Gifts of ADD

November 7, 2013

People used to think ADD was a childhood issue. We know now that a large percentage of adults who had ADD as kids will continue to deal with it to greater and lesser degrees. On my cable TV show, I did a segment on Adult ADD which I’ve been told has been very helpful to many people with ADD and for their families.

Having works with hundreds of folks with AD/HD in the past 30 years, I know that ADD is not a one-size fits all label. And, in addition to difficulties posed by having AD/HD, let’s keep in mind that many of our greatest minds, successful CEO’s and entrepreneurs, artists and others have ADD. Einstein, DaVinci and many other talented inventors, writers, artists, CEOs, athletes had ADD. A good coach helps the person find their strengths and talents.

To watch this show, just click:


Self-Control Can be Learned

December 7, 2011

Self-control is a predictor of success. Research shows that children who learn to control their impulses do better in school, college, work and relationships. But adults who never perfected their self-control can make significant and life-changing improvements with a few simple techniques and
practice. Picture this:

You’re ready to head for bed, emotionally and physically wound down. Just a few simple routines to complete and you can drift into the mysterious state called sleep – check the doors, turn off the lights, brush, floss and settle into the embrace of your bed and sleep.

As you shuffle through the kitchen one last time, the image of a bowl of ice cream snaps into your mind. Wouldn’t the creamy, sweet, cold taste of a small bowl of chocolate be delightful? If
you slow your steps, you’ll likely open the drawer for the ice cream scoop.

It is possible to learn to resist at will. Try picturing something else. Focus on images of your bed or an experience you had of stepping on a scale that stopped short of where it previously was. Too hard? Picture a great play from the last game you watched or some other really good experience. Just know that if you stare at the freezer, you are more likely to indulge.

Have you had the experience of walking away from temptation and having the image weaken and lose its urgency? Try it as an experiment; walk away and see what happens over the next few minutes. Focus on paying attention to your reactions and the process of learning instead of the treat.

Controlling your impulses can be learned, whether it’s to stop putting junk food in your mouth or quieting your frustration with yourself, employees, colleagues or clients. Maybe you’ll never find it easy, always have to push to keep your focus, even fall off track sometimes when you’re
tired, but you can develop improved strength and technique with desire and practice.

Eight Quick Hints:

  • Use distractions to pull your attention away from temptations
  • Don’t re-evaluate previous decisions when you’re under the influence of temptations
  • Develop an unbending pattern of behavior until you’re past thinking about a temptation
  • Understand that developing will power (self-control) is a process of learning and practice
  • Dump the old notion that your abilities or attitudes are set – they aren’t, you can learn new ways
  • Notice, celebrate and savor small bits of progress
  • Have a support person or group who you feel accountable to – who bolsters your self-control
  • Live for the changes that you’re working on and practice them into being

Multiple past failures to grow your self-control simply mean you haven’t yet found the right approach. It’s discouraging, but learning is often a process of gaining knowledge from failures until you start getting a hint of which directions are successful. Try getting a new perspective (a coach’s
point of view) and more emotional support. Remind yourself, “With practice I can learn this.”

Want a more complete primer on how to improve self-control and self-discipline? I help people develop new habits and behaviors; it’s what I’ve been doing for over 30 years. Change takes practice and support, but the actual process is simple.

Jay Livingston

Brand vs. Generic Medications – Does It Matter?

February 23, 2011

Taking prescription medications can be cumbersome. It certainly challenges ones working memory skills to remember the names of medications we take, the dose, what time of day to take it, what the pill is for, the side effects, where we store it in the house so we can find it when we need it, when to call the doctor for a refill, the list goes on. To add more confusion to the mix, most prescriptions have two names, the brand name (like Benadryl) and it’s generic name (diphenhydramine).  So I’ll share a question patients frequently ask me – does it matter?

Traditionally when medication is first approved by the FDA there is a patent placed on the newly “branded” drug. After a certain number of years the patent expires and any other company is welcome to make a copy-cat “generic” of the drug. Is there any difference between the original and the copy? Yes. Does it matter? That depends on who you ask. My opinion -ultimately it depends on the person taking the drug – the patient!

When generics are manufactured, the FDA allows a slight deviation from the amount of active ingredient compared with the original branded version of the medication. Maybe Brand X has 32% of the active ingredient and Generic X has 30%. Probably not a noticeable difference clinically for most people. But, where brands and generics differ the most are in the filler components – the stuff that literally holds the tablet together. These filler components can be completely different, resulting in the pill looking nothing like the original one. The size, shape, and color may be may be unrecognizable when you go to pick it up at the pharmacy. The name – the generic name – may be unrecognizable as well. This is a source of many frustrated phone calls to our office from patients worried that the pharmacy gave them the wrong bottle.

Rule of thumb is that most generics will work fine for most people. However, there are some exceptions so certainly let your doctor know if you are experiencing any change in symptoms or side effects when going to a generic. For example, you could be allergic to the red dye coating of generic Y that wasn’t in brand Y. Or your child may have trouble swallowing generic Z because it’s twice the size of brand Z.

Cost cutting is generally driving the substitution of generic medications in place of the brand. That’s good news if both drugs are equally effective for you. But if you have noticed differences in effectiveness or side effects, ask your doctor to contact your insurance company to do a “Prior Authorization” requesting coverage for the brand. It will usually take 3-5 business days for your insurance company to respond to the doctor’s request so patience and planning are helpful in these situations.

Calming Strategies for Children

June 7, 2010

“He’s a terror when things don’t go his way … We’re always worried that he’s going to make a scene and embarrass us … We find ourselves walking on eggshells, trying to avoid one of his meltdowns.”

I hear a lot of that kind of thing from parents of children I work with in my practice. They tell me they often feel stressed, overwhelmed and exhausted from their child’s frequent struggles and outbursts. Parents jump at the opportunity to learn some effective strategies for coping with this common challenge.

As children move through their day, they are bound to bump into situations that are potentially upsetting. Some children are born with calmer temperments and better self quieting skills, while others need to actively learn and be taught how to cope with everyday disappointments and frustrations in a positive way. This is one of the most important things a parent can help a child do. No child enjoys being out of control … it’s simply the only tactic he knows. The good news is you can help your child learn strategies to cope with his emotions constructively and have an easier time getting along in the family, with peers and in school. The bonus — you get to have stress relief, too!

Creating a “My Hard Times Board” (suggested by Peg Dawson EdD and Richard Guare PhD in their book “Smart but Scattered”) with your child utilizes an excellent tool for teaching him new calming and coping strategies. Remember these few tips before you begin:

  • Child and parent collaborate throughout this entire process. 
  • Choose a time to design this plan when your child is calm and receptive. Nothing constructive can be developed during an outburst!
  • Make sure there’s plenty of opportunity for practice each day. After all, Tiger Woods could never make those spectacular putts without lots of it. Even he misses on occasion and so will your child. Mistakes will happen – you can bank on that. But, your child will be reassured when you let him know that there’s always another chance to try again later.   

STEP I: Together with your child, identify and record a couple of the most common triggers to your child’s outbursts (i.e. parents say “no,” plans don’t work out as anticipated, your child is told to stop doing something fun to do something less enjoyable, your child thinks things aren’t fair).

STEP II: Together, list and record your child’s “can’t do” behaviors that he often uses when he is frustrated (i.e. yell, hit, throw things).

STEP III: Together make a list of your child’s “can do” behaviors to replace the undesirable ones that occur when he is beginning to feel upset. This list is most effective when your child’s personal interests are represented so that his choices are engaging and interesting to him. (Examples of “can do” strategies follow after Step IV).

STEP IV: Now that the board or chart has been designed and your child is invested in the process, it’s important to keep it going by implementing the following concepts.

  • A good way to get started is to have your child choose one of these strategies (that follow) and practice the technique with your child for a few minutes each morning and after school. During each practice have your child pretend he is getting upset, describe the body sensations he feels when he is angry and rehearse his calming strategy. Expect to practice these strategies many times before seeing your child using them successfully. Research tells us that it takes 21 days to make a new habit.
  • You and your child might want to develop a special signal, a visual or verbal cue, that is a reminder to use one of his calming strategies. Remember, when your child chooses one of the positive behaviors on his “can do” list, it’s time to offer up enthusiastic praise and even tangible incentives such as stickers, rewards or special activities. Everyone loves a prize for a job well-done! 

Here’s a sampling of “can do” strategies for calming and redirecting behavior. Personalize this list by creating names that resonate with your child.  

  • Happy Birthday:  Teaching children to take deep breaths when they begin to get upset may seem simplistic, but it’s a lifelong skill for managing stress that has emotional, behavioral and physical benefits. Explain to your child that we all have warning signs that tell us we are getting angry. Help your child recognize the signs his body is sending out that lets him know that he’s getting angry (i.e. face gets red; fists clench; heart pounds; breathe faster). When he feels the warning signs, have him take three deep breaths. Next have your child hold up his hand, palm toward his face with fingers spread. Coach your child to blow on each finger as if he is blowing out five birthday candles, one at a time and very slowly. When you see your child getting frustrated, you might say, “Now might be a great time to blow out the candles.” In the beginning you might want to do the breathing along with your child. Set the pace, modeling for your child and letting your calm presence soothe him. 
  • Cozy & Cool:  With your child’s help, create a “safe spot” where he can go to regroup. This special, positive place in the house is where he can go to calm down, sort things out or just chill out when he needs to be alone. It could be a teepee, a beanbag chair, a hammock, or any space your child sees as comfortable and inviting. In the “safe spot” include soft items like blankets, stuffed animals and a basket of quiet time activities that he can play with while relaxing (books, puzzles). Encourage your child to go to his “safe spot” when he feels himself becoming upset. Teach him that sometimes in an angry situation it is best to walk away, go to his “safe spot” and cool down.
  • My Never Never Land:  Use relaxation visualization to design an imaginary place that makes your child feel calm. Help your child create a mind picture of a special place that makes him feel peaceful with all of the colors, sounds, textures, and smells that go with the memory. For example, a child may have a happy memory of a time at the beach. When he feels upset, he can take a “trip to the beach.” He can close his eyes, smell the ocean air, feel the sand between his toes, and feel the sun shining on him. Given the opportunity to run with this, your child may add props to further enhance the experience. One child I know took his towel and sunglasses to his “beach retreat” whenever he needed a “beach break.”  How clever is that!
  • Picasso’s Playground.  Build a spot that includes an array of art materials that can be used independently as a calming and quieting activity. For some children, working with clay, drawing, or doing crafts is soothing and distracts them from the dilemma at hand. As time goes on, try adding new items to keep up the novelty and high interest of the center. Parents, keep a ready supply of items to have on hand so that you can change and rotate art supplies as needed. Keep your eye out for those treasures that might hold your child’s interest.
  • Shake, Rattle & Roll:  Your child can take a walk, shoot baskets, jump rope, swing on a swing, kick a soccer ball, bounce a ball, or dance to his favorite music. Some children get calming benefits from physical release. 
  • Beatles & Beethoven:  Create a listening center with a CD player and earphones where your child can go to listen to music, books on tape or sing a song into a microphone. Dust off that old karaoke machine!
  • Splish Splash … Takin’ a Bath?  For some children, water is soothing and comforting and gives distance from the problem at hand. Try bubbles in the sink, sprinklers in the yard or an old fashioned bubble bath.

There is no single strategy that is good for every child and every family but with lots of practice, role playing, and simulations, children learn new calming techniques that can help them think before they act. Over time, the goal is for your child to develop both the skill and confidence to handle difficult situations on his own without getting upset and losing control. Remember the best way to teach kids how to manage upsetting feelings constructively is to model calmness through your example. Together, and with a lot of patience, much love and lightheartedness, you and your child will find a calmer and more joyful path.

  Doreen Fay EdD

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

Telling Stories

April 5, 2010

“We were at the store and she began telling me that I couldn’t buy the lawn mower. But I wasn’t going to buy it; I was just asking to see if I could get a discount. She got moody and…”

I surprise many of my new coaching clients when I tell them we’re going to skip the rest of the story. Many of them have been encouraged in therapy to tell these “war” stories. And I can imagine times it might be helpful, but most of the time I don’t want or need to hear them.

My coaching takes a forward pointed approach – “Where do you want to go from here?” not so much “Where have you been?”

When I begin to hear a story that is full of the kind of passion and even blame that underpins most disagreements with partners, I just barge right in and call a stop. I’m interested in only one aspect of the story. What could the speaker have done differently to have a more effective conversation, to reach their goal, to create an alliance with their partner, to change their behavior?

I know life is hard and conversations with partners can be very difficult, but the chances of changing your partner are slight if you haven’t changed yourself. So, I start with the most interesting part, how to change your behavior – the one area of life we all have some control over.

Stories allow us to rehearse our past mistakes and support our old, tired way of seeing things. Looking for new ways to redo the same old situations lets us practice new behaviors and ways of seeing things. Start your new behavior by imagining how to redo the old patterns.

What to do with your feelings about how you’ve been treated or spoken to is trickier. But you have to be careful that you don’t just fan the flames of your feelings by telling the story.

Growth and change, that’s what’s important. When I see my clients changing, I know we’ve hit the right balance.

Jay Livingston

Contact Jay

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

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

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

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