Clinical Musings and Treatment Directions for Procrastination

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This blog is a follow up to a different blog about Procrastination… (check that out here)

Procrastination as a skills deficit (Answer 1 & 2), I’m usually wondering…

  1. Is this person’s brain neurodivergent (for example, Attention Deficit Hyperactive Disorder is a matter of neurodiversity)? ADHD specifically impacts executive functioning skills like task management and can be addressed with either skills training or accommodations. With something like ADHD, I recommend a “break down the task into bite-sized steps” training – we’d do skills training together in session using one of my favorite ADHD manualized evidence-based practices (Thanks for the client workbook Evidence-Based Treatments That Work!). Check out all our providers who offer ADHD skills training here.

Procrastination as avoidance, orientation toward a feared-future (or conceptualized past), fusion, inaction, self-as-content, or unclear values (Answer 1 – 6), I think “Ah, psychological inflexibility” and this is what comes up with…

Avoidance: Is this person struggling with or fighting against feeling overwhelmed (we call this experiential avoidance in ACT lingo); is overwhelm exacerbated by the struggle? Can we – at the very least – not add to overwhelm if we practice acceptance of that sense of overwhelm while still committing to the task at hand? We’d for sure hit up some exposure practices so you can practice feeling overwhelmed while doing a task, and we’d anchor into your values to make it more likely that you’ll continue to choose to move forward while feeling overwhelmed.

  • We see avoidance in a ton of anxiety issues – social anxiety disorder, obsessive-compulsive disorder, phobias, PTSD (which isn’t “technically” an anxiety disorder anymore but whatever).
  • Learn more about the mechanisms that keep PTSD symptoms in place here.

Orientation Toward a Feared-Future (or Past): Basically, does this person have trouble staying in the present moment. We all do! It’s a natural hazard of a mind that can make up stories about times that aren’t now!

Fusion: While I’m not gonna get into it here (there’s another blog on Defusion), I’ll sum it up with a quick, “Fusion is when a thought or emotion is SO BIG that you can’t quite see it as a thought or as part of a bigger process of thinking.” I might tackle each of these with a few fun defusion practices (enter my Mind, “Brenda,” stage left). Then when we have a little bit of distance from that pushy ol’ set of thoughts, we’d do something like Problem-Solving Therapy to make sure you have the skills to move forward.

  • We see fusion a ton in anxiety issues, but also in depression, ADHD, PTSD, disordered eating… I mean… pretty much everywhere in pathology.
  • Check out some common thoughts that show up when depression shows up, and consider whether you’re fused to them by assessing how much you believe that particular thought (research on this from Zette & Hayes, 1986).

Inaction: If what we are dealing with is inaction, we are also likely wrapped up in avoidance so we’d for sure hit up some behavioral activation and exposure therapy (but not in that Foa “fear hierarchy” type of way). The way out of inaction is committed action. See #6 for a bit more about motivating that action.

  • We see inaction as a major feature of depression (Who, with depression, hasn’t met Depression Kitty and been persuaded to crawl under the covers with her for just one more hour?). This is one of the reasons why behavioral activation is so helpful for alleviating depressive symptoms!

Self-As-Content: If a person has narrowly defined themselves as an “I am…” statement, we are likely dealing with a self-as-content issue wherein this narrow definition of self also creates a narrowness in how they respond to stimuli. Basically, if “I am a procrastinator” is how you identify, your behavior will follow suit. If you’re getting whiffs of fusion here, you’re right on track.

Unclear Values: Dr. Kelly Wilson talks often about how values and vulnerabilities are poured from the same vessel – and it’s tempting to think that these are separate constructs. But if we take just one step back, we can often see that we feel the most vulnerable in the domains of our life that we care about most. If unclear values are an issue, our work here would focus on clarifying your values and then linking those values to committed action.

No matter the function of your procrastination, if you’re wanting to get life started and practice more psychological flexibility, hit us up and we are happy to support you on that journey.


Hayes, S.C., Strosahl, K.D., & Wilson, K.G., (2012) Acceptance and Commitment Therapy, Second Edition: The Process and Practice of Mindful Change, 2nd Ed. The Guilford Press.

Zettle, R. D. & Hayes, S. C. (1986). Dysfunctional control by client verbal behavior: The context of reason giving. The Analysis of Verbal Behavior, 4, 30 38.