VIDEO: Treating Anxiety

David Burns on the Paradox of Resistance

According to renowned anxiety expert David Burns, the biggest barrier to treating anxiety successfully—sometimes even in a single session—is recognizing how clients covertly hold onto their symptoms, even when it restricts their lives and seems to cause them enormous distress.

In fact, many clients believe that their anxiety protects them more than it disrupts their lives. And since so much anxiety treatment involves some form of exposure to the very thing that causes them so much discomfort, clients have compelling reasons to resist. That’s why the drop-out rates for anxiety treatment are so high.

In this video, David explains how he addresses outcome and process resistance in a way that quickly leads to meaningful and lasting change with clients.

This approach—directly addressing the perceived perils of change in the very first session of therapy—allows David to forge an entirely different kind of collaborative alliance with his client from the get-go. Using this approach to treating anxiety, he began to see results beyond anything he’d previously achieved in his long and distinguished career. The key is not starting the process of treatment until the client is truly ready to begin.

Rich Simon

Richard Simon, PhD, founded Psychotherapy Networker and served as the editor for more than 40 years. He received every major magazine industry honor, including the National Magazine Award. Rich passed away November 2020, and we honor his memory and contributions to the field every day. 

David Burns

David D. Burns, MD, is an emeritus adjunct clinical professor of psychiatry and behavioral sciences at the Stanford University School of Medicine. His best-selling books, Feeling Good and the Feeling Good Handbook, have sold over five million copies worldwide. Although he was a pioneer in the development of cognitive behavior therapy (CBT), he also created a more powerful approach called TEAM-CBT.

More than 50,000 therapists have attended his training programs over the past 35 years. His website,, offers many free resources for therapists and clients alike, including his tremendously popular Feeling Good Podcasts which draw more than 50,000 downloads per month.