We all do it — procrastinate to some degree. I procrastinated in writing this post. I think it was because I was afraid it wouldn’t be good enough. Good enough for who I have to ask? For me. For my own standards, for the ability to achieve the good results that my last post reached. I tried to remind myself that not every post can outpace the prior one, but early this morning when I first sat down to write, that neat platitude didn’t seem to ease my anxiety.

I surfed the net and read the newspaper on line, I puttered around my apartment organizing and tidying up  — that usually has a calming effect on me, I made and drank endless cups of coffee (thank goodness for my Keurig).

I’m not typically prone to procrastination. In graduate school I was one of those students who started her twenty page paper the weekend after it was assigned and planned the phases of the paper — research, outline, and writing according to the amount of time we had until the due date. My classmates hated me because I never pulled an all-nighter.

Beginning to wonder what else was up — why I couldn’t seem to sit down and get started — I thought back to the last couple of days. Work on Thursday and Friday had been particularly stressful; long, fast-paced days, running from task to task and feeling rushed and unsettled. I had come home late, had a snack for dinner instead of a meal and crashed within fifteen minutes of walking through the door. I had lingering doubts about a new responsibility I’d been handed and met with my director about. Did I do a good enough job? Would she want me to continue?

The doubts about this new task had carried over to my attempt to write my post and I procrastinated determinedly. I told myself I was tired and would write better after I went back to bed and woke up refreshed. I went back to bed. I didn’t write once I got up. Time flew as I did nothing noteworthy. Soon it was time for me to shower and leave to have lunch with a friend. The whole morning was gone, wasted.

My patients are determined procrastinators as well. Those that are in school; whether they are pursing their GED or bachelors or beyond, procrastinate in studying for exams or writing a paper. “I work better under pressure,” they tell me. “My adrenaline kicks in at midnight.” Is this the truth? Are they lying to themselves to rationalize their procrastination? Or are they trying to convince me of something?

Despite their grade on the exam or the paper or even before they know the grade, I try to convince these men and women to explore this pattern and why it repeats itself each time.

“I won’t do it again. I can’t take the not sleeping/the pressure/the anxiety.”

“But it does repeat itself,” I point out. “What do you think you’re afraid of — waiting until the last minute each time?”

I have other patients who are not in school, who are not working, who pretty much spend their days alone, doing nothing. If appropriate, I might raise the idea of a volunteer job, taking some free classes at the library, attending a NAMI (National Alliance for the Mentally Ill) Connections meeting, identifying an interest and joining a group of people with similar interests i.e. a book club or nature walk. If the patient declines, I ask why not, listen and we talk.

Following my 18 month breakdown from 2006 through 2008, as I stabilized, my psychiatrist, Dr. Adena* strongly “encouraged” me to prepare to return to work by either getting a volunteer job or a paid job. I was receiving Social Security Disability so a salary was not the point, just getting out there was. While I lacked confidence in my ability to return to my career as a full-time social worker again, Dr. Adena possesses the philosophy that one should not languish on government rolls. It took me a while, but I got a job as a salesperson at a woman’s clothing store in the mall. I was either folding stacks of sweaters or standing in the front of the store greeting customers. Within five months I was bored out of my mind and I quit work at the mall to look for a part-time job in social work.

I’ve come to believe that being productive in some way, at least for a couple of hours a week is good for almost everybody as long as the person’s symptoms have been stable for some time. Being in school or at some kind of work, being out among people and not isolating — all encourage and build emotional health and wellness.

Patients act interested initially; they take the name and contact information of an organization which they’ve identified an affinity for — an animal shelter and an illness which a relative has suffered from or even died from are the two most popular. Several weeks go by and I might inquire if they’ve looked into what we talked about.

“No, but I will.” I don’t know if they’re procrastinating out of a fear of moving ahead or simply lying to me because they have no intention of following through. Maybe a combination of both. Not letting them get away with those four little words, a discussion ensues. I encourage them to be truthful with me which often wraps up with “Perhaps you’re not quite ready. “Why do you think that’s the case?”

“How about if we revisit it in six months, make it one of the long-term goals on your treatment plan. Is that okay?” A compromise is reached. Postponed, but not forgotten. In the meantime my patient and I can explore obstacles, fears, anxieties, and concerns.

Is this further procrastination? Perhaps, but with a specific purpose, with an end in sight.

I don’t know if I had been seeing a different therapist, if events would have unfolded in the same way. I do believe that without Dr. Adena’s firm conviction and confidence in me, I might very well have never recaptured my career. When she told me I needed to make this move, I stalled for some time and sensed her losing patience. My fear of losing her was more powerful that my desire to procrastinate so I got moving.

I saw my capabilities as fixed and she saw something different. I hope to arouse the same sense of discovery and enthusiasm in my patients as I encourage them to renounce their procrastinating ways.

* Names have been changed

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