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No matter how simple our tasks may initially appear, many, if not all of our tasks require thoughtful action; and it's for that reason many people find procrastination to be a never-ending burden. I usually had a variety of tasks that I simultaneously procrastinated on. Typically, it wasn't that I procrastinated about certain things; rather, it was more that I procrastinated over just about everything. For example: I put off visits to doctors and/or medical tests for months--all the while worrying about the condition of my health. Before leaving home for work I would do a mad scramble searching high and low for my wallet, house keys, cell phone, and pen. I sometimes wondered if there was some special medical classification for persons like myself, who were unable to leave home because they couldn't find their house keys? Was this actually agoraphobia, the fear of leaving home, in disguise? No, I thought. I was trying to leave home, not to remain in it. Bank statements sat in their unopened envelopes on the kitchen table until I had accumulated several months of them. Supposedly, this prevented me from losing valuable free time to a mundane chore like balancing my checkbook. Unfortunately, while putting it off, I had to rely on the bank balances that I obtained from ATM receipts. Usually, it was the fear that the bank might have made an accounting error that would finally prompt me into action and it was then that I faced with the enormous job of having to deal with reconciling six months or more of bank statements and ATM receipts. Utility bills awaited payment because of the drudgery involved in having to sit down, write checks, and deal with my unbalanced checkbook. In order to detach, remove emotion, never go past disappointed, and let things settle, I consciously stop, pull myself to the side, and have a talk with myself. I have a meeting in my mind before I let anything escalate. This is when my logic is strongest and my emotion hasn't taken over. I consciously walk myself through the situation as if the logical, more level-headed, and adult part of my brain is talking to the highly-emotional and childish part of brain and telling it, "Now before you jump to conclusions and freak out, let's put the emotions away, slow down, calm down, and look at this from a logical perspective. It's VERY possible you're making this bigger and worse than what it actually is." I let the logical side of my mind ask the emotional side questions so the emotional side has the opportunity to convince itself of the right answer. When you're emotionally bent out of shape, detach from it, talk to yourself, ask yourself questions, and figure it out.

You know yourself the best and what's happening in your mind. I had something distasteful happen and I just couldn't get over how shitty it made me feel. No matter what I did, I couldn't calm my mind and emotions down so I could get over it. Nothing worked. Not even a 6 mile run through the cold rain. Later that night, as I was lying in bed, I had a meeting in my mind. I let the experienced, adult, level-headed, and straight-thinking part of my mind ask questions to the emotional and childish part of my mind. I asked, "Was this your fault?" and the childish side answered, "No". I asked, "Is there anything you can do about this?" "No." "Is being upset going to change anything?" "No." "Is it possible you're making this bigger and worse than what it really is?" "I am doing that." Then I told myself, "Now that we have a clearer picture on what's going on, it's time to let it go." This meeting lasted for 5 - 10 minutes and once it was done, I felt 99% better and it was no longer a big deal. Screening for illnesses to be treated should be standard practice in primary care and schools, with early intervention when problems are detected. Treatment should be comprehensive and continuous. Treatment should be evidence based or evidence informed. All treatment should be measurement based, aimed at measurable goals, monitored, and used to continuously improve care. Treatment should be safe. Treatment should be collaborative. Treatment should include "shared decision making." Treatment should account for patient preferences. Collaboration should extend, whenever possible, to families and friends. Similia similibus curantur (like cures like) and spiritus contra spiritum (spirits--alcohol--depraves/destroys our spiritual thirst). Treatment should meet linguistic and cultural needs. Treatment should be recovery oriented.

The essential principle of prevention has its own earlier chapter. Screening has also been addressed in that chapter. Just remind yourself once again that panic attacks are not actually dangerous, and that it is safe to allow the panic attack to take place. Remember as well that panic attacks are nearly always quite short. A panic attack does not exceed ten to fifteen minutes in duration, and they are nearly always shorter events than that. Even if the panic attack is an unpleasant and uncomfortable experience, you are not putting yourself in any danger by simply allowing the attack to unfold. You will eventually find that the panic will subside, and you are still perfectly safe and sound. Moreover, you may even find that the panic never comes. You may discover that the tense process of trying to avoid the panic attack, in reality, was the panic attack, and by opening oneself to the possibility of panic, one has actually robbed it of its power. In psychotherapy circles, this approach is known as "riding the wave." It is essentially exactly what it sounds like. Instead of trying to swim against the current by halting one's anxiety, you can simply ride it where it takes you. It will not ever take you to a dangerous place. In short, 1) try to accept and not oppose the panic attack; 2) remember that you will not die from a panic attack; and 3) remind yourself that it will all be over soon - at most in ten minutes from now, but probably sooner. Clothing of all types was draped around my apartment in various and often-inventive places, while several days' worth of socks lay scattered across the floor. Like many habitual procrastinators, being a perpetual latecomer was virtually a lifestyle for me. I recorded countless television programs but never made time to watch them. Making matters worse, instead of writing down what I had videotaped, I merely kept a vague notion in my head of what had been recorded. As one videocassette filled up, yet another one was started. One by one, the tapes would build-up and in my twisted logic and rationalization, I would begin deluding myself that the videocassettes contained only second-rate programs because they could not have been worth watching if I hadn't done so when the programs first aired. It never seemed to occur to me that to have a chance to watch those programs, what I really needed was to begin structuring my time--even if it was my leisure time.

In short, by avoiding my tasks, I expended more mental effort and energy than those tasks would have taken had I only dealt with them in the first place. Unfortunately for me, like many procrastinators, I was still on the decline and still had a long way to go. I was now putting off so many different types of tasks that my problem with procrastination not only grew unchecked, but I also began feeling overwhelmed by my emotions. As a result, my inability to deal with my tasks led to another inability shared by many sufferers of habitual procrastination: that of feeling unable to cope with the enormous despair that I felt over my situation. So, to help myself get over what I thought was a "problem", I simply reduced it into its real and logical form. I stripped it of all thoughts, emotion, and nonsense that could have been making it worse. Once it was down to its logical equivalent, I could see how much of a problem it actually wasn't because I was no longer blowing it out of proportion and making it seem bigger than what it actually was. The logical part of my mind told the emotional part, "Look, dude, calm the f*ck down. You're being too dramatic and making things worse." It also said, "Ok, Mr. Emotional wussy man, I'm going to ask you a series of questions that will help you to calm down and I want you think really hard about the answer. I need you to be completely honest." I turned it into the adult talking to the child. The detached person talking to the attached. Once the logical and emotional parts of my brain were done discussing it and figuring it out, I felt better, saw my own behavior more clearly, and understood the situation better. I figured out that I was upset for no reason, the other person, realistically, didn't do anything wrong, and I was only feeling victimized because I was letting my inner-child have too much input in the discussion. I wasn't controlling my emotions. I was acting like a victim. I was acting like a crybaby about it. I was acting like a big wussy. Once I realized this was happening, I took full personal responsibility for the situation, calmed myself down, and got over it. Instead of making a huge deal and getting bent out of shape about the things you don't understand, sit down and figure it out.

Detach your mind from it and have a discussion with the part of yourself that refused to detach. Take the big emotional mountain and strip it down and reduce it so it becomes a molehill. Before we look at these principles, let's look at how humans change. No book on human behavior, especially on the addictions, is complete without reference to what has been termed the stages of change. Starting in the late 1970s, and culminating in their breakthrough book in 1984 known among professionals as The Stages of Change, James O. Prochaska and Carlo DiClemente developed and revealed a model of change that was agnostic to the many schools of psychotherapy that had emerged in the last century. Instead, using the prevalent therapies as a platform, they identified six stages by which we humans change. The six stages are precontemplation (not ready); contemplation (getting ready); preparation (within a month of taking action); action; maintenance; and, finally, termination (confident there will be no relapse). Talking with somebody about taking action--for example, setting a date to quit smoking or reduce alcohol consumption--who is in the precontemplation phase not only does not work, it can drive them further from taking later action. While these stages can be fluid, they are important for clinicians, family and friends, and policy makers to understand so they can fashion interventions accordingly. On to the principles for good mental health treatment, all equally applicable for the treatment of addiction. Simply "riding the wave" of a panic attack can sound like a tall order. For most of us, it feels like an unnatural response to simply sit and allow something scary to happen inside us. Indeed, trying to tell oneself to accept and not oppose a panic attack can itself become another form of trying to "control" one's emotions, instead of welcoming them. Here, the insights of people who practice meditation, as mentioned in the previous chapter, can be very helpful. Many meditation guides - including those associated with the Buddhist religion - encourage the person meditating to assume a non-interventionist posture to their own thoughts. This means that instead of trying to empty their minds by brute force - which is what some people assume meditation must involve - the person meditating should simply allow thoughts to enter their minds and notice them without trying to change them. People who are new to meditation, however, often misapply this advice. They may find themselves thinking things like "I wish I wasn't thinking about that." They then realize this thought violates the instructions, and they start to reproach themselves for not being perfectly open to new thoughts. What they forget is that the thought "I wish I wasn't thinking about that," is also just a thought.