Persistent and debilitating forms of procrastination practically always co-exist with anxiety, depression, ADD, perfectionism, and other problem conditions. For example, your client has a public speaking anxiety and is a master of excuses to delay executing a gold standard behavioral exposure approach. Instead of addressing anxiety and fear, or preparing for a speech, your client plays computer games.
If your client dodges making meaningful changes, this could connect to a habit of procrastinating. Indeed, you can anticipate that practically every client you see will sometimes procrastinate on following through on dealing with the problem(s) they came to you to help them resolve, as well as the often more important issues that surface in the course of therapy.
By putting the procrastination process into a cognitive, emotive, and behavioral framework, you can help your client discover whether procrastination interferes with positive change-making activities. Cognitively, what is your client's timing for working on changing? If it is "I'll get to it later" or "I'm too busy," these are classic examples of procrastination thinking. Emotively, how does your client feel about meeting a problem-related challenge? This can surface a tendency to dodge discomfort and anxiety over stirring up unpleasant feelings or memories. Behaviorally, what does your client do in lieu of working to make the changes? That question will surface safer activities, such as watching TV. This mapping process opens opportunities for you and your client to explore common mechanisms for delaying change, and for breaking through a procrastination barrier to change.
Clients who procrastinate may already suspect that they are delaying and are prepared to give excuses so they can put off the inevitable changes. Thus, in an awareness-building phase, it is important to interact in a non-judgmental, matter-of-fact manner. Noting that procrastination is normally an automatic process can help assuage possible guilt over procrastinating. Many clients will also resonate with the idea that they can get a twofer benefit. They can simultaneously address what they put off facing and the procrastination problem itself. This approach can help strengthen a therapeutic alliance.
Clients with procrastination may profit from reading and applying techniques from: Procrastination Workbook for Personalized Breaking Patterns.
Addressing a Procrastination-Anxiety Connection
Clients suffering from recurrent anxieties share common bonds. Among them you'll find a procrastination-anxiety connection. You can help speed your clients' progress by helping them see and break this connection.
With your guidance, your client often discovers recurring anxiety beliefs, such as "I'd look like a fool if I spoke before a group." This awareness can be a prelude for changing this parasitic brand of thinking. However, your client won't get far beyond the joys of self-revelation without following up with corrective actions. That's where procrastination can get in the way. Here is an innovative way to address this intertwined process. Take a recurring belief, such as if, "I spoke before a group I'd look like a fool," and redefine it as a belief that also leads to procrastinating. Therapist: "If you fear looking like a fool, what do you ordinarily do?" Client: "Something different." Therapist: "Such as?" Client: "Tweeting my friends." Therapist: "That's an example of procrastination as a defense against a fear." Now, you, the therapist, take it from here.
Clients facing a primary anxiety and secondary procrastination challenges may profit from reading and applying techniques from the book: Cognitive Behavioral Workbook for Anxiety
Addressing a Procrastination-Depression Connection
Activity is a useful remedy for depression, but often not easy for your client to execute. When your client's depression lingers, you can use my circular solution to spur positive activity.
Breaking a procrastination-depression connection often takes executing a circular solution: (1) help educate your client on depression and on how to cope using evidence-based methods, such as exercise and addressing cognitive distortions, (2) if procrastination surfaces, identify the procrastination-depression connection, (3) work with your client on using procrastination techniques that apply to both procrastination and depression.
A five-minute plan to break a procrastination cycle may help spur action against mild to moderate depression, and sometimes the more severe variety. The method involves getting a client commitment to engage a meaningful, measurable and achievable antidepression activity for five minutes. Light exercise is an example. After the first five minutes, your client can choose to do five more minutes, or stop. Here are steps that I follow:
1. Explain the exercise and its purpose. (I'll normally describe the technique as an activity to help break inertia.)
2. Have your client pick a counter-depression activity.
3. When feasible, simulate conditions in the session where your client tests the technique and gets feedback from you.
4. The client tests the method as an activity homework assignment between sessions.
You can use the five-minute plan to set the stage for exploring a potential contradiction. Powerless thinking and resignation add to the load of depression. By executing the five-minute plan your client demonstrates the ability to take proactive steps. For clients who believe they are helpless to do anything when swept by a wave of depression, how are they to explain engaging the five-minute plan? This incongruity can give pause for thought: "How can you be powerless to change when you've demonstrated you have the power to break inertia?" Then, take it from there.
Clients facing primary anxiety and secondary procrastination challenges may profit from reading and applying techniques from the book Cognitive Behavioral Workbook for Depression.
The Procrastinator Label Issue
Client self-labeling, such as "I'm a hopeless procrastinator," can be a barrier to meaningful change. Some clients will identify with the label and feel stuck. I typically explain, "A procrastinator label says more about the folly of making sweeping generalizations about you than it says about you." That intervention typically causes the client to pause in thought. Once past the "procrastinator" label issue, your client may better focus on breaking a procrastination-anxiety or procrastination-depression cycle.
