The Procrastination Cure: Powerful CBT Tools to End Avoidance

The Procrastination Cure: Powerful CBT Tools to End Avoidance | Dr. David Burns & Dr. Jill Levitt

 

Procrastination isn’t a motivation problem. It’s a cycle of avoidance, guilt, self-criticism, and broken promises that keeps people stuck — therapists and clients alike.

 

In this live training, CBT pioneer and bestselling author Dr. David Burns joins Dr. Jill Levitt, Director of Training at the Feeling Good Institute, to teach ten powerful, paradoxical CBT tools that end procrastination fast.

 

Rather than trying to force willpower, these techniques dissolve resistance — helping people take action without relying on motivation.

 

Throughout the session, you’ll apply the tools in real time, so you don’t just learn the theory — you experience how they work.

 

What You’ll Learn:

 

• Why traditional motivation strategies fail — and what works instead

• How avoidance, guilt, and self-criticism reinforce procrastination

• How to use paradoxical CBT tools to create accountability

• Techniques that help clients take action immediately

• How to apply these strategies in your clinical work — and your own life

 

Paradoxical CBT Tools Covered:

 

• The Triple Paradox

• The Blue Plate Special

• Little Steps for Big Feats

• Paradoxical Inquiry

• The Five-Minute Rule

• Your Start Time

• Problem/Solution List

• The Columbo Technique

• “I Stubbornly Refused” / “Mission Accomplished”

• The TIC-TOC Technique

 

Ideal for therapists, counselors, coaches, and anyone who wants practical, evidence-based tools to stop procrastinating and start moving forward.

 

SUMMARY:

 

IN THIS VIDEO:

 

Jill Levitt: We're going to start in just a moment. Welcome everyone to this month's webinar, "The Procrastination Cure: Ten Paradoxical CBT Tools." I'm excited, as always, to be presenting alongside my dear friend, colleague, and mentor Dr. David Burns. I think this topic today is one that we feel, or we hope, is really interesting to you, not just as a therapist helping your patients, but as a human being since all of us truly struggle with procrastination. Also, as a family member, you may have loved ones that struggle with procrastination, so it's our hope that this will be really helpful to you today on many levels. We're also going to give you a chance to practice a lot of the tools that we'll be teaching. Actually, we'll start today with a quick poll. This is just to get to know who you are, our audience, a little bit. Let me run the first poll. Tell us a little bit about yourself: Are you a member of the general public, so not a therapist? Are you a therapist enrolled in CBT All Access or the FastTrack course with us? Or are you a therapist not currently enrolled in one of those courses? In just a moment, instead of entering your info in the chat, go ahead and take the poll. It should show up for you, and then in a moment, I'll end the poll and share the results. Okay, one more second to enter your response. And then I’m going to share with you. So, David, we can see 35% of our audience are general public non-therapists, and about 60% are therapists not enrolled in one of our trainings, and about 7% are therapists enrolled in the FastTrack course.

 

Dr. David Burns: To simplify it, it is 35% general public and 65% therapists.

 

Jill Levitt: Exactly. Good to know. Therapists, you'll be learning tools not only that will be applicable for your patients, but for yourself as well. Let me first do a brief introduction of who Dr. David Burns is, tell you about Feeling Good Institute, and then we'll move on with the content of today. David probably needs no introduction, but he's a world-renowned psychiatrist, a CBT legend, one of the first fathers of CBT, a best-selling author, and the Feeling Great app creator. And David will tell you later on today about the Feeling Great app. I also highly recommend David books; they've been incredibly helpful to me in learning this complicated and exciting model. I'll tell you a little bit about who we are at Feeling Good Institute. Our mission is to help therapists deliver better outcomes so that patients can recover faster and more fully. We train and certify therapists in TEAM-CBT, this framework that we'll tell you about today that was developed by Dr. David Burns. We offer a structured five-level certification path that really reflects the depth of the model. Feeling Good Institute began in 2014 with actually a shared mission and a shared frustration that turned into a vision. Back then, the only way to learn TEAM-CBT was to study directly with David, which we all had the good fortune of doing, or to attend one of David intensives around the country and around the world. We really wanted to bring David model of therapy, TEAM-CBT, to make it more accessible to therapists all over the world. So, we set out to change that, to make David tools, techniques, and training style more accessible to more therapists. This might surprise you, but experience alone doesn't make therapists better. Just doing more sessions week after week doesn't necessarily lead to better outcomes. We know this based on psychotherapy research studies. If anything, we all get a little bit less effective over time. To the contrary, there is good news. We know what works. What works is learning, practicing, getting feedback, and then repeating that cycle through deliberate practice.

 

At Feeling Good Institute, we don't just teach David techniques; we really replicate his training style, which is built on this idea that you only get better through practice and feedback. We really lean into it using deliberate practice exercises to help therapists build their skills. And so we’ll tell you kind of at the end of the webinar today, a little bit about our FastTrack course and CBT All Access. It's a new program we've developed that's a subscription that gives therapists everything they need to build strong, effective CBT skills. It gives you an opportunity to practice, get feedback, have mentorship, and get your CEs and community all in one place. And inside the all access membership you have access to our fasttrack program so what used to take years of intensive training, we offer in this highly structured effective training that you can complete in about six months. So we just want to know what’s available and we’ll share more with you at the end of the webinar today. So have David share with you about the Feeling Great app for therapists and the general public alike, and we'll share some trainings designed to help therapists get better at what we're teaching today. One more housekeeping thing then we’ll move on from here. If you registered as a therapist for the paid version, you'll get an email tomorrow morning after we take all the attendance with a link to complete the CE survey. If you've paid for your CEs and you've attended, we'll send you the survey needed for your certificate within a week. If you didn't pay for CEs and you want to, it's not too late, you can use the link Mike is dropping in the chat box because we've gotten people who attend and say they registered for free but actually wanted the CEs. These are our learning objectives today: we are going to cover so much more than this, but you will at least be learning to identify tempting thoughts and using strategies to combat procrastination. So I’ll say few more words and then I’ll also turn over to David to say some more.

 

We're focusing on addressing resistance and using methods to overcome procrastination, but we want you to understand that this rests within the overall TEAM-CBT model. This model is based on the idea that we use measurement or testing with every patient at every session to track progress and check in with patients, kind of like taking their temperature at the beginning of every session. We don't do therapy without using measurement so that we know that our patients are actually getting better in the ways that they're coming to treatment for. The E in TEAM-CBT stands for Empathy, and that is that we're not just throwing methods at patients; we're actually taking time in the beginning of therapy, and even at the beginning of each session, to connect with our patient, to really see the world through their eyes, to understand them. We have lots of empathy tools that we teach therapists in all of our trainings as well. Then the A in TEAM-CBT stands for Assessment of Resistance. The goal here is to realize that many people, though they want help—someone comes to you, they want to stop procrastinating, they want to get more things done—but there are lots of good reasons for them not to change. We'll teach you a method today to address and melt away resistance, and we want you to be aware that you can't necessarily just teach people tools without addressing resistance first. And then the M in TEAM-CBT stands for Methods, and tons of cognitive, behavioral and other methods that we use to help patients to overcome all sorts of problems. TEAM-CBT is a framework for how all effective therapy works rather than a manual or a model that you can just take off the shelf. I'll run this poll, and then ask you to jump in here, David. But we have a couple of polls also just to ask you. So, let me launch this one. Here's our question: Are you procrastinating on something right now? Because we're going to invite you to do some work with us today if, in fact, you are. You can answer this in yes or no, and I will share the results in one moment. Try to not use the chat box but rather respond to the poll, which hopefully is popping up on your screen. I'll end the poll, and if you didn't have a chance to answer, that's okay, just to keep moving things along. So, 90% of people, David, are procrastinating on something right now.

 

Dr. David Burns: Yeah, okay.

 

Jill Levitt: So that means that we're all in good company.

 

Dr. David Burns: Yeah

 

Jill Levitt: And then the next thing we wanted to ask is how many of you have patients, colleagues, or loved ones that are procrastinating? We'll launch that poll real quick, too. So, if you're not procrastinating, you're in that 10% where you're not putting anything off; you're on top of everything. Do you have patients, colleagues, or loved ones who struggle with procrastination? I'll end this and share this, too. We're just trying to get a general sense. It looks like 95% of people, David know someone who's struggling with procrastination. Okay. And then again, to jump in and have you join us in doing your own work, we're going to ask you, if you are someone who's procrastinating on something, turn to your handout packet and write it down on page four. We've sent you the handout packet in the email that came from Zoom, and then Mike will drop it in the chat box as well, but ideally you got that reminder email and you already printed it out. So, on page four of your handout packet, you can just jot down: what are you procrastinating on? Is it going to the gym? Is it getting your taxes done? Is it writing your chart notes? Returning phone calls? Okay, David, did we want to ask anyone to enter that in the chat box?

 

Dr. David Burns: Yeah, Mike can perhaps share with us a few things people have written in the chat box to let us know what you're procrastinating on.

 

Mike: Saving money, monthly taxes, blog post, putting up YouTube videos, networking, starting my startup, presentations, quitting smoking, business taxes, incorporating mindfulness and exercise, cleaning the house, organizing home, housework, writing a letter, podcasts, looking for a new job, laundry, research project, medical appointments.

 

Dr. David Burns: Great.

 

Jill Levitt: Okay, wonderful. So many different things we can find that we're procrastinating on. The next thing we're going to have you do is to jot down on page four: what are the thoughts that drive your procrastination? I want to be super clear: we're not asking you what do you tell yourself when you've been procrastinating, which might be like "I'm lazy" or "I'm a loser," but what are your thoughts that drive you to procrastinate? Those are usually these kind of thoughts about the task itself. We've got some examples on this slide. David, you want to lead us through this?

 

Dr. David Burns: Well, write them down on page four, and then if some of you add one or two of them in the chat again, Mike, then you can share with us what people are coming up with.

 

Jill Levitt: I was just going to say there's some examples on the slide here. "This is too hard," "I can get this done later," "I'll wait until I'm in the mood," "I've got something more important to do," "I better go check my email." Essentially, we've listed these on the handout on page four, so you can check off the ones that resonate for you and then also add yours to the bottom on page four. You could throw them in the chat too, and we'll just read a couple of them. Mike, you want to read a few to us?

 

Mike: There we go. "This task is too overwhelming," "I don't have time," "I can't do it," "People will judge me," "It has to be perfect," "I have something more important to do," "I'll get to it later," "I'm too tired."

 

Jill Levitt: We're going to come back actually; we're going to do an exercise later using these procrastination thoughts as well. But this was just kind of to get you to start thinking about that. So, we covered what you're procrastinating on and what do you tell yourself when you're procrastinating. Then we're going to ask you, now that you've thought about this yourself, many of you are procrastinating and you're aware of the thoughts that are coming up for you, let me ask you one more question. This is our last poll here: Do you want help with your procrastination? Like, if we could help you today, if you could overcome your procrastination and get that thing done, would you want that help? I'm going to end the poll just to share the general ballpark here. David, it looks like 95% of people are saying, "Yes, please help me," and only 5% of people are going, "Nope, I don't really... I procrastinate but I'm all good, I don't really want your help with that." Okay, David, I'm going to give you some space here. Are you looking at the slides?

 

Dr. David Burns: Do you want me to take over a little on the slides or?

 

Jill Levitt: Yeah.

 

Dr. David Burns: I guess the question in my mind—and I don't know what the next slide is—but most people say what the help they want is motivation. "I need help getting started because I'm just not motivated when I'm procrastinating." I don't know, can we see the next slide so I get in the flow?

 

Jill Levitt: We're not yet there, but this is kind of this idea that many people ask for help, yet procrastination is actually really rewarding. There are lots of good reasons to keep procrastinating. So, before we get to that motivation piece David, we were going to teach them the Triple Paradox. Procrastination is really rewarding, and if someone is procrastinating and you jump in and try to teach them how to stop procrastinating, you're probably going to be fairly unsuccessful.

 

Dr. David Burns: You're taking the words right out of my mouth. You can continue with the Triple Paradox if you like, Jill.

 

Jill Levitt: That's okay, David, I'm happy to have you jump in here.

 

Dr. David Burns: For decades, probably hundreds of years, people have tried to figure out how to help people who procrastinate. I would say for the most part those methods, although they're clever and they sound great on paper, they're ineffective most of the time, nearly all of the time. We're going to be doing a different thing. We're not going to try to help you with your procrastination; we're going to try to persuade you to keep procrastinating. That's a kind of paradoxical approach, but a genuine one. We'd like you to turn to page five of your handout. This may be a little confusing for you, but pay close attention to my words. There's three columns here; this is called the Triple Paradox. When we're working with habits and addictions, it's always the first step that we use. It's very powerful because it hits that motivational resistance component that's overwhelming in procrastination and virtually all other habits and addictions—overeating or whatever it might be.

 

We'd like you to list some of the positive rewards of procrastination. You can see there's three columns here. In the first column it says, "List some advantages of procrastination." There are huge benefits because it's easy. You don't have to do something that's difficult. You can watch a good Warriors game on TV, you can go and get something to eat, whatever. In column one, list as many advantages as you can think of of your procrastination, or if you don't procrastinate, say of someone else's procrastination. But why do we procrastinate?

 

Jill Levitt: I'll make one quick comment David, which is if for whatever reason you're struggling to print the handout packet from the reminder email, you can just make three columns on a piece of paper. Don't spend your time worrying about getting the handout packet if you didn't print it out already. Just draw three lines on the paper. The first column is: What are the benefits of procrastinating? The second is: What are the disadvantages of getting started? And the third is: What does your procrastination show about you and your core values that's positive and awesome? It's written on this slide; you can just draw three columns on any piece of paper or on your computer. Back to you, David.

 

Dr. David Burns: And once you've listed the many benefits of procrastination, hopefully that was easy for you. The middle column might be confusing for you, so pay close attention. In the middle column, we're not listing the disadvantages of procrastination. That's not what we're listing in the middle column. We're listing the opposite: What are the disadvantages of getting started? Like the thing you've been putting off—if you were to get started on it today, what's the downside of that? What's the negative impact of getting started? Once you've gotten a few things in the middle column, hopefully you'll understand that and not list the disadvantages of procrastination. That's easy; that won't help you. But the disadvantages of getting started—in other words, the things that keep you stuck in your procrastination and prevent you from taking steps in the other direction. Then, on in the right-hand column: What does your procrastination show about you and your core values as a human being that's positive and awesome? Again, this is the opposite. Most people teach, "Oh, procrastination is bad, you have to get over it," and that type of thing. We're saying here: What's really good about procrastination? What does it show about you and your values as a human being that's beautiful, positive, or even awesome? In the right-hand column, we want you to praise your procrastination and recognize that it shows many really beautiful and awesome things about you.

 

Jill Levitt: David, maybe what we can do is give a few examples of what might be a benefit of procrastination, what would be a disadvantage of getting started, and what it shows about you and your core values.

 

Dr. David Burns: Well, a huge benefit of procrastination would be that it's kind of easy. I remember for years I wasn't filing things in my office, and so I procrastinated on catching up on my filing. One of the things that's very easy: when I have a receipt or something, I'll just put it on one of these files in my office without even paying attention to what file it's in, and then I'm done with it. Another benefit of procrastination is you may get to do other far more rewarding things than the anxiety-provoking task you're putting off. Then, some of the disadvantages of getting started. It might be, and probably will be, difficult to get started, and it's going to be anxiety-provoking. You're going to have to face all of that angst, all those negative feelings that you've been avoiding—feeling inadequate and facing the task. Then, what your procrastination shows about you and your core values. I'm just saying some of these off the top of my head. It shows that you value pleasure, and that you want to pamper yourself, and that today, you know, we're alive and let's make it a beautiful, rewarding day. It also shows that you're not trying to just be perfect all the time. Can you think of any other core values?

 

Jill Levitt: Yeah, that I like to be fun and impromptu, that I'm not a stick in the mud who always does what she's supposed to do,

 

Dr. David Burns: A rebel of sorts.

 

Jill Levitt: Exactly. For people who are a little perplexed right now, this is actually perplexing. In other words, when people come to you and they say, "Oh, I want help getting started, I want help on my procrastination," you usually just think, "Great, what do we need to do?" and you get started. But the thing is that so many people will stall and they actually won't do what they need to do. Why is that? What we're trying to do is honor the resistance to getting to work. There are so many good reasons to procrastinate, like it's so much more fun to watch TV than it is to get my work done. It's so much more fun to watch just one more Instagram reel than it is to do my taxes. Getting started can feel really unpleasant; it's stressful maybe even to look at my to-do list and to get to work. Again, I don't want to be this person who is all work and no play. We're trying to really honor the voice of your patient's resistance. All three of these are about good reasons not to change.

 

Dr. David Burns: Okay, we need to zip it along. Do we want to get any feedback from people, Jill?

 

Jill Levitt: Sure, we could. Quick, Mike, if you have anything that jumped out to you.

 

Dr. David Burns: But just point out that this is not just a cost-benefit analysis. That's a radically different technique; that's not this at all. In this technique, we are not trying to help you or convince you to change. We're looking only at all the powerful reasons for you not to change, but that we want you to acknowledge that, to feel that, to bring that to conscious awareness. Many therapists will struggle with this approach because therapists sometimes have a compulsion addiction to help and rescue, and this is going in the opposite direction. Attempts to help the procrastinator virtually always end in failure, but it's worse than failure because when you try to help a procrastinator and then they keep procrastinating, the problem hasn't changed, but now it's your fault because you were trying to help them. So they could say, "Oh, my therapist tried to help me, but it didn't work." So, we're going in the opposite direction. Let's push on to the next slide, or do we want to get examples from people?

 

Jill Levitt: Well, let's hear from Mike because we asked Mike to read us a few real quick.

 

Mike: Sure. There's a couple that, you know, "I can prioritize on the go.", “core values”, “enjoy being spontaneous”, “ feeling in control since I get to decide what to focus on”, “I’m experiencing my freedom, not being a slave”, “keeps my world smaller.”

 

Jill Levitt: Great, awesome. Those are great examples. And then David after we've got these three robust columns of all the good reasons to keep procrastinating, then we'd turn to our patient and say, "Given all these positives, why would you want to give this up? Like, why should you change at all?"

 

Dr. David Burns: Yeah, I would turn to you in the audience right now and say, "If you did this exercise and you got a lot of things in the three columns, then why would you want to give it up?" And what would you say if you're a therapist and the patient says, "Well, I've decided I don't want to give up my procrastination; it's really a good thing."

 

Jill Levitt: Do we want to ask David, or should do you want to answer that question?

 

Dr. David Burns: Well, I just asked it.

 

Jill Levitt: So you'd like Mike to read some responses.

 

Dr. David Burns: If any therapists have written in an answer to that.

 

Mike: To that specific question. What would you say as the therapist? Somebody says, "Good for you. Is there something else we can work on together?"

 

Dr. David Burns: Yeah, that's an A+.

 

Mike: That was Angela, our wonderful Angela Poach, put that one in. I see that now. Yeah, that's not a surprise.

 

Jill Levitt: Beautiful response. The idea is we're not helping our patients against their will. If they say, "No, good point," then we say, "Great, is there something else you wanted my help with?" We call that "Sitting with Open Hands." So, we'll move forward because we just did the group exercise with all of you. Then David, we wanted to ask people after doing the Triple Paradox, let's imagine they said, "I really do want help with my procrastination." Then the next question we have on this slide is: What kind of help are you looking for? We did actually want people to drop that in the chat. Just write real quick: if you passed the test of the Triple Paradox and you could argue for why you wanted to change, what kind of help are you looking for? Mike, you could maybe read one or two to us and then we'll keep going.

 

Mike: Some are saying: “help for motivation”, “boost in confidence”, “I want to feel less shame and guilt about my procrastination”, “specific strategies to change my behavior”, “make a plan for moving forward”, help getting started.”

 

Dr. David Burns: Yeah, and that's a great list. If you categorize all the movements and experts who have tried to help people with procrastination in the past 75 years, those are all the things that people have proposed. The research on it is exciting and very inspiring, published actually last week in the New England Journal of Medicine, and they've come to the surprising conclusion that all of those approaches are ineffective all of the time. Never once has a human being been helped by any of the things that you people listed just now. Well, I guess that says it. And so, we're not offering motivation in this seminar. That's because you're not entitled to feel motivated on something you're putting off. You won't get motivated until you've already started the task and you're well into it, and then you're beginning to think, "Oh my gosh, I'm making progress on this; it's not as hard as I think." And then you're going to start to feel motivated. But we can't offer you motivation to get started. People who don't procrastinate never wait around for motivation; they simply focus on getting started. And If you want help getting started with the thing you put in your handout, the thing you're procrastinating on, if that would be of interest, then we're excited to work with you and we're going to show you how to do that right now. But the errors that therapists, parents, or colleagues make with procrastinators is cheerleading—trying to help the person feel more motivated. In fact, your efforts to help will simply encourage the person to continue to procrastinate, and as I mentioned previously, now the failure will be your own. Do you want to do Little Steps for Big Feats, Jill?

 

Jill Levitt: Sure. The goal is that we're not going to try to help our patient to feel motivated, but we're going to say motivation follows action. If you wanted my help in getting started, this is what I would recommend. We try to break down... we ask the patient to break down the task into very small steps, and David calls this Little Steps for Big Feats. And David you wanted to share your example, right?

 

Dr. David Burns: On page six you'll see how to break it down. But I was actually procrastinating for eight or nine years on my filing in my office. I have a pretty big office with a lot of desk space, and I just would make piles. It got to where there must have been 12 or 18 files of unfiled paperwork in here, maybe 12 to 15 inches tall every file. It was just overwhelming to think about. So I said, "Well, what are the tiniest little steps to get started?" Step number one was: sit down at my desk. That's the first thing I'd have to do. Then I wrote down step two, and you can see a similar outline in your folder on page six, and you can fill this in for yourself. What are your five tiny little steps that you can complete in five minutes or less? But I'd have to grab some manila folders from the file cabinet. They're right up there, actually; I saw them a few minutes ago. There's about four or five manila folders. I could order from Amazon a couple hundred manila folders. So, I'd have to grab those manila folders—that's step number two. Then step number three: I'd have to pick up one item from the pile of unfiled stuff. Those piles are everywhere, so I could just reach in anywhere really in my office and grab some unfiled item. Then I could see: is this, say, a receipt for a business expense? Then I could label the folder like that: "Business Expenses." That would be step number four. And step number five: I could put that receipt in that file folder. Those were my five steps. This is an important key, and if we can go to the next slide, I would say that each step should take less than one minute. If you go back to my list, like sit down at my desk, that doesn't even take a minute; it only takes about 10 seconds or 5 seconds. Then grab manila folders from the file drawer; that just takes about 15 or 20 seconds. So, it's critical that these be tiny little steps. Each of all five steps should take less than five minutes. Should we let them go ahead and do that right now, Jill, on page six?

 

Jill Levitt: Sure. Just to get a feel for it, it would be wonderful if you took that task—what you said you were procrastinating on—and break it down into five steps. Again, just the first five steps, making sure that each of them is under a minute. This is challenging, actually, because people want to say, "Spend 30 minutes filing" or "Spend 30 minutes checking my email." We want you to really slow down and break it into tiny tasks. Also, I just want to highlight: if people are having questions that are coming up as we're going along, Dr. David Burns, they can submit those to Mike or submit them to the panelists in the chat box. Then we're going to have a Q&A, and so Mike will relay those questions to us at the end of the workshop. For sure.

 

Dr. David Burns: We'll wait till the end of the workshop to get their questions answered. We're not going to have any Q&A during the webinar Jill?.

 

Jill Levitt: Typically that's what we do. But if you wanted Mike to read a question or two to us right now, we can do that. But yeah that’s what we normally do. If you’d like, that’s totally fine with me.

 

Dr. David Burns: Well, are they asking questions in the chat, Mike?

 

Mike: There are a couple of questions regarding Little Steps for Big Feats. Do you want them right now?

 

Dr. David Burns: Sure, yeah. I think it might help to clarify, and it can be very quick too.

 

Jill Levitt: Absolutely.

 

Mike: Somebody said, "What about when patients say, 'But when I start the tiny step, even if the next step is tiny, I get so overwhelmed and I freeze or want to run away, or you get stuck on the tiny step?'"

 

Dr. David Burns: Well, you might not like this approach. Next question.

 

Mike: Somebody says, "What if a task takes like 20 minutes? For example, exercising."

 

Dr. David Burns: Well, you have to break it down into tiny little pieces. You're not allowed to put in steps that take 20 minutes. You can break any step down into tiny little pieces.

 

Jill Levitt: Remember, this is about getting started. Our experience and that of our patients is that once the task begins, it becomes easier to do. So, if you said, Mike, "I want to go to the gym for a half an hour," what is the first step you would need to do? Maybe lay out my workout clothes or get dressed for the gym. That might take a minute. Get my keys, get in the car, drive to the gym. We actually do get people to break things down into really tiny steps to get them started.

 

Dr. David Burns: It's very doable—100% of the time. It's an important key to overcoming procrastination if that's what you want to do. And if you don't again, if you don't want to do tiny little steps, God bless you and keep looking for huge steps somewhere. All we're offering is quick, irreversible cures here.

 

Jill Levitt: Okay, any other quick questions about this, Mike, or any responses you wanted to contribute?

 

Mike: No, the rest of them are right along those themes, and so I think you've covered them pretty well. Lots of "But what if it just takes this much or that?" Absolutely. This isn't the only method, but it's one of many. This is just to get started.

 

Jill Levitt: Absolutely. But it is hard. I mean, as a therapist, as a human being, I totally agree. I find myself finding tasks that "What if I have to make this phone call and I have to wait on hold for 30 minutes?" But it's still like the first step is get the phone number, the second step is dial the phone number, the third step. It's just getting people to break the task into the first five one-minute steps. All right, should we keep going, David?

 

Dr. David Burns: Yes, absolutely.

 

Jill Levitt: Okay.

 

Dr. David Burns: Now, I would ask you: if you think you need help getting started, a lot of times that's what patients say. That's the help they need; they can't seem to get started. So, then I would say: What step here did you need help with of the ones that you wrote down? For example, if you go back to my five steps, you could say, "David, which of these steps did you need help with? Did you need my help sitting down at your desk? Is that anything that you've done on your own in the past, or would you need me to drop by your house and help you sit down at your desk? Do you need my help grabbing manila folders from the file drawer? Do you need help picking up one item from the pile of unfiled stuff?" If you get my drift, if you set these things up as simple little things that can be done in a minute or even 10 or 15 seconds, then what is it that you need help with? The conclusion is none of these things, actually. Now, if you put something impossibly down like "write a great novel" as step number three, well, you violated the rule here and that's going to stymie you.

 

Jill Levitt: I would just briefly say I had an example come up earlier this week with a patient who, in order to make some extra cash, wanted to start driving for Uber but realized that his insurance card for his car had his mom's name on it rather than his own. He procrastinated for a week dealing with it. Then when we decided to break it down, the first step was texting his mom to ask if she had his insurance card. So rather than spending all session struggling with motivation, it was just, "What's the first step that you would need to take?" I thought it was "call the insurance" or something even more complicated. It was "text my mom." It's like, can you do that right now? Do you need my help? I think when you adapt this mindset David, of breaking things down into small steps and encourage your patient to do that, they do sort of discover that the steps are easier than they anticipated.

 

Jill Levitt: Yeah, go ahead.

 

Dr. David Burns: The next step in this 10-step program we're teaching you is called the Five Minute Rule. Now that you've got something you can do in five minutes, would you commit to working on this task today—not tomorrow or the next day—for five minutes only? Just do that. There's a lot of refusals we get here. People say, "That would only be a drop in the bucket; I need more time to get this done." What would you say to the patient who said that to you?

 

Jill Levitt: We'd love to see this; this is a great thing for you to try out in the chat box. If your patient says... you're going to set this goal of five minutes and your patient says, "But that would just be a drop in the bucket; I need more time to get this done," what might you say? We'll have Mike read some.

 

Mike: "This is just to begin," "This is just to get you started," "A journey of a thousand miles starts with one step."

 

Dr. David Burns: As an aside, that illustrates an error that almost all therapists make almost all the time, even when attending a workshop on how to stop doing that. You're trying to help, you're trying to persuade the patient, and that's the trap that the patient is setting for you. Any attempt to persuade or help or encourage the patient at this point is doomed to failure. But what else are the therapists going to say?

 

Mike: "Shall we revisit the five tasks?", "Let's treat this as an experiment and see what happens," "Looks like you're more motivated for this other thing than the task you want," "What would be a realistic time commitment?", "It sounds like you don't want my help."

 

Dr. David Burns: Okay, I'll let you respond to those many suggestions.

 

Jill Levitt: So many things David, in the same category originally anyway. We heard a bunch that were in that same category of encouraging, right? It's a "Why don't you try this?", "If you do five minutes, then maybe you'll be able to do five minutes more," "I'm only asking you to commit to five minutes." I think you got one, though, that was along the lines of what you recommend, David right? Which was, "Sounds like you don't want my help with this." Someone was moving more in that paradoxical "Sitting with Open Hands" direction.

 

Dr. David Burns: Yeah, that's the key for the therapist. Stop trying to help your patient; stop trying to persuade them. When patients resist, go with the resistance and sit with open hands. Do you want to demonstrate it, Jill, and I'll be the patient?

 

Jill Levitt: Sure, I'm happy to. I was looking to see if we had it on the next slide, but we don't. So, yeah.

 

Dr. David Burns: Well, you know, five minutes... what I've got to do is clean up all this filing in my office, and it's going to be a many hundred-hour task. Scheduling five minutes would be a total waste of time.

 

Jill Levitt: So, it sounds like you're saying the task is just too big and insurmountable, and you're not willing to put five minutes into getting started today.

 

Dr. David Burns: And I would give that an A+ because the patient has two responses: "Yes, I refuse," in which case you could say, "Well, perhaps there's something else I can help you with today, and sounds like procrastination isn't something we should be working on, at least not with the techniques that I have available." Or the patient can say, "Oh, okay, I am willing to do that." That's the response you'll see most of the time when you sit with open hands. But the reason this is so hard for therapists to learn is because you have to give up your addiction to helping and rescuing. As I've often said, and therapists don't hear it when I say it—and I'll say it now and you might not hear it now either—but most therapists want to help and rescue 100% of the time. This whole workshop is dedicated to seeing if we can persuade you—and we may not persuade you—to stop doing that, since that does not work. This is going in the opposite direction and working with the patient in a compassionate but paradoxical manner.

 

Jill Levitt: I love the last thing you said David, because for some therapists, you're wrestling with it thinking maybe it sounds cruel, and at the same time, it's actually incredibly respectful. It's not that our patients don't know what they need to do or can't do it. I think it's actually very respectful to say, "It sounds like you're not willing to put in five minutes of time today, and is there something else you wanted my help with?" Again, rather than thinking that this is snarky or sarcastic, we're really trying to meet the patient where they're at. I think quite often, paradoxically, it puts them in the role of saying, "No, you're right, five minutes is better than nothing." You'd much rather hear your patient say that than have you say that to your patient, right? Which is like you're trying to convince them to change.

 

Dr. David Burns: Yeah, right. I guess I'm still getting some chats here, right?

 

Jill Levitt: So you want to ignore the chats.

 

Dr. David Burns: Okay, now the next step is the patient says they're willing to spend five minutes today. Just five minutes—that's all you're allowed to spend on this task. At the end of five minutes, you've done 100%. But what time of day? I need to know specifically what time it's going to be. Suppose somebody says, "Well, the workshop's over at 1 o’clock West Coast time," and let's say they say, "Well, I can do it at 5 o’clock ." Well, then enter that time that you're willing to do this on page six, where you've listed your five steps. Now we come to a really important tool: the Problem-Solution Sheet.

 

Jill Levitt: I just want to make sure people are pausing, though, to turn to their handout on page six. You broke it down, and then we'd love you, if you're playing along with us and working on your own task, to actually write down what time today you're willing to schedule five minutes for your own task. I'm just reiterating that, but go ahead David.

 

Dr. David Burns: Yeah, great, nice to underscore that. If the patient agrees, we know that when 5 o’clock comes, patients can give themselves a lot of excuses, a lot of problems that kind of interfere. So if you go to page seven of your handout, you'll find the Problem-Solution list. What we want you to do and you can see that on the next slide, I assume is list in the left-hand column the problems that are going to interfere with you getting started at 5 o’clock on whatever your five steps are. Don't worry about the solutions; just list the problems that will interfere with your ability to get started. For example, I might get a call from a friend, or there might be something important, some news event on TV at five that I need to watch, or maybe the kids are going to ask for X, Y, or Z. And you can see a nice list of typical problems: "I'll tell myself I need to eat some snacks and settle down before I start," or "I'll tell myself I'm too anxious," or "I'll remember something more important that I have to do." You can list them here, and now we come to the solution part. Again, this has to be done entirely paradoxically and not in a helpful manner. We'll demonstrate it, but essentially you ask the patient how they're going to solve these problems.

 

Jill Levitt: Sorry, I don't know which slide you want up while you're talking about it.

 

Dr. David Burns: One at a time. Like, okay, suppose a friend calls, what's the solution to that problem? One of two things will happen. The patient will come up with a very simple, logical solution of "I can let the phone ring and listen to the message after the five minutes," or the patient will act helpless, like, "Oh my goodness, if a friend calls, I have no idea how I would cope with that." It's important for the therapist not to offer solutions and not to help with solutions. Again, this means the therapist has to say no to your codependent, helping self. The successful treatment of procrastination and all habits and addictions involves one of the four classic deaths of the therapist self or ego, and this is the death of the helping, codependent self. You have to resist that urge to help. Let's say the patient acts helpless and confused. If they can't find a solution to one of their so called problems, if you try to help, this will intensify resistance. Everything you do to help a procrastinator is guaranteed 100% to make the problem worse. We'll demonstrate the Problem-Solution list here. One will be the therapist, and the therapist will use what we call the Colombo technique, and the other will be the patient. You want to be the therapist?

 

Jill Levitt: I'll let you be the therapist if that's okay, and I'll be the patient.

 

Dr. David Burns: Okay

 

Jill Levitt: Yes.

 

Dr. David Burns: Let's say you have the thought, "I'll tell myself I need to eat some snacks and settle down before I start." This is at 5 o’clock. Jill, what would be a solution? That sounds like a big barrier there because it's fun to eat some snacks—Doritos or something really yummy, or some nice cookie. Is there a way of solving that problem at 5 o’clock?

 

Jill Levitt: Well, I think it really does help me to settle down. So, yeah, I think at 5 o’clock I could grab some snacks and then maybe get the work done, get the filing done, right?

 

Dr. David Burns: Well, I love what you're saying. I think what you're telling me is that there is no solution to this problem. Is that right, Jill?

 

Jill Levitt: No, no, there's got to be a solution to this problem.

 

Dr. David Burns: What would the solution be?

 

Jill Levitt: You're saying if you can't eat snacks at 5 o’clock when you do your filing?

 

Dr. David Burns: Yeah

 

Jill Levitt: Well, I could reward myself for getting my filing done by having some snacks after I do my filing.

 

Dr. David Burns: Okay, let's write that in the right-hand column. Do you think that would be effective?

 

Jill Levitt: Sure, yeah, I think that sounds awesome to me.

 

Dr. David Burns: I just love how you came up with that. That's the style. It may look simple in fact, everything we teach is simple but you may not be able to learn how to do it because you're too codependent and too eager to jump in and help and therefore make the problem worse. This is really the first level of accountability for the patient, and it's fun to do, but you have to be very disciplined when you're doing it. You want to try it on me, Jill?

 

Jill Levitt: Sure, I know you can be very resistant.

 

Dr. David Burns: Yeah, well at 5 o’clock when you sit down to do your filing, you're going to be looking at this 15 feet of piles of paper, 12 to 14 inches high, and you're going to be too anxious to do anything. When you come and sit down to take the first step, you're going to see all of this and you're just going to get so anxious. You'll be a nervous wreck and you'll be unable to even speak a word in the English language.

 

Jill Levitt: That's what we wrote down as the problem. So, what happens David? What would be a possible solution? If it's 5 o’clock and you go to do your step one—let's say grab a manila folder—and you're feeling quite anxious, what would be a solution to that?

 

Dr. David Burns: Well I could tell myself if I go up and because Melanie just got a big bag of Doritos, and I think if I went up and got those Doritos, it would be easier for me to grab a manila folder.

 

Jill Levitt: Right, so that was another problem that you've got. Is there a solution to that? You're wanting to get a snack and you're feeling anxious, but you've decided you're going to start at 5:00 p.m. What could you possibly do to start your work at 5 o’clock?

 

Dr. David Burns: If I really have to do this five-minute deal, I could just focus on the next step, which is reaching up with my left hand and grabbing a manila folder. I can do that no matter how anxious I am.

 

Jill Levitt: Awesome, so let's start with that. It sounds like we can write that in the solution column: "I'll delay my snack until after I'm done and I can reach for the manila folder even when I'm feeling anxious."

 

Dr. David Burns: Well, I thought that was beautifully done. Notice again the simple thing we're trying to demonstrate. Hopefully it doesn't go in one ear and out the other, but Jill did not jump in to help me. When I started making excuses, she sat with open hands, and that means saying maybe this isn't a solvable problem and we should drop this project for today and work on something else. One of two things will happen 95% of the time: the patient will say, "Oh no, there is a solution," because I mean these are not like calculus problems, these are simple things. On the rare occasion if the person says, "No, I just know I'll end up snacking on Doritos for 20 minutes," just say, "Well, I love Doritos too and that's awesome, but it sounds like this approach is not to your liking and we can go in another direction with our session." It's that willingness, in a loving, compassionate way, to let go and to make the patient know you're not going to jump in and rescue or save. You're not going to take the bait, because the patients are going to give you bait over and over again to try to help them. Anytime you take the bait, the whole game has ended.

 

Jill Levitt: David, we have a little bit of time here. I guess two things we could do: one is we could invite people to write down some of their problems on the Problem Solution Sheet and potentially share them, or we could ask for a few questions about the Problem Solution technique before we move on to the next one.

 

Dr. David Burns: Those are both good. If some of you could list a problem you're going to run into if you wrote down a time, and how you're going to solve that problem, that would be fun for us to hear. If you have questions about this, they're always great for illuminating various aspects.

 

Jill Levitt: So, Mike, we're going to put you on the spot here.

 

Mike: There's a couple of things. You were looking for questions or for ideas of problems? Because it seemed like you asked two question there.

 

Jill Levitt: Sorry, I was going to put you on the side here so people could see you while you’re reading to us.

 

Dr. David Burns: I hear somebody said, "The problem: my kids will bother me. Solution: I'll put a sign on the door telling them I'm tied up for the next five minutes or something like that." That sounds great. And then another person... I'll put this to you, Jill, because this is such a critical thing that touches on multiple dimensions. What if the patient gets aggressive when you refuse to help them?

 

Jill Levitt: Could you be specific David? What does that mean they would say? They would say, “What?” Like I just, you know, if they get angry with me, then I would probably fall back to some empathy if that’s what you’re asking

 

Dr. David Burns: Yeah, we want a specific example of what were you doing when the patient got angry? Like, it was the problem solution list and you were ask acting helpless and you know or perhaps you expressed yourself to the patient in a way that was off putting or hurtful in which case as you mentioned Jill empathy works 100% of the time and everything else fails 100% of the time. Then once you've repaired the failure in the therapeutic relationship, then you can come back to your agenda.

 

Jill Levitt: Great. Were there any other problems and solutions you want to share, Mike, or any other questions that you wanted to flag for us?

Mike: There's lots of problems and solutions. Problem: "I'm tired." Solution: "I will allow myself a break or rest only after doing some work." Problem: "Self-evaluation, not being happy with my implementation of the step," "I might not feel like it; do it anyway." "It might be raining; take an umbrella."

 

Jill Levitt: Great, right? We can see that most of the problems are relatively easily solvable.

 

Dr. David Burns: Yeah, and the whole key is not the Problem Solution list; that's called a linear approach, and linear approaches always fail. But we're doing it as a paradoxical approach and letting the patient see: What is your solution? How are you going to solve this? Letting them struggle with it.

 

Jill Levitt: And this, as we say what we call "Sitting with Open Hands," this idea of not solving the problem for the patient and putting them in the driver's seat, is very hard for therapists and human beings—parents, loved ones. We want to jump in and make suggestions. If you really ask yourself what happens if you have a loved one who's procrastinating, a kid who's not doing their homework, and you make suggestions, they usually just dig in their feet even further and say, "No, that's not going to work because of this," or "I guess I could try that," which is like politely saying, "No thank you, I don't think it's going to work." So we're trying to avoid both the therapist or human being from getting into this kind of tug-of-war. You're just dropping the rope and you're letting the patient or loved one argue for change and figure out how to change. Anything else you want to bring up?

 

Dr. David Burns: We've kind of covered that. We’re up to step nine was the last one? Step eight or step seven?

 

Jill Levitt: The Problem-Solution technique is seven, and the Colombo technique was step eight.

 

Dr. David Burns: Oh, okay, right. We didn't skip anything.

 

Jill Levitt: Exactly.

 

Dr. David Burns: So now here is one of the coolest things I programmed into this whole approach. Now let's say you've agreed to do from 5:00 to 5:05 tonight, after the workshop, after our therapy session. Then I say to the patient: at 5:05, you get 100% credit if you go on and continue working on the task—that's up to you—but you won't get any credit for it. You get 100% credit for going through this five-minute exercise. What I'd like you to do, at 5:05 if you're willing, I'd like you to call my phone number—do whatever, my answering service—and leave one of two messages for me: either "Mission Accomplished" or "I Stubbornly Refused." There's two responses the patients might have. Most patients just say, "Okay, I'll do that," and then they actually do the five minutes and they follow through. Occasionally you'll find a patient who at this point gets angry and says, "No, that's stupid. I'll do the five minutes, but I won't call and say 'Mission Accomplished' or 'I Stubbornly Refused.'" If they say that, they're really telling you, "I'm not going to do this five-minute thing." So what I say to them is: I can well understand that you don't want to call and let me know. In my experience, 100% of patients who have stated that have actually failed to do the five minutes. So, I think you've given me a really good bit of information, and I'm going to withdraw the assignment at this point. Then again, you sit with open hands.

 

Jill Levitt: I'll say a few more things about the "I Stubbornly Refuse" technique. First of all, we can use voicemail, we can use email; some therapists have other kinds of HIPAA-compliant messaging. Whatever is the current way that you communicate with patients is how you can have patients message you: "Mission Accomplished" or "I Stubbornly Refused." I sometimes have therapists ask me," David, what happens? Do you respond if they say 'Mission Accomplished'? Do you write them back and say 'Great job'? What if a patient messages you and says 'I stubbornly refused'? How do you respond?"

 

Dr. David Burns: Give us your responses.

 

Jill Levitt: May be similar or different. Therapists get worried that they're going to be involved in all this messaging back and forth. I haven't found that to be a problem. I do tend to respond by saying, "Great job, keep it up." If someone says "Mission Accomplished," it's no skin off my back to do that. I have occasionally had people be accountable and say, "I stubbornly refused," meaning I just didn't do the thing, "I'll try again tomorrow" or something like that. Actually, my response to them is, "Good job being accountable," because at least they wrote me. They wrote me "I Stubbornly Refused," and that was the task. So I positively reinforce them by saying, "Great job being accountable." If they say "I'm going to try again tomorrow," I say "Keep me posted." So those are my thoughts about how you can response to those.

 

Dr. David Burns: Those responses are brilliant, Jill.

 

Jill Levitt: I do know some therapists who don't want to respond, so they let patients know, "You're going to this is sort of a one-way accountability thing, so let me know, and then we'll talk about whether you did it or didn't do it in the next session." The other thing I just want to point out, David, is I do have a lot of patients who also like to use tracking apps now for behaviors like this. I do think person-to-person accountability is the very best, but there are ways that you can easily have patients check, give themselves gold stars, or different things on the phone or apps—there's a "Streak" app or things like that. So just to know that there's lots of ways to build in essentially what we're trying to build in, which is accountability. David you told me when we were talking about this that you wanted to also highlight that if you're not a patient doing this with your therapist and you're just a human being, you can find a friend to be accountable with.

 

Dr. David Burns: Yeah, right.

 

Jill Levitt: So you're texting your friend "I Stubbornly Refused" or "Mission Accomplished," keeping each other on track. And I’ll move to the next one David?

 

Dr. David Burns: Yeah, sure. And that a after step nine, we're pretty much concluded. Generally, most patients just need to break the ice like that. Once I got started with my office, I just started doing it, like five minutes a day. But once I got into filing things, I found it wasn't that difficult. I felt proud and kind of relieved. It took a couple of months, but it was a very exciting experience. I'd been procrastinating on something that turned out to be very mood-elevating. As I look around my office right now, it just looks like a world-class office; everything's so neatly organized. But for me, the trick is always to start with something little. If I say my office is messy, I've got to clean it up; I'll often look around on the floor and find some little tiny white thing on the carpet and I'll just pick that up and put that in the trash and say that's my thing, I did it. But then once I've done that one little thing, I say, "Well, I can do this other little thing too, this other little thing." Another kind of technique I just wanted to include for you, because it's fun and this brings us back to the start of the workshop where we had you write down your negative thoughts. Beck created this technique or borrowed it from somebody, and we called it the Tic-Toc technique. We think about those thoughts as that you have when you're procrastinating, like "Tomorrow will be a better day." Task-Interfering Cognitions (TICs), and then TOC is Task-Oriented Cognitions. You can see that Tic-Toc technique form on page eight of your handout. It's most powerful when used as a role-playing technique, kind of like "Externalization of Voices" or "Externalization of Resistance." We actually call it the Devil's Advocate technique that can be used with any habit or addiction. We can do a couple role reversals and illustrate for people if you like how this works.

 

Jill Levitt: Would you like to be the shrink or the patient, Jill? I'll get Mike off of here for a little bit. Sorry Mike, I kept you on the screen. Either one David, I'll let you pick.

 

Dr. David Burns: Well, I'll be the tempting voice. You can do this with a friend; you don't need a therapist to do this Tic-Toc technique or Devil's Advocate technique. I'm going to play the part of your mind, Jill, that will try to persuade you to procrastinate. Can you give me something specific that you might procrastinate on so I'll have some substance?

 

Jill Levitt: Sure. We're not going to use the ones on the well, we'll use this on the screen but I'll just give you another context. Responding to a complicated email that has multiple parts. There's a bunch of questions that I've gotten in an email from someone that feels kind of hard to respond to.

 

Dr. David Burns: Oh yeah, that's understandable. I'm going to be the part of your brain that wants you to procrastinate. I'm going to talk to you in the second person, "you," but I'm actually Jill talking to Jill. Could I talk to you for a minute, Jill?

 

Jill Levitt: Sure.

 

Dr. David Burns: I know you have that really complicated and quite understandably upsetting email that you have to respond to, and tomorrow will be a better day.

 

Jill Levitt: Yeah, well, I certainly don't want to do it today. Tomorrow sounds a lot more appealing to me. But I've been saying that for a week and I just need to get it done. The longer that I drag it out, the more I think about it and the more uncomfortable it feels. I just need to bite the bullet and get it done.

 

Dr. David Burns: Okay, who won?

 

Jill Levitt: I did. Big or small? I would say big, probably not huge, because it didn't maybe feel specific enough. It felt like I could feel motivated in the moment to do it, but I almost felt like I wanted to make sure I included when and where so I would actually be more likely to do it.

 

Dr. David Burns: Do you want to try it again?

 

Jill Levitt: Yeah, let's try it one more time.

 

Dr. David Burns: You know, Jill, that's a big and complicated email to respond to. It's political; the person sounds kind of pissed off and a little paranoid and hypercritical. You've done a workshop today, and tomorrow will be a better day for you to work on that email.

 

Jill Levitt: Yeah, no, I don't think so. I think I need to get it done today. The goal would be for me to get it done after I finish cleaning up from dinner tonight, to just have that be the very first thing that I do after cleaning up the kitchen, so that it's off my chest and I don't have to think about it anymore.

 

Dr. David Burns: Okay, who won?

 

Jill Levitt: I won. Big or small? That was huge.

 

Dr. David Burns: What made it huge?

 

Jill Levitt: I felt that I focused on getting it done tonight and that I'll feel great when it's finished.

 

Dr. David Burns: Awesome. So that's how you do the Devil's Advocate. Do you want to do a reversal?

 

Jill Levitt: What I was going to say David, is could I have you stay in the therapist role but I'll model a not-great response, and then you can show how you'd respond to that.

 

Dr. David Burns: Sure.

 

Jill Levitt: You know, Jill, five minutes is just a drop in the bucket on that task. That email's going to take a lot more than just five minutes to figure out, so that would be a waste of time spending five minutes on it.

 

Jill Levitt: Yeah, I know that's, yeah, that's what I've been telling myself. That's how it feels. I think that's true.

 

Dr. David Burns: Well, maybe you're saying that isn't something that we should be working on, that you don't want to do that today, and that's cool with me. I mean, I'm not trying to persuade you one way or the other.

 

Jill Levitt: No, I do, I mean, I do want to work on it David.

 

Dr. David Burns: Well, then how are you going to respond to this idea? "You know Jill, five minutes is just a drop in the bucket. That's a complicated email to figure out."

 

Jill Levitt: I'm going to say five minutes is a lot better than nothing, and I don't want to keep putting it off. I'm going to make a commitment to myself to work on it for five minutes. Maybe I'll keep going when the five minutes are done, or maybe I'll at least get five minutes into my response. It beats thinking about it.

 

Dr. David Burns: Who won?

 

Jill Levitt: Yeah, I did. Huge.

 

Dr. David Burns: Okay, and so that's how you do it. You don't stop until the person gets to "huge." Would you recommend role reversals with this technique, Jill?

 

Jill Levitt: I don't think so David. We don't recommend role reversals with the Devil's Advocate technique. It seems like it would kind of reverse the progress we'd making if we were trying to answer or solve the problems for the patient, right?

 

Dr. David Burns: Yeah, absolutely.

 

Jill Levitt: Our goal is to continue to put the problem back to the patient or be willing to sit with open hands.

 

Dr. David Burns: I think that brings us to the next segment of our workshop, which is the Q&A.

 

Jill Levitt: Yeah, I agree. I would love to summarize. Would you like to summarize?

 

Dr. David Burns: The summarize of the techniques you've learned today and they're all paradoxical, starting with the fantastic Triple Paradox. Here you're showing the patient from three different dimensions all the reasons to continue procrastinating. There aren't any therapists in the United States who are currently willing to do that, hardly, because therapists are sadly and foolishly addicted to helping. Which one of our key messages is: trying to help a procrastinator will only make the problem worse. Step two is the "Blue Plate Special." You say, well, if they say they want help with their procrastination, they can persuade you to work with them. You've got to persuade me to work with you; I don't have to persuade you, the patient, to work with me, the therapist. So what kind of help would you be looking for today? Most patients will say, "I need help with motivation." The Blue Plate Special is simply telling the patient that in the menu, motivation is not on the menu for today. You're not entitled to feel motivated until after you've already gotten well into doing this task. Now, if you'd want, I could help you get started.

 

And if they go for that, then you do Little Steps for Big Feats. That's where you discipline yourself to make a list of the first five things you're going to have to do to get started on this task. They have to be little things that take 10 or 15 seconds or 30 seconds to do, to where you can do all five in five minutes or less. Earlier, the patient has said, "Yes, I need help getting started." Then we come to Paradoxical Inquiry. This has to be done with compassion, so it's not coming across as a put-down, but you say, "Now, you mentioned you need help getting started. Did you need help with step one? Did you need help with step two?" You go through the five steps, and the patient actually sees they don't need help with any of those steps. Then that's followed by the Five Minute Rule. Would you be willing today to schedule five minutes only to do those five steps? If they say yes, then you say, "What time do you agree to do that? I want you to be accountable and I want to know exactly when this is going to happen." Then step seven: once they have the start time, they're going to have a lot of problems that are going to get in the way. So you have them list in the left-hand column of the Problem Solution Sheet. Then you use step eight, the Colombo technique, asking them how are you going to solve these problems one at a time, and act helpless if they say they need help finding a solution. You say, "Gosh, I can't solve that either. I don't know the solution. Maybe we should give up on this task." Of course, what you're really saying is these problems that are interfering, you can easily solve these if you choose to. Then step nine, which is crunch time: I want you to contact me via email or texting, or leave a message on my answering machine, either "Mission Accomplished" or "I Stubbornly Refused." That's pretty much the sequence. And the step six is waht used to be, the main focus of this that sounded good on paper and it’s how to talk back to those tempting thoughts and it’s tic toc technique and you can use this technique with any habit or addiction. It's actually the Devil's Advocate technique. But if you try the Tic-Toc technique without these nine steps, without focusing on the issue of motivation resistance, you have a pretty much 100% guarantee of failure because they'll do great in the office, but then when they go home, they won't follow through.

 

Jill Levitt: You could think of it in a way that step 10 is the cognitive intervention and steps one through nine are all motivational. They lead to behavioral.

 

Dr. David Burns: They’re not behavioral. They’re motivational.

 

Jill Levitt: Right, I corrected myself but they're mainly motivational. Step 10 is cognitive. We didn't put it in there because it didn't quite go in the sequence of 1 through 9, but it's not that it has to go at the end; sometimes people will work on that ahead of time. And meaning that could be the first step. But it’s just one sort of part of the sequence that you can explore with your patients.

 

Dr. David Burns: Esther is asking: "What is the Blue Plate Special?" The Blue Plate Special is that in our restaurant, we're not offering motivation. It's not on the menu, Esther. But what we could offer, what is on the menu, is getting help getting started. That is the Little Steps for Big Feats—the five specific things you'd have to do that each take less than one minute to get started. Not to complete the task, just to get started. That is the Little Steps for Big Feats—the five specific things you'd have to do that each take less than one minute to get started. Not to complete the task, just to get started. And Peter Naggie to all panelists can the decision making tool, it flipped off before I could answer it, but two of my favorite people there, Esther and Naggie.

 

Jill Levitt: So, what we could do, essentially what our plan is, is to go over some extra "learn more" slides with you and then do a nice Q&A. And so, if you have questions all along on any of these 10 steps, you can send them in the chat and we'll just share with you now and then we’ll turn our attention to answering question. Does that sound good?

 

Dr. David Burns: Sound good to me

 

Jill Levitt: Okay, Awesome. So let's go through a few more slides with you and then we'll go back and do some Q&A. Just remember, as well, that if you're here and you want to make sure that you get CE credit, you do need to stay till the end of the workshop. We do an attendance check to make sure you are present at the beginning and the end, and then we'll send you your CE survey.

 

Dr. David Burns: One last summary of the workshop: this was a fully paradoxical approach to the treatment of procrastination. This was not a linear approach with helpful techniques.

 

Jill Levitt: Okay, and so we wanted to share with you—lots of people enter questions in the chat box about "How do I learn more?" or "How can I practice this?" and that kind of thing. So I'll just share with you now that you've gotten a little flavor for this model, which is in this case highly paradoxical. We'd love to invite you to our new CBT All Access monthly subscription program. This is brand new, and it's our most efficient and economical, powerful way to help therapists become really excellent. Over the years of teaching and supervising therapists, I've heard things like, "I want a place to practice and get feedback," "I want mentorship from seasoned therapists," "I want a community," because private practice can feel really isolating even when you're thriving. So we've created something that kind of brings all of that together.

 

And so it's a monthly membership designed to offer all of those things to you: a live practice and consultation groups, TEAM-CBT certification including the FastTrack to Level Three course, a CE library that you can start on right away that includes more than 20 hours of content and tests and quizzes so that you can do home study on your own and get CEs, as well as access to special events, live demonstrations, online workshops, David's toolkit. It's all $115 a month and you can cancel any time. If you're also not thrilled with your membership, you can even get your money back within the first 30 days. And many people know about the FastTrack course if you don't know about All Access. The FastTrack course is now available within All Access; it's part of the monthly membership. The FastTrack course is—we're consistently getting awesome feedback from therapists who are finding that it's really a fast and efficient way to learn the TEAM-CBT model. You meet weekly for live online practice groups, and then you also have access to content asynchronously and do some home study work. I won't go through this slide, but as you can see, you learn lots and lots of tools in the FastTrack course and in the All Access membership. So we have the little barcode—I think that's what it's called—at the bottom of the screen if you're interested in learning more about CBT All Access. Then let me have David tell you a little bit about the Feeling Great app and then we can go back and do some Q&A.

 

Dr. David Burns: Well, for the last 40 years or more, a good 50,000 mental health professionals have attended my training programs throughout the United States and Canada—two-day workshops, four-day intensives, that type of thing. But the number who have really learned to do what I do—and what I do when I work with people, it's generally a two-hour session and one-and-done. I don't charge anyone for therapy, so I don't profit from extended therapy. The only profit I get is to see my patients go from sobbing to laughter and joy in a single session, and that's usually possible. But the number of therapists who have learned to do what I do is sadly very minimal. You're looking at two of them right now: Jill Levitt and Mike Christensen, brilliant and compassionate therapists. And Matt May and Kevin Cornelius—there are a number, but not enough to meet the demand. So what I've been doing for the past five years is working pretty much full-time on developing an AI version of myself that will treat you the same way I would treat you if you were coming to me for therapy. It produces fantastic results. It's far more effective than human therapists. Most people experience a complete elimination of symptoms of depression and anxiety within the first 90 minutes of sitting down and using the app. It's a bit of work, but it's only 90 minutes to overcome a lifetime of misery, and it's called the Feeling Great app. In addition, the other thing about it is—I see it says "try it for free," but you can get a lifetime subscription for free if you act now. That's essentially what it is. If you get it and try it out, tell us if you like it and what you like and don't like and that type of thing. We had hoped to go worldwide, but we're a very small team with limited resources and the day hasn't come yet when we can offer it all over the world. We wish we could, but that's what it is.

 

I might say that the patients have ignored us for the most part; people have not clamored to the Feeling Great app. Those who use it swear by it and say it's fantastic—they've learned more in an hour and a half than in years of therapy—but they're pretty much ignoring us. And then therapists are pretty much ignoring us, too. Therapists feel threatened by what we're doing, and that demoralizes me, it angers and frustrates me. Because if you're a therapist, all you'd have to do is start telling your patients to use the Feeling Great app between sessions, and then you'll have me as a co-therapist getting them better. Of course, if you're looking for the buck and you don't want your patients to get better rapidly, then I would strongly encourage you to keep shunning us. But I think that if you're a therapist and you'd like to join the therapy of the future, which is a combination of AI and the human input, that's something phenomenal that's available. But don't shun us for too long because our money is running out; we don't have infinite resources. The day may come soon—I feel what we've developed is the greatest breakthrough in the history of psychiatry and psychology in the past 50 years at least—but it's fragile. It's like a beautiful plant, but it needs nourishment, and it's not getting it right now. So it may die and be lost. Anyway, that's what it is. If you want, you can check it out today and try it out today and see what you think.

 

Jill Levitt: Thanks, David. We also put on this slide just some other free options. We have practice groups that David and I run on Tuesday evenings for therapists, and Rhonda and Kai—or maybe Rhonda and somebody else now—have a Wednesday morning one. David has his podcast and David also has a YouTube channel. So there's so many different ways that you could continue to learn and grow with us. We also offer these monthly two-hour webinars. I'm going to put this on for now, I'm going to leave this slide on for a moment, and I'm also going to move to David and Mike and I all on the screen together, and we'll take some questions now. We have a good amount of time to do some Q&A, which is nice. Quite often we're rushed at the end and can barely answer your questions, so please stick around and hopefully we'll be able to answer lots of questions right now.

 

Q&A Session