Clinical psychology helps people change, or at least get better at accepting the way that they currently think, feel or behave. When working on this, it is useful to have a simple way of describing the psychological work that you are doing. My simple model is called the ITEMS model.

The ITEMS Model

The ITEMS model is quick way of summarising several key concepts from psychology that you can find in a number of different psychological frameworks. We can think of the ITEMS model as listing the five ‘items’, or basic components that interact to make up our everyday experience as a human being. These are based on the acronym ITEMS. These five things are: Inputs; Thoughts, beliefs and rules; Emotions and bodily feelings; Movement and behaviour; and Speech and communication. 

We can see that our everyday, moment-by-moment, psychological experience as a person is built up from different sets of these five things interacting with each other. They don’t just occur independently of each other. They run in loops where one of them triggers one or more others. So, for instance, you might have some Input - let’s say you see an apple. Seeing the apple then makes you Think: ‘this is an apple’. This thought then triggers the Emotion that you feel you want something to eat. This then results in you Moving to pick up the apple to eat it (a behaviour). Lastly, you might say (Speech): ‘I really needed to eat that apple’.

Loops become mental habits

These sequences don’t always just go in exactly the order set out in the ITEMS acronym and used in the apple example above. So, for instance, you might start with an Emotion that just seems to pop up. This then might trigger the Thought: ‘I feel so bad’. That then might, in turn, trigger you to get up and Move to the kitchen and start eating something sweet. Once you are eating your chocolate, or whatever your particular comfort food is, this might then trigger another Thought: ‘I am eating too much chocolate these days’. This then might trigger another Emotion, for instance, guilt, and so on as the loop plays out. To make things more complex, more than one of these ITEMS loops can be running at any point in time, and they can be interacting and triggering each other.

Over time, some of these loops can become mental habits because they have been repeated so often. They are rather like a rut that has been worn in a dirt road where car tires repeatedly travel along the same track. Once they have developed, its tires tend to slip into the preexisting ruts whenever a car travels over them. It is the same with ITEMS loops. A lot of our everyday experience becomes almost as if we are running on autopilot. Of course, this is usually not a problem. For instance, we might look at our phone and realise that it is Monday (Input). We then Think: ‘I need to put the rubbish out’. This triggers us to Move out to the yard and take the rubbish out to the curbside. Most people are relaxed about having many parts of their lives running on autopilot in this way.

some loops can end up causing us difficulties in any of the five ITEMS areas

However, sometimes we can find that particular loops do end up causing us difficulties. This is because we are repeatedly getting into precisely the same sequence of components being triggered. These troublesome loops may end up causing us difficulties in any of the five ITEMS areas. For instance, we might find that we are spending much too much time looking at social media (Input) because it is a way of escaping unpleasant emotions. We may find ourselves with repetitive Thoughts, worrying about how we could have fixed a relationship because these are being triggered by emotions about the relationship that just keep arising. We may end up experiencing painful Emotions because of repetitive behaviours we are indulging in. We might end up habitually repeating behaviours (Movements) (e.g. drinking too much alcohol) because we are trying to escape troublesome thoughts or emotions. Lastly, we might end up often saying (Speech) things to people that are not really appropriate. However, we are saying these because something about the other person (Input) has triggered our Thoughts about how we were treated in the past by others, and this, in turn, has caused us Emotions that lead us to say what we say.

Learning to observe our Loops

If we want to change our day-to-day experience and how we are in the world, we first need to work out which ITEMS loops are causing us problems. How can we do this? Well, if you read, or listen to, anything about psychology or self-development these days, you can’t avoid coming across talk of mindfulness. This is the idea that we should all get more skillful at watching and understanding what is going on for us at any moment in time. This is in contrast to just walking around functioning on autopilot without much idea of what is actually happening inside ourselves. The link between mindfulness and the ITEMS model is that a lot of what mindfulness is trying to do is help us get better at two things. The first of these is observing how we are operating. This consists of being able to observe the sets of ITEMS loops as they whizz by. The second is learning how we can intervene in regard to particular ITEMS loops. Let’s start by looking at the first of these.

What is happening in mindfulness meditation?

Mindfulness meditation is a technique where we sit down in the quietest place we can find, close our eyes, and just start watching and experiencing what is happening inside of us. We are basically trying to learn how to get better at watching the ITEMS loops as they run. If you like computer analogies, then you can see these as lots of small loops of ‘code’ running inside your ‘operating system’. In mindfulness mediation, we are trying to slow these pieces of code down and step back far enough from them to see them operating and what they consist of.

Thinking in terms of the ITEMS model, what are we doing in mindfulness mediation? First, we are turning off much of the Input that we usually experience in everyday life. Second, we are stopping our Movements (behaviour) because the instruction is to just sit silently in most meditation approaches. Even in those where movement is involved, such as walking meditation, people are usually just doing slow and repetitive movements. Third, we are stopping our Speech because we are remaining silent. This makes it a lot easier for us to watch our Thoughts and Emotions. Because of this, mindfulness meditation is like a mini-laboratory in which we can get to watch our ITEMS loops. In this environment, which is much more controlled than our typical day-to-day experience in the outside world, we can just quietly watch our Thoughts and Emotions play out. Even though while meditating, we are much less involved in Inputs, Movements, and Speech, we can still watch our ‘tendencies’ to do these things. These are our desires as to what Input we would rather be having in contrast to just sitting and meditating (e.g. browsing social media); how we would like to be Moving and behaving; and what we would like to be Saying to other people. Observing as a part of mindfulness meditation can be described as ‘getting some distance on our ITEMS loops so we can watch them as they play out’.

A multi-pronged approach targetting specific iTEMS

The second connection between mindfulness meditation and the ITEMS model is that when we are meditating, we are in an excellent position to can start to intervene at different ITEMS points. As noted above, when sitting down to meditate, we have already reduced our Inputs, Movements, and Speech. We can now start to use specific ‘tools’ to work on our Thoughts and Emotions. We use the Focus Your Thoughts Tool to get our thoughts under better control. And we use the Accept Your Feelings Tool to get better at accepting and ‘holding’ our feelings without running away from them. We can also work with our tendencies in regard to Inputs, Movements, and Speech without having to actually act them out. For instance, as we imagine having a discussion with someone, we can see what Emotions are being triggered at the same time. We can then use the Accept Your Feelings Tool to work on the emotions that are being triggered.

The idea is to progressively work towards changing the ITEMS loops that cause us problems and put in place new, more positive ones. Ultimately, we may be able to get some of the new positive loops running on autopilot in the same way that some of the old troublesome loops used to run. But the great thing is that the positive loops will be leading us to be more content rather than towards us being more discontent in our lives. Below, the five ITEMS components are briefly described.

The five ITEMS components

I - Inputs

As living creatures interacting with the world, we are constantly taking in Inputs about what is happening in the outside world. We are seeing, hearing, smelling, tasting, and touching things all the time. Sometimes our survival depends on us paying attention to and correctly recognising, these inputs. For instance, seeing and hearing whether a car is driving down the road towards us is essential for our safety when we want to cross the road. But many of the inputs we experience these days are not critical to our survival. For instance, how much time we spend on social media, watching the news, or watching sport are things that are less about basic survival and more about how we chose to use our time.

Many ITEMS loops are triggered by an initial input. So it is important to work out how much of and what sorts of inputs we want in our lives if we want to get control of the loops that are running in us. The great thing about inputs is that, if we think about it, at any point in time, we potentially have quite a lot of control over the inputs we are experiencing. We can turn off our phones, we can often go to a quieter place or, at least, close our eyes to reduce the inputs we are experiencing.

T - Thoughts

Our minds are constantly coming up with a seemingly endless stream of thoughts. For most people, this stream is like a babbling brook that runs through their head from the moment they become self-aware as a child to the moment they die. If we had as little control over the way our body moved as we do over our thoughts, we would think that there was something seriously wrong with us. However, most people just accept that what they think and how many thoughts they have is largely outside of their conscious control. This doesn’t have to be the case. There are mindfulness techniques that can be used to slow down our thoughts and reduce the number of thoughts that are we having that trigger other ITEMS components and troublesome sequences. For instance, the Focus Your Thoughts Tool.

E - Emotions and bodily feelings

We have emotions or feelings arising all the time. While we tend to experience our thoughts in our heads, we tend to feel our feelings in different parts of our bodies. Often this is in our stomach or down the front of our chests. Emotions sometimes feel like they have just popped up out of nowhere. But if we look at them in more depth, we can often see that they have been triggered by particular inputs, thoughts, behaviours (movements); or things that have been said to us (speech). Many of us have a particular ITEMS loop around negative emotions. This loop runs along the lines of us feeling a negative emotion, and then us moving to go and do something that will distract us from feeling it.

However, trying to avoid feeling the emotion can mean that we are not giving ourselves enough time to process it properly. In many cases, when we have the opportunity - for instance when we are sitting down to do a mindfulness meditation session - we can experiment with just experiencing the emotion, rather than trying to escape from it using a technique such as the Accept Your Feelings Tool. At the end of the day, emotions are just electro-chemical reactions in our bodies. If we just sit with them and experience them, we can find that they naturally start to reduce over time. Also, just sitting with them means that we will gradually get better at experiencing them rather than letting the fact that we are experiencing them worry us excessively.

(Of course, the approach of going into experiencing your feelings should only be used when you feel OK about working in this way. Suppose you find you feel overwhelming emotions or persistently troubling thoughts when doing any type of psychological or self-help work. In that case, you need to talk to a health professional).

This page can always be found at PaulDuignan.Consulting/ITEMS.

Please note that if, when doing any type of psychological or self-development work, you find you are feeling overwhelming emotions or persistently troubling thoughts, you need to talk to a health professional.