a sign of all of the things that are wrong with them, but it really of what's right with them. Why does it make sense that they think and feel this way? And how is it helping them and what does it show about their values that's really positive.

  And one of the things that I really like about that Indrani is, and actually I'm quoting Dr. Burns when I say this, but it's having a lot of meaning for me lately, which is sometimes the biggest change that a person can make is accepting themselves, the way that they are without changing. Because a lot of the time, maybe you've noticed this, when people come in, especially with an anxiety problem, they're telling themselves all the time, "I shouldn't be so afraid. I shouldn't have this anxiety. It's bad for me. I need to get rid of it. I need to push it away. This is wrong for me to feel this way." And one of the problems is, with anxiety especially; the more we try to push it away what happens is the bigger it gets, until it becomes like this huge monster in our life.

  And so if a person can be invited to actually just accept themselves as a human being who sometimes is afraid and really afraid, really anxious and nervous and concerned about what other people think of them, and that that's okay, but that's a human trait that we have. And that's not only just okay, but it's helping them and it's showing beautiful things about them. That's a big step in the change that we're looking for, as well as also reducing resist resistance to therapy methods. And I think that one thing I wanted to make sure I said about that... Oh, I just thought what you did was so beautiful Indrani. Like, I'm totally there with this idea that when they dialed down that radio right to be sweet spot, where the music sounds beautiful, they get to keep these benefits, they get to keep how the anxiety is helping them and all the beautiful values that they hold. Those beautiful values that they hold are just as beautiful as the music that you were describing.

  And when you look at it that way, you've aligned yourself with their resistant part of them. You've taken on the side of the resistance, and it's kind of like you're doing a little bit of bargaining with their unconscious mind. You're saying don't worry. I accept you the way that you are, and I'm not going to force change on you, and I'm not going to make you become a different person and you're not going to lose your beautiful music. Boy, I'm going to use that with everybody I work with from now on. I really liked that Beethoven and the radio dial that you did.

  You know, today I really enjoy the fact that we got to know you a little bit, Indrani, and hear your personal style and the way that you use the tools of TEAM, and especially this super important assessment of resistance piece. And the positive reframing and how beautiful it can be. And I know that we're not actually looking today so much at methods that lower anxiety, but we did all the work that sets it up to be able to be successful. And I think that that was great the way that you demonstrated that, and that's probably what we're going to have time to do as a demonstration today and our time together. So there's a couple things that I would love to talk to you about that would be for the benefit of people listening to this. If somebody enjoyed listening to you today and was looking for a therapist and they were in the Maryland area that you are in, not far from, I think Baltimore and also Washington DC, it's kind of in that general area?

  Indrani: Yep.

  Kevin: Are you open to accepting new patients at this time?

  Indrani: Always. I'm always accepting new patients. I'm always welcoming them into our practice. I generally see patients for about eight to 10 weeks or sessions, and so I always have openings and happy to see patients. And so the best way to contact me is that they can just email me if they want. My email address is Imookerjee25@gmail.com or they can go to the Feeling Good Institute website, and if they put in Maryland, I'll pop right up. And all kinds of information is right there. If all else fails, just Google me, you'll find me that way.

  Kevin: Very good. And I'll just mention, that's feelinggoodinstitute.com, and then there's a great search tool right there. They could even do a drop down menu and choose to find you personally on there too, and of course, Googling you. And I think you said you offer a free consultation initially.

  Indrani: Yeah, a free 15 minute initial consultation. And I'm also doing intensive, but that has to come through Feeling Good Institute and you have to contact Kevin for that, and that is another service that I offer as well.

  Kevin: Yeah, and we can talk a little bit about what that looks like too, because some people might be interested in that. So an Intensive is a whole bunch of therapy in a short amount of time so that a person can make a big powerful change right away in their therapy work. I know you do them all the time. I just had 12 hours with somebody over the last four days, and they made huge progress in lowering anxiety. And now they may move on and work with an individual therapist weekly after this, or they may have what they needed and they'll use the tools on their own, you know, they're deciding about what to do about that. And so, I love that people could consider doing that with you, right? They could work with you in traditional weekly sessions, or they may come to you for an intensive and get a lot of great benefit in a short amount of time.

  It comes to mind to me that as we're recording this, we're coming up on, like lots of holidays are coming up in November and December, so sometimes people have longer breaks and they can take advantage of that time to come in and do an intensive, so this might be a good time of year to do that. And I just want to, you know, we're going to have to to close things here soon, so I just want to say Indrani, what a joy it is to talk to you, to share your skills with our listeners and to so beautifully demonstrate how to address resistance with positive reframing. And I can only imagine the great work that you're doing with your patients and helping them with lowering anxiety and excessive worrying, and people listening to this, hopefully we'll get that awesome opportunity to work with you if they want.

  Indrani: Thank you so much, Kevin. It was entirely my pleasure. I mean, you've been my teacher for a long time, so it was such an honor to do this with you, and thank much.

  Kevin: You're very welcome. And Indrani, another thing came to my mind too that I want to mention, which is you're a level four certified TEAM CBT therapist, so you do training also, right?

  Indrani: I do.

  inteer: And if somebody is a therapist who listened to this and they were interested in learning more about being a TEAM CBT therapist, I'm guessing that they could also contact you about consultation or training. Is that true?

  Indrani: Absolutely. So I'm available for individual supervision, I can also help with prepping for the level three exam. I have been a level three examiner. I also can train organizations psychology department or psychiatry or you know, wherever there's a group of mental health providers, I'd be happy to come out and train them as well.

  Kevin: Well that's beautiful. I'm so excited to hear that. And thanks again for joining us and I'll talk to you soon.

  Indrani: Great. Thank you so much.