Use this worksheet to inspect one episode in which your behavior pulled against a stated intention. Record facts, constraints, a possible immediate payoff and one feasible next action. Do not score your personality or use the sheet to label another person.

Copy the one-page form

EPISODE RECORD
Date / task: _____________________________________________
What I said I wanted: _____________________________________
What I actually did, in observable terms: __________________
Immediate result: _________________________________________
Real constraints / missing resources: ______________________
Evidence for those constraints: ___________________________
Possible payoff of my repeated choice: _____________________
Another possible explanation: _____________________________
Which part is currently mine to act on: ____________________
One feasible next step: ___________________________________
Time / place / support needed: ____________________________
Completion evidence: ______________________________________
Afterward: what happened, and what will I revise? __________

How to interpret the fields

Observable terms name behavior: “opened three template sites” rather than “was useless.” Constraints identify actual conditions. Possible payoff is a question about what the behavior preserves in the short term, such as postponing rejection. It is not proof of an unconscious motive. Completion evidence is an artifact or action you can check.

The form applies Kerub's facts-versus-stories and Authorship distinctions. Those concepts examine your own available contribution without making you responsible for another person's harm or every unfavorable outcome. [A_EGO:9] [A_EGO:INTRO]

Filled example

Task: send revised resume
Wanted: submit the application this week
Did: changed the summary five times; sent nothing
Immediate result: application remains incomplete
Constraint: employer requests a portfolio link; mine exists
Possible payoff: avoiding external evaluation
Other explanation: uncertain whether the link opens correctly
My part: check the link once and submit the requested version
Step: test link in another browser, then send application
Time: Thursday, 10 a.m.
Evidence: submission confirmation saved
Review: link worked; application submitted; outcome unknown

The example is fictional. It intentionally records an unknown hiring outcome. Sending the application is within the chosen task; getting hired is not guaranteed by completing the form.

Use the sheet once, then return to the task

Set aside enough time to answer concretely. If the form keeps expanding into a history of your entire life, narrow it to the episode again. If a real obstacle emerges, write the required request or decision rather than forcing an unavailable action.

Compare the filled sheet with the actual result afterward. Keep useful details; revise assumptions. Do not accumulate forms as a substitute for the next feasible step.

Limits and further help

CCI's clinical resources address procrastination as a specific pattern of delay; this sheet is an original reflection resource, not their worksheet or a clinical assessment. E01 Persistent anxiety or distress may need professional support rather than more forms. E05

For the wider authored perspective, explore THE EGO PATHOLOGIST through its book hub. For a sequence across several sessions, use the self-sabotage workbook; this worksheet is deliberately limited to one episode.