How to get more motivation?

I was listening to a lecture by somebody who said he was a procrastinator, and he said that the problem with people like himself is that they need immediate gratification. This is interesting because the methods I've found that help with this problem provide immediate gratification.

This is useful for all kinds of things you don't feel like doing. If a task seems like it's too big, think of it as a series of tasks that you can take on one at a time, and start with something really, really easy. Cleaning - start by cleaning for 3 or 4 min and take a 5 min break. Or start by just cleaning the kitchen counters. Immediate gratification!  

Reading - start by previewing a chapter you're about to read, looking at headings, sub-headings, etc. Short breaks are good but always watch the clock. Look for natural breaks, like after you finish a chapter or write an outline.

A famous psychiatrist said that when we can't control our feelings we can still control our muscles. If you tell your arms and legs to get you off the couch, they will obey.

Try this when it seems that you're too tired to work. Lie on the couch, close your eyes, and get ready to work by imagining yourself working for 5 minutes. Again, think in terms of taking it step by step and starting with something really easy.

I would rule out something medical first.  take your list of 20 things and just do 3 of them this week.  You are putting too much pressure on yourself to get things done.  Make a reward system where you buy yourself a treat when you get something done.  I have things that need to be done around my house so I hire my nieces and nephews to do the work.  They like extra spending money...we get time together...and my to do list gets some things done...yay.  You don't have to do everything yourself.  Maids often work for cash too....they need extra money too