If they follow the instructions, they will remember to welcome this thought along with the others, instead of trying to fight it. Something similar applies to people experiencing panic. We have seen that trying to "control" your emotions often backfire. You cannot simply "force yourself" to calm down in the hopes that the panic attack will "disappear." Most of us know this from our personal experience. If you have ever been angry, you know that it does no good for someone to tell you to "just calm down." A habitual procrastinator's life is akin to the voyage of a rudderless boat, afloat and underway, yet without the ability to steer and command a course. In much the same way, the procrastinator aimlessly negotiates the waters of life, forever allowing the tides of circumstance to have their way with him. As an adult procrastinator, I often felt like a child lost in a sea of adults. Similar to when I was a five-year-old in Macy's department store and strayed too far from my mother and felt bewildered by the seemingly mountainous range of countertops and endless shopping aisles: "Mommy! Mommy!" I cried out in fear of abandonment. Adult procrastinators act in a somewhat similar fashion, but instead of crying out, we cry inwards by internalizing our feelings of inadequacy and bewilderment through a continuous stream of negative self-talk and self-admonishment. Like many procrastinators, I carried my negative feelings with me, day in and day out, almost as if I were carrying the proverbial "weight of the world" on my shoulders. Here's just a partial list of the sort of judgments I made against myself: I felt as if "I didn't have all my marbles." I not only lacked confidence and respect in myself, but was also convinced that other people "must have" seen the same in me. Overly burdened by the matters I had put aside, as well as my inability to deal with them, I sometimes felt as if I were living in a dream world, unattached to reality or other people. Procrastination wore me down and felt akin to a bad cold. I often felt tired and sluggish, as though every task took all the energy in the world to complete. What I also did, something I've done a lot, is I used what I call a "drama book". I call it a "drama book" because instead of posting, talking about, and sharing negative feelings and problems with the world, something that reflects poorly upon you and makes you look weak, I get the negativity and "drama" out by writing, by hand, in a "drama book". All of your drama and petty, weak, and victim-minded thoughts go in it. It doesn't judge you. It doesn't talk about your business when you're not around.

It's 100% personal and private. It's the same as journaling, except you only dump your negativity and drama into it so you're not dumping it on other people and putting your business online. The important thing is getting the nonsense, weakness, and "poor me" thoughts out of your system and there's a magical process that takes place when you take a pen or a pencil and actually write out on paper what's in your mind. It creates a "release" you don't get from talking about it or typing it out. It's very weak, childish, and socially and emotionally-irresponsible to dump all of your problems, negativity, and drama onto another person so you can "feel better". If you need to vent because you just can't take it anymore, go to the store, buy spiral notebook that's only used for your "drama book" purposes, write in it every time you're having negative and dramatic feelings, and then put it away where no one will read it. There's no specific time you have to use it and there's nothing you have to, specifically, say in it. When you're overwhelmed by negativity, drama, self-doubt, weakness, and being a victim and it's stopping you from focusing, moving forward, and reaching goals, your "drama book" is a tool to help you relieve the pressure. To get the negativity out. To get the nonsense out of your system. It does wonders for your peace of mind. Continuous care means that treatment does not start and stop for any reason or as a result of reluctance or difficulties in obtaining care. Individual reluctance and these difficulties are at work most of the time and thus are critical barriers to be overcome. We don't get better from any condition unless we see its treatment through to its natural conclusion. Continuous care does not necessarily mean intensive care forever, but it does mean maintaining a good working relationship with caregivers and staying the course. Clinicians and clinical services need to be welcoming, accessible, respectful, and vigorously attentive to engaging and retaining patients in care. A great deal has been learned and disseminated about what works in mental health and addictive treatments. Responsible, professional caregivers are always looking for new information and practices that will close what has been called the science-to-practice gap. The evidence referred to here is what has been studied and replicated by trustworthy researchers (i.e., it is evidence based) or is promising but has yet to appear in medical journals (i.e., it is evidence informed). That is what we should want our clinician to put on the table when we meet to discuss treatment options.

But that is not enough. Treatment to target is crucial. We would not begin a diabetes or hypertension treatment or care for a malignancy without a clear measurement baseline, such as HgA1c (a blood test that determines ongoing sugar control in our body, which is more accurate over time than daily blood-glucose readings), blood pressure, or tumor size and activity, that can be regularly monitored to ensure that the treatment is working or can be altered if it is not. This is called treatment-to-target or measurement-based care. Screening instruments to identify a condition and to provide data points, measurements, that can be tracked over time are essential to measurement-based care. Our blood pressure, our heart rate, our lipids, our sugars, are all measured to provide data points for medical management. So too can problem behaviors be screened for, measured, and monitored. In people with addictions, the use of quantifiable measures to assess clinical progress is in its infancy, though research work has used measures for some time. Nevertheless, because people often struggle to understand or empathize with anxiety if they have not experienced it themselves, you may have often received unhelpful advice of this sort from people around you when you are in the midst of a panic attack. How many times, while panicking (or ruminating, if you struggle with depression), have you been told to "just let it go" or to "think about something else"? People with anxiety know that this is easier said than done. All of that is true; however, it is also true that there are simple methods you can apply in the moment of a panic attack that will help mitigate and manage the intense emotions you are feeling. Again, it is important to note that these are not devices to "control" your emotions or to "force" yourself to stop panicking, but quite the opposite - they are ways to help you retain an open and accepting attitude toward yourself and what you are feeling. So, while you are reminding yourself that it is okay to "ride the wave," and that you are not in any danger no matter what happens with your emotions, you can also apply the following remedies and solutions during a panic attack: Engage in simple behaviors or actions that are countervailing to your anxiety and that "cut against the grain" of your panic. Remember above, when we discussed the essay by William James called "What is an Emotion?" James, a famous American philosopher who is best known for helping to invent the philosophy of pragmatism, argued in this short essay that an emotion is really a physical response, rather than a purely mental "internal" state. Applying this insight, we can see that by altering our physical responses, we can also change what we "feel" is happening to us emotionally. In the case of a panic or anxiety response, this means deliberately doing the opposite with your body of what your panic is telling you to do. Perhaps you are thinking anxious thoughts, and you notice that you have tensed your muscles, balled up your firsts, and squared your shoulders. Try simply letting your hand fall open and resting it palm up on your lap instead. Perhaps you notice that you are chewing your fingernails or running your hands through your hair.

Try just leaning back in your seat, leaving your hands open on your legs, and staring out a window. You will be surprised by how much calmer you feel within minutes - or even moments - of doing something with your body that is different from what your anxiety normally dictates. You may not be able to "control" your emotions internally, but you can control your outward bodily actions in response to your emotions, and these actions, in turn, influence what you are feeling. This is one of the core insights of cognitive behavioral therapy. At the moment - and almost immediately - you can change your emotional response by changing what you are doing with your body. Many times, when just the thought of dealing with an anxiety-provoking task came to mind, I would automatically associate that thought with a negative scenario. For example, just before sitting down to scour the on-line classified ads and job-hunt, my mind would conjure up the scenario of sitting in the dentist's chair, or of dealing with an awful drudgery, like housecleaning. I had no sense of the word priority: only crises, deadlines, and external demands prompted me into taking action. Many, if not most of those crises, were of my own making in the first place. By waiting around for disaster to strike, there'd come a time when I simply had to act, and this gave me the perfect excuse to break through the shame that kept me immobilized. However, so far as I was concerned, I was only dealing with them because once again, the evil forces commonly known as "them" had forced my hand. Focusing on only one task at a time was enormous task in and of itself. Whenever I tried to force myself to deal with one task, other tasks I had put off would come flooding back into my mind, as if everything was a priority and needed immediate attention. I felt afraid most of the time. Overwhelmed, I avoided feeling fear and anxiety through various means, like television, food, alcohol and recreational drugs. However, by furthering my avoidance, I not only made my original problems worse, but created other problems as well. It was as though I was waiting for "David" to come and do it. Still, who exactly was "David," and where was he? And why wasn't "David" taking care of "me"? There almost seemed to be two of me ...

"Irresponsible Me" and the more rare, "Responsible Me." A poet might have called it: "A life in such perfect conflict." Spinning hand in hand forming a psychological vortex were two of my worst attributes: an inability to select a single priority to work on, and difficulty focusing on just one task. Regardless of what you're doing, someone will find a reason to criticize you and talk trash. It's a part of life. You can't have your act together and still care about what others think. If you know you're on the right path and doing what you're supposed to, then ignore the opinions and criticism. It's usually coming from people who think they have it together but don't. It's usually coming from people who have no room to talk and criticize. When you clean up your environment and choose to separate yourself from negative and failure-minded people, you will be criticized and told you think you're better than others. You will be called "stuck up". You will get told you forgot where you came from. You will hear you've "changed". When you become busy working towards a better you, a better life, and better goals, you will get told you're not making enough time to have fun. That you're working too much. That you're working too hard. That you need to cut yourself some slack and give yourself a break. That you're being too hard on yourself. When you decide to become an entrepreneur, make your own hours, and become your own boss, you will be told it's not safe. That it's not stable. That you need to find a "real" job. That what you're doing isn't smart.