I Don’t Wanna!

I Don’t Wanna!

 

But I Don’t Feel Like it! …

I was all set to write my next blog post. Great Idea. Gives me joy to share information and helps me to stay in business so I can keep helping clients. I had the time blocked on my calendar for today… but I don’t feel like it! 

The funny/sad thing about “…But I don’t feel like it” – those six short words wield a mighty power, and it’s not for good. We think them frequently, or at least many of us do, yet they are the Destroyers of Productivity (and they don’t do much for self-esteem).

Today the conversation was about writing a blog, but it is a frequent flyer in my head. Here are some typical triggers that lead to this common refrain — I imagine they sound familiar to many of you.

  • I ought to go to the gym…
  • I should re-organize my closet…
  • I need to finish this…
  • I said I would…
  • It’s at the top of my ‘Action’ list…

…BUT I DON’T FEEL LIKE IT!

Just six words, but powerful enough to subvert our best intentions. The enemy of getting things done.

What to do?

I coach my clients on the benefits of reframing a ‘should… must… need to… or have to…’ into a ‘want to.’  Why? Because we’re all more inclined to do what we want. But even wanting to do something can lose traction when the ‘but I don’t feel like it’ button is pressed, and it gets pressed very easily – “I’m tired… I have too much to do…. I’m not sure how to… It’s too much work…  I just don’t wanna!”

These are powerful feelings. Strong enough to triumph over our already-compromised executive functioning capabilities. So, too often, we don’t take action and our temporary emotions/avoidance tendencies get top billing.

I don’t like giving in. Sometimes, sure. Being self-indulgent can be comforting, and there are times when eating an ice cream sundae or taking a nap should take precedence over staying on a diet or doing the laundry. But other times it feels like the nefarious power of ‘I don’t wanna’ is in charge, and even my best plans are unwilling hostages. So, here’s how to fight back.

  • Start from your reality. Step #1 of my 7-Step PowerPlan to Success™ (download for free from https://susanlasky.com) is Self-Awareness, which means acknowledging how you really feel. If you don’t feel like it, why deny the obvious? Step #2 is Self-Acceptance. You already know all those shoulds, oughts, musts, etc., and instead of fighting the way you feel or blaming yourself, accept your mood, so you’re not adding incendiary guilt to the challenge of taking action (…or not). Avoid the trap of SCDD – Self-Compassion Deficit Disorder!

 

  • Remind yourself that you have the power of choice. Step #3 is to Believe in Possibility – that we always have a choice. It’s easy to forget this when caught up in the moment. Still, despite the way you feel (or think), you can find strategies to do things differently, thus producing different results.

 

  • You can take action despite your thoughts and feelings. There is a powerful concept in psychology, including Morita Therapy, the Japanese psychology of Action, that focuses on our ability to take action regardless of the thoughts and feelings that will always get in the way. The trick is to acknowledge them, including the powerful “I don’t feel like it,’ then choose to ignore them… they don’t have to be in control, even though they seem to be. Start small. If you are reluctant to go to the gym, put on your sneakers and have everything you need in a bag by the door. I’ve had clients report back that wearing sneakers ‘magically’ helped them start moving. Worth trying!

 

  • Keep that action simple and immediate. If I think about writing a blog, it can be overwhelming. Overwhelm, especially for people with challenged executive functions or ADHD, causes stress. Our brain perceives this stress as danger, triggering the ‘fight, flight or freeze’ response. While designed to protect us, once released, we’re even less likely to get anything accomplished. So, recognizing I’ve shifted into avoidance mode, my next move isn’t to force things but to do something that will minimize stress and help me get to work. Maybe I’ll just write a few buzz words (Iike I did when I started this blog by writing, “But I don’t feel like it…”). Maybe I’ll get inspired and continue, or perhaps I won’t, but I’ve done something!

 

  • Consider what is actually getting in the way. This may be a waste of time (we don’t know what we don’t know!), but occasionally there’s increased clarity that enables moving forward when you explore why “I don’t wanna.” The kneejerk response “But I don’t feel like it” may be a reaction to a concern that, when acknowledged, can be remedied. Perhaps your reluctance to do something might be because you aren’t sure how to get it done. Maybe you first need to do some research or create a Project sheet and break it down into small, do-able tasks. Maybe you need to ask for help. Or maybe you just have too many things to do and haven’t prioritized. Remember, The Two Magic Words for Productivity: Clarity and Priority. (This is the title of another blog post on my website.)

 

  • Look for the options. Sometimes, exploring what is really getting in the way gives options that boost action.

    • You might be reluctant to even begin straightening up your office because you think it will take most of the day. OK, how can you power up that action switch? Start by setting an alarm, then put on dance music and work for just 50 minutes. Who knows, you may even complete the job in that time, or at least make good progress.
        
    • Or maybe you don’t want to organize your very messy clothes closet. When you explore the ‘why’ it becomes clear that part of your avoidance is frustration due to a lack of space. So, the project shifts to reviewing your clothing with an eye towards donating. As organizing guru Barbara Hemphill says, “You can’t organize clutter.” First, declutter, then you’ll find it easier to organize.

 

  • Look for the motivators. What will encourage activation?

    • It is easier to spend time working on your closet if you have a friend hanging out offering encouragement (external motivation and redirection toward the goal).

    • It also helps to understand that people with ADHD are rarely driven by the common motivators of importance, consequences or rewards (unless they are immediate). But if something is interesting or novel, we’re more likely to WANT to pursue it. I know it’s easier for me to unload the dishwasher (boring and repetitive) if I make it a game to get it done quickly: Beat the TV Commercial. I recently discussed this concept with a client, and she decided the best way to clean her kitchen after dinner is to make having her favorite dessert dependent upon having a cleared counter and sink. The yummy dessert (an immediate reward) was enough of a motivator to make her want to do it. 

So, how did I manage to write this blog, despite my immediate reaction of “But I don’t feel like it!”

  • I started by acknowledging my reluctance, making a bargain with myself that I’d put in the effort for just 30 minutes. (Usually, once I begin, I easily keep going, but it takes a lot to turn on the ignition to activate my engine.)

  • I decided to switch my environment (a very helpful strategy). Many of my clients find they are more productive if they work in a coffee shop, library, or co-working space – even changing rooms can help. I chose to sit outside and enjoy a gorgeous day (studies show that being in nature has a way of resetting/ recharging the brain, so there’s another boost). Note: This blog was originally published during warm weather, pre-pandemic.

  • My small, portable bluetooth speaker played perfect background music at low volume from my playlist (for me, wearing earbuds or earphones would have made the music my primary brain focus and been distracting, rather than enhancing).
     
  • I filled a thermos cup with a tasty drink (self-care). No, it wasn’t wine – not a bad idea, but I was tired and would have drifted off target.

  • I took along my favorite pen and a pad with smooth, thick conducive-to-writing paper (sometimes writing by hand is more inspirational than keyboarding).
     
  • I set a clear intention and decided to put everything else on hold while I wrote. While I had my phone with me, I turned off alerts and kept it out of sight to avoid temptation. (Although yes, I still checked it periodically, sigh…)

  • I then began by writing those six powerful words, “…But I don’t feel like it.” 

There are many ways to overcome these Six Powerful Words. Let’s continue this conversation with your comments on my blog, www.SusanLasky/i-dont-wanna. What are some ideas that work for you?

Just How Difficult is it to have ADHD?

Just How Difficult is it to have ADHD?

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 depends on whether you’ve been able to create a personally ADHD-friendly life!

This is an edited and expanded version of my requested response
to a question posted on Quora.

Set Yourself Up for SUCCESS

Set Yourself Up for SUCCESS

I have mixed feelings about the New Year. 
I can fantasize that my deepest desires will materialize this year. I can feel in control, as I haven’t yet failed to accomplish my goals, nor have I disappointed myself (or anyone else). But I will… Fortunately, I will also succeed at a lot of things, and it is important that I acknowledge my successes, because…

We’re really good at reinforcing our perceived failures.
Sometimes it seems that most of our thinking involves berating ourselves for what we haven’t done, or feeling anxious about what we need, or want, to accomplish. It’s rare that we congratulate ourselves. Even here, in the opening paragraph, I debated whether I should write that I’ll succeed at ‘a lot’ of things, or scale it down to succeeding at just ‘some’ things.

It is important to be self-aware (Step #1 in my 7-Step PowerPlan to Success™), and that means realistically recognizing our strengths, along with our challenges. To do this we can’t listen to our inner Judgmental Critic that constantly tells us we aren’t ‘good enough.’

So how can we set ourselves up for real success?

  1. Accept yourself for who you are. (#2 in the 7-Steps) Take a neutral position – “Yep, I do some good stuff but I’m also good at screwing things up.” The year will have its ups, but also downs. You can’t have good without bad, success without failure, or there is no discernible distinction. So stop beating yourself up for your challenges, and work from your strengths. Expect a roller coaster approach to success, and shoot for improvement, not perfection!
  2. Appreciate micro change. Focus on making small changes that eventually add up, instead of going for the big ones that may never happen. Commit to losing 5 pounds, not 50 (do-able, rather than intimidating or frustrating and thus easily avoided). Clear one drawer or file, instead of feeling you have to rearrange the entire room or file cabinet (so you don’t even start the clean-out). Get that done and you can go for more. Write 15 minutes a day, instead of waiting for that rare combination of available time and energy to spit out your masterpiece. This is the premise of the TUIT Project, my online Action/Accountability group – join us for the next session, beginning January 3rd, www.OvercomeOverwhelm.com.
  3. Get excited by progress, not perfection. Congratulate yourself on your baby-steps. Feel good that you made dinner, even if it was food-assembly of a store-bought roasted chicken and frozen veggies and not a cookbook classic… or that you managed a 10-minute walk, if not the 50-minute work-out… or you organized your tax-related receipts, even if you’ve yet to file from last year. We don’t give ourselves enough credit for the things we do – especially considering how difficult it is to do things that don’t trigger our ‘I wanna’ brains.
  4. Prepare. Make life less confusing by setting aside time for weekly and daily Planning (vs. Doing) sessions… track events on a calendar and use alarm reminders… create project sheets to break down projects into do-able tasks… have the right tools and information on hand so jobs go quicker… know exactly what it is you want to accomplish so you don’t drift… practice difficult conversations so you get your point across in a win-win way… acknowledge when you need help and get it. (Click here to schedule a free initial Coaching Conversation with me.)
  5. Put on the blinders. There will always be more to do. If we let it all in at once, it can be paralyzing. So focus on what you can (or choose) to do at a given time, ignore the rest and save yourself unnecessary and defeatist guilt-trips.
  6. Honor your needs and desires. Get enough sleep. Take time to eat right and be active. Chill out in front of the TV, with a book or video game. Enjoy a hobby. Make time for vacations. Play with your pets. Spend fun time with friends and family.You’ll have less time to accomplish work, but more time for a successful, satisfying life!

Yes, it’s about to be a New Year. Take advantage of this major calendar holiday as an incentive to think about what you really want, then set a realistic (for YOU) plan for making progress towards your goals. Remember to stay grateful for what you have and appreciative of who you are. Give yourself credit for even tiny steps – success breeds success!

Some people consider their birthday as the start of a New Year. The Jewish New Year is usually in September or October, and the Chinese New Year is celebrated in late January or February. But isn’t every day the beginning of a new year? This means we can hit reset and get a fresh start at any time. Good to know!

On a personal note, I am so grateful for those of you I know as clients and friends, and I’m full of caring and compassion for all of my readers. I understand how challenging life can be, and I’m in awe of, and inspired by, your efforts. 

Thank you for being part of our community!

ADHD: It is REAL – Check Out 240+ Years of History

ADHD: It is REAL – Check Out 240+ Years of History

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 childWHY 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.

When It Is Tough to Get Going – Proven Strategies to Get Things Done

When It Is Tough to Get Going – Proven Strategies to Get Things Done

Frustrated by the gap between knowing what you should/want/need to get done and the reality of what you are actually accomplishing? For many people, this is a chronic struggle – especially those with ADD/ADHD/EF (executive function) challenges, myself included! Even when we are at the top of our game there’s still a backlog that can approach critical mass. Do you wonder what the top of your game would be if you could be more Nike™-like and ‘Just Do It.’ Fortunately, there ARE strategies that help, and here are a few:

Begin with Clarity Know exactly what you plan to do AND why you want to do it. Maybe it’s because you need to get something done, but by phrasing it as something you want (even if the reason is to keep your job, pass a course or stay on speaking terms with your partner), it becomes your CHOICE, and our motivational circuits work a lot better when we choose to do something. So convert your ‘have-to’s’ ‘must-do’s’ and ‘need-to’s’ to ‘WANT-TO’s.’

Confusion by Susan Lasky

Think ‘Task’ NOT ‘Project’ – Often, what we want to do is too big to accomplish in a single sitting, leading to a feeling of overwhelm. For many of us, overwhelm is a trigger to shutting down and doing less, rather than ‘attacking’ the project to successfully accomplish it. Our brain perceives the situation as threatening, and shifts into the protective ‘fight, flight or freeze’ mode, which doesn’t help with getting things done.

Avoid overwhelm by identifying the PROJECT (it might be to redo the files, create a newsletter, plan a vacation, organize the closet, write the thesis, ‘do’ the taxes). Whatever it is, break it down into the multiple small steps (TASKS) that are needed to complete the project.

The first task of any project is to create a written Project Sheet that specifies everything you’ll need to get it done, from resources needed (information, people, money, tools) to a step-by-step breakdown of each action, with approximations of the time you’ll need for each step – then double it (or more). Reinforce the steps by writing them down and saying them out loud. Keep the Project Sheet where you can easily refer back to it. (Think weekly and daily planning/review sessions, which take time but totally save you hours!)

Set a Conscious Intention (Commitment) – Once you are clear about WHAT you will do, decide WHEN you’ll get it done – PRIORITIZE. Put each step in your calendar or planner as a Task-Appointment, which is an appointment with yourself to work on a specific task at a specific time.

Saying ‘yes’ without saying ‘when’ is a typical precursor to not getting things done. Consider posting a reminder with the specific task you have prioritized, in a place that will draw your attention back to it when it begins to wander (and accept that it will wander!). You might want to expand your declared focus to prioritize an entire day or a week, “This week I will finish …” This doesn’t mean you won’t do other things, but it helps to swing you back to your key priority when your attention drifts or your interest wanes.

Make it Do-Able – It often helps to set a timer for a short amount of time so you don’t feel ‘trapped.’ It is easier to start something if you know you only have to stay focused on it for 20 minutes (or 15… or 10!). If you don’t complete the task within the time you’ve allotted, that’s okay. Congratulate yourself for having done what you said you would, then set additional Task-Appointments to finish what you’ve successfully begun. Take breaks between scheduled appointments. Some people find background music makes it easier to stay focused (volume and genre do matter!).

Minimize Distractions – Put on your blinders and resist temptation by making it less intrusive. Turn off email notifications, and even the phone if possible. Put a sign on your door that you will be available at 3:30 (or whenever), to minimize interruptions. Use a chalk or white board so visitors can leave messages. Give yourself permission to let go of the guilt from the other projects that need your attention, so you can successfully focus on one at a time. (I’m a brilliant multi-tasker, as long as I only work on one task at a time!)

We can’t quite turn off our brain (although a few minutes of mindful focus before you begin the work can help), so keep a ‘parking lot’ handy – a place to write down the thoughts that pop up and can compromise your focus. You don’t want to forget to make that call, send an email, pick up the dry cleaning, order a replacement phone charger, etc., and these are the things that will often pop into your mind while doing something else. You will think about it, so capture these thoughts in writing or tell it to Siri, OK Google, Alexa or your phone companion. Then you don’t need to shift your attention away from your project in order to remember to do it.

Start Small – When you are REALLY stuck, just open the notebook or computer file and look at the page or screen. Then put your pen to paper or fingers to keypad. They may start moving of their own volition. If not, commit to writing just one sentence, which often opens the gateway to moving forward. Or pull out a folder and skim the papers. Or make a list of what you think you should be doing. It’s the ACTIVATION that’s so difficult. Sometimes, all it takes is a minimal start to trigger our brains to become involved with something we’ve been avoiding. And remember how good it feels to get something done!

Take Breaks & Make Time for Self-Care – Avoid ‘overbooking.’ Often, less IS more. Leave ‘white space’ in your day. Especially when you have things to do in the evening or over the weekend. Leave time between Task-Appointments (if you work for 20 minutes, take a 5-10 minute break, then a longer break every two hours or so). Get up and MOVE (keeps the energy flowing). This is easy to forget when in hyper-focus mode, where we can work for hours on something because we are so caught up in it. Try to remember the law of diminishing returns (and ask yourself what is not getting done that is also important.

Take care of yourself! SELF-CARE is often the first thing to go when we feel there is too much to do.

Stop and Smell the Flowers by Susan Lasky

Yet self-care provides the physical AND mental energy to accomplish more. Think about it – how much more cognitively alert and productive are you after a good night’s SLEEP? Multiple studies are showing that our body and brain use sleep as a time to recharge, including eliminating toxins, so it isn’t, as many feel, a ‘necessary evil,’ but part of the productive process.

We know that EXERCISE boosts our body chemistry so we are more functional (and ofter a lot less ‘hyper’ or ‘antsy’). So fit some version of it into your schedule (again, less is often more if it means you’ll actually do it – sometimes our exercise goals may be somewhat unrealistic). DRINK a lot of water (hydrate). SNACK on fruit or have a protein shake. A quick NAP or MEDITATION can be super-restorative.  Science is proving that time spent OUTSIDE in greenery can dramatically enhance our mood. (The Japanese even have a concept for this called ‘Forest Bathing.’) Yet when we feel ‘behind,’ as is so typical, we deny ourselves these self-care actions that boost our brain chemistry and pay us back with increased focus and productivity.

We NEED and DESERVE to ENJOY ourselves. Take a break to play with your kids or your dog (laughter totally energizes). Pet the cat and let the purring calm your brainwaves. Allow yourself time to garden, paint, create music or anything that comforts your soul. Have lunch with friends or make some private time with your partner, and you’ll usually get MORE done – and feel less deprived or annoyed by having to do the work in the first place!

Accountability Helps – Don’t try to go it alone. Report your progress to a non-judgmental accountability-partner, whether a friend, family member or coach, or consider joining an Accountability Group. (Check out my Get Around TUIT online action group at www.OvercomeOverwhelm.com)

Here’s an accountability strategy that is especially appealing to the tech-savvy. I ask some of my coaching clients to take a photo of their progress and text it to me. It might be a completed page in their planner, homework assignment or business plan, an organized desktop, newly labeled files or an emptied suitcase from last month’s trip – whatever supports their intention at the end of our last coaching session. If they said they would join a study group, go to the library or attend a networking event, I ask for an on-location ‘selfie.’ The photo is fun, helps them to feel more motivated and gives ‘instant’ feedback as to a job well done – not from me, but from their camera 🙂 It is a testament to their success! You can use this accountability strategy with yourself or a friend.

Commit to a Daily Action Plan, which is different than your 50-page ‘To-Do’ list. It has space for just your 3 primary actions and, if you finish those, 3 secondary activities. If you want to check out my Daily Focus form, you can download it here.

Be a Detective – The best strategies may not work for you, or may work for only a short time (so frustrating, but that’s reality). It is okay to acknowledge you are stuck. Maybe you need new tools, techniques or strategies, or just to tweak the ones you’ve been using. Perhaps you would benefit from a greater understanding of how to do something – a workable office requires an understanding of functional organization, and systems that work with the way YOU think – especially for those of us who are ‘out of sight, out of mind’ thinkers. Maybe you’ve been struggling with writing papers because you never really mastered the process from a technical perspective (organization, time and project management and keeping a check on perfectionism!). Perhaps you would benefit from a better system for managing your emails or running meetings.

So now, imagine that you’re solving your problem, but for a friend or colleague. When we take the emotional component out of the equation, it’s often easier to come up with a workable solution. Things can be different, but how to effect successful change? (Step #3 in my PowerPlan to Success: Believe in Possibility, and that you always have a Choice.) Sometimes we just don’t know what we don’t know, and help is needed.

You may benefit from hands-on advice, situational coaching, or exploring the underlying causes that create or compound your challenges. These can include emotional issues, physical problems, learning disabilities, and executive function or attention disorders that can get in the way of success (and here you wasted so much energy blaming yourself for lack of willpower!). Perhaps you struggle with perfectionism, are overly self-critical, feel the work you do isn’t ‘good enough,’ or subconsciously sabotage your success. Remember that it shows strength to work with a consultant, organizer, tutor, coach or therapist to get at the roots of these chronic challenges.

Be Kind to Yourself … Please!!! That’s the most important thing I can leave you with. Studies show that the more you accept yourself, the more productive – and happier – you’ll be!

I’m curious. What do YOU find helps to get things done?

Want to know more?