now from the theory we we have what we call a generic cognitive model the theory applies across all conditions all conditions whether it's just a minor type of problem that person might have like procrastination or losing the temper too easily or it may go all the way to something like schizophrenia and U depression and other conditions so the theory then can help to explain all types of Psychopathology just like anatomy and physiology can explain all the problems that people have in their abdomen or the rest of their body for the surgeon now once you have the theory then let's say a patient comes in and the patient has uh depression and an anxiety and sayfe panic attacks and back pain now how are you as a clinician going to understand that well if you know the theory you're going to be able to get a really quick picture right away so this is the way you would formulate it so from the theory you're going to be able to get a formulation of the various disorders so you might think well a person has back pain and um panic attack sex and depression and what was just there another thing anxiety anxiety so you'd think as you put it together well first perhaps the person had back pain and perhaps it was might have been a a veteran injured injured his back in the war as he gets the back pain he tends to uh Focus his attention on the back pain what happens when you focus your attention on any pain it gets worse so first of all he focuses his attention on that then he gets the belief from that this back pain is going to get worse and worse um and so he tends then to catastrophize so first he has the focus on Body Sensations and then he has the catastrophizing the exaggeration of the body sensation so he gets him self into the mode of focusing on Body Sensations and at the same time exaggerating the meaning of the sensation and in this particular case this catastrophic meaning is that the back pain is going to get worse and worse so then let's assume that uh uh he starts moving around and so on he starts to feel dizzy while he's already in the mode of focusing on the dizziness and as he focuses on the dizziness and starts to catastrophize about it what condition is he going to get next and for this you're not going to get a prize but you're going to get shoved out of here if you don't guess what it is panic attacks people someone said what what did somebody say panic attacks of course so so this isn't a big mystery when the person comes in but if you have a model in advance now the model the way you apply it and just before you actually get to talk to the patient you now have a road map or you you have kind of a picture to know what to look for so then he starts to um to get the panic attacks and you know he's a catastrophizer so he starts to think this is never going to get better uh when he starts to think it's never going to get better um and or let's let's wait before he starts to think it's going to get better then once he has the panic attacks what's going to happen from day today regarding panic attacks he's going to worry that he's going to get another panic attack isn't he so he's going to be anxious all the time so now you have your back pain you have your uh panic attacks you have your anxiety now how does depression come into it I'm never going to get better right so with this conceptual model you get a picture of the entire disorder now we don't know with an individual case whe it's going to fit specifically that pattern so then you have to look at the individual case and you find out that this person let's say has been in combat and maybe in this particular case he has flashbacks and uh has a lot of worries about that particular thing and then as his back pain develops and increases and so on he starts to think more and more of how things getting worse and worse so so then you make your your own case formulation