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Organizing ADHD Brain

Categories: 2012, August

Organizing the ADHD Brain

It’s All About Executive Functions


by Ari Tuckman, PsyD, MBA

Image“Where the *#%^ is that thing?”

THIS IS THE COMMON REFRAIN of those who struggle with disorganization. For many adults with ADHD, getting organized is a constant process that rarely seems to come together. They too often curse the piles when they are frantically looking for that crucial but missing item. In quieter moments, they may feel guilty about not attempting to restore some order to the chaos but just can’t bring themselves to make the investment even though they know they really should. Why is this all so hard? And shouldn’t getting burned a few (hundred) times provide ample motivation to whip those piles into shape once and for all?

To answer these questions, we need to understand the executive functions, our highest-level cognitive processes that help us navigate a complex world and create a better future for ourselves and the people we care about. The executive functions enable us to do what we know we should do. They exist in that gap between intentions and actions by shaping what, when, where, and how we do things. They enable us to bring all of our other talents and abilities to bear on the challenges that life throws at us.

Research has shown that people with ADHD have less reliable executive functions, so they are less consistent with doing the right thing at the right time, despite good intentions and good effort. This certainly applies to organizing, a task that requires strong executive functions. Creating and then maintaining an organizational system are actually pretty complex processes. First, you need to keep in mind everything that you need to organize and then mentally manipulate those objects to figure out good homes for them all. This system should take into account how often you need each item so that the most frequently used are most accessible. This takes a lot of working memory (one of the executive functions). Without it, things get stuck in places that don’t really work.

Once you’ve conceptualized your grand organizational system, you need to kick yourself into gear to put things away and then follow it through to the end, even when you’re tired of doing it (self-activation, another one of the executive functions). Of course, then you need to maintain this system, which means remembering where things are supposed to go as well as managing your time well enough that you have a little extra to clean up as you go. All in all, there’s a lot going on here, both when people with ADHD struggle as well as when they succeed.

Throughout this entire process, we continue to live our distraction-filled lives where new items and new demands keep coming. The world never stands still. It’s the executive functions that enable us to sort through all these competing stimuli so that we can put and keep our attention on what is most important in that moment. According to Russell Barkley’s response inhibition theory, in order to do this, we need to be able to stop the action and put a small pause between stimulus and response. That is, we need to be able to hold back a response to every new stimulus that hits our senses (especially the really interesting but usually less important distractions). Because people with ADHD have less of this ability to stop that quick response, their attention is pulled more easily away from the things that they ideally should be paying attention to. Unfortunately, this especially applies to a lot of organizing activities where the best thing to do in a given moment often loses out to some more enjoyable activity.

Make the most of your executive functions

Let’s take a look at how three of the executive functions affect your organizing activities, followed by some helpful strategies that work around each executive function weakness. The better you understand the executive functions, the better you understand ADHD—and the better position you will be in to create more effective habits.

WORKING MEMORY. Working memory is our most immediate form of memory. It takes in information from the world around us, pulls information from our long-term memories, and then processes it all together. Working memory stores what we are paying attention to. When we get distracted, it’s because some new stimulus or idea knocks the more important information out of our working memory and we forget what we were paying attention to. Therefore, people with stronger working memories tend to also have better control over their attention. Because people with ADHD tend to have weaker working memories compared to their overall intelligence, they are more easily distracted and forgetful.

This weaker working memory leads to numerous difficulties with organizing, starting with remembering all the relevant factors when creating an effective organizational system. Once people with ADHD have created a system, they may have trouble remembering where something was filed away, since information needs to pass through our attention/working memory before it can get transferred into long-term memory. They may also have difficulty remembering to return to a task after an interruption. Finally, they may struggle to remember multistep directions and accurately track where they are in the progression through those steps, such as when sorting through lots of different items and addressing each kind in turn.

Fortunately, because we know about how working memory functions (and where it is vulnerable to getting off-track), we can create strategies that will help you be more consistent:
  Image  Reduce distractions so there is less information competing for your working memory. For example, turn off the phone so you won’t interrupted, ask the kids to occupy themselves for a time, close the office door, etc. This is especially true when the task is more complicated and requires stronger attention. Relatively simple tasks that don’t require a lot of attention, like sorting magazines, may go more quickly with some lively music.
  Image  Do it right away. Try to get in the habit of doing things right away, rather than relying on your working memory to hold it—in other words, stop telling yourself, “I’ll do that in just a minute.”
  Image  Write a reminder. If you can’t do something right away, then at least capture the idea as a reminder so that your working memory doesn’t need to hold it.
  Image  Label things clearly. Use bright and easily readable labels which make it easy to find what you are looking for, rather than relying on your memory of where something is or goes.

PROSPECTIVE MEMORY.
Prospective memory is the ability to remember to remember. It is our mental to-do list that reminds us to do something at the right time and/or place. For example, “I need to call the bank at two o’clock,” or, “I need to look up that information when I get home.” Although written to-do lists are a requirement for most busy lives, we also need to rely on our mental to-do list for those million and one tasks that may not make it onto paper.

For adults with ADHD, those good intentions to do something too often fall through the cracks. This leaves them often scrambling to take care of those tasks that fell off of their radar screen before suddenly popping back on. Sometimes there is still time to do the task, sometimes there isn’t (for example, it’s no use calling the bank after five o’clock). One implication of often jumping to do something is that it doesn’t leave any time to wrap up the current task and put everything away, so partially completed tasks wind up accumulating.

As with working memory, by understanding how your prospective memory works, we can create organizing strategies that are more likely to be successful. For example:
  Image  In sight, in mind. Leaving something out as a reminder can be a great way to remind yourself to do something. For example, put the paperwork you need to fill out tomorrow on your chair before you leave the office. Of course, this only works if you don’t have too many other items that visually swallow up the reminder.
  Image  Put tasks and reminders into your calendar. It’s easier to keep your tasks organized if you put them into your schedule, rather than mentally reminding yourself to complete them. This includes tasks that don’t have a specific time, such as researching a new plumber, but keep slipping off the to-do list if they aren’t assigned a specific time.
  Image  Set an alarm. If you tend to get absorbed into an activity and lose track of time, set a quick alarm to let you know that it’s time to leave for a meeting, for example, or that it’s time to switch to a different activity. You may want to include a little extra time to put away the current project.

SELF-ACTIVATION. Doing the fun stuff is easy. It’s the boring stuff that takes mental effort to start and finish, which is why so many people with ADHD rely on procrastination to help them get going on the undesirable tasks. By contrast, self-activation is the ability to get ourselves going on something without a looming deadline. For many people with ADHD, the process of organizing, putting things away, and tying up loose ends requires more self-activation than they can easily muster. If they do start it, they may run out of steam or get distracted away, so things are left half-finished. Of course, the more chaotic things become, the more onerous and daunting it is to organize it all, so it gets pushed off even longer. So, bad goes to worse. If they do throw themselves into an organizing frenzy, they may not have time to really step back and create the most effective system or think about the best place to put things which makes it harder to find it the next time. In general, when someone is having trouble tackling too many demands on their time, the maintenance activities such as organizing are often the first to go.

All this suggests that certain strategies may help get you going with less white-knuckling:
  Image  Start smaller. If a task is too daunting, shrink it down until it feels doable. For example, if cleaning up your bedroom feels too overwhelming, then start by just throwing all the dirty clothes into the hamper. If you feel up to it, then tackle another piece, but at least this gets you over that initial hump.
  Image  Create mini-deadlines to get going earlier. Related to the prior strategy, break a larger project into several smaller steps, each with its own deadline. This way, even if you procrastinate, you will have a more manageable chunk to bite off so you are more likely to finish that piece on time.
  Image  Remind yourself of the rewards for finishing. Although wanting to avoid a punishment can indeed serve as a motivator, going toward a reward is much more effective. So for example, think, as vividly as possible, about how good it will feel to be able to find something easily after cleaning up your bedroom, rather than focusing on how boring it will be to do it.
  Image  Make a public commitment. Since all people like to feel that they are true to their word, telling someone else that you are going to do something by a particular time can add that extra little bit of motivation you need.

 


Work Around EF Weaknesses

For people with ADHD, weaknesses in working memory, prospective memory, and self-activation affect organizing activities. This article described helpful strategies that work around each executive function weakness and toward creating more effective habits.

ImageWorking memory
  Image  Reduce distractions so there is less information competing for your working memory.
  Image  Do it right away.
  Image  Write a reminder.
  Image  Label things clearly.


Prospective memory
  Image  In sight, in mind.
  Image  Put tasks and reminders into your calendar.
  Image  Set an alarm.


Self-activation
  Image  Start smaller.
  Image  Create mini-deadlines to get going earlier.
  Image  Remind yourself of the rewards for finishing.
  Image  Make a public commitment.

 


Ari Tuckman, PsyD, MBA is the author of Understand Your Brain, Get More Done: The ADHD Executive Functions Workbook (2012), More Attention, Less Deficit: Success Strategies for Adults with ADHD (2009) and Integrative Treatment for Adult ADHD: A Practical, Easy-to-Use Guide for Clinicians (2007). He is a psychologist in private practice in West Chester, Pennsylvania, specializing in the diagnosis and treatment of ADHD, as well as anxiety, depression, substance abuse, and school/work difficulties.

This article originally appeared in the August 2012 issue of Attention magazine. Copyright © 2012 by Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD). All rights reserved. No portion of this article may be reproduced without written permission from CHADD.

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