Thanks for that excellent response. Add to your spectrum of mechanical events the interpersonal factors that exist in both family relations and communication and broader social environments. Symptoms usually have a communicational component and that communication plus the reality within which it has blossomed needs to be addressed in therapy. Finally, the cognitive and emotional (intrapsychic) elements that have also given rise to learning to use muscular, chemical, and perception in this unpleasant way should be examined. (You might say, teaching a person how to relax their trigger finger is even more useful when done in conjunction with helping them decide not to commit suicide to escape their real of perceived environment).
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