Free yourself from emetophobia: Veale

 Free yourself from emetophobia: Veale

Contents

Chapter 1 What is Emetophobia 1

Chapter 2 What keeps emetophobia going 3

Chapter 3 Cognitive Behaviour Therapy 6

Chapter 4 Defining your problems and goals 7

Chapter 5 Actively defeating your Emetophobia 7

Chapter 6 Understanding and dealing with common obstacles 10

Chapter 7 Bringing it all together 12

Chapter 8 Medical treatments for emetophobia 12

Chapter 9 Considering your support network 13

Chapter 10 Advice for friends families and partners 13

Chapter 1 What is Emetophobia

Generally a fear of self being sick, occasionally purely other (rather than other infects me and I am sick)

 

Images

Can have intrusive images, flashback, to that awful time, or flashforward to that awful time.

The images will be of disgust of other judgement, of lack of control

 

Fear

Of uncertainty, will I or wont I get it

 

Physical

There is often an accompanied nausea , uncomfortable feelings in the stomach what accompany a fear of being sick.

 

Emotions

Anxiety

 

Thoughts

That it will go on for ever

That others will find me repulsive if I’m sick

 

Attention

Self focused

 

Behaviours

Avoidance of threats: food poisoning, ill people. Both are checked and restricted

 

Feeling sick and vomiting are difficult to avoid at some point it will happen.

90% of sufferers are women.  Men may feel more shame to admit it, women are more hygienic, more sensitive to being revolting and more likely to develop contamination fears in OCD.

 

OCD a problem with uncertainty if someone will vomit is on the continuum up to emetophobia

 

There is often repetitive behaviour to prevent being sick

Check sell by dates

Cooking excessively

Check if people are sick

Not sit close to people

Excessive hand washing

 

Comorbidity

OCD and emetophobia on a spectrum around fear of contamination

Emetophobia and social anxiety 10-20% comorbid, fear of being judged as revolting

Emetophobia and health anxiety: strong similarities, worry about sickness, avoidance sick triggers, body checking, only difference one is a fear of serious illness the other a fear of vomit

Emetophobia and panic attacks, people can experience panic attacks when they fear they will vomit

 

Chapter 2 What keeps emetophobia going

Old Brain: reptilian: threat\drive system: triune brain

Emetophobia

Threat system over engaged

Drive system as a defence: keep busy

 

Threat of emetophobia made by the new brain, enacted by the old brain, as the threat and drive system, go into service of the new brain. Whilst the threat starts with the new brain, gets the old brain involved, then the new brain, cant turn off the old brain but rationalising.

 

The emotions that play a part of emetophobia are anxiety, through the fear of becoming sick. Disgust at the act of being sick. Emetophobics have stronger and more sensitive producers of disgust experiences.   Disgust may also be associated with a sign of danger.  Anger is involved at the person who might threaten sickness on you, but that person could be yourself. Anger can also be at yourself for not doing something you wanted to do because of emetophobia.

 

Early life experiences.

People might have vomited, and believed\were they were abandoned, shamed, harshly judged, laughed at,  and the associate vomiting with that.  There might be the ideas that they were seen as disgusting and not the vomit, i.e. their behaviour. When they vomited they might have experienced it as violent, and them as out of control, they might not have been comforted, rather shamed.

 

Environmental factors

Seeing a loved one vomit then becoming seriously ill.

Abuse at the time of the vomiting episode

Over protective parents : their implied awfulness of  vomiting.

Being physically vulnerable and catching a vomiting bug

 

Personality factors

Emetophobics have a strong sense of internal control, that they can control what happens to them

Physical factors

Higher levels of somatization, i.e. expressing emotions physical

 

What maintains emetophobia

Expectancy of vomiting, through thoughts, and physical feelings.

Judging vomiting as being 10% awful

 

Vicious cycle

Anxious thoughts about vomiting

Anxiety

Somatised into physical feelings

Increases fear that I will be sick

 

Short term payoff long term problem

Worrying\reassurance seeking: (however they focus on the problem reinforce how awful it is, and increase its perceived likelihood)

Self focussed attention and looking for danger: again stimulate feeling sin the body, increase the sense of the awfulness of it,  Increases belief that you can control vomiting, but when you need to vomit you cant stop it, and that’s a good thing!

Avoidance: maintains the belief in the awfulness, shrinks your world, and leads you to not learn how to manage situation, or indeed to find out you can manage a lot better than you think. Avoidance maintains anxiety as the next time you face the situation you feel anxious and have to avoid it.

Safety seeking and compulsive behaviours e.g. checking sell by, over cooking, handwashing. Here every time we do them, we are reminding ourselves how awful vomit is, that we can protect ourselves against it and that actually we will be safe if we don’t do them (self perpetuating)

The awfulness of vomiting also increases with the levels of effort you put into stopping it (paradoxically)

 

 

 

Chapter 3 Cognitive Behaviour Therapy

Emetophobia: peoples anxiety is somatised,  they scan their bodies and believe their body sensations are a sign that they will  vomit, they will lose control and it will be truly awful. This relates to safety seeking behaviours and avoidance.

 

Psychoeducation:

A reflex for humans, when our body thinks it has ingested a toxin.  Rats don’t vomit, that’s why rat poison works so well.  You stop vomiting when there’s nothing in the stomach, vomiting might be horrible but it has a distinct start and end.

 

Theory A: You are at risk of vomiting any time. Vomiting is awful, you will lose control and it and your anxiety will go on for ever,  a fate worse than death, and you cannot bear it. You must engage in SSBs, and avoid many things.

(This is an anxiety problem and gets maintained with the vicious flower)

Theory B: Vomiting is unpleasant, useful and you can bear it. This is a problem of vomit, and we will assume it is true.  The problem you have is because you are trying to not vomit!

(This is  a pathogen and biology problem)

 

With Theory A\B we can use behavioural experiments to test if its more A, does the problem get worse with changes in emotions for instance.

 

Erp: Graded exposure key to emetophobia, to learn that avoidance and safety behaviours aren’t needed, so reduces the maintenance of the fear

 

Image rescripting:  Rescript, rebuild and loving eyes;

 

Chapter 4 Defining your problems and goals

Rate severity of emetophobia

Define the problem by rating varies domains of your life and how much emetophobia gets in the way of it.

Set SMART goals

 

Chapter 5 Actively defeating your Emetophobia

The length of the problem, the more effort you will need to put into it. Testing predictions, ERP and drop safety behaviours.  More effort you put in at the beginning the greater your momentum.

With emetophobia the aim is to tolerate its related anxiety and disgust, so that you can act in ways that are important to you and not to manage your anxiety and disgust. Whilst it is important to face you fears and to learn that they are disproportionate, having techniques to manage anxiety can help if the emotions are very strong.

Techniques to tolerate anxiety

1.      Slow breathing

a.      Make sure your outbreath is 2 beats longer than your in breath.  Breathe into the belly

2.      Connect with others\and the world: there is a tendency to have self focussed attention which enhances the anxiety, really look at a plant, bird, person, talk to them, listen to them.  Get some emotional support for what you are doing is hard, not rather getting reassurance that you wont be sick

3.      Cold water

a.      Put your face in cold water, which stimulates your parasympathetic nervous system

4.      Grounding technique

a.      5:1

 

ERP

Face a manageable level of fear of something that is important to you.

Learn you can tolerate the anxiety.

Let the anxiety\your body learn there is nothing scary in this situation (the only scary thing is the anxiety!)

Anxiety isn’t pleasant but it isn’t going to harm you.

Anxiety and disgust help you prepare for a threat, but what if there isn’t a threat, what if it is a false alarm.

For every step on the graded hierarchy it is important to stay with the anxiety until it has reduced by at least half.

Jumping around the hierarchy is more effective than a linear approach.

Chaining exposure tasks can be powerful, so eat a food you might avoid in a busy public place, then read in the car on the way home.

Practice once a day, to build up momentum.

During your exposure act as if theory b is true.       

Notice  subtle SSBs whilst doing exposure, mental reassurance, small sips of water.

Be compassionate to yourself, speak in soothing tones, to encourage yourself to do something difficult.

 

Behavioural experiments

Drop SSBs and see what the effect is: Test theory A.

Person fake vomits in public: see what happens

Eat food you have avoided: see what happens

Don’t over cook: see what happens

 

So Theory A: it could happen any time, it would be awful you need to protect yourself, and we can understand this via a vicious flower, and that it’s a problem of anxiety

Theory B, its  a vomit problem, its unpleasant, it will happen, you can bear it.

 

Image/Memory work

Change the image

Different characters, different form, don’t end at the worst point.

Most images problems end at the worst point!!

Rescript the image: Relive, rescript and loving eyes.

 

Changing your thinking

Change your relationship with your thoughts via mindfulness.

 

Reassurance seeking

Key distinction between assurance which is a one off that things will be ok, to reassurance, repeated questioning that things will be ok.

 

Working with attention

Our attention goes to our body and “abnormal” sensations, or threats in our environment. We are laser focussed on the problem and its solutions, so we need to widen our attention to positive, neutral and negative things that are not related to vomit.

Learn when you are not anxious, use when you are:

Pick a sense, I’ve used sound

1.      Sound attention: notice sounds, close, near, far away. Listen mindfully.

2.      Switch attention between them. Spend a minute on each one

3.      Practice and when mastered then use it when anxious to switch your attention to something less threatening

 

Working with Worry

Worry isn’t like problem solving, its about things outside of our control, its about getting a sense of certainty over something (even though you cant be).

Monitor your worries and classify them

Have they happened, can you control them?

If you cant do anything about it, then commit to something different, if you can do something about it then do it. Best doing something different is something that you value that takes up mental energy. You could do something about vomit, if I vomit then, which would be vomit safety plan. When I vomit, what would be nice is, this would be as opposed to avoiding vomit at all cost.

 

Chapter 6 Understanding and dealing with common obstacles

 

Trying too hard to be perfect

Don’t achieve, so stop

Putting effort into the right\best therapist\approach\understanding etc, slows you down.

Rather just start, and try to improve things for yourself, with good enough.

 

Fear of making things worse

You will fear dropping your SSBs will make things worse and you will vomit, but

Emetophobics and non Emetophobics have the same rates of vomiting.

 

Fear of looking back and regretting change

You feel comfortable where you are, known is better than unknown. Remind yourself of why you are doing this.  Think of your eulogy would you want it contain lived a life protecting yourself from vomit?

 

Wanting coping techniques and mechanisms

This would just be new SSBs and leave the belief in place that vomit is awful and I must control it. CBT aims to get you to say vomiting is possible, rare, but possible. Unpleasant but tolerable.

 

Shame and self criticism

Shame can prevent opening up about your difficulties. You might have shame about your initial vomit incident, shame about your emetophobia, shame about difficulties in dealing with it, layers of shame.

 

Intolerance of discomfort

In ERP you are building up your distress tolerance amongst other things. Mindfulness can help

 

Not enough time

Evaluate available time, can you save some time, is now the right time?

 

Insufficient dose of deliberate practice

Don’t leave too longer gap between ERPs as you want to build up momentum, like bicycling down a hill, like taking a plaster off its easier just to do it, not to think about it, or try to do it slowly.

 

Chapter 7 Bringing it all together

Monitor your progress and build evidence for Theory B

Rate your goal progress

Consolidate what you’ve learnt, in terms of maintenance cycle and techniques

Managing lapses, relapse prevention. What do you need to keep doing to stay healthy?

Early warning signs of lapse, and response.

 

Chapter 8 Medical treatments for emetophobia

There is anti nausea medication, but emetophobics nausea is caused by anxiety.  Anti nausea drugs don’t stop you being sick.

SSRI

Possibly after CBT for severe emetophobia\OCD. Effects start at 4 weeks, and it can take up to 16 weeks to see the full effect.  Stay on it for 12 weeks before deciding if it does\doesn’t work.

The worst side effects are at the start and they reduce, although not sexual difficulties.  Side effects more likely with a big increase in dose.

Side effects

Short term

Diarrhoea/Constipation

Nausea

Headaches

Sweating

Dry mouth

Tremor

Sleepiness

Emotional numbness

Sexual problems: cant orgasm, lose libido

Loss of appetite

Agitation

 

 

 

Chapter 9 Considering your support network

Can be helpful to have a support network when doing something hard like this, to encourage and comfort, to celebrate, all of which will help you to progress.

 

However, people can misunderstand your problems, which can leave you feeling isolated.

But you can explain your thoughts and feelings and the impact it has  let them know it’s the most common specific phobia in UK

 

Friends and family

They may be difficult to use as a support  network as

They may make judgements about you, gossip about you, you may worry about them being a burden, they , may minimize your problems, you may feel shame.

Emotional support is different from reassurance seeking. Emotional support is when you are having a hard time, is validating, encouraging, listening and the like. Reassurance is when someone tells you repeatedly that you aren’t going to vomit\panic etc.

Whilst it might be scary to do, opening up to the right friends and family can be very powerful to get emotional support (and not reassurance).

 

Equality act, says workplaces cant treat you differently due to your mental health, if it affects your long term ability to perform your duties, so it cant discriminate, so adaption needs to be made.  Employers cant ask about your mental health before offering you a job. Employers must prevent you being harassed.

 

Chapter 10 Advice for friends families and partners

Supporting a person with emetophobia is about supporting, encouraging, helping them manage their distress, championing them and celebrating their successes. They need to face their fears to find out they are ungrounded, what keeps their problem going is avoiding their fears. They need to be able to see their anxiety is tolerable and is not indicative of something bad happening.

Agree with them what would be helpful from you, and how.

Children with emetophobia as they are less able to label emotions, will typically report physical problems. 

Procrastination

Procrastination

Contents

Introduction 2

Enhancers 3

Structure 3

Time 3

Rigid and critical self relationship 3

Reasons to procrastinate 3

To avoid failure 3

To avoid success 4

To avoid losing control 4

Tasks should be 4

To avoid the imperfect 4

To avoid losing your identity 4

To avoid feeling lonely \abandoned 4

To avoid doing demeaning tasks 4

To avoid making a decision 5

To avoid distress 5

To maintain your self worth 5

To increase excitement 5

The brain made me do it 5

What maintains procrastination 5

What gets in the way of tackling procrastination 6

Your identity 7

How procrastination can be helpful 8

Steps to Change 8

Preparing to change 8

Understanding 8

Motivating 8

Troubleshooting 8

Changing procrastination 8

Approach 8

Plan Preparation 9

Plan Implementation 9

Feedback\Learning 10

Rejuvenating\Rewarding activity 10

Helpers 10

Organising 10

Managing 11

THE FREEDOM FROM PROCRASTINATION CODE 11

 

Introduction

Procrastination is a difficulty of ambivalence. Its wanting to do something you don’t want to do for some reason.  If this ambivalence wasn’t there, then it would be a clear “No”   I don’t want to do that, and we wouldn’t have a problem. But the problem is you do want to do the thing, and for certain reasons you don’t want to as well, and the putting off the task, just makes it harder, even though you want to or maybe need to do it.

There are several main reasons why you don’t want to do it

1.       You could succeed

2.       You could fail

3.       You are being controlled by doing this task

4.       You will be known

5.       You will be separated

6.       Things should go well

Fear of success might mean you fear extra responsibility or losing friends through succeeding

Fear of failure means you might not want to try as if you fail it wasn’t because of your talent

Fear of control, means that doing the task means doing what someone else wants and that feels really unpleasant as you aren’t getting to do what you want.

Fear of intimacy means that If you choose to do something people get to know who you are ,and can engage with you, but this might be unpleasant for you, as you might fear not being liked .

Fear of separation means if you still have tasks to do then you are still connected with something\someone.

Fear of things going badly means that you have a belief that if things aren’t going well, it means something bad about you, youre incompetent, or something bad about the task, you’ve chosen wrongly.

So, there is something unaware about procrastinating,  it is an unconscious compromise. Its trying to leave possibility alive. I could have been successful; I can do what I want to do, I friends will still like me as I’m not successful. Although its compromise generally ends up causing some very concrete problems.

Procrastination is an avoidance strategy of pushing things into the long grass, forgetting things by putting them in the increasingly long list of things to be done, things in the bottom draw.

Procrastination can also be fuelled by desire and indecision, there are all these things to do, what shall I do, instead of choosing absolutely they are left as good ideas that are put off.

Enhancers

Things that can enhance procrastination are ADHD. With this then your attention is difficult to focus on less pleasant tasks so you procrastinate.  Likewise a lot of other exciting task ideas may come along which again may distract you.

There is also something cultural with social media and smart phones where there seems many distractions to focus on the unpleasant thing to be done. When you add that in to working from home where work gets mixed with home life then putting things off increases.

 

Structure

Time

There also seems something about the procrastinator’s relationship with time, so this could be the time of a child. There is objective time chronos, and subjectively felt time,. The procrastinator firstly has a divergence between these two senses of time. Secondlyre the bad thing they must do will go on for ever (subjective time), making it unpleasant. Also, if there is a least a minute left then there is all the time that is needed to complete the task (magic time).  Then there also seems a lack of time awareness, where engagement in things is not related to the overall things that need to be done, almost executive time.

An infant lives in the present, and time is the distance between a desire and its satisfaction. This distance can be felt as pain, and can feel like it will go on for ever.

An adolescent also has a sense of endless time and limitless possibiltiies.

Procrastination might be a sign that the the past is dragging you back, rather than the future pulling you forward

There is also a sense of self holding self-back. This could be because perfection is demanded of me, and I don’t want to admit I’m not perfect. It could be because low status is how I see myself so I don’t want to produce higher status as that would be unfamiliar.

Rigid and critical self relationship

Procrastinators can set unrealistic goals in terms of quantity and quality, and be self punishing if they don’t achieve them, so they become unwilling to start. Theres almost a vanity that is being maintained. The thought of being ordinary is intolerable.

 

 

Reasons to procrastinate

What we need to understand is what makes doing the task so unpleasant. We need to understand the tension between wanting to do it, and not wanting to do it, where the latter isn’t in awareness

To avoid failure

·         As you can maintain your belief in your specialness as you didn’t try

·         I must do things perfectly and that’s too hard

·         There is a right way, and not choosing it is a disaster

·         Sees things as competition and hate losing

·         Fearing that I might be a failure and fearing the repercussions from self and other if this is the case.

·         Fearing a mistake as on the basis of a fixed mindset, that you are born with ability that you just need to prove, then a mistake proves you are a failure.

If I don’t try\do, then I can maintain my belief that there is a perfect solution,  and that I could have done things outstandingly. If I got things wrong, or lost this would be awful and I would criticise myself.

To avoid success

Success might be unpleasant as:

·         increased responsibility\work and loss of control\freedom\playfulness.

·         increased attention, avoid disappointment

·         being disliked by people for being too competitive\successful

·         contradicts your beliefs about yourself, Im a failure etc.

To avoid losing control

·         Not doing a task you don’t want to do asserts your control\power in the world

·         It allows you to assert control, without having a direct conflict with a more powerful  being.

Tasks should be

·         Easy

·         Understandable

A task which will be procrastinated might me an impossible task in terms of quantity\quality and the process should be easy and the outcome should be outstanding. There is a vanity\pride in this were it should be outstanding. If this is not the case then the procrastinator can be self critical. This makes the task really unpleasant and so whilst I want to do it, it has become aversive.  Doing it and getting it wrong will make me less of a person (because I will criticise myself) so I will avoid doing it.

To avoid the imperfect

There can be a desire to do things perfectly and because that is hard therefore the task is put off. As effort indicates that this may not be perfect.

To avoid losing your identity

If you do something for someone else it can diminish your sense of yourself  and can lead to what it means to be you won’t be respected, so you avoid doing the task and feel more yourself.

To avoid feeling lonely \abandoned

·         You always have things to do, as procrastination means tasks take longer

·         Some tasks can develop your independence, but if you procrastinate then potentially other people can look after you

To avoid doing demeaning tasks

If you have a powerful belief in your specialness, and ability you might then want to procrastinate  tasks that don’t accord with that belief. This could be because the feelings of doing things that are less that you think you should be doing, or feeling a failure are very powerful for you maybe because you haven’t often felt them.

To avoid making a decision

·         It could be wrong (perfectionism)

·         I would lose all those other possibilities

·         Fear of getting it wrong (self criticism, other criticism)

To avoid distress

·         Pleasurable tasks feel timeless, and it feels very painful to do things that aren’t like this

·         Any of the above reasons produce distress that can then want to be avoided. So theres a sense of how tasks should be, and if they aren’t like that then they are avoided

To maintain your self worth

Self worth=ability=performance, so if I don’t try, this breaks this connections

Sometimes impossible standards are an attempt to overcome LSE

To increase excitement

A mundane task left until the last moment becomes more exciting

The brain made me do it

·         You procrastinated on a task, you pair the task with distress, then you procrastinate again, you deepen that pairing, after a while it becomes habituatl to procrastinate with that task.

·         If you can’t comfort yourself, then difficult tasks are really difficult

·         Weak executive function (sleep deprivation, ADHD), can allow you to become disorganised, and you procrastinate unconsciously as you forget deadline

·         The inability to inhibit yourself to do an unpleasant task, when there is something else available will again contribute to procrastination

 

What maintains procrastination

The task to be done produces distress (for some reason), a history of procrastination produces extra distress associating the task with the distress of procrastinating about it.  Now being stressed, and the threat part of your brain is activated it becomes harder to do the task. So, the procrastination is maintained by the negative reinforcement of avoiding the unpleasant feelings of distress , and by the strengthening of the beliefs about the task e.g. “I can’t do it” supported by the decrease in ability due to the stress. Given the avoidance of the distress then procrastination is also maintained as the skills of managing distress aren’t developed.

As a procrastinator might hop from task to task, as they are unpleasant, then they may not also get the pleasure of starting, working and completing a task, So then tasks are unpleasant and have less pay off to them.

In turn tasks can be associated with all the unpleasant thoughts\feelings and behaviours. So as the similar task\situation is faced then there can be all the memory of previous similar tasks coming back and a priming of a way of paying attention\thinking\feeling as there is an expectation of what the task will be like. The brain through repetition wires neural pathways, so when I see x, then I think y, then I feel z.

What can help reduce the maintenance of procrastination is to start to break the neural pathways. So, when you get stuck in procrastination take a break (mind\body) which can then give other experiences related to the task.  Likewise starting small and getting some success in terms of doing the task and concentrating can also rewire as it reassociates the task with non procrastinatory experience.

There can be a style of thinking that can maintain procrastination. Its around dichotomous thinking, where a task must be the correct one (or its wrong), must be easy\always enjoyable (or I’m doing it wrong), or it must be done outstandingly.

 

The secondary gain for procrastination, can be to maintain illusions. That I am brilliant, as if I never try this will never be tested. That there is a perfect solution, if I never choose, it can still be out there.  There is also something about not being known as if I don’t choose, and show myself I am still an illusion for you, as you don’t know me.

 

What gets in the way of tackling procrastination

If you stop procrastinating, what new problems or situations would you have to face that you don’t have to contend with now?

My illusions could be shattered . . .

What if I finally do my best, but I’m mediocre?

I might not be able to achieve what I always thought I could.

 I couldn’t feel superior if I found I was in the same boat as others.

 

There’s always more to do . . .

I’ll turn into a workaholic.

I’ll take on more and more responsibilities and put my own needs last.

 I’ll find there’s even more to do than I thought.

It will never end.

 

My relationships would change and not for the better . . .

 It’s lonely at the top; I’d lose my friends.

 People will compete with me and try to cut me down.

My flaws will be obvious, and no one will like me.

Everyone will be envious of me.

I’ll be too different from my family.

 

I’d lose control over my life . . .

I’d have to accept a lot of other people’s routines and expectations.

I’d have to learn new things and be a novice again.

I’d rather be the expert.

 I’ll be taken over by this new culture.

People will demand more and more of me—and I can’t say “No.”

 

Life would seem boring . . .

 I would miss the excitement and challenge of “cutting it close.”

I wouldn’t be inspired, and I’d be less creative.

Things done early will seem too easy.

That’s no fun!

 

I’d be completely responsible for myself . . .

 I couldn’t blame other people or circumstances for what I do or don’t do.

What would it be like to be completely on my own without getting everyone to help me at the last minute?

 I’d have to make a lot of difficult decisions about how to spend my time.

 

 I wouldn’t be a nice person anymore . . .

If I’m successful, I might turn into a pompous ass.

I’d become self-righteous and disdainful of those who still procrastinate.

I might be dull, less fun, no longer a unique person.

I’d start to feel competitive with everyone else.

 

Maybe I don’t deserve this . . .

I’d have to acknowledge that I’m worth something.

I haven’t punished myself enough for procrastinating.

I’d be even more disappointed in myself if I started to procrastinate again.

 

Your identity

There can be things you see as your identity that make it harder to let go of procrastination

1.       The loveable clown

2.       The saint: always looking after others but putting my needs off

3.       The renaissance man: knows about everything but never can attend to one thing

4.       The miracle worker: can pull it out of the bag in the last 5 mins (but I created the problem)

5.       The blank slate: I don’t know what I want in life, so can’t direct my energy

 

How procrastination can be helpful

·         It can show that you don’t want to do what you are doing and there could be good reasons for this that procrastination is pointing to you acting against your values.

 

 

 

Steps to Change

 

Preparing to change

 

Understanding

Establish procrastination areas:

Establish procrastination patterns and themes.

Establish procrastination style: what do you do

 

Motivating

Evaluate Procrastination

External costs: e.g. problems at work

Internal costs: e.g. LSE

 

Troubleshooting

As you set yourself tasks to help you change you will hit resistance and procrastination. When you do use this to understand more about procrastination.

 

Changing procrastination

Approach

Aim build confidence, by getting some success.

Break tasks into small achievable steps

Use an energising activity at start of tasks and a pleasurable\meaningful activity at end of tasks to energise and stimulate the work.

Aim to increase your understanding of yourself, your procrastination and achievement whatever happens

Plan Preparation

Write down why you procrastinate (Write 5 parts of it, e.g. fear of failure, fear of being controlled)

Write down the emotions that encourage you to procrastinate (I feel x when I need to do y)

Write down what keeps you procrastinating: Fears if you didn’t procrastinate (see above)

Write down 5 costs (internal and external) of procrastination

Write down 5 benefits of reducing procrastination

Write a plan for tackling procrastination (general energiser, specific procrastination reducer with rewards, general pleasure\meaning enhancer, this wrapped in a learning\feedback mechanism )

Learn emotional acceptance technique

Have a logbook\learning journal

 

Plan Implementation

Start of day: Run

Plan:

Break task into small time chunks

Think about how you can distract yourself and if you need to make some time for those things later in the day.

Establish rejuvenating\rewarding activity around it

Write or say what is important about doing this task (internal motives, external incentives)

Write or say how I can make this task more interesting\motivating (how quickly I can do it, what I can learn etc?)

Task implementation

Do task, if successful take a rejuvenating break/get a reward (Exercise? Movement? Music? Change of scene?)

If having difficulty with task then write or say the meaning of the difficulty (e.g. fear of failure), notice the emotion that goes with this. Do some emotional management or compassion exercises then return to task.

 

End of day: Pleasurable\Meaningful activity

 

 

Feedback\Learning

Have three sections

Understanding procrastination, thoughts and emotions

Helpers and hinderers

Troubleshooting

Either at end of day, end of task or during difficulty write down any increase of wisdom in any of the areas

 

 

 

Rejuvenating\Rewarding activity

Mindful: A sacred pause: connecting to the moment, what it feels like in your body, emotions, feelings, sensations what sounds you notice.

Exercise: Some exercise: walking outside, moving around the house, doing a yoga pose, doing an exercise

Relaxation: Progressive muscle relaxation, Soothing imagery, Soothing breathing

Compassion: Notice what’s gone well to encourage and support and offer compassion to any difficulties or struggles.

Social: Message a friend

 

 

Helpers

Organising

Set a timer for the task on your phone

Write a plan for the day at the start of the day

Create a regular time during the day to do certain things, e.g. look for houses, socialise etc

Break things into very small bits, use one minute time allocations

Wellbeing: ensure you are getting enough sleep\eating well\socialising\having pleasure and meaning

Create an “Unschedule” a weekly plan of all the things you are going to do, notice what you feel about that and then see what time you have for what you should do or if you need to adjust the schedule

 

Managing

What can you delegate?

What can you say no to?

What can be good enough rather than perfect?

What do you love doing: do more of it!

How can you schedule your day to maximum effect (hard tasks first, small task firsts get some motivation?

 

THE FREEDOM FROM PROCRASTINATION CODE

 It is not possible to be perfect . Making an effort is a good thing . It is not a sign of stupidity or weakness . Failure is not dangerous . Failure is an ordinary part of every life . The real failure is not living . Everyone has limitations , including me . If it’s worth doing , it’s worth making mistakes along the way . Challenge will help me grow . I’m entitled to succeed , and I can deal with other people’s reactions to my success . If I do well this time , I still have a choice about next time . Following someone else’s rules does not mean I have absolutely no power . If I show my real self , I can have real relationships with people who like the real me . There are many possible answers , and I need to find what I feel is right .

 

 

 

Cognitive restructuring

 

How to change thoughts

 

I have a thought, for instance  “I'm a loser” and I want to change it, as it causes me distress through my emotional and behavioural response to it.

 

Arguing with the thought wont always be successful as you might hold the belief not due to evidence but rather its function. In other words I want to punish myself so that I seek to motivate myself by trying to overcome it.

Likewise there can be so many pieces of evidence for and against you wont ever resolve this, by argument. Arguing with a belief can also be self defeating as it highlights the significance of the thought, which in turn means its something to care about.

Beliefs seem intricate,  composed out of their function, relation to evidence, , related to how I see myself, how others see me and this is both currently and in the past. So as holding a belief is significantly more than evidence changing this generally is never enough.

So one way to help change a thought is not to, rather to decide if its helpful or not and whether to take any notice of it.  Mindfulness can be a great help in this . Changing attention to something more helpful than this thought can be helpful.

This approach comes from Acceptance and commitment therapy and you can read more from the

Happiness trap .

 

Working with distressing worry

 

Working with distressing worry

 

 

Introduction

You might have a worry that you know isn’t helpful.

With this worry, there can be a tendency to use your fight or flight systems as if they were an external threat.

As you fight with worry, you might argue with it, tell yourself not to worry, or give yourself evidence why you don’t need to worry and the worry continues.

As you go into flight mode with worry, you might try to distract yourself, or numb yourself somehow with food or drink or drugs.

Whilst sometimes these strategies can be useful, oftentimes the worry doesn’t go away, paradoxically it gets amplified, plus you can get new problems on top, because you couldn’t get rid of your worry, or your avoidance strategies come with a set of new problems.

 

What can help?

Stage 1 Acknowledgement

1.       Notice the worry.

a.       You may want to try saying to yourself.

b.       I’m noticing that I’m worrying about x

2.       Then notice what your underling fear is that takes you to this worry

a.       E.g. I’m afraid that something good I’ve made will go wrong

3.       Then notice your current emotion(s)

a.       You may want to say to yourself, I’m noticing I’m feeling x

As you do this simple thing, many things may happen.

·         You slow down and engage rational parts of your brain

·         You distance yourself from the worry\emotions, which both minimises it, puts  you in relationship with it, and shows you how it will pass

 

 

Stage 2 Body

Notice what’s happening in your body

 

Describe the feelings in your body that relate to your feelings

Notice what’s happening in another part of your body that doesn’t feel like this, e.g., your legs, glutes, feet, etc

 

As you do this simple thing, many things may happen.

·         You relate to yourself at the most fundamental level, which can make your bodily feeling, feel acknowledged which can lead to its change

·         You may notice that the feeling is part of you, not all of you. Which can minimize the power of the feeling

 

Stage 3

Return to what you were doing, before this

Do this by using a grounding exercise

1.       Really notice 5 things you can see, as if they are art, and you have never seen them before

2.       Really notice 4 things you can hear, as if  they are music and you have never heard them before. Notice sounds close to and in the distance

3.       Really notice 3 things you can feel, allow your fingers to explore, like you have never felt this thing before

4.       Really notice 2 things you can smell, notice both the strong and subtle smells, the simple and the complex

5.       Take one really slow deep breath, and make sure the outbreath is longer than the in breath

As you do this simple thing many things may happen.

·         You may return to the “present” away from the imagined future in your head

·         You may feel that you can do what’s important to you even when you’re not feeling great

·         You have more control

·         The worry\feelings have less control

·         You do more things that are important to you

Turbo charge

You can turbo charge this process by using mindfulness. Use a regular breathing meditation to strengthen your awareness (noticing thoughts\feelings) and strengthen your ability to move attention (rather than get caught up in the worry\feeling notice it\the body and return )

 

Extras

Compassion

Once you have got the hang of this, you may also notice what the feeling was before the thought\feeling came. If its different you may want to ask if a friend felt like this how would I respond to them, and try the same approach with yourself

Writing

If you find it difficult to return back to what you were doing and the worry returns. Then open a document and write down your worries. If it’s the second time you are dong this, read your worries before you write them down

Working with distressing thoughts and feelings

 Working with distressing thoughts and feelings

 

 

Introduction

You might have distressing thoughts, unwanted thoughts or feelings. Thoughts that if someone else said that to you, you wouldn’t like, critical ones maybe. There might be unpleasant emotions around, anxiety about what could happen, or low mood about what has happened.

With both of these thoughts or feelings, there can be a tendency to use our fight or flight systems as if they were an external threat.

As we fight with thoughts, we might argue  with them, tell ourselves to pull our socks up.

As we go into flight mode with thouights, we might try to distract ourselves, with feelings we might try to numb ourselves somehow with food or drink or drugs.

Whilst sometimes these strategies can be useful, oftentimes the thought\feeling doesn’t go away, paradoxically it gets amplified, plus you can get new problems on top, because you couldn’t get rid of the thought\feeling or your avoidance strategies come with a set of new problems.

 

What can help

Stage 1

Notice the thought\feeling

 

You may want to try saying to yourself

Im having the feeling of x or Im having the thought y

Or

A part of me is feeling x a part of me is thinking y

 

As you do this simple thing, many things may happen.

·         You slow down and engage rational parts of your brain

·         You distance yourself from the thought\feeling, which both minimises it, puts  you in relationship with it, and shows you how it will pass

 

 

Stage 2

Notice what’s happening in your body

 

You may want to describe the feelings in your body or maybe just simply feel them

You may want to find a phrase to describe how you are feeling in your body

 

As you do this simple thing, many things may happen.

·         You relate to yourself at the most fundamental level, which can make your bodily feeling, feel good\change

·         You may notice that the feeling is part of you, not all of you. Which can minimize the power of the feeling

 

Stage 3

Return to what you were doing, before this

 

As you do this simple thing many things may happen.

·         You may feel that you can do wahts important to you even when youre not feeling great

·         You have more control

·         The thoughts\feelings have less control

·         You do more things that are important to you

Turbo charge

You can turbo charge this process by using mindfulness. Use a regular breathing meditation to strengthen your awareness (noticing thoughts\feelings) and strengthen your ability to move attention (rather than get caught up in the thought\feeling notice it\the body and return )

 

Extras

Once you have got the hang of this, you may also notice what the feeling was before the thought\feeling came. If its different you may want to ask if a friend felt like this how would I respond to them, and try the same approach with yourself