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

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Not as Bad as it Seems

October 27, 2009

Most of us grew up hearing many messages from our families, school teachers or other kids that suggested we had a lot we should feel bad about; we heard about everything we did wrong and very little about what we did right. Our school work was covered with marks that pointed out everything we did wrong; our mistakes at home got the most attention; and the nearly all the most dramatic feelings we heard were about our failures. It’s not surprising then that after all the repetitions of the negative we often end up feeling we’re not very worthy of positive feedback.

Negativity narrows us. We tend to have a narrower range of emotions, less creativity, fewer social connections, have a harder time with self-insight and more. The effects of negativity go even further though, we tend to be more affected by illness, have less resilience and be more prone to responding to others negatively.

Many of my clients find that it is as hard as anything they’ve done to try to find the good in themselves. I ask them to appreciate themselves and they freeze. I ask them point out the positive changes, or where they’ve succeeded and I get blank stares and a, “This stuff is hard!”

After we’ve worked together for awhile my questions will begin to bring a pause and sometimes a big laugh – they have caught themselves in a negative, dead-end thought process. Recently, one of my clients explained just how hard it was for him to notice the positive. He said with a wry grin, “What you’re asking is just about as hard as giving myself a frontal lobotomy.” Awareness and humor are a transition point for many of my clients.

They start noticing and sharing a few things they are proud they did, or an aspect of their personality they like. They discover that when they look at themselves carefully there are many more positive things to report on than negative. The day they interrupt me to be sure I noticed a positive piece of growth or success in an area we’ve focused on, that’s the day they realize this positive stuff isn’t as bad as it seems; in fact, eventually, it’s no harder than eating an ice-cream cone on a hot day.

Therapy is about working to bring more joy and meaning into your life. If you’re ready for a transition or even assume you can’t change, give me a call and let’s find a way to discover the positives.

Szifra Birke

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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

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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.

Substance Abuse and ADHD

September 14, 2009


If you are diagnosed with ADHD then you should know you are also at a higher risk for developing alcohol or other substance abuse problems. 52% of individuals who are diagnosed with ADD will have to deal with substance abuse during their lifetimes.

In a study of young adults with ADHD, Timothy Wilens, M.D., associate professor of psychiatry at Harvard Medical School said, “70 percent were using substances (not to get high, but) to improve their mood, to sleep better, or for other reasons”.

Many of my clients who have abused cocaine, alcohol or marijuana say that when they first started using, the drugs helped them concentrate, they made fewer “stupid” decisions and most of all they felt much calmer. The term “self-medicating” is used to describe this type of use.

“When people with ADHD get older, the hyperactive component often diminishes,” says William Dodson, M.D., an ADHD specialist, “but inside, they’re just as hyper as ever. They need something to calm their brain enough to be productive.”

Treating ADHD with medications appears to reduce the tendency to abuse drugs and alcohol. In a study at MGH and Harvard Medical School, 75 percent of boys diagnosed with ADHD and not receiving medication started abusing marijuana, alcohol, hallucinogens, stimulants, or cocaine within 4 years of the study’s beginning, while only 25 percent of the boys diagnosed with ADHD and taking medication and 18 percent of the boys without ADHD did. This means the medications reduced the risk of substance abuse or dependence by 84 percent.

When I first started treating high functioning adults with ADHD there was a debate about whether to first treat the ADHD or the substance abuse; many people felt it wasn’t effective to deal with both at the same time. I encouraged my patients to tackle the two issues together and I’m pleased to see that that is now the accepted approach.

We have research to show that the combination of medication where necessary along with therapy is a potent approach to many mental health issues. My experience shows that this is certainly true for the treatment for ADHD. Medication, therapy, coaching or a blend of these approaches helps my clients manage their lives more effectively including managing their substance use and abuse.

How can you tell if you’re on the road to abusing alcohol? These statistics from William R. Miller and Ricardo F. Munoz’s, “How to Control your Drinking: A Practical Guide to Responsible Drinking” (1982) give some guidance on how Americans drink. Where do you fall?

  • Over 80% drink less than 3 or more drinks per week or not at all (32%)
  • Only 16-18% drink at least 10-13 drinks per week (about 2 per day on average)
  • Only 11% drink 20 drinks per week (about 3 per day on average)
  • Only 6% drink 40 drinks per week (about 6 per day on average)
  • Only 3% drink 10 or more per day

If you would like to take a closer look at your substance use, I’d encourage you to get an experienced professional’s help in evaluating whether you need to make some changes.

Szifra Birke, M.S.

Email Szifra

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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Why Distractions Grab Us

August 4, 2009

Our worlds are filled with distractions – emails, loud conversations, cell phones, radios and televisions–the list seems endless. But why do these grab and hold our attention when we have projects that are important or urgent?

In her book “Rapt” Winifred Gallagher takes a close look at the science of paying attention. Apparently our brains are hardwired to focus on the most “colorful” thing in our environment; read this as loud, interesting or literally colorful. Brain scans show our brains light differently up when these kinds of events invade our environment.

It is certainly difficult to fight this biologically based pull, and even more so if your brain is hyper-sensitive to distractions. But science shows that we can pull our attention away from a sight or sound that grabs our attention. We can use our pre-frontal cortex, the aware thinking part of the brain to override the intrusion. With practice and solid techniques we can improve our capacity to focus.

We can increase our abilities through biofeedback, regular meditation and cues that invoke our thinking. Ms. Gallagher is a fan of meditation to increase focus, but she admits to using an even simpler method when she’s trapped in a noisy environment – earplugs. She compares this to a personal stimulus control shelter. This is similar to my suggestion to my clients that they consider facing the wall rather than the crowd in a restaurant.

Ms. Gallagher says that after a period of concentration, our prefrontal cortex probably needs a break.  Simple tasks like answering e-mail or returning phone calls can help us rest and be ready to focus again. Beware of getting distracted though, because after an interruption the brain can take 20 minutes to do its equivalent of rebooting and refocusing.

Ms. Gallagher also feels that “Multitasking is a myth.” “You cannot do two things at once. The mechanism of attention is selection: it’s either this or it’s that. People don’t understand that attention is a finite resource, like money.”

To have fewer distractions and fewer 20 minute periods of rebooting, try turning down the frequency of email retrieval, work on difficult or important projects first while your brain is most able to manage distractions well, and arrange uninterrupted work time. For more ideas consider talking with an experienced ADD coach.

Jay Livingston can be contacted at Jay@Livingstonservices.com or 978-446-9600

Competing with a Computer Screen

June 16, 2009

Marty sat talking to me with his eyes on his computer screen and regularly input burst of typing. I tried sitting at the other end of his desk so he would be forced to look away from the screen, but he just pushed his chair back and swung his head from the screen to me until I lost out and he was back to starring at the screen.

More and more jobs seem to necessitate people keeping an eye out for incoming emails or require the completion of a computer form as part of the appointment process. I first encountered this at a specialist’s office where the physician did a remarkably thorough job, but rarely looked up from his screen. Now I see my ADD clients struggle with it.

Some people think I’m entertaining and my wife even thinks I’m funny, but I couldn’t get Marty to take his eyes off his screen. I reminded him that he was not paying attention and he apologized but quickly drifted back. I finally asked him to turn off the monitor while we talked about what to do. He was very willing, but the interesting thing was he kept checking the blank screen every 15 to 30 seconds. That was better though because he would check in with me more often and his conversation was more responsive.

The computer is a huge time safer and it is a huge interruption and distraction. Those with ADD have to be particularly vigilant about letting it dominate their day. A few suggestions:

·         Turn off the monitor when you’re having meetings or business conversations; it’s easy to fire it back up again.

·         Close the email program or set it to not go looking for email but once an hour – you can always manually click the send/receive button.

·         Turn off all signals that you have email and set a kitchen timer for one hour to remind you to check.

·         Move away from your desk when you’re having a business conversation so that you’re not distracted by other non-technological things on your desk.

·         Get a squeeze ball or some other fidget toy to play with while you talk.

Marty came up with an interesting solution on his own, he now takes notes with a pen while we talk; of course he spends a lot of time starring at his notebook. Funny but that doesn’t bother me nearly as much.

Jay Livingston can be contacted at Jay@LivingstonServices.com

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