514: Ask David w/ Dr. Matt May

514: Ask David w/ Dr. Matt May Schizophrenia, Resistance, TEAM's Future, and What Makes a Great Therapist In this thought-provoking Ask David episode, Dr. David Burns is joined by Kevin Cornelius, LMFT, and special guest Dr. Matt May, psychiatrist, TEAM-CBT therapist, and longtime colleague of Dr. Burns. Together, they tackle challenging listener questions about schizophrenia, emotional suffering, resistance to change, therapist training, and the future of psychotherapy.

Along the way, the conversation becomes deeply personal as David reflects on the qualities that shaped the development of TEAM-CBT, his hopes and concerns for the future of psychotherapy, and the lessons he's learned after decades of clinical work.

Our Special Guest: Dr. Matt May Kevin welcomes Dr. Matt May back to the podcast. Matt is a psychiatrist trained at Stanford who has worked closely with David for more than twenty years. Although trained in psychiatry, Matt explains that his work today focuses almost entirely on TEAM-CBT rather than medication management.

David praises Matt as one of the most gifted therapists he has ever known, highlighting his warmth, compassion, humility, and clinical expertise.

Question #1: Can TEAM-CBT Help the Negative Symptoms of Schizophrenia? A listener asks whether TEAM-CBT can help with the so-called "three A's" of schizophrenia:

Apathy Avolition (severe lack of motivation) Anhedonia (loss of pleasure) or whether medication is the primary treatment.

David's Response David challenges the assumptions behind the question itself.

Rather than viewing people through the lens of diagnostic labels and symptoms, he emphasizes that TEAM-CBT begins by asking:

"What would you like help with?"

He argues that therapists often fall into the trap of acting like experts who believe they already know what a patient needs based on a diagnosis. TEAM-CBT takes the opposite approach, focusing on the individual person's goals, struggles, and hopes.

David shares an early experience treating a patient with schizophrenia. Initially, he tried to challenge the patient's delusional beliefs directly through cognitive techniques. When the patient simply reinterpreted the evidence to support the delusion, David realized he was pursuing his own agenda rather than the patient's.

The lesson: