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Tom came back 2 weeks later with his diary. Table 2 displays one example of the situations he wrote.

Table 2. Third session

Situation	Feeling of well-being	Interrupting thoughts
Morning. I am at home studying.	I was able to study well for one entire hour.	Now something will happen to spoil your morning → obsession.

I must say that I did not know what to expect. Tom was a bright, well-educated, and sensitive young man. I wanted to see whether, with some simple indications (as my orthopedic surgeon), he could develop his way to recovery. Indeed he had identified not only feelings of well-being, but what interrupted those feelings. I was using the framework of rationale-emotive and cognitive therapies, and I decided then to opt for the cognitive schema. I thus explained to him what automatic thoughts are [6]. I used Aaron Beck's description [6]. They often occur in specific situations and do not arise as a result of reasoning or reflection, but by reflex. They are relatively autonomous: the subject makes no effort to initiate them and often has troubles turning them off [6]. I explained to Tom how some thoughts he had reported could fit Beck's model of automatic thought [6]. I then asked him to add another column to his diary (in addition to situation, feeling of well-being, and interrupting thoughts) that was indicated as ‘observer's interpretation’; in this column he should write what an observer (actually the subject distancing himself/herself from the situation) would be likely to think in those circumstances. At the same time I continued to write behavioral prescriptions in the diary. In addition to attending the university again, he had selected the topic of a course he had already attended for a potential exam. I asked him to attempt to study again, with increasing times of application (15 min first, then 30 min, then 1 h, and so on). He was asked to come back in 2 weeks.