I was asked recently if it is typical for adults with ADHD to have difficulty making a decision and committing to it. I don’t know if there is any research supporting my opinion, but I believe it is true. It is consistent with my observations.
If ADHD is defined by inhibition difficulties, it makes sense that we would have trouble, not only with inhibiting attention and impulses, but with inhibiting attention to a stream of thoughts flooding our brains. Selectively focusing attention requires inhibiting attention to everything swirling around us and inside us. What we call attention “deficit” disorder may be an attention “surplus” disorder!
Here is one example of superfluous mental activity: Do I really want to accept this job offer, or am I just desperate to stop spinning about my career? Am I just settling if I take the job. Will I regret it? The thought of making the wrong decision makes me anxious. Did I over-sell myself in the other interview? What if I take the more challenging job and can’t perform as expected? What if I choose a job without being absolutely certain, and realize later that I’ve made a terrible mistake? What will I do if I make a bad decision? My anxiety is out the roof.
The director of an anxiety disorders clinic defined obsessive worry as “trying to control the future by thinking about it.” Adding more cognitive activity means more anxiety, not less, and the extra anxiety can immobilize us.
Meditation is one way to reduce anxiety that rises from spinning thoughts. Less superfluous mental activity means more clarity. Medicine also helps inhibit attention so you can remain mindfully focused on the task at hand.
Ambivalence is not abnormal. We cannot eliminate uncertainty in life, but we can learn how to tolerate it better. Our most difficult decisions in life are ones we must make with insufficient data. Wishing to know more, to be more certain, is just wishing.
“He prefers the security of known misery to the misery of unfamiliar insecurity.” ― Sheldon B. Kopp, If You Meet the Buddha on the Road, Kill Him: The Pilgrimage Of Psychotherapy Patients
Are you dreading the holidays or looking forward to them? For many reasons, holidays can create extraordinary stress.
I remember my mother’s annual holiday efforts, decorating the house and preparing food for a Christmas gathering for her three siblings, their spouses, and the children. I was fond of them all and looked forward to seeing them. But they seemed different when they were all together. After an evening meal, the grownups would sit in the family room, occasionally breaking the silence with a comment. No one openly disagreed with anyone, although I don’t believe they were sincerely in lockstep with one another. Sometimes they focused on the television instead of each another. They always departed earlier than our other friends would have. While cleaning up afterward, my mom — who loved entertaining friends — would complain that no one seemed to enjoy the event and would vow never to host it again. She repeated the routine for years…including the vow.
In a friend’s family, two elderly brothers — his wife’s uncles — normally refused to attend events where both were invited. My friend insisted that both come to his house for Thanksgiving, believing that he could facilitate some kind of reconciliation. He sat them next to one another at the dining room table. For his generosity, he got to observe their pettiness and rude behavior firsthand during the holiday meal.
Other families have far worse stories of nasty fights after excessive indulgence and early departures with hurt feelings.
Here are ten tips for preventing emotional chaos during holidays:
- If you don’t want to host an event, then don’t. If you invite a rude person, expect rude behavior.
- Be realistic and accept that your ideal might not be realized.
- When hosting an event, start preparing early so you can be relaxed and flexible when guests arrive. If you’re at ease, they will be too.
- Give kindness, even to those who may not be kind to you. A gift is not a trade; don’t expect anything in return.
- Be yourself, and be that same self to everyone. Reacting to a difficult person by being difficult is constructing another self.
- Remember that disagreeable people wouldn’t cause suffering if they didn’t suffer in some way.
- Old grudges are just bad memories. Stop rationalizing that you are better than someone you don’t get along with.
- Don’t fret about negative emotions, or you will double your discomfort. Embrace your uncomfortable feelings; don’t compound them.
- Abandon thoughts that bubble up from inense feelings. They are distortions.
- Holiday events are therapeutic opportunities. The more challenging they are, the more you can learn about your emotional self.
For great holiday entertainment, watch “The Family Stone,” a story about a family’s emotional chaos during a holiday reunion of adult children. Sarah Jessica Parker won an Academy Award for her performance.
When you were a kid, did you ever walk to the end of a diving board and stop to contemplate whether to jump, flip, or dive, and then ponder how cold the water might be? Did the impatient kids waiting in line behind you yell, “Just jump!” If so, they restored your awareness of them, and you probably took action. You jumped.
One strategy for activating is to jump into a task before your distracting self-talk gets in the way. Like jumping into a pool, you can circumvent superfluous thoughts by leaping into action. Jumping can be a useful strategy, but if you are jumping only to stop the swirling mental activity, you might begin ironing your socks when you should be paying your bills.
Wanting to get out of your head so you can get something done is noble. But leaping indiscriminately just to escape feeling overwhelmed can send you down the wrong trail. The cost of investing your undivided attention in an unimportant task gets you further behind on an important task. Then you are right back to feeling overwhelmed and immobilized.
What would happen if you jumped back before jumping forward? What if you paused to consider all the tasks competing for your attention, identify the ones that must get done today, decide where to start, and consider how much available time you have? Open awareness is a kind of soft and expansive attention that allows the mental space to conceptualize and prioritize, and where you are mindful of the big picture, the calendar, the clock, the task list, other people, and the future.
Adults with ADHD prefer acting over planning, and we’d rather have our attention locked in on something—even a daydream—than sit patiently in an open state of awareness. Working efficiently requires access to both states of awareness, selective attention and open awareness, and for intentionally directing our attention between them.
Getting mindlessly stuck in selective attention (some call it “hyper-focus”), is why we ask, “Where did the time go?” Estimating how long a task will take, and tracking time as you work, are important for living well with ADHD.
Okay…enough time on this blog…next item…check phone messages before my first client arrives.
Robert Wright, author of Why Buddhism is True, describes experiments that demonstrate how feelings are influenced by stories we have been told, or the stories we tell ourselves. In one of them, wine experts were unaware that the same Bordeaux was in two different bottles. One of them had a premium label, and the other was labeled as a table wine. Forty out of fifty-two subjects chose the former as the better wine.
In a similar study, several wines were used, and prices were attached to all of them. Only two bottles had the same wine, one that was priced at $90 and another priced at $10. As you might guess, the $90 bottle was chosen as the better of the two. What is most striking is the effect of the apparent “story lines” on their brain activity, as measured by brain scans. When subjects drank wine from the $90 bottle, researchers observed more activity in the medial orbitofrontal cortex than in the brains of those drinking the $10 bottle. That part of the brain is associated with the experience of pleasure.
Negative story lines affect us too. In the second chapter of Living Well with ADHD, I compare washing one dish to cleaning the kitchen. Washing a dish does not require thought about how messy the kitchen is, estimation of how long the dreaded task will take, or consideration of how much worse it is to wash pots and pans than plates. Awfulizing about a task makes it unpleasant, whereas, interrupting the negative meaning-making helps us activate. If no one is making you wash the dishes…like my parents made me…you don’t have to commit to washing a second dish after the first…but you probably will.
Just knowing that activating is one of the greatest and most understated challenges for adults with ADHD can help us “jump,” as some ADHD experts call activating. Jumping into a task, before we have had time to consider the stories our brains want us to believe, can help us turn that corner. In time, the old stories get disproven and the task demystified. We can’t fake it and just make ourselves believe that the task is pleasant, but with practice, we can learn to notice the automatic thoughts that otherwise are like white noise. They are there, buzzing around us, whether we see them or not. If we don’t notice them, they do more harm than if we see then for what they are…just mental activity…extra thoughts that are not useful. You don’t need the extra head on top of your head.
Adults with ADHD were once children with ADHD. Many of them were bullied, ridiculed, criticized, shamed, suspended, expelled from school, compared negatively to their siblings, or humiliated in front of their classmates. While the actual risk of harm may be less in adulthood, the conditioned brain may still anticipate harm and remain vigilant and easily aroused. The arousal can take the form of fear or rage and may lead to striking out, withdrawing, or being defensive. The primary arousal cannot be controlled simply by will or changed immediately.
What can you do if you can’t prevent or extinguish an uncomfortable feeling? You can get up close to it where you can examine it and know it as a sensation. You can watch the thought that arises from it and observe it as mental activity. If you pause before responding to an emotion-driven thought, then you have a better chance to observe it as an event. To borrow from the millennial generation’s vocabulary, “It’s a thing.”
I’m not suggesting that humans are nothing but conditioned lab rats, but only that our brains form mental habits around traumatic events. If we habitually believe that our feelings and thoughts are the same as reality, we will be enslaved by our feelings and distorted perceptions. Our actions will be driven by a desire to resolve the discomfort rather than stay the course and attain our goals. Staying the course usually requires willingness to tolerate discomfort.
Psychologists have a name for buying thoughts as truths. They call it cognitive fusion. Meditation teachers call it attachment.
You don’t have to buy the “story lines” (thoughts) that your emotionally flooded brain is trying to sell. To pause and suspend belief in them is to maintain an open and wise mind.
If anyone reading this blog found my eyeglasses at the CIBC Theater in Chicago during the October 6 evening performance of “Hamilton,” please let me know how I can retrieve them. I was fumbling as the play was ending, trying to get my ticket to fit in the case with the glasses so I would have a memento to keep. I should have just bought a t-shirt, the cost of which was the same as my return trip to the theater.
George Washington opened the door for me when I returned…seriously! He directed me to the stage door entrance, and the office where lost and found items are conveniently kept. Thanks George. I still believe my glasses are under seat D318.
I’m grateful for the driver who waited for me while I searched for the stage door. I had already paid and said goodbye, thinking I would be on Monroe Street for a while. I might have been left by Lyft.
Thanks to the Southwest Airlines employee who printed another boarding pass for me while my wife and daughter boarded with the B group. I found mine in my suitcase when I got home.
When you’re checking your voice messages—right hand gripping the steering wheel, left hand holding your phone—is there anything more annoying than being behind someone who is on the phone? They must be texting, you think. How inconsiderate! And then someone honks their horn behind you because the light has turned green. How annoying is that?
Seriously, adults with ADHD are far more likely than others to be cited for traffic violations. They are two to four times more likely to crash, and when they do, they are more likely to be at fault. They are far more likely than others to be cited for speeding, reckless driving, and driving without a license.
I never speed in my own neighborhood. That is what I told the cop who pulled me over about a week ago. He checked my license and asked, “Why are you speeding in your own neighborhood? What’s the hurry?” I knew the answer to the second question: “There is never a reason to speed and endanger others, sir.” I assured him that I never speed in my neighborhood. It is where I walk in the morning. He looked at me like I’m an alien and said, “You mean you never get caught.”
“You probably hear it often, but seriously, I don’t,” I insisted, and that is a fact if you consider that “never” actually means no more often than once a year. It reminds me of what my wife says whenever I lose my keys and say to her, “I never lose my keys.” She replies, “You always say that when you lose your keys.”
The policeman still looked doubtful. I complained to him about others who speed in my community and drivers who pass me in the turn lane when I’m trying to turn into my neighborhood. His doubt penetrated my my prefrontal cortex, and I knew it was time to stop talking, which is difficult for me, especially when I’m a little nervous…and in a hurry.
He was kind not to cite me. “Please slow down,” he said. I assured him that I would. I think he let me off the hook because I live in the neighborhood he was patrolling, and he knew that I knew he was trying to protect my neighbors and me from people like me.
Great news! I noticed that my rinsed coffee cup was in the dishwasher last Tuesday evening (see previous blog). I asked my wife if she had found it. She not only admitted to “stealing” my coffee, she apologized! She told me that she was driving to work Tuesday morning and took a sip of her coffee. She noticed that it had no cream and realized she had picked up my cup.
Sometimes, I’m not the inattentive one. It feels better than good to be on the receiving end of an apology!
I’m on my second cup of coffee this morning, not that I finished the first…just misplaced it. I will probably stumble onto it tonight after work. Here are the places where it is not: on the table where I’m working, in either bathroom, on my bedside table, in the laundry room, near the plants that I watered, on the deck, on top of my car, in the pantry where I keep the oatmeal, in the microwave, on the shelf where I keep coffee mugs, in the refrigerator, and none of those same places when I looked the second and third times.
My cat doesn’t have it, assuming he is being honest. He has walked off with a toothbrush before!
Here are places I haven’t ruled out: in my wife’s hand as she left for work (but she uses cream and I’m lactose intolerant), in my garage (I haven’t been out there because it has too much clutter for my car to fit), in the mailbox or at the track where I walked this morning.
My wife often discovers items I have misplaced, but she left for work early. I need some of those tags to put on my mugs, the ones that allow you to locate items with your cell phone. If I misplace the cell phone, I still have a landline I can use to call it…and maybe the ringer will be turned on!
I didn’t meditate this morning…can you tell?
This is me without a task list: Oh, I forgot to email Darrell this morning…but first I need to eat something…and then I will go to the grocery…but I haven’t scooped the litter yet…OMG, the cat missed the litter box and left a mess…that reminds me, I need to unclog the bathtub drain…but I haven’t had my coffee yet…that’s my cell phone ringing…”no problem, this is a good time”…now, I must get off the phone and get busy…I need to mulch the new cypress trees before the rain comes…that felt so productive…now what was it that I needed to do first thing this morning? …Oh, I need to email Darrell…oh no, I forgot to run water in the tub after the Liquid Plumber…oh s**t, I didn’t finish cleaning up the cat’s accident…my dermatology appointment is in two hours…I may not have time to go to the grocery…where did the time go?
This is me with a task list: Scoop litter…done…send email to Darrell…done…eat breakfast…done…go to the grocery…done…ignore the phone and let it go to voicemail…good…put mulching on tomorrow’s to-do list…done…unclog the drain…done…there is plenty of time to get ready for my appointment…shut up, there is no such thing as plenty of time…get ready and leave early…done!
The ADHD problem is less about failing to direct attention to where it is needed, and more about failing to inhibit attention to many appealing alternatives to the task at hand. A task list helps hold attention in place. Otherwise, the surplus of attention can make us feel overwhelmed by tasks that should be manageable.
If complexity is a problem, then simplicity is a solution. The iPhone is too distracting for me; there is much more than my task list on it. I prefer the activity of writing my to-do list on a page in a binder with a brightly colored cover, one that won’t be used for anything else. The activity of writing slows my mental activity to a mindful pace and helps me remember the tasks. I do best when I approach each task as if it is all I have to do. It keeps me from looking ahead.
If you have used strategies and tools that once worked for you, then resurrect them. If you are trying a reasonable strategy that just isn’t working for you, give it up and try another way. After finding and using an effective strategy, expect the wheels to come off the tracks eventually. Once you are aware that you stopped doing something that was working, don’t waste time criticizing yourself. Just quietly put the wheels back on the tracks. Self-criticism is superfluous mental activity, just another distraction. It’s like having a head on top of your head; you don’t need the extra head!