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Text: Cecilia Odlind, previously published in Medicinsk Vetenskap no 2 2019.

Penning a long text like the one you are currently reading requires focus. As a writer, I am constantly tempted to postpone my writing in order to take on other, simpler tasks. Answering email, sharing a post on social media, cleaning my desk. When I do, this is called productive procrastination – I am getting a lot of things done, but I am not doing what I am supposed to. But there is no fooling . Telling him something vague about sending him this text for review “some time next week” is not good enough.

“What day will you be sending it?” By clarifying the goal, it becomes easier for you to attain it, he explains.

Another tip that he gives me is to divide the assignment into smaller milestones.

“If the value of completing the activity is far in the future, other tasks will be more rewarding in the moment. But by setting milestones, you move the reward forward in time,” says Alexander Rozental.

Believing that you can do it – “I will finish this text and it will be a good one” – is also an important source of motivation.

“If you have been postponing a lot of your tasks for a long time, there is a great risk that you have lost faith in your own ability to deliver,” he says.

In addition we are affected by our own level of impulsiveness.

“If you are easily distracted, remove all distractions.”

Wrote a popular science book

All of these tips are taken from the treatment that Alexander Rozental and his colleagues have developed for people who procrastinate.  

“It was while I was training to become a psychologist that I encountered a patient who was having a lot of trouble with procrastinating behaviour. The subject caught my interest and led to me writing a popular science book on the subject together with journalist Lina Wennersten: Dansa på deadline (Dancing on the deadline). In it, we describe the treatment that my colleagues at Stockholm University and I have now evaluated,” says Alexander Rozental. 

The results of the studies, which constitute the first major evaluations on this subject, showed that the treatment can reduce the procrastinating behaviour. Group therapy is particularly effective. In addition, the participants had fewer symptoms of anxiety and depression and experienced a higher quality of life. The evaluation was carried out using students, who are also the typical patients.

“Young people between the ages of 15 and 25 are the ones who most often seek help for procrastination. They run into problems when they can no longer carry out their assignments as easily as before, for example when transitioning from upper secondary school to higher education, or from university to work. They do not always have the necessary structure, neither naturally nor from their upbringing,” says Alexander Rozental.

Most people get better

But it is possible to practice these skills, and most people get better at handling deadlines with age. However, some fall into procrastinating behaviour more easily than others; one example is people suffering from what is known as anxious perfectionism. They worry a lot about how their performance will be received, and they therefore find it difficult to finish on time. In this case, the trick is to challenge the notion of what would happen if things do not work out as planned.

“The disaster almost always fails to manifest. And there is time to be saved.  The effort required to go from a good level to a perfect level rarely pays off,” says Alexander Rozental.

Another group with increased risk of procrastinating behaviour comprises people with ADHD. This must be taken into consideration when treating the behaviour. But procrastinating can also be due to a lack of initiative and fatigue experienced by people suffering from depression.

“In that case, the patient needs to primarily be treated for their depression.”

In addition to research on procrastination, Alexander Rozental has also worked in a slightly more controversial research field: The unwanted or negative effects of psychological treatment.

“It has previously been argued that conversation therapy can do no harm. However, if the therapy is expected to have positive effects, then it must be powerful enough to risk causing harm. We know that 5–10 per cent of all patients experience a deterioration in their symptoms during psychological treatment.

Temporary discomfort expected

A temporary feeling of increased discomfort as a result of certain treatment elements, such as fatigue during CBT treatment of sleeping problems, is to be expected. But then it should turn around, and the patient should feel that the therapy is lessening the symptoms. However, British research has shown that different therapists have varying degrees of success. Some, whom Alexander Rozental refers to as ‘toxic’, seem instead to aggravate the symptoms. In the studies conducted on the subject, the therapists have used evidence-based methods, but perhaps they are applying the methods incorrectly or they are not getting the correct message across to the patient. Then there are those who are unusually successful, the so-called supertherapists.

“We don’t really know much about what separates these groups. I feel it is important to find out in order to increase the chances of identifying the patients who deteriorate early on and offer them alternative treatment,” he says. 

Alexander Rozental is currently planning the next stage: One example would be to carry out in-depth studies where the researchers record therapy sessions in order to analyse exactly what is being said.

Could this not be a somewhat sensitive issue for a therapist to be studied in such detail?

“Absolutely. But most psychologists feel positive about this issue being raised, and they understand the importance of finding out more. Then there are those who are concerned that the focus on the negative effects will deter patients from seeking help,” says Alexander Rozental.