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by Judith Kolberg and Kathleen Nadeau
Brunner-Routledge, 2002
Review by Jack R. Anderson, M.D. on Aug 8th 2004

ADD-Friendly Ways to Organize Your Life

     If you're going to write a book on organization, the first thing you should do is be sure the book itself is well organized. In this respect the authors have outdone themselves. To begin with, the book is divided into 7 parts which are arranged in accordance with the time-honored tripartite model of written and oral presentations: "First you tell 'em what you're gonna tell 'em; then you tell 'em; then you tell 'em what you told 'em." In Part one, "Getting Started" and Part two, "Taking Charge of ADD," they tell their readers what they are going to tell them about organizing their lives; in Part three, "Thing Organizing," Part four, "Time Organizing," and Part five, "Paper Organizing," they tell their readers about organizing their lives; and in Part six, "Conclusion," they tell them what they told them about organizing their lives. Part seven deals with resources that can help with organizing and ADD.

     Each chapter itself is easy to read and follow, with short sentences and paragraphs. Headings and sub-headings are in bold type, and numbered lists are double spaced.

     In the body of the book, Chapters Three, Four and Five, mnemonic devices are used frequently. For example, "EAST" stands for "trying to do everything at the same time," "Chaos" for "can't have anyone over syndrome," and "OOSOM" for "out of sight out of mind."

     All of the chapters in Parts Three, Four and Five present solutions to organizational problems in three categories: "Level One Solutions: Ways to Help Yourself;" "Level Two Solutions: Help from Friends and Family;" and "Level Three Solutions: Help from Professionals."

     In this reviewer's opinion, the authors' methodically following the same general outline in chapter after chapter is one of the greatest—if not the greatest—strength of the book. The organizationally challenged reader almost certainly will be influenced, either consciously or unconsciously, by this outstanding example of effective and successful processing of experience.

 

     The authors don't expect adults with ADD-related organizational problems to solve them by themselves. To the contrary, they urge them to "give themselves permission to obtain the help they need," in order to counteract the ubiquitous social pressure on adults to grow up and handle their own problems.

     For one who feels overwhelmed by the disorder in his house, it is recommended that he find a friend who can work with him as a "clutter companion." The clutter companion stays with him as he goes through the disorderly piles of objects in dresser drawers, closets, kitchen sinks, garages, etc., and helps him maintain focus and avoid the procrastination and avoidance that usually interfere with his attempts at organization.

     Another recommended helper is a "paper partner," a "friend or family member who is good at organizing documents, files and papers." The paper partner serves much the same purpose as the clutter companion in helping the ADD adult to stay on the job until the papers are properly sorted and filed in such a way that they can be easily recovered. It is noted that the authors recommend that filing cabinets be discarded except for long-term storage, because it is too easy to just hide papers in them and never take appropriate action.

     A "time tutor" is "someone who gets to places on time, seems to have a reasonable schedule, and accomplishes pretty much what they (sic) need to in the course of a day." The time tutor—also a friend or family member rather than a professional—can help the ADD adult become more aware of time and avoid distractions. One recommended method is the development of a "time log." This is a list of errands and tasks that routinely occur in the ADD adult's week with columns to record the start-time, finish-time and time-to-complete for each item. The time tutor helps in the development of the time log and calls or e-mails daily to remind his friend or relative to keep the log current. After a week or so the time log provides information for more accurate scheduling.

     A "body double" is someone who doesn't necessarily do anything. The double's just being with you gives you support and is a constant reminder that you are supposed to stay in focus on your organizing task.

     "Sometimes," the authors recommend, "adults with ADD need a level of support more intensive than family, friends, or coworkers can provide." A professional organizer is an independent contractor who helps develop custom-designed solutions and provides hands-on support for their implementation. The authors warn that not all professional organizers are good at working with ADD adults and recommend care in their selection.

     Another source of professional help is an ADD coach. The authors explain that an ADD coach can take over where the professional organizer (PO) leaves off. The PO may work on-site, providing hands-on help to reduce the disorder in your house and your life, and the ADD coach typically works by telephone to help you maintain order by building and maintaining effective habits.

     The final source of professional help recommended by the authors is a psychotherapist or counselor. This mental health professional has the necessary skills to recognize and treat depression, anxiety or other emotional or psychological conditions that may interfere with attempts to become better organized.

 

     A lot of lines, paragraphs and pages are devoted to the discussion of  "Level One Solutions," ways the ADD adult can help her- or himself. For simple organizing challenges, self-help may be sufficient, and when professional help is needed at the start of a program, self-help may be all that is needed to maintain organizational habits and patterns once they are established.

     Some specific recommendations for "creating your own structure and support" are: creating schedules for yourself—for example doing your laundry weekly rather than waiting until you have no more clean clothes; breaking down huge tasks into smaller components—organizing a messy closet a shelf or two at a time instead of trying to do the whole job at once; and developing habits and routines for accomplishing recurrent tasks at certain times and places.

     The authors spend more than a page explaining ways to change bedtime habits.  They have found sleep habits to be exceptionally resistant to change for most adults with ADD. They advise against trying to adjust sleeping patterns by simply going to bed earlier than usual and turning off the lights. This, they say is an "ADD-unfriendly" way to try to change a habit. Instead, they recommend a five-step approach:

     First, they advise changing your evening routine so that you have at least an hour to relax before turning off the light;

     Second, you should move your bedtime earlier by twenty-minute increments rather than by an hour or more. This gives your body a chance to adjust to the new bedtime more gradually;

     Third, you have to quit staying up late weekends, which gives your body confusing messages as to what you want your sleep schedule to be;

     Fourth, you may have to use other devices to help change your sleep habits. For example, a meditation tape to help you relax and go to sleep, or an automatic alarm system that slowly illuminates your bedroom at the same time every morning;

     Fifth, you may have to enlist your time tutor's help. He could call you every evening to remind you that it's your bedtime.

    

     The authors follow their detailed discussion of how to change your sleep habits with a 10-step model of ADD-friendly habit building:

1.      Tie a new habit to an old one; 2. Make the habit as easy to do as possible; 3. Make it hard to ignore, for example tie your car keys to it; 4. Put reminders, like sticky notes, everywhere; 5. Visualize yourself doing the new behavior; 6. Practice "instant corrections." If you forget to do it on time, go and do it the minute you remember, no matter how inconvenient; 7. Get back on the horse and ride. Don't give up on developing a new habit just because you forget to do it a few times; 8. Problem-solve if it's not working. Change details until you get it right; 9. Practice the habit for at least thirty days in a row, using a calendar to keep track; 10. Reward yourself. Do some positive reinforcement by celebrating when you reach your thirty-day goal successfully.

 

     In this reviewer's opinion, ADD-friendly Ways to Organize Your Life is an exceptionally well-written book that could be of inestimable value to those adults who believe they could improve the quality of their lives by changing the habitual ways they do things—and that's probably ninety percent of us. However, I'm afraid that adults with ADD of any significant degree of severity, while wholeheartedly agreeing with all of the author's recommendations, will still find ways to procrastinate, ignore, forget and generally muck up their programs so that they remain disorganized and unproductive.

     Although there seems to be no doubt that adult ADD is a valid psychiatric diagnosis, it is not clearly identified by specific physical or laboratory findings. EEG's and neurological exams are usually normal. Hallucinations and delusions are usually absent. In fact, it is often difficult to differentiate the true adult ADD patient from social misfits who are often "diagnosed" as "lazy slobs," because of their messy habits and their avoidance of work.

     Since Dorothea Dix gave us a push during the Nineteenth Century, we have come a long ways in our care of the mentally disordered, and, to our credit, we devote an increasing share of our resources to their treatment and support. However, with the current proliferation of "diagnoses," and the consequent burgeoning of our mental health budgets, in the not-so-distant future something's gotta' give.

     Somehow, we're going to have to come up with some tests and procedures that will separate those patients who have an identifiable mental disorder that requires treatment and support at social expense, from those individuals who are not ill and should care for and support themselves. And we mental health professionals are going to have to quit encouraging individuals to believe that all of their behavior is ineluctably caused by antecedent events or "chemical imbalances." One way or the other, we should find a way to convince each other that most of us are in charge of our own lives and should be held responsible—given credit or blame—for what we do.

     Kohlberg and Nadeau's ADD-Friendly Ways to Organize Your Life is a step in the right direction. In "Level One Solutions: Ways to Help Yourself," which are scattered throughout their book, choice and self-determination are emphasized.

    

     If you haven't read this book yet, you should get right on it. It's a keeper.

 

© 2004 Jack R. Anderson

 

 

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  Jack R. Anderson, M.D. is a retired psychiatrist living in Lincoln, Nebraska