A New Way to Help Change Your Behavior

May 1, 2010

David told me he needed help getting things done on time, but when I started talking with him about how he managed the details of his life, he stopped talking about changing and started talking about how he had always been late and would never change.

“I always say I will get a project done early, but I never have. I always just end up feeling like such a loser and then I do it again the same way next time. I can’t change.”

Ron came into our first meeting and said his wife was about to leave him because he was never on time.

“I promise to be home before the kids are in bed, but then I just get caught in a project at work and it’s 9:00 PM before I get home. I’ve tried everything, but I’m just not going to change.”

Sheila and Ted were referred by Ted’s doctor for couple’s coaching. When I asked, “What would your life look like if it suddenly improved?” Sheila’s frustration just burst forth.

“He keeps telling me that he’ll do better, but it’s been fifteen years and he still never gets anywhere on time. Am I supposed to act like that’s normal?”

Ted looked up sheepishly and reported, “I feel terrible and I know I’m impossible to live with, but no matter what I try it doesn’t work. I’m just a mess; what can I do?”

Each of these clients ended up making changes that made life easier for them and for their spouses and work colleagues. And where did I suggest they start? By forgiving themselves.

A study by M. Wohl et al, detailed in a paper entitled, “I Forgive Myself, Now I Can Study: How Forgiveness for Procrastinating Can Reduce Future Procrastinating,” gives some interesting evidence that forgiving yourself for messing up can help free you to give a better effort at trying again.

In my practice I’ve seen that an increased ability to implement a new approach, along with an effective technique and the support of an understanding ally can make a huge difference. I encourage my clients to pay close attention to the fact we’re talking about forgiving themselves. And while it may be helpful for their spouse to forgive them, it’s the self-forgiveness and then a sincere new effort that is key.

Did you know that old dogs can learn new tricks? And people of all ages can and do learn new ways to act in their lives, especially if they can forgive themselves for past mistakes.

Give a call if I can help, 978-446-9600.

Jay Livingston

ADHD and Sleep

March 21, 2010

Children and adults with AD/HD may frequently experience problems with sleep. You may know this all too well in your family. Many people have difficultly falling asleep while others nod off easily, but then wake frequently during the night. Unfortunately the resulting lack of sleep exacerbates the primary AD/HD problems with attention, concentration, and impulsiveness.

Phase delayed sleep is the most common sleep disorder that accompanies AD/HD. Phase delayed sleep disorder is a fancy way to say the person goes to bed too late and then has trouble getting up in the morning. The hypothalamus in our brains helps to regulate sleep/wake cycles and is basically malfunctioning in an individual with phase delayed sleep.

Is your family short on rest? Try good sleep hygiene including consistent sleep/wake times and creating comfort around your bedtime routine. Reduce energizing activities a few hours before going to bed. Leave the shades open so sunlight shines through early in the morning; light tells the brain it is time to get up!

When behavioral strategies fail, consider over the counter remedies such as melatonin or valerian root. These are natural supplements that help induce sleep and have some clinical research studies to support their benefits and safe use.

You may also want to talk to your doctor about medication. There are newer non-addicting sleep medications such as lunesta and rozerem that have been FDA approved for chronic use in adults and other medication options for children with sleep issues. In our practice I do prescribe sleep medications temporarily to assist patients in getting on a good sleep schedule. Once sleep is well regulated, we recommend weaning off the medication and using behavioral strategies to continue getting your zzzz’s.

Have a restful night!

Theresa Cerulli, M.D.

One Approach to Procrastination

February 26, 2010

If you tend to procrastinate until a deadline is on top of you and forcing you to get things done, and you know this is hurting the quality of your work, causing stress to you and probably to your clients, boss or family, then how do you stop procrastinating about dealing with your procrastination?

This might be a fun puzzle if it weren’t so crucial that you find a way to get started changing your approach. One of the common side effects of procrastination is that people in your life lose trust in you and get angry. As you well know, this is usually matched by your own anger at yourself. But this pressure usually doesn’t translate into motivation to get started.

If life were a sport and you were critiquing yourself for missing critical shots because you didn’t keep your eye on the ball, I’d be pointing out that your focus on past mistakes is taking your attention away from the current situation, taking your “eye” off the ball again. Drop the self-critique, get a bit of help with your technique and try again.

The best hitters in baseball look for, and can see, the stitching on the ball as it comes at them at up to a hundred miles an hour. They know that they need to look for this detail to pull their attention to the ball; just looking in the direction of the ball doesn’t allow them to see the tiny changes in directions that they need to see in order to connect with the pitch. Golfers watch the dimples on the ball as it sits on the tee.

To get started on a project, focus on the details of getting started. What project will you start? Schedule it in your calendar. What small, discreet aspect of the project will you do? Define it and plan on doing just that much. What exactly will your next action on the project be? Write it out very simply as a task.

Think about teeing up the project – choose which one you’re going to work on.  Keep your head down, your eye on the ball and hit it just well enough to move it down the course and keep it in the fairway – do a small piece of it.  Now you’re ready for the next shot – concentrate on the new swing no matter whether you’re in the rough or on the course.

For you baseball fans, what you’re looking for is a single, not a home run; don’t over reach. Just connect with the pitch. Basketball aficionados, take one step and move the ball down the court. Every foot closer to the basket increases the odds of a score. Tennis players, make a solid smooth hit and get the ball across the net and into the court. Now set up for the next shot.

What do you need to get done? Right now schedule a time to work on it, and resolve to treat it like an important meeting. What is the first little step to getting the project started or moving it ahead? Write it down on your task list.

Procrastination can be head faked that easily.

Contact Jay Livingston

Couples Coaching

January 21, 2010

What is “Couples Coaching”?

Many of my clients who have ADD have exasperated spouses who are upset with them about starting too many projects and finishing too few, interrupting mid sentence, being late, losing keys, cell phone, etc.… I’m sure you can add to this list.

When I suggest the option of couple’s coaching to them, they’re surprised. Couple’s coaching is a relatively new offering for couples struggling with the affects of ADD or ADHD in the family. Couples’ coaching has similarities to, but is quite different from couples counseling, marriage counseling, and psychotherapy.

A traditional coach will work with you or your spouse. A couple’s coach works with you and your spouse. This person is not a life coach, and may or may not be an ADD implementation coach. Couples’ coaches that I recommend have a deep knowledge of relationships, ADD and ADHD, and some training in family work.

Many issues that couples contend with are completely unrelated to ADD. Expectations, communication styles, different ways of figuring things out, needs for intimacy and connection, and money can all create challenges to smooth and comfortable relating. Then there are the ADD-related issues like disorganization, losing focus, clutter, a different sense of time, starting and not completing tasks, impulsive communication and/or decision making… You get the idea.

Partners (non-ADD or less ADD) may contact the coach because they are frustrated or annoyed. People struggling with ADD symptoms may also initiate the call because they really want to please their partners, are trying very hard to make things work better, don’t want to have conflicts, and want to make positive lasting changes.

Coaching can be helpful for both newlyweds and couples who have been together 25 (or 45) years.

At Cerulli and Associates, we have a variety of professionals, including a couple’s coach; Jay Livingston does executive coaching and ADHD coaching, alongside his skillful couples coaching. He and I work closely, sometimes seeing couples together. I’ve found this blending of skills and approaches to work really well for certain couples.


On Second Thought…

January 14, 2010

Some interesting research shows that on first impulse we usually tend to overrate but occasionally underrate our abilities, and it’s only after a moment’s reflection, in which our brain gets a chance to bring its full cognitive capabilities to the evaluation, that we estimate our skills accurately.

You’ve probably heard of the study where almost all drivers rated their driving as better than most other drivers, a clearly unrealistic self-evaluation. Although I’m pretty sure my skills do put me in the top tier of drivers.

Clearly, we sometimes don’t do a good job of evaluating ourselves.

When studies ask self-evaluation questions a second time, after a moment’s pause, the answers are a more realistic assessment. How good are you at estimating time? “Excellent?” How excellent? “Oh, the “pretty ok when I’m paying attention” kind of excellent.”

This information may be particularly important for those with ADHD who have a tendency toward impulsiveness and over-optimistic projections. Think of quickly answering a question about when you will be home with “Half an hour!” After a minute of slowing down and working it out, you might agree that the most likely correct answer would be an hour or more.

By waiting you’ve allowed yourself time to tap into your ability to compute details and mathematically figure out answer to questions, and you’ve allowed your intuitive side time to process unconscious information and experiences you have stored.

“Can you take on this new project?” If you answer “Sure!” without a pause to allow realistic concerns to bubble up, you’re trying to function at your best by using only part of your ability. It is clearly in our long-term interest to pause long enough to give our brains time to bring their full potential to bear on our response.

I’d suggest you pause, breathe, say, “Let me check my schedule and task list.” Do anything to allow your full intelligence and experience time to evaluate your answer.

Jay Livingston

Releasing Toxic Shame

December 21, 2009

“To feel shame is to feel seen in an exposed and diminished way. …you turn your eyes inward, watching and scrutinizing every minute detail of behavior. This internal critical observation is excruciating.”                                                                                                                                     John Bradshaw

There is perhaps no human emotion more paralyzing than shame, greater even than fear itself. Unfortunately, many of the people who walk into my office are consumed with an overwhelming sense of personal shame. The reasons are as varied as the people themselves.
• I have not succeeded in school because I am too lazy.
• I was victimized as a child and I believe I should have done something to stop it from happening.
• I gamble because it’s the only way I can imagine finding financial freedom, but when I lose, it only makes things worse.
• I don’t speak to my wife the way I should.
• I don’t trust other people.

For one such shame-filled client, I put a sign up in my office which reads:
Attention: You have just entered a shame-free zone
The wording of this sign is purposeful since I believe that therapeutic progress cannot be made if one is mired in that sense of shame. The coat of shame needs to be taken off and left at the door before the real work can be done.
It is important to define the type of shame I am referring to. When we mess up, whether it’s joking with someone in an insensitive manner, or something more egregious, embarrassment assists us in the process of recognizing our mistakes, taking responsibility for them and then making amends for our transgressions. Shame, on the other hand, is a toxic belief that we are unworthy, loveless or unredeemable. “Toxic shame feels much worse than guilt. With guilt, you’ve done something wrong; but you can repair that – you can do something about it. With toxic shame there’s something wrong with you and there’s nothing you can do about it; you are inadequate and defective.”                                                                                                                                                                                                               (Leo Booth/John Bradshaw)

Toxic shame seems to condemn us to an existence of self-loathing, endless emotional pain or existing in a state of numbness to the world around us. Shame anesthetizes us to the possibilities of growth and relationship with others. Shame binds us and holds us captive, no different than a prison cell. It is the toxic shame that we need to recognize as destructive and unhelpful if we ever hope to find peace and connection.
There is always a reason why we do the things we do. The fact that we blame ourselves or see ourselves as defective is a construct that most often other people gave us. Take my examples above.
• I have not succeeded in school because I am too lazy.
o If, like many of my clients you have ADHD, you weren’t organically designed to be immediately successful in a classroom. If teachers and parents keep telling you that you just need to work a little harder, what option did you have other than to blame yourself and feel shame?
• I was victimized as a child and I believe I should have done something to stop it from happening.
o This is common reaction of children who have been abused. Adults have the power. It is their responsibility to keep a child safe; not the child’s, and yet most victims take on the burden of trying to figure out how they could have prevented the abuse.
• I gamble because it’s the only way I can imagine finding financial freedom, but when I lose, it only makes things worse.
o When we find ourselves in this type of financial bind, it is easy to understand how desperation drives us toward unlikely hopes about how we can be delivered from our anxiety and fear. Most people don’t confront overwhelming challenges with rational thoughts. And while it is normal to wish financial woes away by gambling, it virtually never works. These are times to ask others for help and ideas about how to move forward to resolve the dilemmas.
• I don’t speak to my wife the way I should.
o While there are many reasons why this may be true, there is usually some environmental factor which fuels this difficulty. If we lacked role models, for example, on how to speak with a spouse, or we struggle with a low self-appraisal, intimate communication with others is never easy.
• I don’t trust other people.
o Trust is something we learn from our parents and other important people in our early years. If adults proved to be untrustworthy, why would we trust anyone? In my experience, most individuals with this type of history have a “wish/fear” related to intimate connections with others. They both long for intimacy and, given the dominant, fearful expectations held tightly within, they reject it. The promise of intimacy and unconditional love is experienced as nothing more than a shallow or empty gesture. The recipient of such an offering, in order to keep themselves safe from the harm of disappointment, believes that they must reject the overture and assume it is not real. They remain “safe” but alone, isolated and shame-filled that they cannot obtain that which they crave.

All of these situations involve people who are simply doing what they were programmed to do, or are responding to painful situations the way most of us would. Why then, is it appropriate to feel guilt and shame for doing what makes sense? I don’t like it when I see people misunderstand their capabilities, or blame themselves for being victimized, or utilizing flawed strategies to make things better, or keeping a distance between themselves and others, but I understand it. I don’t judge it, rather, I attempt to help those “afflicted” with shame understand where it came from and how to put it down! If there is “fault” to be assessed, usually the fault sits with someone or something else. And when people are caught up in shame and guilt, they almost always fall back on the very behaviors and attitudes that keep them in distress or alone.

Once freed from the shame, individuals can then utilize all of their cognitive energies to managing their lives more effectively. No one deserves to sit with crippling and paralyzing shame. Shame doesn’t move people forward, it merely keeps them held back from experiencing life in its fullest form. While we all need to learn from our mistakes, we all too deserve to live an existence free of toxic shame.

Walter Sherburne, LICSW
68 Park Street
Andover, MA 01810

Moving and Fidgeting

December 6, 2009

I was watching a video piece about a stand-up, school-room desk and was pleased to see an accessory it features, a foot swing. Let me back up.

I find myself more and more interested in stand-up desks as a way to counteract the effects of sitting long hours. When I get time to reply to emails or work at my computer, it feels like a great time to be on my feet, moving and maybe even burning a few calories.

So, as I have been perusing the web exploring stand-up desk options. I discovered a company that makes stand-up desks for students that has a “U” shaped metal rod to rest a foot on, and the rod swings. The kids report that it helps them manage their energy and even stay out of trouble – sometimes. I love the idea and have always provided something similar for my clients, many of whom have ADHD.

Every chair in my therapy room has at least one fidget object near it, soft stress balls, clear plastic magic wands with floating confetti inside, coasters, pillows and foot rests are the current selection. Clients find wonderful things to do with these items as they work off enough energy to sit and talk with me. The balls are constantly flying from hand to hand or being thrown in the air and caught one-handed in a continual game of catch, squeezed to a pulp.

The magic wands get twirled between fingers, rolled between hands, stared at with hypnotic attention as the confetti floats languidly down only to have the wand flipped on its end sending the confetti floating down once more, or beat like a drum stick, with an occasionally desperate rhythm, against clients’ legs.

Pillows get hugged, folded, punched and prodded. Coasters are slid, balanced on end, tossed and tapped. Foot rests are pushed and pulled. An observer of my sessions would be hard pressed to find a moment of complete inactivity during the 60 to 90 minute sessions.

One client told me that he knew I understood ADHD the minute he saw the “toys.”

Szifra (Shifra) Birke

Contact me


October 19, 2009

Coaching has three distinct steps:

·         Learn how to address a topic or issue you want to change

·         Implement an effective approach or solution

·         Keep at it through the ups and downs of your life

Using a system even when things are going well, or making adjustments in routines so that you don’t fall behind again is one of the major challenges to managing responsibilities more effectively. For many high-energy, bright, creative people routines can quickly become boring and our attention will drift to the next new or interesting project.

I find it tricky to help clients understand they need to stick with the coaching process until they have practiced pulling themselves out of a backslide toward chaos. When coaching has helped get things going better, and there is room to breathe again, it can feel discouraging to contemplate the next failure, but inevitably the pressures will build; you will drop your adherence to the systems that you learned; and pretty soon you will need to stop yourself and re-start the process. Done early, a restart can quickly get things back on track.

Each year sports teams start their season practices with conditioning (most players have let it slide during the off season) and practice of the basics (both to reestablish high quality patterns and responses and to build player skills to a higher level.) Musicians regularly play scales slowly and deliberately so that they can listen and improve the fundamentals their creative music depends on. Those of us that lead complex lives need to practice the fundamental skills that help keep us focused during times of pressure, skills that encourage us to quickly work our way back into proven routines.

You can always call your coach to remind you of what to do when things start coming apart, but your coach should also be helping you develop the ability to become self-correcting. Only with practice will you see a pile of papers that has grown too big and say, “I need to do a quick sort of this pile, but I have to be careful not to get too involved. I’ll set a timer for 15 minutes and try to make one pass through it.”

When a project is late you will stop for a minute and say, “Have I scheduled time in my book to work on this? What is the next small action to take to get started?” Or you will recognize that you don’t feel pressure yet, no one is upset at you – yet, and you will practice the techniques you learned to generate some of your own sense of urgency so that you get motivated to get to work.

Becoming self-correcting is a huge step toward successful self-regulation; be sure it’s on your agenda and your coach’s.

Jay Livingston

Contact Jay

The Myth of Multitasking

October 8, 2009

I was recently asked to write an article on multitasking and wanted to share some of those insights with you. The take home message  – there is no such thing as multitasking, at least for your brain. The human brain, even yours, is not wired for multitasking. The brain is complex and sophisticated enough to put a man on the moon, but it has a fatal flaw. The brain is only capable of paying attention to one thing at a time.

This may be hard to believe given the numerous reponsibilities we are bombarded with daily. But even while you are diligently juggling 20 tasks simultaneously, your brain is actually only paying attention to one at a time. When you multitask, your brain has to rapidly shift attention back and forth between those items at hand. This very minute your brain may be toggling among reading this blog, your blackberry pinging, the telephone ringing, and your toddler crying in the next room.

Why is this important? It turns out that the microseconds it takes our brain to toggle between items has a time cost associated. And the time costs increase the more complicated the tasks. In other words, when we multitask, we lose time!  Those microseconds lost with each attentional shift can really add up at the end of the day. That is the myth of multitasking.

Researchers from the Federal Aviation Administration in collaboration with the University of Michigan found that students asked to solve 2 math problems did so faster if they completed one at a time consecutively rather than simultaneously. The speed of task completion was also faster if the task was less complex and familiar.

This research suggests one way to improve human performance is to stop multitasking! Your brain truly works most efficiently when completing one task before attending to the next. Contrary to popular belief you are not saving time by having your email inbox open 24/7. You are losing time. Feel free to share this blog with your boss.

Some practical tips:

  • Try answering emails on a schedule i.e. 3 times/day.
  • Open only one computer program at a time and complete that task before opening the next window.
  • Hang your version of a Do Not Disturb sign to limit interruptions.
  • Limit cell phone use while driving (those microseconds of shifting attention could cost a life).
  • Remove all technology from the dinner table.
  • For household mail use the OHIO principile “Only Handle it Once”. Act on it, file it, or toss it. Just don’t pile it!
  • In conversations practice repeating back or paraphrasing what you just heard. It forces you to focus and helps the other person feel understood.
  • Meditate – the ultimate focus!

Theresa Cerulli, M.D.

Easy Way to Plan Your Week

September 7, 2009

We live our lives caught amid almost unlimited past, present and future demands. Making decisions about how to use our limited time and energy often means choosing among those projects that feel most urgent, finishing long-postponed tasks or planning for future success; planning almost always gets put aside.

Those with ADD or an ADD style are more likely than most to find themselves involved in urgent projects that have been let go a little too long and if they are going to look toward the future, they often just glimpse discrete, cutting-edge projects that grab their attention and beg for implementation. Future planning to reduce crises and move projects ahead before they become urgent gets no attention.

Planning doesn’t have to be tough. It starts with a simple assessment of your needs for the next few weeks.

  • What would you like to have time for if you were going to function at your best?
  • Time to catch up on paperwork?
  • Time to review which projects need to get done soon?
  • Set-aside time to contact new prospects? Uninterrupted creative time?

Now you know what needs to happen, you only have to figure out when.

Which things need to happen every day? Every Week? Once a month? Get out your calendar and find a time to schedule the task. Your upcoming month will have the beginning of a plan.

Planning can start at both ends of the time line. What will things look like in one to three years? Or what does my next week need to contain? The best idea is to start simple and address a fuller picture as you get more comfortable. Discouraged just thinking about it? Try this…

  •  What would you like to work on this week?
  • What is a simple beginning action that you could take? 
  • What time could you schedule to do that action tomorrow? (15 minutes may be all you need.)
  •  Schedule a block of follow-up time for each day the rest of the week.
  •  When you finish tomorrow decide on the step or steps for the next day.

You’ve planned part of a week! Pick a project to schedule the following week. Of course there are any number of things that you would benefit from learning about planning and long-term strategies, but even week to week planning has boosted the productivity of many of my sales and executive coaching clients.

Jay Livingston

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