Only the Dead Fish go with the Flow

February 22, 2013 by  
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This is the first of a three part series called, Only the Dead Fish Go with the Flow, that helps explain how human problems come into being. In this film I explore the negative consequences of going with the flow, like the dead fish, and how it ultimately leads to a loss of control. 

I then go onto explain what happens when you move from a comfort zone to a discomfort zone, with common consequences being low mood, depression, anxiety and stress.

The Dead Fish

Cognitive Behaviour Therapy (CBT Therapy)

Cognitive Behaviour Therapy (CBT) is a very effective strategy for helping you go against the flow, so that you’re not one of the dead fish, once again to regain control of your life and thereby helping you move from your discomfort zone back into your comfort zone.

It is often very surprising for people when they realise the consequences of going with the flow but even more so when they see how little effort it really takes to go against the flow. 

If you suffer depression, anxiety or stress then you have probably been going with the flow like the dead fish. 

The text from the film is here in case you prefer being able to read it.

Hi I’m Dr David Purves

Have you ever wondered how human problems such as stress, anxiety and depression come about?

If you have you’re not alone. 

Virtually every client I’ve ever had in my consulting room has said, "I didn’t think this would happen to me. How did this happen?"

Well if you want to know the answer to that question stay tuned.

Some years ago a client said to me only the dead fish go with the flow which I thought was a very profound statement. 

Only the dead fish go with the flow … and that brings me to the River Thames here in Berkshire where I live.

The River Thames

The River Thames originates in Gloucestershire and goes through some counties, through Berkshire, through London and down in to the sea.

Now, the non tidal part of the Thames always goes the same way. It never goes the other way. If you had a boat on the River Thames and you went with the flow like the dead fish you’d have no control over where you went. You wouldn’t be able to stop and start. You wouldn’t be able to have any control over your destination, like the dead fish. 

To gain control you have to go ever so slightly against the flow and then the rudders and propeller can bite and you can steer and you can do whatever you want.

So the first part of the answer to the question of, “how did I get here” is that going with the flow gives you no control over the destination that you’ll end up in or the quality of your journey.

From Dead Fish to Boiling Frogs

Now a client, a different client, said to me a few years ago, “If you get a frog and you put it in a pan of cold water and you put the pan of cold water on a cooker  and you very slowly heat the water, the frog will stay in the water until it eventually boils to death. Alternatively if you put the frog straight into the boiling water it will jump straight out.”

Now why might a frog stay in the boiling water until it boils to death? What’s the mechanism by which that could happen?

Well, frogs and cats and pretty much all animals and humans have change neurons in the brain.

Now change neurons are designed to notice change on a moment by moment basis. They’re really interested in contrast.

So if you were to put a frog in the water and heat it up very slowly the change from comfort zone to discomfort zone is so slow that the change neurons don’t fire and the frog doesn’t recognise that it’s moving inextricably from a comfort zone to a discomfort zone. And isn’t that the part of the answer to the question of how do human problems occur?

Comfort Zones and Discomfort Zones

We start off in a comfort zone and we say yes that’s OK. I’ll cope, it’s not too bad. But slowly, as the process of change occurs we move from our comfort zone to our discomfort zone. All of a sudden you wake up and say, “How did I get here? I don’t like this at all! Ahhhhhh!”

Now if you find yourself in a discomfort zone you feel low, depressed, anxious or stressed. You’re going to be underestimating your strengths and resources and you’re going to be overestimating your faults and failings.

The present experience that you’re having is not going to be something that you’re really enjoying  and the future just does not look attractive at all.

If you’re anxious you’re feeling unsafe and vulnerable. You’re probably putting quite a lot of effort into trying to stay safe but what that means is you’re squeezing your life down until you have a much much smaller living space that feels a bit more like a comfort zone but actually you’re doing less than you used to do. You’re pushing yourself out less than you did before and you’re actually restricting your life by a substantial extent.

If you’re stressed, the tasks and the things that you need to achieve far exceed your perception of your ability to achieve them; you don’t have enough time, not enough resources to do things adequately. 

So if you find yourself in a discomfort zone what can you do about it?

Well traditionally some form of psychotherapy has always been good to help you to go against the flow and to move back from the discomfort zone towards the comfort zone.

Of course not everyone wants to access face-to-face therapy. Not everyone wants to embark on it. Not everyone wants to go through that process.

If you did, however, cognitive behaviour therapy or CBT therapy is the treatment of choice. It’s what the Government recommends. It’s what the National Institute for Health and Clinical Excellence recommends but CBT therapy is relatively scarce in some parts of the world. It’s expensive and it’s not something you might want to embark on.

For that reason I’ve created the Mood Control CBT System. Mood Control enables you to have the benefits of CBT in your life via your own computer. Mood Control delivers a CBT coaching course to you wherever you are in the world.

Now, I’ll be telling you a little bit more about Mood Control in a later film. This film is part of a series. In the next film I’m going to offer you a very strange thought.

Your brain is not your friend.

Your brain will actually create goals that you wouldn’t sign up for and then it can motivate you to achieve those goals.

Your brain can create anxiety and stress. It can create those experiences for you and then keep you trapped in them.

Well, if you want to know how that happens. If you want to know the means, the mechanism for how that occurs, make sure you watch the next film.

If we have your email address you’ll get it automatically. If not you can sign up below to receive the next film, free.

I hope that you’ve found this film interesting and potentially thought provoking. Whatever problem you struggle with – depression, anxiety, stress, panic, OCD, generalised anxieties – it’s likely that the benefits of CBT therapy will reduce the burden of the problem you have and potentially take you all the way back from the discomfort zone in to your comfort zone.

Thanks for taking the time to listen. 

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What is CBT therapy?

November 26, 2012 by  
Filed under Cognitive Behavioural Therapy

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 What is CBT? is now housed on the AnxietyWizard.com

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CBT as a depression treatment and anxiety therapy

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Creative Imagination

November 11, 2011 by  
Filed under Cognitive Behavioural Therapy, Self Help

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Ae you looking for a depression and anxiety treatment? If so, you’re not alone. Depression and anxiety problems are so common in society that every human being, including those who are not anxious or down, must share common psychological processes with those who are anxious or down. Any Depression Treatment or Anxiety Therapy always has to address these issues sooner or later.

The ability to become anxious or down must be built into us. There is no other explanation for this phenomenon. I have worked with many hundreds of clients over the years and I have always tried to see the common features  of clients’ problems. Because common features always reveal something of the basic mechanisms of any problem. And understanding the basic mechanism is really useful if you want to create solutions.     The act of Imagination is perhaps one of the most creative experiences we can have. It is powerful stuff. Imagination can motivate you to invent a life changing tool, but it can also take you down to the depths of despair. Imagination can be dangerous if not properly seen for what it is: a raw power that can be harnessed or ignored. Harness it and it can serve you well, giving you a lifetime of interest and engagement. Ignore it and you are at its mercy. It can destroy you.

This film explains a little more about Creative Imagination.  

 

In any Depression and Anxiety treatment which involves therapy a therapist will almost always find elements of problematic imagination. Let me give you two examples that are pretty representative of those commonly seen in a CBT Therapy clinic. The first is a key component of the group of Anxiety Problems focused on social phobia or social anxiety. The sufferer will usually have a powerful set of mental images that show them being embarrassed or exposed as a fool, or a fraud in public. They are being ridiculed and made to look weak and helpless. The use of their imagination to create anxiety provoking mental images that while having never happened nevertheless ‘capture’ their deepest fears about themselves is very damaging and limiting. The emotions evoked by these very negative mental images is so strong that it seems to make sense to avoid situations where these fantasies may come to pass.

The second example will most commonly be seen in the CBT Therapy clinic for a Depression Treatment. This is often represented as an inner dialog where the sufferer imagines themselves in a conversation with another person and in this they are being criticized, found to be at fault and failing to live up to the standards expected of them. The power of this fantasy conversation is in the emotion invested into it by the imagination. The most troubling and damaging emotions are evoked, and this often makes the sufferer feel helpless to act in any positive way.Both of these examples are very commonly seen in many depression and anxiety treatment settings. It is fundamental to the success of the CBT Therapy that they be challenged rigorously.  The sheer power of these fantasy products of the imagination cannot be underestimated. The good news is that they can be challenged successfully and the negative emotions they create consigned to history. In this process the sufferer can experience a freedom from anxiety and depression perhaps never before dreamed of.

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Use CBT Therapy to reduce depression

September 20, 2011 by  
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A good goal in life is to develop the ability to think accurately about things. This is harder than you might imagine but all effort is repaid ten-fold. It is a goal of every Anxiety Therapy or Depression Treatment within CBT Therapy that you become clearer on what is accurate in your life and what is inaccurate.

The alternative to accurate thinking is inaccurate thinking and that leads to depression and Anxiety Problems, so let’s be clear… the stakes are high.

CBT Therapy

The most effective therapeutic approach for treating low mood and clinical depression is called Cognitive Behavior Therapy or CBT Therapy.

CBT Therapy is a structured approach to working on some of the better defined and understood aspects of depression and anxiety. There is good evidence that it is both an effective and an empowering form of therapy because you are an active participant in helping yourself.

Let’s offer an example of the power of negative thought to frighten and depress you. Imagine that you have to speak in front of a large group of people who you think are knowledgeable about your subject. You believe that your performance is important. It matters to you how well you do. Depending upon your experience of this kind of activity, your reaction might range from excitement to absolute terror.

What would make you feel terrified?

Let us assume that you are rather more on the terror side. What would make you feel terrified?

It is easy to imagine that because you believe the talk to be important, you are also aware of every possible negative outcome that you can imagine. And, it can now feel like anxiety problems are leaking into your life ruining some of the things you hold dearest.

Here are some examples:

I will make a fool of my self.

People will know I am a fraud.

People will see I do not know enough.

I will lose control and panic while I am speaking.

People will laugh at me.

If you believed that any of these were true, or even likely, how would you feel?

You would probably feel a mixture of fear, shame, guilt, despair, helplessness, panic, anger, anxiety and a strong desire to run away and hide.

You have not even given the talk, but all of these emotions are the result of how you imagine it might go.

Self-defeating and damaging beliefs

In low mood and depression it is very common to hold a series of self-defeating and damaging beliefs about yourself. These beliefs detract from your ability to enjoy your life.

If they are very strong they can even make your very survival problematic. Many of the negative beliefs you hold about yourself have never been demonstrated, neither is there any evidence to support them.Suppose you gave a successful talk 99 times and one time you gave a poor talk.Which would be the most memorable and which would you think most accurately reflected who you are?

We reckon its the one bad talk.

Free from fear

All of your life you have probably had normal everyday experiences. It is very rare for the negative beliefs you hold about yourself to have been demonstrated in reality.

They reside in your mind and direct you to feel bad, but there is probably little or no evidence that they reflect reality.

CBT Therapy and more specifically depression treatment or anxiety therapy is a means of accessing these damaging negative beliefs and finding ways of understanding their actions and then testing them against reality.  This process is easy to describe but in reality it is a profound re-working of the most fundamental negative beliefs you hold about yourself, the world and your future.

A Depression Treatment that really gets to grips with helping you to challenge your deepest negative self beliefs can literally change your life. Likewise an Anxiety Therapy that frees you from fear is a great gift to be cherished. When clear and open reality baths your deepest held negative beliefs this can be a great relief and is definitely a life changing experience that is worth seeking out.

For one-to-one consultation with Dr Purves please contact his here.

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The warning signs of depression

The warning signs of depression

Reading based Psychologist Dr David Purves from Berkshire Psychology Service outlines the warning signs of depression. If you believe you struggle with low mood then please read this report. Depression is usually a treatable illness. The first thing to do is gather good information.

Depression is a word that covers a wide range of mental health problems but the main characteristic is a loss of good, positive feelings and an accompanying loss of interest or enjoyment in things, people and activities. Often the first people to see the warning signs of depression are those closest to the sufferer.

It may seem a paradox but there can be value and even comfort in knowing and naming a problem. If you know and name you also have access to the knowledge based that has accumulated on how to understand and treat that problem. And this is a necessary precursor to being able to move forward. Knowledge and an attitude of action towards the problem of low mood and depression is a very positive first step in starting to feel better. Let’s map the warning signs of depression onto a CBT understanding of low mood and depression.

Understanding the CBT understanding of depression

We will now develop the very important fact that thoughts, feelings and behaviors are linked in creating your low mood. Indeed, there is a constant interplay between your thoughts, feelings and behaviours.

If you think negative thoughts about yourself you will feel negative emotions.

And, if you feel low you will find more opportunities to undermine yourself creating even more negative thoughts.

This two way relationship always works in this way.

In addition, if you think negative thoughts about yourself and feel down you will do less of the things that previously helped sustain your good mood (behaviors). You will go out less, keep in touch with friends less and, get less pleasure from what you do try. Reducing your activity repertoire only depresses you further.

Despite having the warning signs of depression: How can I control my emotions?

It is very hard to directly control your emotions, sometimes you feel low and at other times you feel better.

It can be hard to know why your mood fluctuates as it does and finding these missing links takes time and effort.

Depression feel like the life is being squeezed from you.

Depression feel like the life is being squeezed from you.

It is very common for people with depressed mood to say, ‘I wake up and I do not know why I feel down’.

But, you may also not know that you can change how you feel.

Indeed, how you feel often has little to do with ‘who you are’ (your personal identity) and more to do with an habitual negative way of thinking that has somehow gotten out of control (balance).

It can be very hard to pull yourself out of a low mood simply by willing yourself to feel better.

But, research has shown that a very effective way of reversing low mood is to pay more attention to the thoughts that accompany the mood and to challenge them for accuracy.

Depression is like having a blue mood distort every experience you have.

Depression is like having a blue mood distort every experience you have.

What both clinical and research experience tells us, and what it is often possible to identify for yourself, is that the thoughts you have lead to the mood you experience.

What you really need to understand is that you cannot have good and positive thoughts yet feel down.

You always have thoughts that flow in the same direction as the mood you experience. While you cannot easily control your mood you can much more easily control your thoughts.

This is the principle of the cognitive aspect of cognitive behaviour therapy (CBT). If you control/manage your thoughts then you can much more easily control your mood.

Physical symptoms are often noteworthy warning signs of depression

Negative thoughts and feelings often give rise to troubling physical symptoms, such as those below.

  • feelings of stress
  • feelings of fear or dread
  • numbness (which means there are no feelings that you can recognize)
  • hunger
  • agitation
  • dullness
  • anger
  • sleepiness
  • anxiety
  • fear of people
  • fear of challenges
  • unexplained pain
  • irritable bowel
  • headaches

Physical symptoms can often seem unrelated to your negative thoughts or mood. You may find that you have an upset stomach or pain that seems to have no good reason for being there. Alternatively, if you have been injured the pain seems to be worse on some days and leads to you feeling hopeless and even helpless to combat it. You may find that you experience headaches that leave you unable to attempt any activity at all.

Whatever your experience of physical symptoms these are often linked to the way that you think about yourself and hence how you feel about yourself.

The bottom line is this:

When you think negative thoughts and feel low your body responds by being more troublesome!

The important point is this:

How your body reacts, how you feel, how you think and what you do are all interrelated.

When one is down they are all troublesome.

When one is up they are all more manageable. These big four aspects of your experience are all intimately connected and cannot be experienced separately.

Mike’s Story of depression

Mike had been feeling down about his work. He was behind in processing applications and he thought that his boss was now watching him for mistakes. These feelings made it harder for him to concentrate and do a good job. On Tuesday night, Mike had trouble going to sleep because he was worrying that

Stress at work is a common cause of depression

Stress at work is a common cause of depression

In the morning, Mike slept through his alarm clock and when his wife Julia questioned something he did he just lost it!

He shouted. She thought he was over-reacting. He then left the house without shaving or tidying himself up, he missed his breakfast; all day at work Mike felt out of sorts and conspicuous.

Stress at work is a common cause of depression

This case is not at all untypical of someone who is feeling strain from work or some other place, and that strain is expressed at home maybe towards someone who might not be responsible for causing it in the first place. Perhaps you’ve been there yourself?

You are sensitive to how other people treat you.

It is a social world where you interact with other people in differing situations.

While you are sensitive to the ways that other people treat you, you also interpret the world around you in line with the ways you think about yourself and how the world works.

It is obvious that the social environment, or context, in which you live directly impacts on how you think, feel and act.

This was clearly the case for Mike.

The context of his work stress was enough to make him feel uncertain and watched and spoil the quality of his home life. Later when Mike went to his regular therapy session, to help combat his depression, he was able to describe what he was thinking and feeling and how this affected his behaviour on Wednesday morning.

Mike said that his work had been much less enjoyable lately. A new boss had made things that he normally felt were easy, now quite stressful. This made him question a lot of things he previously took for granted.

Clearly, this was not a comfortable situation for Mike.

So on Wednesday morning, all of this was on his mind. All of the stress and strain that Mike’s job was taking on him made it difficult to sleep and left him feeling drained. This in turn lowered his resistance to further stressors, such as a last minute job at work, or an offhand comment from a colleague.

Your Thoughts can be depressive

What can you do if you think you have depression warning signs?

It is not always easy to identify the thoughts you have about things when you are actually doing them. It is much easier to look back on situations and identify them later. But if you try hard enough it is often possible to find some key negative thoughts that influence your mood and behaviour.

Mike could identify one thought that really increased his stress levels: “If I don’t get to work on time my boss will think I am a failure again.”

Your emotions are the direct experience of depression

Mike felt a complex set of emotions on Wednesday morning, but one feeling that he was able to identify was that he was irritated or maybe even angry at his wife for making him late (although she was not to blame).

He later recognized and felt sorry about his outburst.

Although, feeling guilty about this actually did not help Mike.

Your behaviours really affect depression

A combination of all of the above led Mike to act the way he did.

The cumulative effect of his job stress (context), his poor sleep and stressed state (physical sensations), the belief that his boss would think of him as a failure (thought), the outburst of anger (emotion), made him leave the house

Relationship problems are a common source of stress and even depression

Relationship problems are a common source of stress and even depression

unprepared (behaviour).

He may have felt a sense of righteous indignation when the front door slammed.Yet, for the rest of the day, unshaven, he felt conspicuous and worse than the day before.

His actions did not help to solve his perceived problem, in fact in his mind it just made it worse.

It is not hard to imagine how he would feel when he went back home again on Wednesday night!

Mapping the forces of depression

 

Depression is caused by the interaction of 5 processes.

Depression is caused by the interaction of 5 processes.

We can map out the forces that led to Mike acting as he did.

How it all interacts

We can think of physical sensations, thoughts, feelings, and behaviours as all interacting within the context of the environment. These factors are pictured above in the ‘Map of Forces’.

The important point to gain from this example is that for Mike’s all five of these factors interacted to lead to his self-defeating actions. They were all linked together.

A good personal relationship is a great way to fight low mood.

A good personal relationship is a great way to fight low mood.

It is usual to have one main factor with all of the others interacting with it in some way. So when one thing changes all others also change to accommodate it.

This has to happen because the whole system is connected.

This means that if Mike wanted to change some aspect of his life he would have some choice in deciding where to place his efforts and gain the change he wanted.

This is equally true for you!

Even if you have the warning signs of depression you can change any aspect of the five domains outlined above and then every other aspect must change in some way to react to the deliberate effort you have made.

So what’s the best treatment for depression?

The cognitive behaviour therapy method of treatment of depression generally focuses on three aspects of your experience that are more under your conscious control than the other two.

The things you have the most control over are:

The context of depression

You can change aspects of you work experience, your home experience, your relationship with a partner or with other members of your family.

Doing one thing differently affects everything else; remember this: subtle and small changes only need to be made at first.

Thoughts related to depression

You may not feel that you have much control over negative and self-defeating thoughts but you can learn to take much more conscious control over these.

The important point about negative thoughts is that they seem to occur automatically.

In CBT they are actually called automatic negative thoughts (ANTs) because they come to mind so readily. Actually, the ability of ANTs to pop into your mind increases dramatically as your mood gets lower. ANTs are usually personally negative and are always inaccurate. They are the worst possible interpretation of anything! Consequently, they are very good at being depressing.

The behaviour of depression

When you think about something you have done and you feel you failed at it, you are less likely to do that activity again. This makes sense and as a general rule is probably a good thing. It means that you tend to focus your efforts into areas where you may have more ability.When you feel low however, you have a tendency to misinterpret signals from the world around you.

You may feel bad about something you have not done, when actually everything is the same as it was previously.

To quote Mark Twain,I have suffered many misfortunes in my life, most of which did not happen.’

You generalise from specific examples to more general ones and feel defeated.
You see obstacles where previously you saw opportunities.
You feel overwhelmed (feeling), tell yourself that ‘it is too hard’ (thought) and do not bother to try (behaviour)!

One of the depression warning  signs and a very important and serious consequence of depression is that your activity level decreases.

Does this make you feel better or worse?

The answer is always worse!

As you decrease your level of activity the opportunities to interact with the world and to test the reality of your negative thoughts reduce. Hence the negative thoughts about yourself seem to gain in strength and validity. You actually behave as if you believed the negative things you think and say about yourself. Hence depression!

Conclusion

The three main areas where you can start to recognize and change the aspects of your experience that create low mood. Have been outlined. If the first instance it is hugely important to get an assessment by an expert. Thereafter there is a reliable and effective path out of depression. All you have to do is take the steps as they are explained and laid out for you.

Dr David Purves and Berkshire Psychology Service  provides a complete cognitive behavioral therapy treatment program. Dr Purves provides you with all the tools you need to help you create the life you want and to take more control over depression.

An anti-depressant tool to use now

Dr Purves recommends a self help exercise to fight negative thoughts

Dr Purves recommends a self help exercise to fight negative thoughts

Here is a tool that you can use to start the battle against the falsehoods your brain creates to depress your mood and spoil your experience of life. The most fundamental step in defeating depression is recognizing the negative thoughts themselves and then challenging them to account for their accuracy.

If you’ve identified with some of the depression warning signs. Start to overcome depression here:-

    1. Take a piece of A4 paper and at the top write the most damaging negative thought you have about yourself in black ink. This works well if it is the thought that really drags your mood down. Examples that are common are: I am a fraud, useless, odd, damaged, unlovable,  etc. Make sure there is only one thought here. If you have more than one thought that comes to mind put the others on different sheets of paper for later on.
    2. Now you need to rate how much you believe this thought, the best thing to do is to rate how true it feels to you at this very moment in time the scale is ‘0’ not at all true and ‘10’ as true as it can possibly be.
    3. Next use the rest of the paper to make a list of as many reasons as you can find that show the thought to be untrue and use a coloured pen for this. Examples might be: I have friends, I can complete tasks, I try hard, I do my best, I am not responsible for others, I can manage my money, I can listen to people, I can read a book, I can play, I can cook, I have been successful before, I passed my driving test (note: that examples do not have to be substantial they only have to disconfirm the negative thought).
    4. Use as much of the paper as you can, spread out, write things even if you don’t fully believe them. Use your imagination, allow yourself to go back in memory and find examples that disconfirm the negative thought. Things have not always been as they are now; remember the way things are when you feel better. Give yourself over to a flight of fancy, allow yourself to be liberated for a moment from the negative thought and create the alternatives to it. Really challenge the negative thought, find as many alternatives to it as you are able.
    5. After you have spent no less than 10 minutes challenging the negative thought re-rate how true it feels 0….10 once again. The rating of how true the thought feels is likely to changed and even gone down from the previous score. The less true something feels the less bothersome it is to you.

What you have demonstrated is that the way you think about something determines how you feel about it. Change the thought and you change the feeling. This is the key to using CBT therapy to change your life. It is not a trivial enterprise; it is one of the most important things you can do to ensure a good life. But it really works.

Contact Dr David Purves NOW

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Dead Fish Go With The Flow

This is the first of a three part series that helps explain how human problems come into being. In this film I explore the negative consequences of going with the flow and how it ultimately leads to a loss of control. I then go onto explain what happens when you move from a comfort zone to a discomfort zone, with common consequences being low mood, depresssion, anxiety and stress. Cognitive Behaviour Therapy (CBT) is a very effective strategy for helping you go against the flow once again to regain control of your life and thereby help you move from your discomfort zone back into your comfort zone.

Film one


Dead Fish Go With The Flow Film two click here

Dead Fish Go With The Flow Film three  click here

 

 
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