It's either one or the other, but not both. Since you already know where the stories, lying, and excuses have landed you, the only choice left is to move on from them and let them be part of your past. You've told the exaggerated stories so many times that you enjoy the validation and pity you receive from them. You've told yourself the lies so many times you actually believe them. You've used the excuses so many times you believe they're actually holding you back and standing in your way. It's all a bunch of trash - you know it and I know it. The stories you needlessly repeat to yourself and others don't matter anymore. Quit giving them life. Quit attaching emotions and emotional energy to them. They're not affecting your decisions and abilities in this moment. The lies you keep telling yourself are, simply, a waste of your thoughts and emotions. The excuses you keep using to justify your current position are, simply, you dodging responsibility for your own bad decisions and results. Anything you're using to pin the blame on, get rid of it. Anything you're using to hide behind, get rid of it. Emotions can be difficult and emotionally smart people know when to take care of themselves. For example, when you have had a difficult day what are the things you do to take care of yourself? Do you have a long hot bath and relax? Do you talk to a friend? Do you get a DVD or video and watch that? There are times when you need to take care of other people's emotions and there are times when you need to motivate yourself and others.

People who are anxious often spend so much time worrying about what is happening to them that they can miss the benefits of taking in the environment around them. Emotionally smart people have developed the ability to pick up other people's emotions. Using skills such as empathy (the ability to imagine what it might feel like to see the world from another perspective), a smart person considers how the other person might be feeling, realizing that such recognition can encourage a more co-operative relationship. It is true that some anxious people are very good at being sensitive to others but have lost contact with the importance of their own needs. Think about people and situations where you feel a connection with what the person is feeling. This ability of being able to imagine what it is like for the other person is called empathy. Choose friends or use characters from films or television, then list their names. Think about why you empathize with the people you have chosen, and write these reasons against each person's name. Now, list all the ways in which you would demonstrate your understanding to another person (e.g., giving the person my full attention or using certain words). There are times when strong emotions get in the way. There may be times when it is better to put off your own needs and wants for a future pay-off. Some people find themselves so caught up in their immediate emotions that they forget there is a bigger picture. Anxious people often do this but for the wrong reasons - more because of their own fears rather than as a life strategy. Think of two situations where you have motivated yourself or other people. In particular, think of situations where there have been strong emotions. How did you cope with the strong emotion so that you were able to complete the task in hand? Structure your notes in the following way. Life is full of relationships so it makes sense to consider the behaviours that help create happy and productive relationships while recognising those that destroy them. Some people fear that if they praise themselves or others it will lead to a slacking off in effort. It is well documented that children who are constantly criticized are more likely to have poor confidence and to stop trying to improve.

They may even feel anxious about getting things wrong. Success encourages success and every time you or someone else does something well (even partially well) it is one more step towards building an anxiety-free life. Now write your own epitaph in your notebook. How would you like to be remembered? I've written mine so that you can see what one could look like. She lived her life with enthusiasm. She cared for others but knew how to have a good time. She had a go even when she was scared and she is remembered with love. When you wrote your epitaph what feelings came up for you? Look at what you have written and consider whether you are living your life in a way that is likely to make your words come true. What changes do you need to make and how will you set about making those changes? On discharge from the detox program, Dr. Brown continued counseling, random drug urine tests, and almost daily NA meetings. He worked in nonmedical service jobs for six months until his physician monitor, selected by the impaired physician program, thought he could return to medical practice, though under supervision and with continued drug testing and adherence to his recovery program. Dr. Brown is a success story. He did not die of his addiction, develop hepatitis or get HIV from dirty needles, commit violent crimes to fund his habit, or do any (known) damage to his patients before he ran away to try to spare himself from what he needed to do. His ego functioning, when drug-free, was at the higher end, and he had the capacity for altruism, delayed gratification, and sublimation. He also had a stable marriage and a spouse who could just as well support him in recovery as try to help him elude treatment. He had a profession to return to that he loved, and colleagues invested in his returning to work and a life of contribution.

He did the work of ongoing, comprehensive treatment, which included individual and group therapy, and NA. Drug testing added to his capacity to stay clean because he knew he would be caught if he used. And the prospect of returning to practice was a beacon for him to seek. Yet Dr. Brown remains at risk to relapse. That's how it is with a substance use disorder. He will likely be in recovery for most of the lifetime ahead of him, though some people can, over time, truly put their habit behind them and regain their higher-level ego functions and the psychic resilience to rise above the addiction, never again to return to it. (This was the case for John Noble, after many years.) Recovery takes work. But it can happen with good treatment, support, purpose, the tincture of time, and keeping hope alive in patient, family, and treating clinicians. Ego development, going from limited ego capacities in children to ego capabilities that result in generativity and dignity in adults, is a lifelong pursuit. Not only is it never over, I believe that almost everyone can move up the defensive gradient with the right kind of support and coaching. It is hard and takes time. But it is not nearly as hard or protracted as a life of interpersonal conflict, emotional distress, and foreclosed opportunities in love and work. Many of the cliches associated with mental health professionals in our popular culture, in other words, are badly out of date. Contemporary clinical psychology focuses on how people can get well in the here and now. In particular, it is interested in how people can alter their thought processes and behavioral patterns in ways that help them achieve greater happiness, freedom, and autonomy in their daily lives. Many of the methods used most often by psychotherapists today fall under the heading of cognitive behavioral therapy, which we will discuss more fully in subsequent chapters. In technical term used by most mental health practitioners - and found in such important reference works as the Diagnostic and Statistical Manual of Mental Disorders, or DSM - anxiety, and panic disorder are distinct. Specifically, panic disorder is one particular form of a variety of conditions that fall under the heading of anxiety disorders. Having your act together means respecting yourself enough to keep your thoughts, emotions, behavior, habits, and life under control.

It means having enough self-respect to stay focused on becoming better every second, every minute, and every hour of every day. It means controlling what you think, say, and do and making sure all of your actions are in align with, and pushing you towards, your goals and targets. Respect your word to yourself. Respect your self-discipline. Respect your time and energy. Respect your targets and goals. Respect your schedule. Respect your rules. Respect your boundaries. Respect yourself. Respect your life. Respect the amount of time you have to get things done and make them happen. As we saw above, however, the various forms of anxiety disorder often overlap and can bleed into one another. A person may experience a specific phobia or fear - such as a fear of dying, social phobia (a fear of being on display, of making a fool of oneself, etc.), fear of losing control of their actions, etc. - which causes them to experience a panic attack in a particular situation. They then become afraid of having another panic attack, and so they start to engage in avoidant behaviors so as to escape the kinds of situations that originally provoked the attack. Having an occasional panic attack in the course of your life is not necessarily a sign of a disorder or a larger problem. Moreover, it is completely normal to experience times of fear, anxiety about the future, and stress in the ordinary course of living. If panic attacks are becoming a recurrent feature of your life, however, and if you are engaging in behaviors to avoid them that are preventing you from living your life fully or are blocking you from the things you would like to do, then it might be time to seek help from a therapist or other mental health professional. Respect yourself enough to do what you say you're going to do.