1. problem solving as overview problems & difficulties symptoms therapeutic responses

2. inner change outer change biological factors therapeutic alliance symptoms

3. biochemistry & outer change outer change biological factors therapeutic alliance medication, herbs, supplements, food, light, sleep, etc general activation: exercise, interests & relationships targeted activation: responses to trigger factors & desensitisation inner change

4. inner change outer change 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 inner change

5. key points of this handout  trauma memories are very common in depression and anxiety as well as in ptsd  elicit these memories and ‘images’ gently and carefully  disorder onset, severity and persistence seem contributed to by memories and ‘images’  lessons from ptsd treatment may well improve treatment of depression and anxiety

6. involuntary memories are normal  involuntary memories of personal life events are reported at least 5 or 6 times daily by “normals”  typically these memories are cued by identifiable aspects of one’s current situation  memories often take their emotional tone from one’s current mood - typically happiness or sadness - and then reinforce this mood  memories are often of recent or of unusual events  intrusive thoughts are even more common and when 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