Feeling Good by David Burns: what the book teaches

What is Feeling Good?

Feeling Good is a self-help book by the American psychiatrist David Burns, first published in 1980 and revised in 1999. Burns trained with Aaron Beck, and the book puts Beck's cognitive approach to low mood into plain language for readers at home. It has stayed in print for more than forty years and is one of the best-known self-help books based on CBT.

What's the main idea?

The book's starting point is the one at the heart of CBT: your feelings follow the way you think about what happens, not only what happens. When you're low, the thoughts that run through your mind tend to be distorted in familiar ways, and because they feel true, they keep the low mood going.

The good news in that idea is practical. A thought can be written down, looked at and answered. You don't have to wait to feel better before you start.

What does the book teach?

In our own summary, the book works through three things.

Spotting the thinking errors. Burns lists ten common patterns, from all-or-nothing thinking to labelling and should statements. The list is the part most readers remember.

Answering the thoughts in writing. The book's main method is a written exercise in columns: the automatic thought, the thinking error it contains, and a more realistic answer. It's close to what is now usually called a thought record. Burns stresses that the answer has to be believable to you, not just cheerful.

Specific problems. Later chapters apply the same method to self-criticism, guilt, anger, the need for approval, perfectionism and the "do-nothing" state, where stopping activities makes the mood worse. For that last one the book suggests planning small activities and noticing how they go, the idea behind activity scheduling.

What does the written method look like?

A short example, in the spirit of the book's columns. After a friend cancels plans, the automatic thought is: "Nobody really wants to spend time with me." You might believe it 80%.

• The thinking errors: overgeneralising (one cancellation becomes "nobody"), and mind reading (you don't know why she cancelled).
• A more realistic answer: "She said her child was ill. Two people asked me out last month. One cancelled plan doesn't tell me how people feel about me."
• Believing the first thought now: perhaps 30%.

Writing matters. Answering a thought in your head tends to go round in circles; on paper you can see it, test it and come back to it later.

What about The Feeling Good Handbook?

Burns followed the book in 1989 with The Feeling Good Handbook. It uses the same methods but adds more on anxiety, worry and relationships, with more forms and exercises to fill in. If Feeling Good is the explanation, the handbook is closer to a workbook. Many readers start with one and dip into the other for the chapters that fit them.

Did reading it help people?

Researchers have tested Feeling Good as "bibliotherapy", meaning reading a self-help book on your own. In small studies by Forrest Scogin and colleagues in the late 1980s and 1990s, older and younger adults with mild to moderate low mood who read the book over a few weeks did better on mood questionnaires than people who were waiting to start. These were small trials, and their results apply to the people in them, not to everyone.

NICE, which writes the guidance for the NHS in England, includes guided self-help based on CBT among the options for less severe depression. "Guided" matters: it means self-help with support from a practitioner.

Why has it lasted so long?

Part of the answer is the writing. Burns explains ideas with everyday examples and a light touch, and he speaks to the reader directly rather than to clinicians. Another part is that the methods are concrete: the book asks you to do something on paper, today, rather than wait for insight. And the core idea, that a thought can be checked like any other claim, is easy to remember once you have seen it work on one of your own thoughts. Many later self-help books based on CBT, and many CBT apps and worksheets, use the same building blocks.

Is it right for you?

Many people find the book clear and practical. It's also long, and a lot to take in when you're very low. A few points to keep in mind:

• Start small. One chapter, one written exercise, is a good start.
• Pick the chapters that fit. You don't have to read it in order; the chapters on guilt or self-criticism stand on their own.
• Come back to it. Many readers find a method makes more sense the second time, after trying it once.
• Writing it down works better than reading about it. The book says so itself.
• Low mood that lasts deserves a conversation with your doctor, especially if it's getting worse or you have thoughts of harming yourself. A book is not a substitute for that.

If you'd like to try the main method, the thought record and the double-standard exercise in ThinkGO follow the same CBT steps, one question at a time. ThinkGO isn't connected with the book or its author.