You either understand everything I say or you're no good as a therapist, or you don't care about me at all. This is perfectionism, one of the things which feeds procrastination, and these are also examples of-all-or nothing thinking. Perfectionism also leads to my wanting to play the piano well after only one lesson, or without practicing, or without having to learn the scales. So I take one lesson and then I quit, because it's going to take time and effort. Further, since one lesson didn't do it, I must have no skill. So I feel inadequate and ashamed. Well, I knew I was going to fail anyway. Or similarly, I drop out of therapy after a few sessions, because you're saying I need to do homework and it's going to take time to cure my phobia, and I just wanted to come in and have you fix it for me, quickly. Assertiveness is a way of talking about your wishes and feelings in a direct, honest and respectful way. If you have something to say, but don't know how to put it into words, try following the "3 F" script by stating the Facts, Feelings and a Fair request. Assertiveness is a skill that takes some practice, but leads to more honest and deep relationships over time. Useful assertive skills include: using assertive body language, negotiating, saying "no" and dealing with criticism. Shit does, indeed, happen. The world is not necessarily neat and orderly. You cannot always control the bad things that happen. The future is inherently uncertain. Other people may not have experienced particularly traumatic events in life, but they simply have an underdeveloped IC that can't process information as rapidly as it should. The good news is that, for either of the above groups, brain research shows that the brain is like a muscle. Just like physical exercise builds muscle tissue, creating bigger muscles, different thinking exercises and behaviors create thicker, faster neural connections between different parts of the brain. The process by which we can "beef up" the volume of different structures in the brain is called neuroplasticity.

Neuroplasticity allows the brain to constantly rewire itself so that it can retain new information and adapt to new environments. Of course, there is a significant difference between having a purpose and living a purpose. Many people can describe their purpose, but when you examine their actions, you'll find a disconnect. I have one client who said his whole purpose was to make his family happy. When he came to work with me, he was eighty pounds overweight with high blood pressure; he was spending twelve hours a day at his highly stressful job. At forty-eight, he was a heart attack waiting to happen. But he really thought he was making his family happy because he was providing them with an upscale lifestyle. With three children under twelve, how was he going to make his family happy and provide for them if he became sick or even died? What if his nonstop work led to issues in his marriage and ended in divorce? And, perhaps most importantly, what about the thing he was unconsciously withholding from his family: a loving and nondistracted father and husband? I've given you a lot of examples, because I want you to understand this and to be able spot this behavior when you are doing it. That is the start of the path to changing the pattern: "Hey! I know what that is; that's all-or-nothing thinking again!" Once we note the distorted thinking, we can use self-talk to correct it. Often, though, just recognizing it can be enough, as it dissolves in the light of reason. We have a tendency to all-or-nothing thinking and perfectionism, which can cause or reinforce a lot of our problems. When we learn to spot this we can cope with it, although maybe with some effort and not perfectly. This is one of the areas where therapy can be very helpful. Pain flare-ups are unpleasant but normal. Planning ahead for pain flare-ups can reduce your suffering and help you get back to your regular activities more easily. A good first step is to notice what puts you at risk for a pain flare-up, and to watch for early warning signs that a pain flare-up may be coming.

Consciously renaming a particular experience as something else teaches the IC to stop automatically slapping an "anxiety" wrapper on every heightened state that bubbles up from the primitive brain and, instead, be more and more sophisticated and efficient at detecting subtle differences between different heightened states. Although people commonly use these two terms interchangeably, from a psychological perspective they are quite different. Fear is the natural, biological, and appropriate response to an imminent threat. Anxiety is when the brain's natural fear circuits get hijacked by something that isn't an immediate danger or could even be good for us (for instance, accepting a great new job or standing up for ourselves). In a sense, anxiety is fear's evil twin. It is useful to prepare for pain flare-ups by planning in advance which coping strategies you will use. Consider including these strategies in your plan: taking breaks from the pain, calming your body and mind, and challenging the pain with gentle activity. Avoid extreme thinking; for example, "Either I'm perfect or I'm worthless"; "If I don't know something, then I'm stupid"; "I am either a success or a failure." Are neither pie-in-the-sky optimists nor unwieldy pessimists, but instead take the middle ground of being reasonably hopeful. Do not spend their lives lamenting the imperfections in the world but instead see them as opportunities for constructive growth and change. It does take some measure of courage to face reality as it is, and in your actions to remain mindful of its inherent risks. In this way, guiding virtues like courage, authenticity, self-control, decisiveness, tolerance, self-respect, empathy, and prudence form an interlocking network of mutually supportive dimensions of metaphysical security. Of course, there are different types of demanding perfection, and thus different ways in which you, in particular, may be insecure about reality. We'll address these different types of demanding perfection in Chapter Two, where you will begin to explore the particular way, or ways, you may be demanding perfection. This book will help you work on strengthening the particular virtues that relate most directly to the specific insecurities that lead you to demand perfection. We develop the capacity for fear early. By eight months in utero, a baby's fear and protection circuitry is fully developed and ready for action. Throughout life, in the face of a real threat, this circuitry injects chemicals into our brain and bloodstream to ramp up our senses and speed up our reaction time so that we can see all the ways we could respond and, if necessary, escape. When the fear-systems in our brain work properly, they serve a protective function, warning us away from danger and easing off once the threat has passed. We worked together to help him find balance in his life. He reevaluated the parts of his relationship with his children and wife--he was acting like their caregiver all of the time--so they took more responsibility.

He took a look at his job and made a very healthy switch to a different company. He changed his diet to his blood type and developed an exercise plan to his body type. He even took up meditation. Now healthy and content with himself, his home life, and work, he is really living his purpose to make his family happy by being an amazing husband and father. He is doing it by practicing self-care and tapping into his deep beauty and inner worth. I have another client, a woman in her late thirties, whose great passion is travel. Her purpose was to tour the world and write about her adventures. However, she was convinced she would never be able to do it. Because of a car accident in her teens, she had ongoing pain in her back in addition to anxiety when she was in an automobile. After consulting with her health team, she began working with me. I helped her become the authority in her life. She had an aha moment when she understood that if she could manage her pain and develop plans to work around her anxiety with cars, then she would be able to achieve her purpose. I grew up hearing, "If it's worth doing, it's worth doing well." That is a lie, especially if by well you mean perfectly. When we lived in Baltimore, we spent lots of time raking up the fall leaves. Was it worth the effort to get every last leaf? Of course not, especially since they were still falling while we were raking. It was just fine to get most of them. How about changing to "Anything worth doing is worth doing well enough."? That way we can avoid both of the pitfalls, perfectionism and halfway-sloppy. There are other lies that are part of the American tradition, like "You can be anything you want to be." I could never have been an NFL football player even if I had abused steroids.

"You can do anything you set your mind to." I was never going to be a good pole vaulter, or a professional singer or a tap dancer. I would never be able to remember where I had put my keys if I didn't have a strategy. It wouldn't have mattered how hard I tried or how much I set my mind or how much I wanted to. These lies all support a perfectionistic viewpoint, and since we don't measure up to the goal, they feed our sense of inadequacy and failure. They just make life harder. The perfect is the enemy of the good. Perfectionism and all-or-nothing thinking undermine us. We need to learn to love "good enough", if it really is good enough. If we have ADD, trying harder isn't going to work. We need to try smarter. We need to use strategies. I used to know that whatever I tried to do was not going to turn out right, so I would save time and energy by not putting much time or effort into the task. This was especially true with projects, like carpentry projects, for example. I was always thinking that I would be smart and take short cuts and use gimmicks and so I wouldn't need to do it the way other people would do it. I wouldn't take the time, effort or expense to do it right. I would just slop through it and say that it was good enough. In fact, it usually wasn't. And I would get annoyed with my wife when she pointed this out, "I'm not going to have that dog house in my yard!" and "I'm just going to call a plumber; he'll know how to do it right." But I wasn't only saving time and effort and expense; more importantly, I was saving face and protecting my self-esteem. I wouldn't try to do it the right way, because I couldn't, so I would do it the "clever way," I told myself. Another lie, or at least misconception, is that we can do better by just trying harder.