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Oct 6
41m 58s

470: Ask David: Rhonda's Three Questions...

David Burns, MD
About this episode

Procrastination: Be Gone!

And "Physician, Heal Thyself!"

Really? Why?

The answers to today's questions are brief and were written prior to the show. Listen to the podcast for a more in-depth discussion of each question.

This will be podcast #470 on 10/6/2025

Procrastination: Be Gone!

And Physician, Heal Thyself! Really? Why?

The answers to today's questions are brief and were written prior to the show. Listen to the podcast for a more in-depth discussion of each question.

  1. Rhonda asks: Why do people procrastinate?
  2. Rhonda asks: Wouldn't you first deal with the negative thoughts that are a part of the procrastination before working on it?
  3. Rhonda asks: Here is a question I have: You often say, "physician heal thyself," and encourage personal work by the therapist. Why does the therapist have to face their own issues to help someone else? A heart surgeon doesn't have to have heart surgery in order to conduct surgery on their patient. Why does a therapist have to do their personal work?

Rhonda writes:

I have been thinking a lot about procrastination since we met last week.  Why do people procrastinate?

It's one thing not to put away a stack of files on your desk, it's another thing to procrastinate on something major, like finishing your dissertation, doing your taxes, or some things that have a major consequence.  It's a habit like anything else so there is a cue, the pattern, and the reward.

Cue: I don't want to finish my dissertation because it's overwhelming and I don't think I am smart enough to finish it, and I don't want to face it.

Pattern: Procrastinate

Reward: Relief that I have avoided it another day.

So, wouldn't you first deal with the negative thoughts that are a part of the procrastination before working on it?

I've also been thinking a lot about positive reframing. I always do it, even with a client who has done it before, to remind people, and keep alive, their positive qualities, and to encourage more embracing/accepting of their symptoms as beautiful parts of themselves. With clients who have experience doing Positive Reframe, reframing their THOUGHTS, not just their feelings, can give a lot of insight.

Here is a question I have, you often say, "physician heal thyself," and encourage personal work by the therapist.  Why does the therapist have to face their own issues to help someone else?  A heart surgeon doesn't have to have heart surgery in order to conduct surgery on their patient.  Why does a therapist?

David replies

  1. People procrastinate because they don't want to do the thing they are putting off. There is no one reason, since we're all different. And we all tend to avoid things that seem unpleasant, and gravitate towards things that are more pleasant. I classify it in the general category of "Habit / Addiction."
  2. For years I dealt with the reasons people procrastinate as a first step, including the thoughts they have at the moment they procrastinate. I thought my job was to "help" the person who was procrastinating. This was universally unsuccessful, and not their failure became MY failure. This allowed them to continue procrastinating, since the doctor was trying to help them, and responsible for helping them.

I decided, instead, to go with an approach that works. It took a number of years to figure that out! But it was a huge relief!

  1. We don't say that a psychiatrist or psychologist has to have schizophrenia or be cured of schizophrenia to help someone with schizophrenia. And we don't say that a mental health professional has to have OCD to treat someone with OCD effectively. No one has ever claimed that.

What I am saying is that a heart surgeon has to have credibility and training in successful heart surgery to get the license practice surgery. But how does a mental professional get credibility?

Well, let's say that you've once had severe public speaking anxiety, as I have had. And social anxiety as well. So, when a patient comes to me with social anxiety or public speaking anxiety, I can say, "Oh, I've had that too, and I know exactly how awful that can feel. And, it's going to be a pleasure to show you the way out of the woods."

This message is generally welcomed by patients because it conveys two messages:

  1. I know how much you're suffering, because I've experienced it myself.
  2. I have the skills and the confidence to treat you successfully.

Would you want to go to a therapist for the treatment of your own public speaking anxiety, or shyness, if you knew that the therapist had these problems and still hadn't found a cure for themself?

There are other powerful reasons for doing your own personal work:

  1. You can see the impact of therapist errors if colleagues have tried to treat you without good empathy or methods.
  2. You can see what recovery / enlightenment mean at a much deeper level!
  3. You can see how and why certain techniques can be so critically important and helpful, and why many others will not be helpful.
  4. Once you have done your own work successfully, and experienced your own "enlightenment" or "recovery" or whatever you want to call it, you are no longer a mental health professional / technician type of therapist. You graduate to the "healer" class!

During the live show, I went through the structure of the new approach to procrastination, and she sent this email right after finishing her "Mission Accomplished" or "I stubbornly refused" task.

Dear Matt and David!

Successfully completed!

Thank you,

Rhonda

Thanks for listening today!

Rhonda, Matt, and David

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