Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder

by Edward M. Hallowell

Think of a thermometer and the mercury it contains. If you have ever broken a thermometer, you know what happens to the mercury. The ADD mind is like spilled mercury, running and beading. Structure is the vessel needed to contain the mercury of the ADD mind, to keep it from being here and there and everywhere all at once. Structure allows the ADD mind to be put to best use, rather than dissipating itself like so many tiny beads of mercury on the floor.

Structure refers to essential tools like lists, reminders, notepads, appointment books, filing systems, Rolodexes, bulletin boards, schedules, receipts, IN- and OUT-boxes, answering machines, computer systems, alarm clocks, and alarm watches. Structure refers to the set of external controls that one sets up to compensate for unreliable internal controls. Most people with ADD cannot depend upon their internal controls to keep things organized and to keep themselves on task over time. For them a reliable system of external controls is essential. Setting up a system does not have to be boring; in fact, one can be quite creative in devising a workable structure. And once in place, the system will be calming and confidence-building. We particularly recommend a scheme of reorganizing one’s life that we call pattern planning. This system of time management operates on the same principle as automatic withdrawals from your bank account: by making the withdrawals (of money or time) from your account automatic, you don’t have to plan them every time; they just happen. You plug certain regular appointments or obligations into the pattern of your week so you attend to them automatically. This frees up your limited planning time to focus on other activities. Simple in its conception, pattern planning can reduce the stresses of planning one’s life considerably. It is easy to set up. You start by making a list of all the regular tasks, obligations, and appointments you have every week—you...

Tips for the Coach At the beginning of treatment there should be brief (ten-to-fifteen-minute) daily check-ins with the coach, in person or over the phone. The discussion should focus on the practical and concrete—what are your plans? what is due tomorrow? what are you doing to get ready for tomorrow?—as well as on the abstract—how do you feel? what is your mood? These questions can be organized by the initials H.O.P.E. as follows: H—Help: Ask the person you are coaching, what kind of help do you need? Begin by getting an update and seeing what specific assistance is needed. O—Obligations: Ask specifically what obligations are upcoming and what the person is doing to prepare for them. You must ask. If you don’t ask, the individual may forget to tell you. P—Plans: Ask about ongoing plans. It is very helpful to remind people with ADD of their goals. They often forget them, quite literally, and so stop working toward them. If they say they don’t know what their goals are, try to help them define them. Goals function as a kind of guard against aimlessness, drawing the individual through time toward a desired place. E—Encouragement: The most fun part of the coach’s job. The coach should really get into it and not be embarrassed to be rah-rah. The coach is joining a battle against chaos and negativity; the more affirmative he or she can be the better. Don’t be daunted by cynicism. It takes a while to undo a lifetime of negativity.