A personal, passionate and practical guide to the mental health benefits of bird watching.
I broke down in 2013 and it nearly broke me. Shaking and hateful, I tried the things the doctor said I should. Yes - medication helped. Counselling was enlightening and mindfulness definitely grounded me. Nothing came close to nature, particularly birds. First it was a Buzzard, regally soaring over a stubble-field and filling me with hope and joy. Then it was a Dunnock – parading on the lawn in front of me – how had I never noticed such beauty before? Soon, every avian encounter, took me one step closer to accepting who I am.
Bird Therapy is my passion. It’s a shared sounding board and my natural escape clause. I came to realise that other people felt the wonder of our wild birds too – people who were willing to share their darkest moments and joyous observations with me. Come with me - let’s go to the heath and inhale coconut-scented gorse as a Woodlark flutes and tumbles above us. Join me in the darkened bird hide as dusk closes in, its walls releasing warmed-wooden air - while a flock of Green Sandpipers patter and probe just in front of us. You certainly don't have to be a skilled birdwatcher to enjoy this book - I definitely wasn't when I experienced Bird Therapy. Even if you are, I hope, too, that it will help you discover new rewards in your hobby.
You will see quotes, anecdotes and ideas. There will be dark moments and then others filled with light - and birds. You will be introduced to existing research and read profound words people have shared with me. We will walk down to the frozen lake at my patch in winter and then out onto the heath on a June evening – ethereal Nightjars swirling around our heads in the half-light. Most importantly, I hope that you will recognise how birdwatching has helped me and how it could possibly help you. To advocate this, each chapter ends with some practical tips to take away and apply to your own birdwatching and nature experiences. It’s as much about how birdwatching can help you as how it’s helped me.
A Dunnock, a Pallas’s Warbler and a plethora of patterns
‘It has long been an axiom of mine that the little things are infinitely the most important’ – Arthur Conan Doyle
Do you ever take notice of birds? If you do, then I wonder, what the first bird was that you really took notice of? You might recall a childhood experience, you might recall something that happened in the last week. I recall the simple fact that I only took notice relatively recently - just two years prior to writing this.
The first bird that I really took notice of was a Dunnock. A garden visitor that’s often misidentified as a House Sparrow and subsequently, overlooked. Dunnock’s are everywhere, yet we never seem to truly notice them. I was seated in a suburban garden on the outskirts of Norwich on a decidedly chilly January morning. Not quite cold enough to ice over the pond - the gentle accompaniment of trickling water floated past my ears as it tumbled down the ornamental waterfall.
Sitting opposite the bare hedge, notepad in gloved hands, I sat, staring at the bird feeders in anticipation. Why? Well, I was participating in the Royal Society for the Protection of Birds’ (RSPB) Big Garden Birdwatch - observing and recording the bird species seen in the garden over a designated hour, then submitting the data so that trends can be monitored. Anyone with even a mild interest in wildlife can join in with this easily-accessible activity and giving something back to nature is a truly rewarding act – explored later in the book.
The Dunnock hopped along the naked flowerbed and joined me on the lawn, close to my freezing toes. Positioned opposite the feeders, I was patiently waiting and dreaming of Goldfinches popping onto them - or perhaps a cotton-wool coated Long-tailed Tit. Instead, I was treated to nothing of the sort, so I began to watch the Dunnock. It was confident alright - always a metre or so in front of me; patrolling the lawn then stopping and cocking its head to pick insects up. Occasionally it would stop and look at me and I would duly look back. I had started to take notice.
Dunnocks are the archetypal ‘little brown job’, which is a term that birdwatchers tend to assign to any small, nondescript and (obviously) brown bird. If you take the time to properly study one, you’ll see a deep palette of colours and markings taking shape. Delving further into the detail – you’ll realise just how intricately marked they are. Bird identification guides often remark on their ‘drab brown colouring’ and ‘overall dark appearance’. This is a somewhat lazy conclusion - neglecting to mention the linear streaking that runs down their mantle. Bold and uniform, dropping down from their smoky grey, almost blue, chest and throat. These birds are subtly beautiful and not drab at all. I only discovered this because I took notice in the first place.
A pair of Dunnocks are a regular feature underneath the bird-feeders in my back-garden. I’m sure they visit many gardens and urban green spaces, but I’m also sure that many people wouldn’t recognise one at first, even at a third, glance. Each day, birds that are defined as common are often overlooked. However, as you immerse yourself in the world of birdwatching, you come to appreciate the beauty in the common species as well as the scarcer ones. The Dunnock is a prime example but really, all of our garden birds fall into this category.
Garden bird feeding is by far the easiest, and most accessible way to engage with birdwatching; and to a degree, nature. The best thing about it is that it can take place from within the comfort of your home. Lately, I’ve been spending more time observing the birds that visit my garden feeders – with the majority of my observations occurring from the kitchen. The bird feeders are strategically placed so they can be viewed from all of the rear-facing windows. I’m usually occupied with a culinary task, but as soon as a bird pops onto the feeder I become distracted from the task at hand as I take note of who has come visiting.
Through these observations I have been able to deduce the regular visitors to the garden. Take ‘Colin’ the Coal Tit for example, who heralds his arrival with a couple of piping ‘tweee’ calls, before zipping into view with a flash of wing-bars before deftly taking a sunflower seed over to the fence for dismantling. There’s also the pair of Collared Doves, one usually on the fence watching, as the other searches for any scraps of food left on the grass. On colder days, I know that the visitors are likely to be more varied and this can lead to some purposeful procrastination during the washing -up process.
These recurring visitors generate a sense of consistency and safety within me - two words that were always recurrent in my counselling sessions. It’s reassuring to know that the garden birds are there, even when I’m not. Through careful observation and the two-way relationship of feeding then watching – my garden birds have become an important part of my life. Winter is the best time to keep an eye out, as the colder weather and reduced food availability can bring some interesting visitors to bird feeders. It’s a simple pleasure, but knowing that in the depths of a cold snap, I might have a troupe of Long-tailed Tits hanging off my feeders; can brighten up the darkest of days
In ways like this, nature and birdwatching, can offer us a great deal of stability. In the life of someone living with daily mental-health issues this can act as an anchor to the present and provide a great deal of grounding. Take time to notice the simple pleasures around you, especially when it comes to your garden bird community. Welcome the brazen Blackbird as he cocks his head on your lawn, searching for worms. Embrace the characterful Robin, singing from every available song post and shadowing you as you turn over your flowerbeds. Take notice.
The garden is an excellent place to start taking notice of the bird life around you and a perfect first-step towards getting to know your bird community. The next logical progression and the one that I followed in my birdwatching journey was to start looking outwards. In late 2014, I started to explore my local area, with an aim to finding out more about the avifauna closer to home; and perhaps find myself a local patch – something which I will explore the benefits of later in this book.
In seeking out localised birdwatching sites, the rekindling of a childhood interest in maps and geography blossomed. This then combined with a new-found interest in bird habitats and suddenly, any cluster on a map that might appeal to the local avifauna became interesting. To develop an awareness of possible birdwatching locations, I purposely read more about the vicinity - investigating older bird sightings and learning about biodiversity. Sundays became the ‘birdwatching day’ and as winter was approaching - a circular driving route began to form that took in as many varied sites as possible. This created a further sense of reassurance, providing familiarity and comfort.
On the first of these circuits, travelling between two new sites, a flurry of colour flew across the road just ahead. Slowing the second gear trundle to a halt, I raised my binoculars and there sat three pairs of Bullfinches in the bare hedge. Handbrake on - I sat, watching and breathing, slowly. Bullfinches are beautiful birds, both the males and the females. The males wear resplendent tones of salmon pink, with slate grey shoulders and pitch black wings and caps. Females are a little subtler, with more of a peachy-grey wash and generally lighter in colour. Such brightness in the dark winter months – they resonated against their spindly Hawthorn backdrop.
Driving down another nearby lane, the hedgerow was heaving with birds. Unfortunately, the engine hum flushed them all into flight and down onto an adjacent field. Pulling over the car to snatch a look, I alighted and – sidled over to the field edge for a better view. Fifteen Yellowhammers were perched in a bare tree with a single ice-cream-coloured Brambling amongst them. Other colourful finches flanked the flock - Green, Gold and Chaff. All are considered ‘farmland specialists’ and the focused planning to pass through some farmland had paid off.
During that moment, watching the flock of finches, I was also allowing myself to become lost and absorbed in the sights in front of me. In these early days of my interest in birdwatching, I was still burdened with an inability to manage and regulate my mental health. Birdwatching quickly became an escape route and I started to notice that when I was out, on my own, experiencing nature and birds in a personal and intimate way; I was noticeably more relaxed. My breathing rate slowed and I closed my mind to repetitive thoughts and worries. The only focus was observing birds and learning about them.
The notion of feeling lost is a recurring theme in my life and one that kept cropping up throughout a year of weekly counselling sessions. After a few sessions discussing this theme, I attributed it to several circumstances surrounding my childhood, which seemed to had followed me through to adulthood. When faced with change, my default response is to obsessively plan everything - as I outlined in chapter one. My counsellor named this meticulous planning and attention to detail, ‘mapping’, in the sense that I was always trying to map my life in an effort to reduce anxieties. Paradoxically, this led to me having unrealistic expectations – ultimately causing more anxiety as I obsess about everything being perfect.
This process of mapping can be a particularly frustrating element of my OCD – as I constantly seek perfection. In some ways, this is quite sad, as I’m aware that I will probably never be truly happy (if there is such a state) Even more frustrating is that I know, rationally, that there isn’t always a perfect outcome in life, so I fall back on to the things that are familiar to me -t he tried and tested. These default responses and reactions mean that when I find things unfamiliar and challenging, I often crumble under the pressure and my anxiety goes through the roof. This usually manifests in an emotional shutdown, where I rapidly become embittered and defensive.
I have several compulsions to counteract these feelings, also described in the opening chapter. However, since I have been interested in birdwatching, I’ve been able to channel these obsessions and compulsions into the hobby instead. This removes some obsessive emphases from everyday life – helping my symptoms and compulsions to manifest less in other aspects of my life, such as my job.
Initially, I connected this to the listing aspect of birdwatching. Listing is where one keeps lists of bird species they see - perhaps for the garden, a particular site or over a specific timeframe. A list is a record. A list is continuity, order and arrangement. A list is a pattern and I like patterns. I find them rhythmic and soothing – calming my fizzy head. Birdwatching is awash with patterns and logical sequences – offering a perfect and naturally-occurring antithesis to the chaos of everyday life.
In paying attention to these finer details, I noticed that I was finding out more about myself. The calmness I was experiencing was going home with me – it was going to work with me. I noticed that I was starting to feel more relaxed with life in general, as I had found a place and time to unpack my worries. A pattern was emerging. Birds provide logic and consistency. They make sense and they represent freedom; in their ability to fly and live such simple and ordered lives. Several survey respondents echoed the sentiment about nature making sense to them. Further patterns were forming.
Another of these patterns manifested itself in the way of birds appearing in particular places at specific times. This frames events chronologically – becoming part of nature’s own calendar. For a novice birdwatcher, the impact of seasonal changes and weather patterns on bird movement and distribution can be daunting. However, exploring the depths of these rhythms can be comforting in itself - create an understanding of how the environment alters around you and how birds and their arrival can help us look forward to the future. The first Wheatears of Spring arriving on the Norfolk coast, act as markers that warmer times are coming. They are nature’s way of signposting the future for us – natures beacons of hope.
The pattern and repetition of visiting the same place over time brought additional balance and stability. It enables the developing of a sense of what should, and could, turn up somewhere. This in turn has can foster a sense of normality and security, helping to alleviate feelings of anxiety and disappointment. As patterns help to ease my own anxiety, finding that they were firmly entrenched in birdwatching made me feel a closer affinity to it, and to nature in general. Certain moments cement this affinity further, with many of these described in these pages.
From two years of attentive observation and taking notice of the patterns around me, I can tell you what to expect at my patch at most times of the year. I can tell you what to expect when the wind changes or the sun blazes. I’ve watched the same species come and go and their numbers rise and fall. I’ve watched them build nests, incubate, raise and fledge their young. I’ve watched them congregate in the centre of the lake when the temperature drops and take to the air in a cacophony of splashes and wingbeats when a dog-walker passes. From taking notice of the usual, everyday nuances of the birds at my patch, I’ve built a stronger connection with them and with the land itself; as is explored in chapter seven.
I wrote earlier about the Dunnock and its intricate feather patterns, but what about some of our more remarkably coloured birds? There was a Yellowhammer once, singing atop a tree. Their song - “a little bit of bread and no cheese” – is well-known throughout the British countryside and they truly are a delight to observe. Intricate mustard-yellow feather markings are interwoven with darker, russet-caramel tones. To watch one sing from a lofty perch is positively enthralling. Watch them release their familiar farmland melody and block out your worries – while that song washes over you – nothing else matters. There is so much beauty to discover in another, often-overlooked bird.
Visual experiences and aesthetics form the basis of much of my writing and I particularly love the colours found in nature. It was August – the late summer sun was blazing down and warming exposed arms as ‘t-shirt weather ‘took hold. Arriving at the usual vantage point in the south-east corner of the lake, out came the tripods legs as the scope took its position by the two alder trees. The air hung still and warm, perhaps a little heavy like a storm may be on its way soon. Absorbing the panoramic view with the naked eye, I took stock of my surroundings. I was staring into a landscape painting - spellbound by every brushstroke and undulation in the canvas. The colours were so sharp and vivid in the midday sun that they all seemed to blend into one palette.
The lime and mint-green sundae shades of vegetation starkly met the midnight-black water surface. Which itself would be intermittently lit up by sunlight, transforming it into glass and revealing the caramel lake bed below. An upward glance and the light-floral shades grew darker and stronger, as ancient deciduous trees rose at the lakeside. Eventually they peaked, forming an undulating border with the azure- blue sky - no clouds to be seen. There are so many colours and flavours to be found in natural settings – embrace them. Next time that you are outdoors, stop and immerse yourself in the colours around you. Take notice of them fully and allow them to wash over you. This primal pleasure can be easily missed and is often a calming and rejuvenating experience. The meditation of nature’s colours is often inspirational and every outdoor space holds natural beauty somewhere.
Sometimes it can be frustratingly difficult to find the best language possible for you to really feel an experience and conjure up matching imagery. One has to place themselves back into the moment in question and will always realise how blessed we are to have such natural beauty around us. It’s incredibly difficult to capture the beauty and feelings that these moments invoke, in just a lyrical snapshot. It is said that ‘a picture paints a thousand words’, yet sometimes I don’t even think a thousand words could truly capture some pictures.
In chapter seven, I consider whether certain aspects of our environment, such as its aesthetics, can help to restore and rejuvenate us. There is an aspect of this that is relevant to this chapter. In his fantastic report for the RSPB, titled ‘Natural Thinking’, Dr. William Bird brought together a number of theories relating to nature and its positive effects on mental health. One of the theories he describes is called Attention Restoration Theory (ART). An idea first outlined in the 1980s by psychologists Stephen and Rachel Kaplan and with an obvious correlation with birdwatching.
ART identifies two forms of attention: direct and indirect. Direct attention is identified as the act of paying attention - in a way that is intentional and purposeful. Conversely, indirect attention is instinctive, voluntary and natural; referred to throughout the report as ‘fascination’. An example of an everyday act that fits both criteria is driving a car. Attention must be directed to the road, other road users and hazards. However, the physical act of driving, of using the pedals and changing the gears, becomes a natural process over time, something that we do without thinking - an indirect action.
Generally, indirect attention is a pleasurable act and requires little or no effort. Unlike direct attention, which actually requires us to make an effort and is often laborious; focused more on having to do something rather than wanting to. This means that we then have to make a concerted effort in order to block out any pleasurable distractions, using even more grey matter to do so. The whole process can become tiring and the Kaplan’s coined the phrase ‘Directed Attention Fatigue’ (DAF) to acknowledge this. Invariably, we will need to have a break or rest after any spurt of directed attention, so that we can re-energise and refocus.
When applied to birdwatching, the majority, if not all, of the time spent observing birds, is pleasurable. You choose to do it, but overall, it isn’t say a forced action. Therefore, birdwatching could be considered as a form of indirect attention and once I noticed this in my own birdwatching own experiences, I found so much more joy in just ‘being’, instead of trying, whilst I indulged. The fundamental action of birdwatching: ‘find bird, observe bird’, is not tiring in itself. Obviously trudging down the shingle of Blakeney Point, checking every inch of sea buckthorn in search of autumn migrants, is hugely tiring – but it is a choice to do so.
When you physically raise your binoculars to observe a bird, a particular conundrum arises. To observe something through your binoculars is a forced act. The binoculars have to be held up to your eyes and your focus/attention is directed at the target. This is a bit of a paradox - although your attention is directed at the target, it is still not directed attention. Yes, it is intentional and purposeful, but it isn’t laborious or tiring. Perhaps this is why I and many others, find birdwatching to be a relaxing and reinvigorating pastime. Fundamentally though, birdwatching is not a mentally strenuous activity.
Amongst the random 100 survey respondents, someone wrote that ‘everything else is blocked out as you scan through a flock of waders or the like.’ What a lovely statement and thought – scanning through a flock of birds to find your troubles dissipating within them. When your line of vision is cocooned by your binocular barrels, the distractions of the outside world are shut out. The only object of attention is whatever is encased within those lenses and everything else lingering in the periphery fades away. The mind can wander and relax, whilst still in the security of a visual and mental cushion. It allows you to disappear into an insular world – the world of birds through an optical lens.
As one becomes more confident in their avian and outdoor awareness, an additional sense starts developing. A sense for birdwatching that’s obvious in those who have spent many hours observing birds and becoming immersed in particular habitats. They seem to become acutely aware of any slight movement they see in vegetation, however deep. I find that, personally, I can stop anywhere, allow my senses to sharpen and my breathing to slow its pace – until I fall into an almost meditative state. I begin to detect movement and as I scan, either with binoculars or the naked eye, I start to pick up these kinetic nuances in all areas of my peripheral vision.
Focusing on any flurry of movement - a new challenge awaits me every time I choose to accept it; the challenge to identify the bird species. This may involve lengthy observations, note-taking and even taking a photograph if possible. It’s a multi-faceted and multi-sensory experience that takes me away from any external worries. This challenge - this skill - can be honed on a smaller scale. Perhaps at home, or in a park, garden or outdoor space. Just watching the foliage of any trees or shrubs that are familiar to you, can be a fantastic baseline for developing this sense of movement. Through practice, this can be transferred to a controlled environment such as a wildlife reserve, before unleashing your new-found bird sense everywhere you go.
A perfect example of this sense in action, comes from a memorable day shared with a birdwatching friend, at one of my favourite places on the Norfolk coast - Waxham. This particular friend and I share a strong affiliation with the east coast of Norfolk - an affiliation that I believe stems from the fact I visited the area a lot as a child. As an adult and more importantly as a birdwatcher, I often find myself going there in favourable conditions to try and find scarce and/or rare birds; and that’s what we were attempting to achieve on that day.
We had worked hard and walked far, but were coming to the realisation that perhaps it wasn’t to be our day. After walking nearly five miles along the newly-cut dune paths and back, it had begun to feel as though we weren’t going to find anything particularly scarce. Although, to be fair, we had encountered a handful of beautiful Yellow-browed Warblers – stunning Siberian vagrants, that arrive on our shores in good numbers in late Autumn. These diminutive green warblers are distinguished by the distinctive yellow eyebrow that their name suggests. This meant that the day wasn’t completely devoid of the marvels of bird migration but I could sense my friend’s despondency. So, as we continued walking back down the path, I tried to invigorate him, saying ‘it will be in the next bush mate’. Admittedly, I was starting to disbelieve my own words.
We approached an expansive beech tree, which, since the paths had been cut through the scrub, now loomed over us. Last autumn I had needed to work this area from the dune ridge above and it was great to be able to look up into the canopy from the new route. The tree was literally swarming with Goldcrests. The smallest breeding bird in the UK, their numbers swell on the coast in late Autumn, bolstered by migrating birds from Siberia. Although tiny, they are easily recognised by the vivid golden-yellow crest on their heads. There were so many of them in that Beech that I wouldn’t even like to estimate their numbers. We stopped for a while, absorbing the spectacle and scanning through the flock, hoping for another Yellow-browed Warbler to appear. Then a flicker of movement directly in front of me caught my attention.
It was the combination of movement and lurid colour that had drawn my eye, a flash of yellow below the darkened overhang of the tree. I had been studying my bird books to get to know which Siberian wanderers we might encounter that day. The brightness of the yellow, could it be a Pallas’s Leaf Warbler? I called it to my friend ‘Pallas’s?!’ A moment, a heartbeat – I waited. He quickly trained his binoculars over to where I was looking and soon we were both observing the bird in question. Flitting through the branches was a stunning little passerine, a combination of greens and yellows; a lemony rump, bright double wing-bars and a bulbous central crown stripe. This is a key feature of Pallas’s Leaf Warblers – bold, prominent and the colour of warm custard.
It was only from the initial movement in my peripheral vision, that we even saw this magnificent bird. My bird sense had certainly worked. It was the first time I had seen one of these Siberian sprites and it filled me with a great feeling of joy and also camaraderie in having found it with someone I enjoy birdwatching with. Not only was this a new bird for me but I had also been building myself up to potentially seeing one that day by drilling the description into my mind. That made it feel even more special and what seemed like a damp squib of a day had been charged with an electric, positive energy.
This is all part of the waiting game that birds often play with you. This has to be countered through honing the innate ability to notice subtle moments in nature; like knowing a skulking bird is behind some foliage or hearing a snatch of birdsong to then patiently wait for the singer to appear. This game of hide and seek can be incredibly invigorating, especially if you are using all your senses to locate a bird. It fosters a sense of patience where one can harness mindfulness approaches such as slow -breathing and immersive observation – ultimately promoting relaxation.
A quote from a survey respondent resonated strongly in their own observation on the beauty of this process, stating that ‘the lift in mood I experience when I finally spot that bird I can hear hiding in the foliage and when you witness something beautiful and no-one else is around is amazing.’ In noticing and harnessing these sensory experiences, the key theme of this chapter is reinforced. Birdwatching can be a journey of personal development, a development in self-awareness and reflection, and for me this is one of the most beautiful elements of how birdwatching can help with mental health issues. In summary and to close - the more I have taken notice of and absorbed the natural world around me, the more self-aware I have become. When outdoors and immersed in a walk at the patch, I contemplate things, I relax, I breathe and I take notice of so much more. This has helped me to notice when I’m stressed or of low mood and has helped me to take notice of myself and my interactions with the world around me.
Overleaf I share with you some tips on how to bring the ethos of noticing into your birdwatching and wider outdoor experiences.
A few practical tips for taking notice;
· Get to know the birds in your garden or any nearby outdoor space and notice how they behave and interact.
· Try to develop a sense of ‘being’ whilst birdwatching, rather than overtly trying.
· Take time to notice the intricacies of feather patterns and markings. Some of the most beautifully underrated birds are around us every day.
· Pay attention to how being outside and engaging with birds makes you feel. Harness positive experiences and try to recognise what makes them so.
· Reflect on and absorb the colours in nature and in outdoor settings. Try to appreciate them more in every setting.
· Recognise that birdwatching is a multi-sensory experience to help enjoy your experiences on more levels.
· Develop your ‘bird sense’ – it can reveal so many of nature’s secrets to you.
Christmas and a Cover Reveal
Friday, 14 December 2018
To all of Bird Therapy’s supporters, I wish you a lovely festive period! Christmas can be such a rubbish time for people, as can winter in general. There’s actually a whole chapter in the book about birdwatching in winter and the wonder of roving nomadic flocks in the cold months.
The publishing process continues to be as exciting as ever. Unbound have consulted and discussed every aspect of the…
Thursday, 8 November 2018
So, just to keep everyone updated, especially in my self-imposed Twitter absence; things are going really well with the book. The development edit led to some sweeping changes in the way I'd formulated the book, but thanks to Simon, the editor, it reads so much more smoothly than it did. It was difficult, as some of the feedback led to some major chopping of passages, but it made totsal sense. I…
My favourite signs of spring
Wednesday, 11 April 2018
For those of you who follow me on Twitter, I posted this poem on the 8th of April - inspired by a visit to my local patch:
"Through hanging mists and drizzle drifts, my favourite signs of spring. The Blackcap’s back, his tuneful scratch is warm and uplifting. Three Swallows strafe across the lake, from blossom starts to sing. A Willow Warbler - descending grace, my favourite signs of spring."…
Notes from Norfolk - New pledge reward
Tuesday, 20 March 2018
I'm just back from filming the video for the top of the pledge page. We did it at my local patch, which was perfect, although I just wanted to watch the ducks most of the time! We now have a new pledge reward up on the page, called 'Notes from Norfolk'. For a £60.00 pledge, you get a mounted, A4 photographic print of aone of 5 species of birds - each one numbered and signed by the photographer Les…
These people are helping to fund Bird Therapy.