There is no easy answer to this question, for many reasons.
ADHD (Attention-Deficit Hyperactivity Disorder, also known as ADD) is on a continuum, meaning it can be mild, moderate or severe. The less extreme the symptoms, the easier it is to compensate, making it less difficult to live with ADHD. The reverse also applies.
Millions of adults have the symptoms associated with ADHD, but not the diagnosis, possibly because their symptoms, although enough to qualify for a diagnosis, are on the milder end of the spectrum. Or they may have learned to cope, or just accepted the way they are, perhaps (unfairly) attributing some of neurobiological symptoms to moral failings (lazy, inconsiderate, careless, foolish, etc.).
ADHD is a diagnosis based on having checked off a sufficient number of symptoms from a laundry list of age-related options. Each of those symptoms can vary in terms of how problematic they can be, and under what conditions (at home, school, work, leisure). That’s a lot of variability. There is even variation within the ADHD diagnosis, as you can be primarily impulsive/hyperactive, primarily inattentive or combination type.
For some, having ADHD is a strength. Their ADHD-related characteristics (or some of them) are essential to their personal and professional success. Consider the high percentage of ADDers in certain careers, such as entrepreneurs, artists, musicians, first-responders, comedians, sales, etc. While the manifestations of ADHD may not be as helpful for all aspects of their jobs, nor in all areas of their lives, they would find life more difficult without it.
Unfortunately, for most people, ADHD also leads to certain struggles. The degree to which those struggles make life difficult will vary. If you struggle with time management but aren’t in a job or life situation where following the clock is critical, then that becomes less of a problem. If you struggle with organization, but have assistants at work and help at home, that challenge is less problematic. If you need to be ‘on the go’ and are a student confined to sitting in a classroom, you might be considered hyperactive, from a negative perspective. But if you have a career where you aren’t confined to your office and you also enjoy an active leisure life, your drive to move shifts to a non-issue, and even an asset.
ADHD symptoms vary – one person could be physically hyperactive, and another hypoactive. High energy, low energy. Some people do well in a chaotic environment (many police, firefighters, EMT’s, ER docs, floor traders, teachers, etc. have ADHD) while others would be totally overwhelmed by the noise and activity. Many people with ADHD thrive in the bustle of a big city, while others seek the peace of a countryside or seashore. So, finding an environment and career that suits you makes a difference in how you’ll view life, and how difficult it is, or isn’t, to have ADHD.
ADHD is inconsistent. Not just from person to person or from child to adult, but from day to day. Sometimes it can feel debilitating or dysfunctional; other times you are on a roll and exceptionally productive. Understanding, and accepting yourself (instead of letting your inner Judgmental Critic be in charge) makes those unproductive times less frustrating.
Other factors contribute. If you are surrounded by critical people, whether at work, socially or at home, you’ll obviously find life more challenging than if you have support and understanding. The more you are juggling (work, school, home, partner, children, aging parents, etc.), the harder it is – for anyone. The hormonal changes of aging or the stress of illness will also exacerbate the ADHD symptoms.
Having ADHD can be really frustrating. It’s tough when you struggle with things that ‘should’ be simple (although you may excel when tackling more difficult challenges). It’s sad when you aren’t achieving your potential, even when you might be considered successful (but you know you could be doing much more). It can be extremely stressful when you know you need/want to do something but can’t activate (an executive function), or you are doing something you need to stop, but can’t find the brakes.
Strategies are critical for managing your ADHD symptoms.
There is often a reduction in ADHD-related difficulties when you take time for self-care and stress-reducing activities (exercise, sufficient sleep, outdoor time, mindfulness, journaling, eating well, hobbies, creative, sports and social activities, pets, family fun time and time to nurture relationships, etc.)
Some people benefit from medication, but if you couldn’t play the piano before meds, you can’t play it after – you’re just more available to learning how, which can make a difference.
Some ADHD tendencies are best avoided (or require professional intervention). People with ADHD often have impulsivity control issues and addictive personalities, acting without thinking, whether it’s reckless driving, alcohol, drugs, food, sex, shopping, gambling, internet, etc. They also tend to get caught up in thinking without acting, making it difficult to get things done. Obsessive thinking and perfectionism often come into play, getting in the way of productivity.
When the ADHD brain feels overwhelmed, instead of tackling the issues, it is more likely to shift into the fight, flight or freeze mode – major avoidance. This is an automatic, brain-based reaction to fear, confusion or stress. So, it’s critical to find strategies that will keep you from feeling overwhelmed.
Tools and strategies help to manage ADHD-related challenges. If you struggle to get places on time, meet deadlines, begin or finish tasks and projects, get and stay organized, manage schedules and lists, create and follow routines, prioritize, self-advocate, make decisions, communicate effectively, etc., it isn’t enough to want things to change. You need specific compensatory strategies that work with the way you think – not the way you wish you thought. The right tools make living with your ADHD a lot less difficult. (That’s what Coaching is about!)
ADHD is only part of the mix – we have different personalities, interests, strengths, intellectual and emotional gifts, co-existing diagnoses, etc. Some people with ADHD will excel in school, while many others find it a total challenge. Some will be artistic or creative; others might be athletic or musical, all of the above or none of them. Some will thrive in the limelight; others will avoid it. It isn’t just the ADHD we need to manage; it’s finding a life that supports us on many levels. It’s easier to cope with the difficulties that come from ADHD when we are engaged in activities that play to our strengths.
There are so many aspects of life that are impacted by ADHD, from relationships to finances, from career to self-care. You can find ways to compensate, and even excel, but it takes effort and self-awareness. The answer to, “How difficult is it to live with ADHD?” largely dependson whether you’ve been able to create a personally ADHD-friendly life!
Most of us want, even long for, a more organized life. A good start is to create a less cluttered home. When we free ourselves from the pressures of excess possessions and over-accumulation, then figure out the best systems for maintaining the stuff we do keep, we open up more than physical space. We gain more time and energy for family, friends, interests, hobbies and experiences.
One of the best ways to get organized is to commit to working at it for a set amount of time on most days – slow and steady may not win the race but it will get stuff accomplished! My online Action-Accountability Group, The TUIT Project, will support your doing just that. You can join the current session or begin next month. www.OvercomeOverwhelm.com
You’ve probably heard of the KonMari phenomenon. If you haven’t, you will (of course you will, I’m mentioning it here!) It is the popularization of Marie Kondo’s method of organizing (‘tidying up’), based on the premise that everything you own should ‘spark joy,’ or let it go. Her message transforms the focus of decluttering and straightening up (tidying) from having to get rid of stuff (loss) to consciously reviewing everything you own and keeping only those items you cherish (gain).
I like this re-frame, but I also have mixed feelings. I’m glad the concept of organizing (and hiring Professional Organizers) is becoming better known through her bestselling book, The Life Changing Magic of Tidying Up: The Japanese Art of Decluttering and Organizing, along with her international publicity and media appearances, her follow-up books (which clarify some of the overly-simplified concepts in her first book), and now her hit Netflix series (which features more relatable homes and families than programs like Hoarders).
I love the positivity and spirituality of Kondo’s message. However, as a Professional Organizer for more than 25 years (and here you thought I was just a Productivity/ADHD coach!), her ‘revolutionary’ ideas have been around for a long time. There are many veteran organizers who have long promoted the benefits of organization from an energy-creating, spiritually uplifting, life-freeing perspective (check out Julie Morgenstern’s classic book, Organizing from the Inside Out), but Kondo’s adorable, single-focused persona and clear method appeals to our deepest desires and makes them seem attainable. Who doesn’t want to ‘spark joy’ (or, as an Old Navy ad puts it, ‘ignite delight!’)? She has been amazingly successful in spreading her message (and it doesn’t hurt to have a marketing/social media guru for a husband and as the CEO of KonMari Media).
During a recent meeting of my local NAPO (the National Association of Productivity and Organizing Professionals) group, we had a somewhat heated discussion about the pros and cons of the KonMari method. It’s a hot topic among organizers everywhere. Here are some opinions from both sides of the debate (I’ve added my comments in brackets with my initials):
Angela Kantarellis, an energetic and very professional organizer, writes in her newsletter about ‘three compelling benefits’:
A powerful brand. “Marie Kondo’s message is simple, clear and consistent. Her brand is positive, light and lovely and she embodies that brand.”
The concept ofpure energy. Quoting from Kondo’s book, “One theme underlying my method of tidying is transforming the home into a sacred space, a power spot, filled with pure energy.” Kondo spent 5 years as a Shinto shrine maiden, which has inspired her philosophy. The KonMari method elevates tidying of the home to a spiritual practice. Creating a home filled with pure energy is quite compelling.
Joy and gratitude. The process of going through all your worldly possessions one by one is quite an undertaking. Kondo … has infused the KonMari brand with a rigorously positive energy. The tidying process becomes one that is both good for you and indulgent, like a week at a luxurious spa. The hallmark of the KonMari method is asking each object, as you are holding it, if it ‘sparks joy.’ If it doesn’t, out it goes, but before it does, you thank it for its service.
“Will you be inspired by watching the (Netflix) show? Perhaps. Will her methods become your methods? Perhaps. Will everything you keep spark joy? I can think of many items I need that do not spark joy in my life! Think about it… the toilet brush… no joy, the broom… no joy, the vacuum cleaner… no joy, the pooper scooper…nooo joy! However, these things are necessary in my life. What I have noticed is that having a clean toilet, clean floor or no pet hair on the furniture is satisfying and makes me feel good, and that is the feeling I am looking for.
[Perhaps feeling good about the benefits of having an item can be the equivalent to ‘sparking joy.’ And, to be fair to Marie K, in an interview in Architectural Digest she says, “Hold them up (your belongings) one by one as you ask yourself, ‘Do I truly need this?’ or ‘Does it spark joy for me?’ Apparently, she’s recently gotten the message to also highlight need; not just joy. –SL]
What I do know is that having a system that you follow every day is the key. Maintenance of the system is critical to staying on track. And, most importantly, having less is something that most, if not all, of us could embrace in our journey to greater joy.”
[When I talk about Organization, I distinguish its components. There’s setting up systems, implementing them, and maintaining them, which is actually Time Management, rather than Organization. You can be great at maintaining systems, but can’t figure out how to set them up, which makes you a perfect candidate for getting an initial boost from a Professional Organizer. I have a talent for designing systems that work, whether for space management or office productivity. But I’m abysmal at maintaining systems, which is why I’ve periodically had the dubious honor of using photos of my office as ‘before’ pictures (which is my trigger to devote time/energy to an office clean-up)! I, like many of my clients, need to budget in clean-up time/maintenance, as it won’t happen on its own. –SL]
“… what Marie Kondo and all Professional Organizers attempt to do is to transfer knowledge and train their clients in systems. Marie’s systems are very clear, and her clients embrace them. I cheer anyone who can make the world a more organized place. What I also know is that her methodology will not work for everyone. Truly, there is no one size fits all answer to getting organized. If you are drawn to her, then you know what to do. If not, there are lots of other equally talented, empathic, non-judgmental Professional Organizers out there. No system is perfect; the one that works for you is the one you subscribe to and use every single day! “
Ramona Creel, a wonderfully opinionated, veteran organizer and author of The Professional Organizer’s Bible, wrote a scathing Facebook post that also makes a lot of sense:
Problem #1 – One Size Does Not Fit All … Anyone who suggests that ‘rolling your socks stresses them out, and they need to be able to rest separately from each other so they can recuperate after the hard work of supporting your feet’ is not functioning in the same plane of reality as the vast majority of my clients. I’m sort of joking, but this KonMari tip highlights a major problem I have with her approach – that it comes in the form of ‘commandments’ she sincerely believes all humans (regardless of their situation or circumstances) should follow. I’m sorry to inform you, Miss Kondo… that’s not how getting organized works! Just ‘cuz this bizarre set of rules you’ve created helped you ‘tidy up,’ doesn’t mean they’re the answer for anyone else.
[In her Architectural Digest interview, Marie K expands on the sock folding issue by saying, “…What I mean by ‘allowing the socks to rest’ is that the elastic will get stretched over time and will wear out sooner if you roll socks into a ball.” So either she’s gotten the message that most people don’t think socks have feelings, or she didn’t make it clear the first time. I’ve actually folded socks for years, because I can fit more into a drawer (BTW, unlike Marie K, or Ramona, I am not a minimalist – the photo below shows only some of my socks – the rest are still in a giant laundry bag because I don’t make the time to put them away!) –SL]
A truly functional and lasting system is tailor-made to align with your lifestyle, way of thinking, habits, proclivities, and personal weird-ities. My work with clients is all about creating customized approaches that suit each individual’s way of living their lives. The KonMari ‘do it my way or you’re doing it wrong’ method is completely antithetical to what Professional Organizing is all about – and it deeply DEEPLY offends my organizational sensibilities. It also leads to my next point…
Problem #2 – Setting Yourself Up for Failure … As I said, the way each person interacts with and thinks about their stuff is unique, different from anyone else on the planet. For any system to perfectly match these quirks, it must also be unique. It’s been proven in our industry time and time again: Cookie cutter solutions are destined to fail for the vast majority of people who try them. So … you end up feeling like you failed and are even MORE daunted by your mess than pre-KonMari.
[For clients with ADHD, executive function or chronic disorganization challenges, any kind of a ‘must do standardized approach’ is particularly problematic. Guidelines are helpful; mandates are not. For some people it’s ridiculous to use a specific number, like Kondo’s ‘30’, as the limit for the number of books you keep… or to have only one white t-shirt… or to go through your clothing by putting EVERYTHING you own on the bed at once – that’s easily a trigger for overwhelm and avoidance. Even the concept of touching each item before determining its fate is dangerous to those people for whom physical contact intensifies their ownership/emotional bonds. –SL]
Professional Organizers already struggle daily to help their clients overcome the feeling that they are somehow defective because they can’t stay organized, and this crap doesn’t help any. Plus, it’s not actually teaching clients any useful skills. TRULY understanding an organizing principle (like categorization or containerizing or having a logical reason for where you store things) means you can apply it in a way that suits your needs – and then apply it differently for your spouse, and differently for your kids, and differently for your staff at work. I’m personally about teaching principles that ANYONE can utilize, no matter what their situation, and that ain’t happening here.
[Marie K does (somewhat) address the concept of categorization when she talks about what I’ve always called functional organizing, by saying, “Everything you’d need to write a letter can go in your ‘stationery’ location.” –SL]
The reason REAL Professional Organizers insist on customized systems is so the client can maintain those systems on their own for years to come without the organizer’s help. Attempting to impose someone else’s logic on your stuff, trying to force yourself to become an entirely different person in order to adapt to a system – that’s a recipe for disaster.
[Kondo emphasizes the importance of organizing everything at once, “Organize your space thoroughly, completely, in one go… If your idea of tidying up is to clean up your room a little at a time… it won’t have much effect on your life.” Dramatic transitions are life-changing, but it takes time to get organized. Quick, transformative results are inspiring, but if that’s your organizational goal, you’ll need to put a lot of other things on hold, including any tendencies to get overwhelmed by volume and pressure. Decision-making fatigue is real. Imagine going through everything you own and saying “Yes, sparks joy so I’ll keep it… No, thanks for your service” and donate or discard. I applaud Kondo’s end goal of a life-changing transformation, but how much of that could you take in one sitting (even if over a period of several days), without tuning out completely? –SL]
Problem #3 – She’s Not Saying Anything New …. I also have issues whenever pop culture praises some newcomer for discovering a supposedly ‘innovative’ way of functioning, when all they’re doing is regurgitating what someone else said years and years before them. (I had the same beef with Stephen Covey when he stole Eisenhower’s ‘urgent-vs-important’ matrix and called it his own – betcha didn’t know he did that!)
Even down to her key concept of appreciating the role an item served in your life as a way of allowing yourself to let it go, KonMari isn’t saying anything that I and my colleagues haven’t been preaching for decades. In fact, the mantra I’ve used with my clients for 20+ years (‘beautiful, useful, or loved’) sounds awfully familiar to the concept of ‘sparking joy,’ yet is far older than Miss Marie. It comes from William Morris (head of the Arts and Crafts movement in the 1800s). He and Thoreau and their buddies were helping folks downsize before KonMari existed in even a gonadal state. She’s just saying it in a way the media has latched onto – but she’s dumbed this concept down to the point of that it’s lost all practical application. Which leads me to my next point…
Problem #4 – Over-Simplification … “Does it spark joy?” Well, let’s see. Tax returns don’t spark joy, but they do they keep the IRS off your ass. The lawnmower generally doesn’t spark joy, but it does keep the neighbors from reporting you to the HOA. My toothbrush does not spark any particular sense of joy, but it does keep my teeth in my mouth. I don’t know much of anyone for whom toilet plungers or rectal thermometers or pet-urine-stain-remover especially ‘sparks joy’ – but they come in awfully damned handy when you need them, I would argue that’s a valuable reason to keep something!
I find the concept of sparking joy too simplistic and limiting. I prefer (again) to teach William Morris’s mantra to my clients – is it ‘beautiful, useful, or loved’? That ‘useful’ category is getting the short shrift in KonMari land. Joy-sparkage also doesn’t take into account things like records retention guidelines (how long you’re legally required to keep a document in case of legal problems down the road). Follow KonMari to the letter, and you stand a good chance of ending up in jail!
[OK, this totally makes sense, but it might be an oversimplification of the KonMari approach, especially now that she includes the value of ‘need.’ –SL]
Problem #5 – A Surface Solution at Best … The biggest clutter dilemma my clients face has nothing to do with letting go – it’s the slavish (and often unconscious) need to continue accumulating, even after they’ve cleared the decks. Overcoming that requires an understanding of the psychology behind your particular clutter triggers, because your reasons for accumulating … are very different than anyone else’s. They’re driven by childhood experiences, feelings of loss and lack, the values your family attached to ‘things,’ your ideas about status and success and security. It’s far, FAR more complex an issue.
Clutter comes from trying to fill a hole in your life with stuff [and, according to master organizer Barbara Hemphill, ‘postponed decisions.’ – SL ]. Unless you can understand what your particular hole looks like, the piles are just going to come back. To overcome that, you have to understand what drives you accumulate, and your reasons may have exactly zilch to do with joy-sparkage. (I can hand you a million hoarders who desperately love every single piece of trash in their house. If they followed the KonMari method, they’d still be buried in squalor!)
Part of what we Professional Organizers do is more akin to counseling than ‘tidying up.’ We understand how to dig deeper and get at the root of your clutter… how to ask the hard questions that go beyond, “Does it spark joy?”… how to uncover hidden feelings you didn’t even know were bringing extraneous crap into your life. We help you achieve a level of awareness about your beliefs, motivations, and actions that keeps clutter at bay. KonMari’s ‘method’ doesn’t really address this.
[I am concerned that Kondo repeatedly calls her clients ‘lazy.’ She may say it as an incentive to get her clients moving, but for anyone with executive function challenges, depression, anxiety or ADD/ADHD – them’s fighting words! A good P.O. would help a client to get into action, not criticize them for being stuck. Getting going on something (activation or initiation) is a brain-based executive function,which is very compromised when you have any of the above conditions. So please don’t tell me I am what I’m battling not to be– it doesn’t help me to feel encouraged in any way! –SL]
Problem #6 – This Isn’t Organizing … At least she’s honest about what she’s doing in the title of her book – she’s ‘tidying up,’ which any P.O. worth his/her salt will tell you is NOT the same thing as getting organized. I’ve been doing this professionally for more than 20 years, and I can tell you there’s a whole-hell-of-a-lot more to staying organized than cleaning out. That’s just the tip of the iceberg! REAL organization requires a holistic approach, that tackles the clutter in your use of time, your management of information, your ability to prioritize and draw healthy boundaries, your spending, your relationships, your own head. Most of my clients’ organizational knots AIN’T gonna get untangled with an overly-simplified, “Does it spark joy?”
[I’m glad the popularization of the KonMari method has brought lots of attention to the benefits of organizing. There are now Professional Organizers who are certified in this approach, and many others who utilize some of the concepts. The KonMari method has been helpful for many, but it is not appropriate for everyone. While I have read and heard glowing testimonials from people who have tried it, I’m not sure how many of them were dealing with chronic disorganization, executive function issues or ADD/ADHD (although I can see where the clear methodology and set rules can be appealing). –SL]
As you’ve read here, there are very different takes on the KonMari method, with validity for them all. Which side of the debate are you on? Leave your comments below.
Need help to feel more in control of your environment and yourself?
Individual Coaching helps develop strategies and systems that work with the way YOU think. We can also do Virtual Organizing using photos and video. Click here to schedule an Initial Conversation with me. You can also find qualified local Professional Organizers by searching the member listings on NAPO or the ICD (Institute for Challenging Disorganization).
Online Group – One of the best ways to get organized is to commit to working at it for a set amount of time most days. (Marie Kondo, most of us do not have the time or energy to tackle everything at once!) My online Action-Accountability Group, The TUIT Project, will support your doing just that, helping you to actually get around ‘To IT.’ New sessions begin monthly, so sign up now!
Group Coaching– Interested in a video-chat coaching group? Send me an email with the best day and time!
If we’re always in action – or inaction, without taking a conscious pause to step back, observe, reflect and perhaps redirect, we’re doing ourselves an injustice. All pauses are not the same. Check these out:
PLANNING Pause – I often talk about Planning Time vs. Doing Time – how important it is to set aside specific time to focus on deciding what you need to do and how you’ll get it done (Clarity) along with when you’ll do it (Priority). When you pause to plan, your efficiency quota can increase exponentially! See my blog “TheTwo Magic Words for Productivity: Clarity and Priority.”
REFLECTION Pause – Another helpful distinction is Reflection Time vs. Action Time. The idea here is to make the time, while working on a project (preferably one task at a time!), to pause and think about the efficacy of your actions. Ask yourself if what you are doing now (task, project, direction, etc.) is the best thing for you to be doing at this point in time. Consciously consider whether your actions will help you to finish the project, attain a goal or, on a broader scale, live a life you love! If so, continue; if not, redirect your efforts.
HABIT Pause – One of the benefits of Reflection Time is seeing patterns you might have overlooked,or known but ignored. You can’t fix what you don’t realize is broken, so take a pause to think about it. Members of my online Action/Accountability group, The TUIT Project, are asked to consider not just what they’ve accomplished, but what worked and what got in the way. How can you build on that? What habits/patterns support your efforts, and which ones hold you back?Here’s an example: Annie is a TUIT group member who identified chronic perfectionism as getting in the way of her productivity. While helpful to a certain extent (especially knowing how easy it is to get distracted and careless), it’s also easy to have too much of an otherwise helpful thing – ever hear of ‘paralysis by analysis, or ruin something that was working by overthinking or over correcting, or miss a deadline because you wanted to fix ‘one more thing’? Awareness helps, and awareness begins with a pause.
DOING Pause: Redirect – I don’t believe you can just stop doing – or thinking – about something. There will be a void and you have to fill that void with a different ‘something.’ So, telling yourself to be less of a perfectionist is not going to be very helpful unless you then substitute another conceptor behavior. In Annie’s case, an internal bell now rings when she’s caught up in perfectionism, and she reminds herself, “Go with Good ‘Nough!” as a replacement mantra for perfectionistic behavior. Successful people don’t constantly second guess themselves – they get into action and move forward towards completion, pushing through the obstacles instead of getting stuck in finding a perfect solution. See my blog “Ready – Fire – Aim.”
ACTION Pause – Sometimes, an Action Pause is the best way to get something done. Temporarily walk away from it – avoids the law of diminishing returns. Shift to another task or recharge with exercise, an outdoor break, play break or even a quick nap.
PROCESSING Pause – Many people with ADHD also have a degree of ‘slow processing.’ This has nothing to do with intelligence, nor the ability to understand concepts (which we often get quicker than many people). It does, I think, reflect the way many of us understand things. We need to relate new information to something we’ve already processed, whether consciously or not. Facts in a vacuum don’t work. So it may take a bit of time to absorb the new info and tie it together with something we already have stored in our atypical brain. That is partially our genius – we make links that many others will not. It’s also our challenge, because we may not easily get stuff that others pick up without pause. Allow yourself the gift of the pause. Take time, without guilt, to absorb things, whether it’s a conversation, a lecture or a scenic view. Don’t apologize for that blank stare when someone is talking, or feel pressured into a quick response, but do have a response ready, “Hmmm… I’m thinking about that.”
SPEAKING Pause – People with ADHD tend to be impulsive, which can mean blurting out what they think without thinking it through. Poor short-term memory can also contribute to the rush to get a thought out before we forget it. Sometimes we are so focused on what we want to say that we’re not in full listening mode. This can by annoying to others, and then some. A great idea that is poorly communicated is doomed. So, recognizing this tendency, pause to consider if what you want to say is appropriate, helpful, timely and succinct. If not, remain on ‘pause.’
THINKING Pause – Therapists, coaches and some teachers are trained to ask a question, then pause, giving the recipient time to reflect and respond. We have so much going on in our lives that it takes time to think, so that we can pull out what is most pertinent, relevant or important. It’s easier to discuss things at a superficial level, but when we pause to really think about something, that’s when we open the door for those ‘Ah Ha!’ moments. What do you think about the PAUSE? What are some Pauses that work for you? Share them in the comments section below.
It’s tough enough that many of us have challenges with ADHD/Executive Functions (organization, time management, prioritization, activation, short-term memory, etc.). But we compound the problems when we add guilt to the mix.
I may not be happy that I’m not checking off all my To-Do’s
– even when I’ve realistically created a theoretically do-able Daily Action Plan. Feeling a degree of
anxiety about accomplishing things can be helpful as an impetus to action, but dwelling on my failures is totally
unproductive – and unfair!
ADHD and EF
challenges are neurobiological, which means they exist, like it or not. It
isn’t a question of morality, intelligence or willpower. I can find strategies
to compensate and even excel, but without them, I will struggle with even
simple tasks. And there are days when even my best strategies will go unheeded.
I can write this blog and feel energized, but before I
began, I shut my eyes to avoid looking at the kitchen counter that needs
straightening, saying ‘later.’ As a productivity/ADHD/organization coach (ah, the irony!), I tell myself to just
take 10 minutes on the counter (which would totally be enough time), but my
brain cries out that I might lose the train of thought that inspired me to
write this. So, the kitchen counter waits.
My brain works in a
way that is sometimes quite incredibly wonderful, but won’t usually win awards
for straightening up, making calls I’d rather avoid or working on tasks that
don’t light up my engagement button. Activation, or getting started on
something, has little to do with motivation. I may really want to lower my
cable bill, but initiating a call to the cable company to complain meets brain
resistance and is easily postponed (it’s important, but not urgent, and has now
been on my list for several months!).
I can choose to feel
shame and guilt, or I can choose self-acceptance. My challenges aren’t
excuses, but they are explanations. I choose to not spend my life focusing on
what I don’t do/haven’t done, because that would be a sad way to live. Instead,
I look at what I do accomplish (often things that were not on my Action list)
and appreciate my efforts. I look at
where I’m struggling, and focus on compensatory strategies to help me do
Here’s an example:
My natural tendency is to be late for just about anything. When I was honest
about this, and the negative affects it had on both myself and others (my PowerPlan to Success™ Step #1,
Self-Awareness), I accepted responsibility, tempered by knowing I have
brain-based challenges that contribute to lateness (Step #2, Self-Acceptance).
HOWEVER, I decided I could still improve (Step #3, Belief in Possibility, and
that You Always Have a Choice). So, I
developed a load of compensatory strategies, both practical and mindset. Now
I’m late only occasionally, but if I didn’t use these strategies, I’d be back
to old habits.
It’s a waste of energy and a drain on your spirit to mourn the person you are not. Yesterday morning I spoke with a client, Annie who felt shame when she used a timer to remind her of things. It reminded her that she “was a failure, because I can’t do it myself.” We discussed this, and Annie was able to reframe her thinking from one of failure and self-blame to a positive take. She focused on how terrific it was to proactively compensate for a brain-based challenge that she could not control by willpower alone. She shifted from feeling defeated by her perceived failure to feeling empowered by her decision to let a tool (the timer) create a successful outcome.
That same afternoon I spoke with Paul, who was berating himself for not having done something on a timely basis that resulted in some really negative consequences. We spoke about systems that could make a difference going forward, but the real issue was one of Self-Acceptance. For any system to be effective, it must be used. So he needed to understand and accept that he has executive function deficits that require conscious compensation:
He can’t rely on his memory. There has to be an independent trigger to take action. (Although Paul’s need was for a long-term reminder, accepting, and finding a strategy to compensate for his poor working memory was similar to Annie’s realization that using a timer was smart, necessary and nothing to feel ashamed about.)
He can’t depend on getting something done immediately, even when remembered on a timely basis. This can be a struggle for anyone, but is particularly tough for those with ADHD. (Research shows we are less motivated by Importance than those with neurotypical brains.) Build white space, or open-time cushions, into your calendar, in case you need to delay a scheduled To-Do, then have a can’t-miss way to remind yourself when you’ve run out of avoidance time.
When Paul accepted the reality of how he worked (or didn’t!), he also let go of the shame he had attached to his failure to take timely action. And we came up with some nifty strategies to avoid this in the future.
We always have a choice. We can be the 5-foot tall person who spends her life bemoaning the fact (totally out of her control) that she isn’t 5’10”, or the woman who is 5’10” and wishes she was more petite, or we can focus on our reality and make the most out of it. We can be the person who refuses to wear glasses because he doesn’t think they look good, or we can buy funky glasses that mirror our personality or mood and have fun with it. We can want to lose weight and keep feeling guilty about our lack of willpower, or we can find a program with strategies (not willpower!) that work for us. We can take charge of our efforts, instead of being ruled by inadequacy and self-judgment. Will we always succeed, no. But there’s a lot less stress, and less time wasted wallowing in self-blame and guilt.
Please, stop beating yourself up for struggling. Accept that your wonderful, creative and capable brain has some challenges. Find strategies to help and give yourself credit for workarounds. When things don’t go the way you’d like, refuse to define yourself by your struggles – and don’t let others erode your self-esteem.
If you need help finding alternative strategies, there are terrific books (I’ve listed a few in www.SusanLasky/Resources), and a wealth of good podcasts, webcasts and articles online. Also, consider the benefits of individual coaching to jump-start change – click here to schedule our no-obligation Initial Conversation. If we’ve worked together and you have some new (or recurring) issues, let’s catch up!
Sometimes it is more difficult to believe in the power of possibility than at other times. So, when we have reminders, hold onto them!
What am I talking about? In my 7-Step PowerPlan to Success™ (you can download the free ebook here), the first Step is Self-Awareness – knowing who you are, and aren’t… what you’re likely to do, and what you probably won’t… what you like, and what you don’t. It’s about accepting your reality, and so Step #2 is Self-Acceptance. This isn’t about giving in or giving up, but about starting from where you are, not where you (or others) wish you were. New studies are showing that Self-Acceptance is fundamental to both happiness and, perhaps surprisingly, productivity. Making better choices that suit you, and planning realistically, helps minimize overwhelm, which then makes it easier to get things done.
Knowing… and accepting… yourself doesn’t mean you can’t change or improve. That’s why Step #3 is Belief in Possibility – that you always have a choice in the matter. You can’t always control a situation, but how you choose to react can change your life (and often the lives of others, as have those people who began movements or charities after being affected by negative events in their personal lives).
But I’m writing this to talk about the inner power we have that is sooo easy to overlook. Sometimes we’re reminded, and that helps. Today I had an old post of mine pop up on Facebook. It was about an event that happened three years ago, and I’m thankful for the reminder that I have the inner power to do things that I may not intellectually or emotionally believe possible.
I was at an energy workshop. The presenter was Dr. Gene Ang, a Yale-trained neurobiologist. He spoke about the power we have to heal, ourselves and others. To prove that our minds (and spirit) can do things that science would scoff at, we were all given heavy-weight metal utensils (forks and spoons). He walked us through an exercise that ended with being able to bend these thick and solid utensils with thought and energy, not strength. Of course we tried to bend them in every way (including using double fisted grip strength) before the exercise, with no success (ok, no WWE members in the group).
Then we did the energy exercise, and those spoons started bending – I mean really bending. It wasn’t our physical strength that did it, but our focus and will, channeling stronger forces as we loosely held these store-bought utensils by their handles. I admit – I was totally frustrated, being one of the last non-benders in the room. I let out a healthy expletive, directed towards my recalcitrant spoon, and let go of trying. The spoon immediately ‘softened’ in my hand and bent totally in half (see the picture – it’s a cell photo of my handiwork). Wow!
So when you’re running low on positive possibility, remember the spoons – change is within you! Apparently, the Universe wants us to succeed, when we’re really clear about what we want, and willing to put in targeted effort.
I especially like this spoon story at this time of year, bringing the focus from shopping and stress back to miracles and possibility.
How ADD/ADHD Diagnostic Terminology (and Thinking) Has Changed
ADHD is NOT a new or made-up disorder, contrary to what the skeptics have been saying for the 25+ years that I’ve been an ADD coach, diagnosed ADDult and parent of a now-grown child with ADHD. So respond to the critics by showing them more than 240 years of ADHD history!
Let’s start with some clarity: ADHD refers to Attention-Deficit/ Hyperactivity Disorder. There are three primary subtypes, or presentations – Primarily Inattentive (often referred to as ADD), Primarily Hyperactive-Impulsive and Combined type. An individual can have symptoms that are mild, moderate or severe, and this may change over time or depending on the situation.
Current figures vary, but the CDC says that approximately 9-11% of school-aged children have been diagnosed with ADHD. It is estimated that 4-7% of adults have the disorder.While almost everyone experiences some of the symptoms some of the time, an actual diagnosis is based on several factors. For more on this see the CHADD Fact Sheet. For a free adult screener, go to www.SusanLasky.com/resources/ and scroll down to Free Evaluations & Screeners.
With so much attention on ADHD, there are those who say it doesn’t exist. So here is some historic perspective that will put to rest any thoughts that ADD/ADHD is a NEW or MADE-UP Disorder. (You may not like everything you read, but ADHD can be debilitating!)
1775 – Dr. Melchior Adam published the textbook Der Philosophische Arzt that contained a description of the inattentive and impulsive behaviors associated with ADHD. This is probably the first textbook ‘description’ of this syndrome. It is also notable for not focusing strictly on the hyperactive symptoms, where most emphasis has historically been placed.
“He studies his matters only superficially; his judgments are erroneous and he misconceives the worth of things because he does not spend enough time and patience to search a matter individually or by the piece with the adequate accuracy. Such people only hear half of everything; they memorize or inform only half of it or do it in a messy manner. According to a proverb, they generally know a little bit of all and nothing of the whole… They are mostly reckless, often copious considering imprudent projects, but they are also most inconstant in execution.”
BEST OF ALL: Dr. Adam’s treatment recommendations from over 240 years ago included massage and exercise!
Inconsistency is a major problem for people with ADHD – if they can do something sometimes, why not always? Although people with ADHD can be VERY detail oriented and focused, it isn’t always possible – especially when the subject isn’t of particular interest. (One of the main reasons people dispute this diagnosis is that, when interested, children and adults with ADHD can be attentive, to the point of hyperfocus, yet staying focused at other times can be very difficult. This isn’t intentional – it’s brain-based, frustrating and at the heart of this disorder.)
1798 – Sir Alexander Crichton, MD, published a book An Inquiry into the Nature and Origin of Mental Derangementwherein he said:
“In this disease of attention, if it can with propriety be called so, every impression seems to agitate the person, and gives him, or her, an unnatural degree of mental restlessness. People walking up and down the room, a slight noise in the same, the moving of a table, the shutting a door suddenly, a slight excess of heat or of cold, too much light, or too little light, all destroy constant attention in such patients, inasmuch as it is easily excited by every impression… they have a particular name for the state of their nerves, which is expressive enough of their feelings. They say they have the fidgets.” (p.272).
Dr. Crichton suggested that these children needed special educational intervention (in 1798!) and noted that it was obvious that they had a problem attending “even how hard they did try.”
“Every public teacher must have observed that there are many to whom the dryness and difficulties of the Latin and Greek grammars are so disgusting that neither the terrors of the rod, nor the indulgence of kind entreaty can cause them to give their attention to them.” (p.278).
I LOVE THIS – discussing the need for educational interventions more than 200 years ago!
1844 – Heinrich Hoffman was a progressive psychiatrist who rejected the common beliefs of his time that psychiatric patients were obsessed or criminal, and instead considered mental disorders as medical issues. He published an illustrated children’s book with a poem called ‘Fidgety Phil,’ a classic description of a hyperactive child. An 1847 edition of the book also had a story about “Johnny Look-in-the-Air,” about an inattentive child. WHY DO PEOPLE continue to insist that ADD/ADHD is a NEW disorder!?!
1902 – Sir George Frederick Still, MD (the father of British pediatrics) introduced the concept of a Defect of Moral Character during a series of lectures to the Royal College of Physicians in the U.K. on ‘some abnormal psychical conditions in children,’ published later that year in The Lancet.“There is a defect of moral consciousness which cannot be accounted for by any fault of the environment.” He described 43 children who had serious problems with sustained attention and self-regulation, who were often aggressive, defiant, resistant to discipline, excessively emotional or passionate, showed little inhibitory volition, had serious problems with sustained attention and could not learn from the consequences of their actions, though their intellect was normal. Describing a 6 year old boy:
“…with marked moral defect, was unable to keep his attention even to a game for more than a very short time, and as might be expected, the failure of attention was very noticeable at school, with the result that in some cases the child was backward in school attainments, although in manner and ordinary conversation he appeared as bright and intelligent as any child could be.
Dr. Still proposed a biological predisposition to this behavioral condition that was probably hereditary in some children and the result of pre- or postnatal injury in others.
Following the 1917-1928 Encephalitis lethargica worldwide outbreaks and the 1919-1920 Influenza pandemic, the behavioral symptoms in many surviving children led to the speculation that there is a causal relationship between brain damage and behavior. Children often became:
“… hyperactive, distractible, irritable, antisocial, destructive, unruly, and unmanageable in school. They frequently disturbed the whole class and were regarded as quarrelsome and impulsive, often leaving the school building during class time without permission.” (Ross and Ross 1976 p.15).
This was called Postencephalitic Behavior Disorder or the Brain-Injured Child Syndrome.
1932 – Drs. Franz Kramer and Hans Pollnow described a Hyperkinetic Disease of Infancy. The most distinguishing characteristic was daytime motor restlessness, unlike the postencephalitic motor drive that also affected sleep. They also noted:
“…distractibility by new and intensive stimuli, inability to concentrate on difficult tasks, refusing to answer questions and appearing not to listen when spoken to directly.”
Noting that symptoms, especially motor restlessness, decline in intensity by age 7, they called it Hyperkinesis of Childhood.
1937 – Psychiatrist Charles Bradley administered Benzedrine sulfate, an amphetamine, to “problem” children at the Emma Pendleton Bradley Home in Providence, Rhode Island, in an attempt to alleviate headaches. However, Bradley noticed an unexpected effect upon the behavior of the children: improved school performance, social interactions, and emotional responses.
“The most striking change in behavior occurred in the school activities of many of these patients. There appeared a definite ‘drive’ to accomplish as much as possible. Fifteen of the 30 children responded to Benzedrine by becoming distinctly subdued in their emotional responses. Clinically in all cases, this was an improvement from the social viewpoint.”
This was probably the first documented use of stimulants in children with ADHD behaviors. Although an inadvertent side effect of treatment or headaches, Dr Charles Bradley saw noticeable improvement in behavior.
1930’s and 1940’s – Further research supported the idea of a causal connection between brain damage and ‘deviant’ behavior, referred to as Minimal Brain Damage.
1956 – Although scientists could not identify the biological mechanism, Dr. Bradley’s Benzedrine experiments created a scientific model for further research on stimulant drugs to treat hyperactivity. In 1956, psychiatrists began to prescribe Ritalin (methylphenidate, or MPH), a stimulant drug similar to Benzedrine with known benefits for children’s behavior and few side effects. PROTESTS THAT MPH IS UNTESTED?After more than 60 years? It may not be right for everyone, but it HAS been vetted.
1957 – Studies by Laufer et al addressed the possibility that children with the Hyperkinetic Impulse Disordermay not have brain damage, but rather a functional disturbance of the brain. So the idea that every child presenting with abnormal behavior had Minimal Brain Damage was disputed. (Birth of the neuro-atypical brain concept?)
1963 – The Oxford International Study Group of Child Neurology held a conference and stated that brain damage should not be inferred from problematic behavior signs alone. They advocated for a shift to the term Minimal Brain Dysfunction.I KIND OF BUY INTO THIS ONE– or maybe just Minimal (or Variable) Brain Difference or the Neuro-Atypical Brain!
1968 – Considering the term Minimal Brain Dysfunction as too general and heterogeneous, the term Hyperkinetic Impulse Disorder evolved into the diagnostic term (as defined in the Diagnostic and Statistical Manual published by the American Psychiatric Association) DSM-II: Hyperkinetic Reaction of Childhood– “The disorder is characterized by overactivity, restlessness, distractibility, and short attention span, especially in young children; the behavior usually diminishes by adolescence.” (1968, p.50)
1972 – Psychologist Virginia Douglas presented a paper to the Canadian Psychological Association, arguing that deficits in sustained attention and impulse control were more significant features of the disorder than hyperactivity, resulting in a change in the conceptualization of the Hyperkinetic Reaction of Childhood.
1980 – The disorder was given a new diagnostic label in DSM-III: Attention Deficit Disorder (ADD), with or without Hyperactivity. The three separate symptom lists were for inattention, impulsivity and hyperactivity, along with an explicit numerical cutoff score, specific guidelines for age of onset, duration of symptoms and a requirement of exclusion of other childhood psychiatric conditions. Note: This was a departure from the International Classification of Diseases (ICD-9) published by the World Health Organization, which continued to focus on hyperactivity as the primary indicator of the disorder.
1987 – The two subtypes were removed and the disorder was renamed, in DSM-IIIR: Attention Deficit Hyperactivity Disorder (ADHD), in an effort to further improve the criteria, in particular with respect to empirical validation (largely based on Russell Barkley’s concerns about qualitative similarities, or whether the two types had to be considered as two separate psychiatric disorders). The subtype “ADD without hyperactivity” was removed and assigned to a residual category named “undifferentiated ADD.”
1994 – Realizing that ADHD was not exclusively a childhood disorder, but a chronic, persistent disorder remaining into adulthood in many cases, and based on additional research, in DSM-IV: Attention Deficit Hyperactivity Disorder (ADHD)recognized the three subtypes of ADHD, along with the possibility of diagnosing a purely inattentive form of the disorder. The subtypes: Predominantly Inattentive Type, Predominantly Hyperactive-Impulsive Type and Combined Type, with symptoms of both. It also accredited the diagnosis of ADHD in adulthood by including examples of workplace difficulties in the depiction of symptoms. Note: There was now more similarity between definitions of the diagnosis with the International Classification of Diseases (ICD-10), although the ICD-10 was more demanding about cross-situational pervasiveness of symptoms.
2000 – A text revision, DSM-IV –TR, did not change the definition of ADHD, but was more descriptive of the symptoms.
2013 – DSM-5: Attention Deficit Hyperactivity Disorder (ADHD) now distinguishes ADHD as a ‘Neurodevelopmental Disorder.’ It is truly no longer solely a disorder of childhood, but one that reflects brain developmental issues throughout the life span. (See factsheet.)
There are still 18 primary symptoms divided into two major groupings: inattention and hyperactivity/impulsivity.
The subtypes have been replaced with presentation specifiers that correlate to the prior subtype. Presentation can change over a lifespan.
New descriptions are more age-appropriate (a child might run about or climb, an adolescent or adult might feel restless).
The age of onset has been raised from age 7 to 12, and now multiple symptoms are required to be present in more than one setting (home, school, work, social). Note: Future DSM’s may include Adult Onset ADHD.
The required number of symptoms for ages 17+ is reduced from 6 to 5 in either the inattentive or hyperactive/impulsive categories.
The DSM-5 recognizes that ADHD and autism spectrum disorder may coexist.
So that’s it… for now. I still do not like the term ‘Attention Deficit Hyperactivity Disorder.’ I relate more to ones like ‘Attention Surplus Disorder’ (Ned Hallowell) or ‘Information Processing Disorder‘ (I’ve heard this from several people, initially from the psychiatrist William Koch), or even ‘Behavioral Inhibition Disorder’* (I believe Russell Barkley coined this term),
*This theoretical model links inhibition to 4 executive neuropsychological functions: (a) working memory, (b) self-regulation of affect-motivation-arousal, (c) internalization of speech, and (d) reconstitution (behavioral analysis and synthesis). Extended to ADHD, Barkley especially see deficits in behavioral inhibition, working memory, regulation of motivation, and motor control in those with ADHD.
I believe there is a greater difference between subtypes (indicators) that will ultimately result in several different diagnoses. Nor should the importance of Executive Function challenges in ADD/ADHD be underrated. Dr. Thomas E Brown has been instrumental in supporting the relevance of Executive Functions and Emotions in relation to ADHD.
The DSM-listed diagnostic symptoms are not comprehensive by any means. The symptoms now mention organization, which is often a major problem. Still, there isn’t enough awareness of time and energy-related challenges… transitions… time blips… activation/procrastination… completion… hyperfocus (which is why I’ve been writing this for hours and ignoring the other things, like sleep, that are essential)… short term memory issues and future-blindness… and the overwhelming ADD ‘fog’…
I’ve been working with ADHD issues since 1989, and as a Productivity & ADHD coach/ consultant, professional organizer, ADDult and mom of a now-grown son with ADHD, I see patterns, and they differ within the umbrella ‘ADHD diagnosis.’ For instance, I don’t see any diagnostic symptoms having to do with decision-making. Yet, in general, many people with ‘ADD’ tend to be less decisive than someone with ‘ADHD’ (although making the right decision is another story, especially when impulsivity is involved!).
My work with clients primarily focuses on developing compensatory strategies for Executive Function (EF) challenges, which can include planning, prioritization, activation, time and project management, organization, sustaining focus and effort, utilizing working memory, self-awareness and acceptance, etc. There are many people with ADHD who haven’t been diagnosed because they think of ADHD in terms of an 8-year old boy running around in circles and disturbing their classmates – not the quiet daydreamer, the academically hi-achieving Ph.D. or the successful entrepreneur.
So the saga of the ADD / ADHD diagnosis continues to develop. It is clearly NOT a new or ‘made-up’ disorder. The ADHD brain is neuro-atypical and does operate differently. While under certain circumstances this can be beneficial (just check out the vast number of entrepreneurs, inventors, creatives, athletes, politicians, professionals and celebrities who have it), there are definite challenges that negatively affect performance, judgment, relationships and self-esteem.
The more we know about ADHD, its history, impact and treatments, the better the lives of those who have it and those who teach, love, live or work with them.