1. the types of response overlap in the real world these different types of response often overlap with each other tackling problems & difficulties directly tackling the effects of problems & difficulties focus towards focus away

2. tackling the problems directly  problems/difficulties that contribute to the symptoms may include predisposing, precipitating & maintaining factors  problems may have occurred in any of several different life areas e.g. heredity, lifestyle, relationships, trauma, etc  tackling problems/difficulties may involve therapies e.g. surgery or medication, though often therapies tackle problem effects more than the problems themselves  tackling problems/difficulties may involve actions by oneself e.g. sorting out interpersonal conflicts or financial difficulties, reducing workload, improving diet & so on … usually best to choose problems & difficulties that seem most important or most easy to tackle:

3. tackling effects by focusing away  focus on what’s important in one’s life, e.g. priorities from respected figures and 80 th birthday party exercises  ask what one would be doing if one didn’t have the symptoms and begin to work towards this in small steps  focus on relationships, physical exercise, activities that give one or have given one a sense of achievement or pleasure  imagery exercises e.g. in one’s mind going to pleasant places, going out of one’s body, or using age regression responses that distance or redirect attention away from effects of problems & difficulties:

4. tackling effects by focusing towards  clarify how problem effects have limited your life and begin to tackle these limitations methodically step by step  by understanding the background & development of the problem, it is sometimes possible and relevant to learn to blame oneself and others less and thus begin to feel better  expressing one’s feelings & thoughts about the problem & and its effects through talking/writing can be very helpful  imagery exercises e.g. in one’s mind reducing symptom severity through diminution, acceptance, or transformation responses that direct attention towards effects aiming to change them or see them differently:

5. imagery: using pain as example  all methods: often helpful to stop using the word pain – substitute an alternative like “the sensation”; good as well to encourage/congratulate oneself for one’s coping efforts  distancing: possibilities include imaging pleasant scenes, activities, or memories; regression to an age before pain came; imaging moving out of one’s body  approach: often better than distancing: possibilities include transformation by focus on a less distressing aspect of the sensation such as warmth, pressure, vibration; diminution by imagining a glove, cold-numbness, or transferable anaesthetic; acceptance and letting go body-mind reactions

6. choosing the best responses a)what has worked for you in the past b)personal strengths and resources c) well supported, general facts & guidelines d) own underlying values/respected figures e) pluses & minuses, costs & benefits some ways of deciding between alternatives: