Experienced clinicians know not to give up hope even though it can be hard to predict when recovery will really kick in; people with addiction, and their families, need to know this as well to stay the course, to persist and be there when a person wants to try again. What we don't want to see or admit, we do not remedy. Within a family and within our culture, tackling addiction starts with detecting it. Simple screening tests for alcohol, drugs, and tobacco exist and can be made standard practice throughout medical care (and in educational and counseling settings). SBIRT--Screening, Brief Intervention, and Referral to Treatment, discussed earlier in this book--is a recognized, proven, and even reimbursed medical procedure that awaits general use despite the consequences we suffer from not using it. Since he'd never take action unless he were forced to, only external circumstances prompted Jerry into acting; however, by continually working on a crisis-by-crisis basis, Jerry builds up a great deal of self-directed anger, which plays havoc with his ability to view his tasks with clarity. Where a non-procrastinator would deem Jerry's lifestyle as far too stressful, as far as Jerry is concerned, "it's just another day." As a result of his ever-changing priorities, Jerry is floating through life; putting out one fire after another, without ever getting control of the conflagration. This brings us to our next characteristic of the human ostrich. By acting only when his hand is forced by circumstances, and not through his own decisions, Jerry refuses to take responsibility for his own life. He often says that he "doesn't like being tied down to anything," and it shows. Having never quite found himself in the workplace, Jerry has held a seemingly endless variety of jobs, and he's switched careers several times as well. He's also picked up and moved a few times, almost hoping that by changing location, his life too might change. By not attaching himself to any particular vocation or location, Jerry has enjoyed a certain sense of freedom--but he's now seeing a cost to this lifestyle. He has begun to feel envious of friends whose lives appear more stable and established than his own. The only thing that could possibly be greater than the number of tasks a habitual procrastinator has put off might be the number of excuses they can come up with. In a sense, it comes down to what they're most skilled at: "doing," or "not doing." Which one describes you best? If you said "not doing," try not to be hard on yourself. Few persons would take the time to read this book unless they had a genuine problem with procrastination. It's better to be honest with yourself about the extent of your habitual procrastination than to continue making excuses for your inaction, as well as excuses for your excuses. Research studies have long shown that children of Holocaust victims often develop trauma symptoms as well from hearing the stories of their parents or from grandparents describing what had happened to them.

Even health professionals who deal with trauma patients can develop secondary trauma due to repeatedly listening to their patients' experiences. Though this secondary trauma may not seem as serious as what trauma victims experience directly, it can still have an impact that shapes how people view their own lives and how they deal with stress. And, as you can imagine, this is one of the reasons that the suicide rate in health care professionals can be so much higher than average. But there is also the depression that can occur in people who experience long-term trauma. People living in war zones, who are in long-term abusive relationships, or are dealing with chronic sexual or physical abuse often develop what has been termed complex posttraumatic disorder (C-PTSD). First proposed by Judith Herman in her 1992 book, Trauma and Recovery, she suggested that people dealing with long-term stress often showed symptoms very different from people experiencing single-event traumas. As a result, they can often become passive and withdrawn (due to learned helplessness), or develop highly unstable personalities. Along with all the classic symptoms of depression, they can also show other symptoms such as self-cutting; substance abuse; violent behavior; and, in many cases, suicide attempts. This kind of chronic trauma can take many different forms though. Religious, sexual, or ethnic minorities in many Western countries are often victimized by violent hate crimes intended to intimidate them. Whether or not individual members experience these crimes directly, the fact that the violence was directed at the community to which they belong is enough to make them feel victimized. This is often referred to as identity trauma since it involves attacks on a person's sense of identity as much as it is a physical threat. There is also collective trauma, which can strike an entire nation after a wide-scale event such as 9/11 or the recent Boston Marathon bombings. Though the panic subsides fairly quickly, the ever-present sense of Will it happen again? never really goes away. A group of scientists at McGill University in Montreal has looked into which sort of transport is best for our mood. The study was conducted among 3,400 people - during summer and winter - and it examined six typical means of transport: car, bus, train, metro, bicycle and foot. The researchers looked at the satisfaction gained in several aspects of the journeys and from this calculated one overall satisfaction score for each mode of transport. They found that the greatest satisfaction was experienced by those who could walk to work, while those who had to take the bus were the least satisfied. Obviously, you might say.

If you can walk to work, you can't have a three-hour commute. That is true: the length of the commute does dictate our transport options somewhat. So, it's particularly interesting to study commuters over time and observe what happens when they change their form of transport. Fortunately, that is exactly what scientists from the universities of East Anglia and York have done, by following a group of eighteen thousand Britons over eighteen years in the 2014 study `Does Active Commuting Improve Psychological Well-being? Longitudinal Evidence from Eighteen Waves of the British Household Panel Survey' (the rule of thumb in academic papers being, the longer the title, the better). They found that people who switched from driving to walking or cycling experienced improvements in psychological well-being - even if the trip now took longer. I cycle to work and pass a large public garden on my way. The garden is one of the ways I can sense that spring is coming: I can smell when the cherry trees are blooming. Part of the reason why we feel in a better mood when cycling rather than driving is that our senses are more engaged. We simply feel more alive - walking is a more sensual experience than driving. Especially if you engage in what the Japanese call shinrin-yoku. Time chunks work for long and grueling days. Don't focus on making it to the end of the day because it'll make your day seem longer. Focus on making it to your next break time. Once you reach your break time, forget about the last few hours you just endured and move onto focusing only on the next few hours. It's less stressful and less overwhelming. Once your mind adjusts, making it through a 12 hour day is no big deal. One Navy SEAL, when asked his mental process for making it through BUD/S, Basic Underwater Demolition/SEAL Training, a 24-week training course that pushes you to your physical and mental limits, said that the only way he made it was focusing on making it through the current evolution (training exercise). He didn't worry about making it to the end of the day, week, month, and course. He knew that if he focused on the current evolution and nothing else, he'll make it through it and he can keep repeating the process over and over until he reached the ultimate goal of graduating BUD/S and becoming a Navy SEAL.

Evaluations aren't bad. They help you determine which path you're on, how you're doing, and the direction in which you should be headed. Most of us hate evaluations because we're subjecting ourselves to criticism - and criticism never feels good. So to limit the negative, take ammo away from those looking to find fault, and to make it easier, regularly evaluate yourself and your own performance. You don't need another person, who is no smarter than you, telling you how you're doing and how you can improve. You should be able to determine that yourself. Evaluating yourself instead of letting others evaluate you helps you become more open to learning, finding your weaknesses, and getting better. You're less likely to get your feelings hurt and feel insulted. Before you start a project, analyze everything that has to happen, determine the objective and big goal, figure out all the steps involved, break it down into manageable sizes, and set a performance standard for the project. Visualizing yourself doing each step of the project and making a detailed list makes it easier. Once it's broken down and documented, figure out about how long each step will take, give yourself a time limit to do it, and then get to work hitting each target and completing each step. This helps you go into it with a clear mind. People may take many different paths to addiction recovery. No one path works for everyone. Community Reinforcement and Family Training (CRAFT), noted earlier, is a valuable resource for families developed by Dr. Robert Meyers. His work begins with recognizing the value of most families (and friends) in enabling a person with a substance use disorder to begin the work of recovery. For some, 12-step programs are lifesaving. Others benefit from medications that aid in remaining drug-free (as noted earlier, medication-assisted treatment, or MAT) coupled with psychotherapy. We all, not just addicts, need to surround ourselves with people who want to support our well-being, and to assiduously avoid people who want to exploit and otherwise take advantage of us.

Addiction remains America's most neglected disease. When celebrities, sports figures, and political leaders go public about their addictions, that helps diminish stigma and foster hope, just as the Huffingtons did. There are an abundance of treatments for addiction, and no shoe fits all feet; many interventions are usually better than just one or two. With complex problems, which surely include substance use disorders, we have to use a lot of good stuff, heartily applied over time, to increase the chances of success. The road begins by walking it. Excuses were an important mechanism to the way in which I procrastinated. In essence, they provided me with a back-up system to bolster what little self-esteem I had. While some excuses worked really well--others simply worked. Without a bona fide excuse, what else could you possibly say to a superior at work who was expecting a report that had not been submitted on time? How about: "It seemed boring to me at the time; do you still want it?" That just doesn't have the air of authority that "I was too busy to get around to it" has. Marching in step along with not "do"-ing is the procrastinator's desire for all tasks to be simple in nature, and to flow effortlessly toward completion. The procrastinator does not stand alone in this respect. He shares similar attitudes with compulsive gamblers who want to "take the easy way out," and those who seek the equivalent in get-rich-quick schemes, which purport to offer the benefits of hard work, but without the responsibilities and all the hassles. Gambling also describes how procrastinators lead their lives, because they are playing the odds that they will succeed in getting over on their responsibilities. While we might hope that by diverting our attention away from pressing matters, we'll regain some sense of control over our lives, although we may not be gambling in a casino, our long-term results are similar. While the gambler loses money, we lose pride within ourselves. It's natural for habitual procrastinators to feel overwhelmed, and to want to avoid or flee, when faced with a complicated task. Avoidance goes hand in hand with frustration--the more frustrated we feel, the more we may delay dealing with our tasks. This is one reason why many procrastinators begin to shut down at just the thought of dealing with a complicated task. As you can see, trauma can occur in many different ways and often affects not only victims of trauma but the people close to them as well.