problem solving as overviewproblem solving as overview

problems & difficulties

symptoms

therapeutic responses

therapeutic responsestherapeutic responses

innerchange

outerchange

biologicalfactors

therapeutic alliance

symptoms

biochemistry & outer changebiochemistry & outer change

outerchange

biologicalfactors

therapeutic alliance

medication, herbs,supplements, food,

light, sleep, etc

general activation: exercise, interests &

relationshipstargeted activation:

responses to trigger factors & desensitisation

innerchange

inner changeinner change

outerchange

biological

factors

therapeutic alliance

challenge current beliefs: education/normalisation and behavioural experiments to change viewpoint

inner focus: calming skills, mindfulness, internal desensitisation, attention training and imagery

emotional processing: simple & complex

innerchange

key points of this key points of this handouthandout

trauma memories are very trauma memories are very common in depression and common in depression and anxiety as well as in ptsdanxiety as well as in ptsd

elicit these memories and elicit these memories and ‘images’ gently and carefully‘images’ gently and carefully

disorder onset, severity and disorder onset, severity and persistence seem persistence seem contributed to by memories contributed to by memories and ‘images’and ‘images’

lessons from ptsd treatment lessons from ptsd treatment may well improve treatment may well improve treatment of depression and anxietyof depression and anxiety

involuntary memories are involuntary memories are normalnormal

involuntary memories of personal life events are involuntary memories of personal life events are reported at least 5 or 6 times daily by “normals”reported at least 5 or 6 times daily by “normals”

typically these memories are cued by typically these memories are cued by identifiable aspects of one’s current situationidentifiable aspects of one’s current situation

memories often take their emotional tone from memories often take their emotional tone from one’s current mood - typically happiness or one’s current mood - typically happiness or sadness - and then reinforce this moodsadness - and then reinforce this mood

memories are often of recent or of unusual memories are often of recent or of unusual eventsevents

intrusive thoughts are even more common and intrusive thoughts are even more common and when negative tend to be characterised by fearwhen negative tend to be characterised by fear

Berntsen D Involuntary autobiographical memories Appl Cog Psychol 1996;10:435-54

Brewin CR et al Intrusive thoughts and intrusive memories in a nonclinical sample Cognition & Emotion 1996;10:107-12