Thursday, March 10, 2016

Positive Difference Making Fundamentals in Focus - Staying in the Now




I again must apologize, dear readers, for this post has too long been delayed. 

I talk about all my Positive Difference Making Fundamentals yet have not delivered the most important factor and daily habit to truly making them all work and for you to get on the path to better mental health, better emotional stability and to work past and even end your suffering. Today's concept - staying in the now and living one day at a time - is the glue that holds it all together and makes it work. It's the glue that will hold you all together and make you work. 

So again, I apologize. In my defense, however, I'll say that sometimes it takes the passage of time practicing all these things to realize which is the most important.

At any rate, better late than never. 


We who suffer mental health difficulties ranging from anxiety to depression to major psychiatric disorders like bipolar disorder and schizophrenia will have to endure a lot of off the cuff "fluff advice". Actually, come to think of it, we'll have to endure a lot of completely useless "advice" from supposedly highly trained professionals. During the worst of my disorder between the spring of 2010 and the end of 2012, I often felt inundated with "advice", almost all of it unsolicited. None of it felt useful and as I was slowly (or at times quickly) losing my mind (not in the popular colloquial sense of that expression but in the real and severe sense), these barrages of seemingly simplistic folksy bits of "advice" not only didn't help at all, it only increased my frustration, aggravation and thus worsening mental states. The advice itself almost literally drove me insane.

Plus - plus! - I saw over the course of my roughly three and a half years at the hands of the mental health system no fewer than twenty psychiatrists and somewhere between half a dozen to ten psychologists. Every now and again the message was right, but the delivery was ... ham handed, shall we say. There are reasons for this disconnect between professionals and we peeps, but I'll get to that another day. Suffice for now to say that much of what we're told and how we're told it ends up being not particularly useful.

Two bits of advice that drove me crazy - and I'll get to why below - were being told to "stay in the now" and to "live one day at a time".


However, in the dawn of 2013 when I started my now (sort of) famous quest for "why?" in understanding psychiatric disorders and what to do about them outside of the dominant paradigm of the pharmacological treatment pushed by psychiatry and the mental health care system and I read anything and everything I could, I came across the concept of "staying in the now" again and again and again. One of the best books I ran across early in that mad (sort of literally) dash to learn everything I could was How to Stop Worring and Start Living by Dale Carnegie, a truly timeless book of practical approaches to dealing with stressful worry.

That book impacted me in a number of powerful ways. The interviews and real world research he did to compile all the stories and techniques that went into that book covered a span from the late 1800's up to the depression and World War II years. And as I read story after story of people being crippled and broken by anxiety and worry and depression to the point of destroyed physical health and to the brink of suicide, it struck me that people have always suffered for similar reasons. This is probably true of every generation but we modern generations - roughly the baby boomers through today's millennials - always somehow think we're the first ones in history to experience something like depression and anxiety. We could certainly argue that there are more stressors around today and that we're exposed to more of the world's ills (and today is nothing compared to many points of the past) and that this is making mental illnesses more common and widespread, but the core reasons and the experience of it are the same as always. 

In any case, reading through all the stories or case studies, the striking familiarity of them to today's cases and the language used to describe them hit me between the eyes. This made the methods described within the book to overcome acute or chronic internal crises all the more interesting and powerful to me. 

Two chapters stood out most to me and were the greatest source of methods for learning to live more free from stress and anxiety and how to get through the periods of being hammered by suicidal darkness. The one I'll get to another time and the other forms the basis for today's post - learning to live one day at a time, stay within one day at a time and within the moment. 

Carnegie laid out the basic principles of living within the present day in multiple ways from the scriptures of various religious books to the teachings of ancient texts to how modern (at the time of the book's writing in the 1940's) CEOs managed their enormous workloads and pressures; all stressed the importance of staying within the present day. Throughout ancient history through to more recent times, it seems, people have learned that the best way to deal with life's stresses and sources of anxiety was to stay within the present day and present day only. 

As well, Carnegie gave numerous examples of how people on the verge of suicide or were literally becoming sick with stress and anxiety turned their lives around in big and productive ways by simply learning to stay within the present day. 

So that's a very powerful historical perspective. 

Not to mention that the concepts of one day at a time and staying in the now are fundamental tenets of Eastern thought and mind philosophies that have been successfully taught and practiced for 2,500 years.

This is a very brief summary of everything I looked into regarding "living one day at a time" but I can tell you that the real world historical evidence for it being necessary to a healthier mind was pretty much irrefutable. 

However, as most of us who struggle with moderate to severe mood or psychiatric disorders will know, "staying in the now" or "living one day at a time" ranks very high in the easier said than done department; it's very easy to say (and give out as advice), quite different in actual daily practice. 

As with everything we are told to do for healthier minds but which we find so hard to practice, I wanted to know why it was so difficult for us to do. 



Why it's so hard 



Staying in the now or the present day and keeping our minds within these "compartments" (as Carnegie referred to them) is not easy. There are reasons most people have such difficulty with it and why we mental health peeps especially struggle with it so let's have a look at some of them.

One reason is memories and the power of them. Much of what we experience as memories is of past events and of our past lives (known as "episodic memories"). These kinds of memories, of course, are a massive part of Who We Are. As well, it is now well understood that painful memories will become more "seared in" to our memory banks and thus will haunt or plague us more (PTSD is at the high end of this scale). One thing that differentiates us mentally suffering peeps is that we form memories more powerfully than most people. As our lives become more painfully difficult, circuits and regions involved in memory formation create more negative memories. This can build up over a lifetime or it can take place during a several year stretch of particularly difficult mental health struggles during which a great deal of very powerful and painful memories can almost literally burn themselves into our minds making them seemingly inescapable.

Additionally, there are some powerful brain regions involved in what is known as ruminating thoughts. These are thoughts in which we examine our distress and pain and their causes and consequences, largely by accessing the aforementioned memory "data". It is not necessarily wrong to ruminate or reflect on what we'll term simply as "things that went wrong", it is an important and perfectly natural part of how we learn from past mistakes. This brain and mental circuitry is supposed to be there and utilized. As with all our neuronal hardware, it evolved for a reason. It is in these specialized networks where we experience and process such feelings as guilt, remorse and "right and wrong" and so on. People in whom these regions and circuitry are not as active become disordered in a different and perhaps less socially correct way. Inactivity in these regions is thought to be a part of what goes on in the brain of a psychopath - this absence of ruminating over guilt, mistakes, right and wrong, etc. We wouldn't want to be like that, would we!

However, in the "disordered thinking" we see in unipolar depression, the depressive phases of bipolar, and anxiety disorders,  the regions and networks involved in ruminating thinking become far too stimulated and activated becoming "locked on" thus "trapping" us in nearly endless loops of ruminating and guilt and grief filled thinking which almost invariably ends up in very negative thoughts and mindsets and beating ourselves up. These endless thoughts - and look at the ginormous amounts of "past memory data" we could dig up and go over - become a massive weight we drag around that makes it nigh on impossible to move forward in life. This then becomes an enormous source for further anxiety, stress and dark depressive episodes.

Because the brain regions involved in creating ruminating and guilt and grief filled thoughts are a very powerful and important set of brain regions, however, it does not relinquish its "role" in your thought processes and mental states easily (and for good reasons, as we saw above). More in a moment. 

On the opposite side of the coin is our deeply and uniquely human "predictive functions". A huge part of what makes humans able to do many of the things we do which other animals cannot is being able to "plan for the future". What enables us to do this are brain regions that can take all kinds of present and past information and extrapolate that into the future, creating a "model" from which to work and plan on. As with any networked brain function, though, it can work for us or against us. When we are getting trapped in worry and melting down with anxiety, a good deal of that is over the future and what we "see" there.

Again, this is a very powerful mental process of networked brain regions that, like all our brain functions, is to a great extent part of our "zombie programs"; brain functions that run for the most part autonomously below our conscious control. Our self-reflection and "ruminating on mistakes and the past" regions are the same - programs that more or less will "run" whether we want them to or not.


When you look at and study depression and anxiety at their roots, much of what both drives and creates it is this constant loop of ruminating about negative past events and projecting this forward into a negative future. 

This is partially how the stress response system and related networks are designed to work. This system "records" a bad event, kicks in the brain areas involved in examining these bad events (ostensibly to learn from them), then notifies the "predictive functions" that are supposed to help us prevent them from happening again. But with chronic stress and anxiety this system gets "locked" into this maladaptive loop creating a tragic cycle that traps us into negative rumination and "forecasting" scarily dark futures. 

But the more we dwell in negative pasts and forecast negative futures, this - guess what?! - creates more anxiety, which further stimulates the stress response system which further stimulates the "examine past events" regions which further stimulates and floods the "forecasting" equipment with dark negativity and ... well, as you've no doubt noticed, that's a hell of a shitty loop to be caught in. 

Tied to both of the ruminating and future forecasting regions are various brain networks involved in the human capacity for imagination which, by its very nature, works well outside the laws of "objective reality". These networks that create the power of imagination can become terribly tied up with both our past and future mental images, also creating frightening mental states which again triggers our stress response system which again triggers "examine mistake" and "project future" regions and ... round and round we go, where we stop, nobody knows. You know the drill all too well. 



Why Not Staying in the Present Day Creates So Much Mental Distress and Anxiety



To begin to understand this, let's go back to our "conscious awareness plate".

For new readers, or to remind regular readers, we'll just briefly revisit what consciousness is. "Consciousness" is that moving picture show you see when you are awake. It represents what you are thinking and imagining, it is what the brain is experiencing and then puts in your "mind". As I've mentioned several times, however, it represents only a tiny fraction of what is going on in your brain at any given time.

The renowned neurobiologist Bernard Baars, whose Cognitive Theory of Consciousness (1) is still regarded as one of the most important and widely cited models for understanding and explaining consciousness, describes consciousness as a "global work space", global meaning all regions in the brain are, or could be involved, and work space meaning what we have on the "plates" of our minds to deal with at any one time. 

I have likened conscious awareness and this "work space" to the screens and speakers of our computers. What is on the screen and playing through the speakers is what we deal with at any one time out of all the programming and tools our computers are capable of and so it is with our mind. 

This concept of conscious awareness and what we're "working on" at any one time - this global work space - is not unlike the RAM and working memory in our computer. If we attempt to run too many programs on our computer at once, it will freeze or crash. And so it is with our working minds. It is literally not possible for your brain, your consciousness, your mental "work space", to hold so much from our past plus so much from all our future days PLUS the present all at once and actually deal properly with any of it. 

There is a complicated network of regions involved with what we are consciously experiencing or working on at any one time and like all brain regions and networks, their capacity to handle and run "data" is limited. Greatly involved is our "short term" or "working" memory. This is very limited. It is not just your brain that is limited in this regard, all brains are. They can be trained to handle more (which is what I'm cleverly trying to get you to do), but the capacity of all the regions and networks involved is greatly limited by very hard "laws" of elementary brain functioning physics and biology. Not to mention, how every cell in your brain and body creates energy (a series that examines energy depletion in bipolar disorder but the fundamentals of which apply to all brain functioning) and the general "energy economy" of the brain is also of vital importance to understand. Think of your brain having limited watts on which to run and filling our "working plate" with too many functions of past, present and future very quickly drains the energy reserves down to very low - dangerously low for many of us. When our brain energy reserves run too low is when we are most likely to experience overwhelm and meltdown.

Thus, if we flood this "work space" of our minds with too much past, future and present "data", it will freeze, melt down and you will experience overwhelm and stress and anxiety (thus further stimulating this horrendous loop). 

So it's not just that your brain cannot function under these conditions, no brain can - not even the healthiest of brains. 

Another way to look at this mental state overload is as a form of multitasking. Numerous, numerous studies have demonstrated how poor we are at multitasking (and the better we "think" we are at it, the poorer we'll actually perform at it). So think of trying to juggle so much from the past along with so much from the future then piling that on top of the present as a particularly bad form of attempted and tragically performed multitasking - your brain simply can't do it, nor can any brain.  



So learning to stay in the present moment and only deal with the present day is absolutely vital for clearing up space in your conscious "working plate" so that you can work on what is before you properly.


To further understand how all this works and why we get so easily trapped into these loops and why it's hard to break them, we need to quickly revisit something we've learned before - the principles of neuroplasticity - and something that will undoubtedly be new to many of my readers, and a rather recent way of how neuroscientists examine brain functions, the concept of default mode networks. These are highly complex interacting networks and regions that, to put it very briefly for today, are what your brain "defaults" to when it has "nothing better to do". In other words, in a more or less resting state, these networks and what they do are what our brains will fall back on when the brain appears to be "at rest", IE; what it will most naturally tend towards when not actively engaged in a relatively focused task. 

There are many, many different and individualized kinds of default mode networks among us, and no two are exactly alike. I posit that in many of us mentally suffering peeps, one of our most pernicious resting state or default mode networks is this agonizing loop of suffering we just briefly looked at. 

These networks and loops become part of our resting state default modes because of the "dark side of neuroplasticity" - the more a given set of regions and networks, etc is activated, the more "wired in" and dominant it becomes (this is a very well known and studied aspect of neuroplasticity). 

I also posit that we each have more than one or several default mode networks; this negative past ruminating and negative future projecting and resultant meltdown one being but one of them - one that we'd like to rid ourselves of!

So to summarize, is it hard to stay "in the now" and live "one day at a time" and stay within the day and not get trapped in the past and not project negative futures? Absolutely it is. 

However, in all my research and study reviewing vast bodies of all manner of studies, I found no other way to retrain our brains to avoid these crippling cycles (and they are crippling) than to build the habit of living within the present day.


How to start training your mind to stay in the present day or moment

We'll try to keep this very simple for now. 

What I'd love is for you to tie this into mindfulness meditation cognitive behaviour therapy. What I do is put on some zen meditation music  (via YouTube), using that to slowly wake up my mind first thing in the morning. I do perhaps fifteen minutes of the mindfulness CBT to get my mind cleared of troubling thoughts or situations and then I try to set up my day. Based on what I've been working on in the CTB, I remind myself of my core values and goals based on them and then I do the best I can to plan my day around what I can do to move those forward. 

Foremost, I remind myself to stick to what I can do that day and that day only. This will not, as we saw above, be easy for you in the beginning thus has to be a daily reminder.

The simple meditation practices I have utilized and talked about in the past help train my mind to stay on my present task and day (which in my present life is almost always reading and researching or holding discussions related to that).

You - or I or anyone - are defined by your daily actions, so ask yourself each morning - what am I going to do today to make a difference on this day? These needn't be major things. Just small steps and gestures can often do. And then do your best to follow through on what you can do to move these things forward that day. 

There are times I think about the past and future, but I have now carefully trained myself to think only of "information" relevant to my present task or tasks. I have learned to better let go of the emotional attachments of past and future information.

This, however, is when times are "good" and things are going well and life (and I) is relatively stable. 

As you know, we cannot avoid difficulties in life and days of bad mental states. These are not going to stop happening, I'm afraid. Something will happen - a trigger - and we'll get hammered by pain and perhaps experience times of panic. Or some sort of destabilizing event or events will happen in our lives that greatly stress us out and start the whole loop again. These are the days when our minds will most be tempted to get into that negative rumination about the past and imagining dark, hopeless futures. These are the days we will really be tested. 

This though, my friends, is when the importance of making these healthy brain practices part of our daily routines really comes to the fore. 

If we practice staying in the present day enough, if we consistently train our minds in these ways, it is during the hard times that our brains will have a better chance at "defaulting" to this new mental habit rather than the bad mental habits of the past. We may have to more consciously work on it, though. In hard times, we just have to focus on getting through the hour, then the morning, then the afternoon and then the rest of the day. Don't even allow yourself to think about the whole day!

This is the key to any seemingly impossible monumental task, my friends - breaking it down into the smallest doable bites possible and doing the best we can to only handle them one at a time (and I know how challenging this can be to those who are juggling home life and a career and so on).

And this is where another daily habit can prove invaluable - no matter the task, no matter the difficulties, no matter the pain, if it is important to my long term values and goals, I train myself to get the best possible result I can out of whatever it is. I have trained myself not to let myself plunge into the sinkhole of "fuck it" and throwing in the towel on myself. This has been and often remains very, very, very challenging but I have for the most part instilled this "refuse to lose" mindset. It is true that some days we have to say "fuck it", but instead of thinking of it as completely throwing in the towel, it is merely letting go of it for that day. 

And it is through approaching each day like this that we learn to separate our present from our past, however painful or difficult it was. As we do this day by day, we can begin to leave our painful pasts behind, to lessen their grip on us. This is how we begin to retrain our brain networks to break the cycles we looked at above.

This is also how we train our brain to let go of it's predilection for "forecasting" the "future". This one of the human mind's worst habits and for mental health suffering peeps one of the greater sources of overwhelm and anxiety meltdowns. 

Rather than getting stuck in the impossible (literally impossible) mind trap of "predicting" the future, practicing staying within the day and doing the best we can with each day is how we build our future. Build each day as well as we can and the future will take care of itself. This is how we learn not to create self fulfilling prophesies for negative futures based on past events and not to erroneously believe we can "predict" the future. 

This practice of staying in the now and within the day is how we can learn to bust many mental health crushing cognitive distortions and other cognitive bias thinking that sabotages our goals and truer needs. 

I will admit that there are days I realize I just don't "have it" that day, and do what I can to defer the most difficult tasks to a time I have more energy or am more able. When we take each day on its own, when we get hammered by very difficult pain, we can remind ourselves that it's only "that day" and learn better to get through it and not let it become more major than it need to be.

Or I may remind myself to be compassionate with myself, to not expect to be my best all the time and to just see how I can get the most out of that day with what I have that day. I try to stay focused on getting the best out of whatever task I'm doing or situation I'm in and accept that that's the best I can do on that day. 

At the end of the day, I sort of do a repeat of my morning mindfulness CBT, using it to evaluate how things went in a non-judgmental way. 

Then - critically important - I let that day go. I can go to sleep knowing I did the best that I could in handling that day and that day only. I create a sort of "reset" button for my mind to "clear the cache" of that day and assure myself that I'll get through the next day in the same manner as well. This is how we prevent a bad day from becoming a massive long bad period that traps us back into the negative past/future loops we looked at. 


Yes, yes, I know what you may thinking - the present is what hurts and sucks so bad and that's the problem.

This is very difficult indeed and there were many times that the last place I wanted to be was in the present! This is when that fluff "just stay in the present" advice used to drive me nuts. "The present is the problem", I wanted to scream!

But in the end, I knew the only way to work past that was one day at a time and this started to pay off after a while. Each day I would try to commit myself to making that day the best I could make it, to create the most positive memories and outcomes I could and so on. If it was a terrible day and I managed to survive it okay, I would congratulate myself with a little fist pump and a "yes!". 

And if we do this bit by bit, day by day, we can start to create a better and better "present" that isn't so hard to be in. Bit by bit we can create a present that we want to be in.

And of course every day I do as many of my Positive Difference Making Fundamentals as I can. I compiled a long list so that no matter how bad things were going, I could practice something that would have a positive effect on my mind. Many of those are designed for long term effects so I knew that even if it didn't have an immediate effect, I was doing my brain good for the long term.

And this is how all major change happens, folks - staying focused on little steps practiced daily. We go step by step through the day, then day by day through the week, focusing on creating the best outcomes we can for that day and that day only and one day we can look back and see that we're not in as bad a place as we were. Then another day we can look and see we have our lives moving forward more positively and with more hope and belief. 

But we must be very, very cautious of "great days". These can be like hidden traps. We can get too up and feel like we can rush ahead and this can set us up for failure or a return to bad habits. So even on our best days, we must try as best we can to stay within ourselves for that day and not take on too much. Even the best days are only that day and that day only. The next day is a different day. 

And this, folks, is how I deal with living with infamously hard to treat Bipolar Type I in men fifty and over (the well documented worst category of the bipolar spectrum) - without medications or drugs of any kind. This is how I keep my mental states relatively stable without medications or drugs. This is how I don't plunge into weeks and months of dark hopeless depression and how I prevent myself from kiting up into dangerous episodes of mania. This is how I worked - and work - my way past crippling anxiety and worry. This is how I get through the challenges of living with a condition the long term physical damage of which has left me disabled and not able to earn a living in normal ways. This is how I work my way past horrendous tendencies to suicidal distress. This is how I survived the horrendous prospect of living outdoors through a Canadian winter with a very difficult health condition. 

A review of any case where a person grew out of terrible lives, circumstances and conditions will reveal the same process. 

So I need you to commit to the same - living one day at a time and focusing on doing only what you can in that day only. Commit each morning to making that day and that day only the best you can that day. Then each day at the end, let that day go - think of it as emptying your "cache" - and reminding yourself that you'll get through the next day as well as you can too, no matter what. 

Do this and in time I can promise you that you'll tame some pretty major polar bears. You'll sleep better, live with less stress and anxiety and work your way to a more positive future. This is how you'll train your brain not to get caught in those loops of rumination about the past and imagining dark hopeless futures. 

I can also promise you - from the bottom of my neuroscience heart - that your brain cannot properly function any other way. NO brain can. If there is only one habit that I write about and teach that you choose to master, make it this one. Give your brain just the present day to work on and see what a difference it makes after a month, then several months, then a year and so on. All kinds of mental and cognitive functions will improve when you're not "overloading your circuits" all the time. 

As always, thank you for reading. 

And as always, yes you can. Yes. You. Can. 


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(1) I don't, by the way, expect most readers to follow the links to complex articles or research pieces. Many of my readers are of the academic bent and it is mostly for them that I often include links to outside sources. Which is not to say I am discouraging anyone from further study, but it is not necessary either.

 

7 comments:

  1. Brad, just wonderfully lucid treatment about staying in the now... and particularly relevant now for me at this moment. Our ability to process challenges forward is indeed not always and asset just as is being mired in the past. You've laid this out brilliantly in a way that I can grasp.

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    1. Thank you so much for reading and for commenting, Mark.

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  2. Brad, this is a great piece. I am inspired to renew my commitment to daily practice. Thank you.
    Richard

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    1. Thank you for reading, Richard and for taking the time to comment. I'm glad you found it inspiring. :)

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  3. Brad, Thanks you for bringing this piece to my attention. It was exactly what I needed to hear (I know I read it, but I felt you were talking to me). I can not thank you enough for your gift of love to others who suffer from various mental problems, or have a loved one who does, or both. You are a hero without a cape. Thank you. Yes. Thank. You.

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    1. Thank you, Laura. My goodness that means a lot to me.

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  4. I'm not sure that not staying in the here and no creates the fear and anxiety that people want to control. Our past defines who we are and gives us our sense of place in society and value, in fact without our past we wouldn't have experience of a here and now. In a similar way thinking of the future is what gives us purpose, we have a vision of who and where we are aiming for. It allows us to prepare to meet problems and plan strategies.
    However at particular times in our lives our emotional experience, which largely controls how we think distorts our perceptions of both past and future typically to match and confirm our emotional state. I think techniques that suggest people put all their cognitive resources into their current awareness can reduce this effect, but I see it as a way to help people to endure their distress, rather than live a fully functioning life. Its true that emotionally charged material capture our limited cognitive resources and can leave us ruminating on past pain or predicting future failures leaving people with nothing to control their current lives.
    I'm never overly keen on biological explanations of experience but it seems reasonable that the neuroplasticity of learning may underpin how people get stuck in these thinking patterns, In fact the idea is consistent with a lot of the research on the cognitive model of depression which suggests that a persons thinking style is not a good explanation as a cause of depression, but is certainly involved in its maintenance.
    I think when linking these ideas to therapy, it makes sense if you are going to try and alter aspects of thinking you need to be aware of what these aspects are, mindfulness provides an opportunity to observe your own thinking, to notice what is significant and how you attribute meaning. This gets people used to monitoring their thinking and provides the basis for the best ways to alter thinking habits in a very personal way. It also helps people to see their feelings as objects of interest and study, it objectifies the feelings themselves, giving them less ability to control thinking.
    People can reduce the tendency for automatic responses and by examining them de-legitimise them, but they also need to re-establish ways of thinking that not only are more rational but are more rewarding. There is a major problem in that depression does reduce persistence and motivation and to be effective requires persistence and effort, in many ways this may be the main function of a therapist, I think its extremely difficult to do these things without support. I think for some people drugs can be very useful but a potential problem is the way they can interfere with new learning and people may attribute any success to the drugs rather than their own efforts.
    So I think that despite me not liking biological explanations, it makes it sound as if we should be calling in electricians, I think in this case the model fits well. I suspect that your writing about your personal experiences and the problems in implementation of the ideas will be particularly useful, therapists don't really understand the problems people face in applying their advice and in fact there is little written about it. The combination of a theoretical rational, how its applied and experience of specific techniques is unusual in an article which is a real shame, really its how they all should be written.

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