The Disorganized Mind: Coaching Your ADHD Brain to Take Control of Your Time, Tasks, and Talents

RC

394 .A85

R37 2008

The Disorganized Mind

COACHING YOUR ADHD

BRAIN TO TAKE CON'TROL OF YOUR

TIME, TASKS, AND TALENTS

Nancy A. Ratey, Ed.M, M.C.C., S.C.A.C.

~

ST. MARTIN'S PRESS NEW YORK

SAUK VALLEY CC lRC

THIS BOO K IS IN MEMOR Y O F

My father Clair Wi lliam Young (8/3 0/ 1924- 5/7/2 004) No ma tter what, you never los t hope, and yo u always be lieved in me .

Your determinatio n and persevera nc e in helping me taught

me to neve r give up. Your spirit lives on l

THE DI SORGAN IZED ~; I :-1 D.

Copyright © 2008 by Kancy A. Ratey.

Foreword copyrigh t © 2008 by Joh n J. Ratey. M D.

Afterword cop}Tight © 2008 by Sa m Gold stein. Ph.D.

All rig ht s reserved . Printed in the Uni ted States of America.

No part of this boo k may be used or reproduced in any manne r whatsoever

wit hout written permiss ion except in the case of brief qu otations

embodi ed in critical articles or reviews. For info rmati on. add ress

St. Ma rtin 's Press, 175 Fifth Ave nu e, "lew York, N.Y. 100 I O.

The circ um stances "nd experie nces desc ribed in thi s book are all dra wn from

the ~ lIth o r's wo rk as an .\DHD coach over th e pas t fl ft ee n yea rs. The names and other

id entir,~ n g characteristics of clients and their fami ly memb ers

have bee n changed to respec t thei r privacy.

Some of the material in thi s boo k has appeared, in different format , in

Clilliciall 's C; uide to Adult ADHD Assessment tlllLl Intervelltion, edi ted by

Sam Go lds tein and Anne Teet~r Ellison (Academ ic Press, 2002).

'vvW\\'.srmartins .com

Book desig n !ry M ar)' A. Wirth I.. tBI\A RY OF CONGB ES S C ATA LO Gt NG · IN- [, U BI.J CAT IO'l nATA A\ AtLABL E U P O N REQ l E O, I

ISBi\ -13: 978-0·3 12-3 5533 ·3

ISB:'-J- l0 0-3 12-3553 3-5

First Edition : April 2008

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My best fri end Cara Dunne- Ya tes (3 / 17/197 0- 10/20/2004) Your immense love fo r life, laugh ter, an d adventure was

a source of grea t stre ngth a nd joy to me. You were the

ultima te teac her of how to live in the mome nt and

not sweat the small stuff. I miss yo u greatly.

My colleague in arms

Laura W hitworth, M CC (lO/ 15/ 1947-2/28/2007) T hank yo u for sharing a vision wi th me . We di d itl

Your gift of bei ng abl e to "hol d the space" allowe d me

to always keep my eye on the bigge r picture

for that \ris ion to grow.

Contents

Acknowledgments Foreword by John PART I

ix

J. Ratey, M. D.

xi

Coaching

Chapter 1 How I Come to Coaching Chapter 2

How Coaching Works

3

15

Chapter 3

Self-Coaching

31

Chapter 4

Finding the A-N-S-W-E-R

49

Coaching the ADHD Brain

85

PART II

Chapter 5

Time Mismanagement

Chapler 6

Procrastination

109

139

89

Chapter 7

Impulsivity

Chapter 8

Distractibility

163

Chapter 9

Transitions

191

PART III

Strategies for a Balanced Life

211

Chapter 10

Strategies of the Home En vironment

217

Chapter 11

Strategies for Maintaining Physical Health

225

Chapter 12

Strategies for Maintaining Spiritual and Mental Well ness

235

PART IV

Living or Working with Someone with ADHD

Chapter 13

loving Someone with ADHD , or, Did I Sign Up for This?

241

243

Chapter 14 Working for or with Someone w ith ADHD, or,

Right-Brained Exec Needs left-Brained Right Hand! Final Thoughts

251

263

Afterword by Sam Goldstein, Ph .D.

265

Appen dix A

267

Index of Strategies

Appendix B ADHD Resources Index

269

277

About the Author

285

Acknowledgments

I am blessed and humbled to do the work I do. To each and every one of my clients, thank you for letting me into your lives. It is an honor and privilege to have been part of your journey. VI/ere it not for your courage to step forvvard , to put your trust in me , and to share your pain, struggles, and triumphs, there would be no book. I especially thank those clients and colleagues who shared their insights with me as I planned and wrote this book. Ned Hallowell, the field of ADHD coaching would not exist were it not for you. You saw the missing link, the way to fill the gap, to create a way for individuals with ADHD to live a more ful­ filling life on a day-to-day basis. It was coaching. Sue Sussman, I am forever indebted to you for opening the door and taking that leap of faith with me to create the l\'ational Coaching Network. It was your vision that breathed life into coaching. And to Bonnie Favorite, for helping to give shape and form to our initial training model so we could share coaching with the world , thank you. ~Iadelyn Griffith-Haynie and Eric Kohner, your pioneering ef­ forts set the stage for ADHD coaching. Thank you for your tire­ less efforts and for helping to pave the way for coaching to become vvhat it is today.

Jt

Acknowledgments

Also, thank you to ADDA and CHADD for your years of sup­ port for the concept of ADHD coaching. There are many people who either directly or indirectly sup­ ported me in giving birth to this book. I thank each of you for your contributions. Thank you to Faith Hamlin, my agent; Sheila CUITY Oakes, my editor at St. Martin's Press; Whitney Barrows, my"San­ cho Panza"; Sherry Lowry, a wonderful coach; Joe Blackmore, Gordon Curtis, Sam Goldstein, Jackie Grupe, Ben Hillyard, Pat and Peter Latham, Karen Lu, Theresa Maitland, Terry Matlen, Rich Mintzer, Kathleen Nadeau, Patty Quinn, Sally Snowman, Dean and Sari Solden, Robert Tudisco, and Renee Van Notten. One of the most difficult aspects of writing this book was sus­ taining the energy it demanded, something that would have been insurmountable without the support, encouragement, and love of my family, friends, and colleagues. Thank you all for being there when I needed you and for contributing your memories, insights, and words. The process of writing a book is difficult to explain. It certainly takes a lot out of the person writing it, but I think it takes an equal toll on the person's family. From Ohio, Michigan, and Brazil, mine reached out to me here in Boston on a regular basis, cheering me on. To each of you, I offer love and continued thanks for the encouragement you gave to me through it all. I am eternally grateful to my mother, June Young, whose en­ during love and support have been my wings. Thank you for teaching me to laugh and for laughing with me, still. To my friend and writer, Maureen Ackerman, thank you for giving voice to my e>"'Periences and for letting your imagination and belief in possibility inform the pages of this book. And to my husband, John, there are no words to express how much I appreciate your steadfastness. None of this would have been possible without your unwavering love, patience, support, and expertise. You teach me, always, what "I love you" means.

Foreword by John J. Ratey M.D.

In the late 1980s, when Ned Hallowell and I were first refining our ideas about ADHD that led to our three Distraction books, we realized that when working with our adult ADHD patients, we were doing something different from simply exploring the past with these patients in an attempt to change their futures. We were doing neither classical psychotherapy nor basic diagno­ sis and drug treatment. Our work was different from therapy and could be done by someone who had enough training and aware­ ness of what ADHD was all about. Ned coined the term ADD coaching-we called it ADD back then-and he wrote about this in Driven to Distraction. About that time, Nancy and I married. I became aware that coaching was already happening in the treatment of dyslexia and that Nancy was a natural coach. She soon teamed up with Susan Sussman to combine their experiences and thoughts into a for­ malized curriculum to teach others how to coach adults with

ADHD. Since that time, I have come to understand and appreciate more about what ADHD is in the brain and what coaching offers in response to this type of brain difference. One of the biggest problems for patients with ADHD is that they cannot sustain the

xii

Forew ord

Foreword

motivation to accomplish their goals, even when they have the talent and skill to do so. This fact generates many of the pejora­ tive labels that those with ADHD accrue; they are seen as lazy, inept, and undepen dable. In brain lingo, the coach acts as an ex­ ternal frontal cortex of the left hemisphere, or specifically the ex­ ecutive Functioning brain area, helping the individual to maintain arousal and remember motivation to succeed . Most individuals with ADHD eventually learn that they need something to help them gain control over their lives, and those who come looking for help are, at various levels, ready to change. As a psychiatrist, I work with my patients on therapeutic issues, diagnosing and fine-tuning their medications. Often, however, as these issues are being worked on, some of the daily living issues persist. When patients are at the point of really wanting to tackle these issues and become masters of their own lives, they seek out the service of a coach to move forward on their own. Time and tim e again , I've seen how Nancy helps her clients acknowledge their difficulties and begin to develop what I have called "the militant vigilance" that is so necessary to deal with their deficits . The relationship, as it is in any generative relation­ ship focusing on personal growth, is highlighted in Nancy's work with clients. Changing the brain is hard, but you can teach an old dog new tricks, and the kind of humor-filled bond that develops between Nancy and her clients helps to cement and further their attempts at changing. Coaching works at many levels. The re lationship helps by in­ creasing arousal and alertness in the accountability and obliga­ tions that set up what I call "good guilt. " ADHD clients are often overw helmed with gUilt and shame at not fulfilling 'vvhat they know they can do . But in Nancy's evolved system, clients learn to set their goals and identify that which they wish to become with­ out the gUilt and shame frequently associated with ADHD. The coaching experie nce also helps the ADHD brain forgo

immediate gratification and keep in mind the concept of future reward. If individuals ",,lith A DHD could hold on to the motive, remember the cons equences , and keep the reward in mind , they could move forward toward completing tas ks and meeting goals . Rather than maintaining focus on a distant goaJ , however, the ADHD brain's atte ntion is typically grabbed hy ll , hip s.256

ADHD , 19+ ') 5

se lf· coac hing . ++

A -'\I ·S-W ·J · R tool. 196 204

tim .. II1dnagcll l ~ nt problem s, 90-9 1

sLutte ring, 3. 5

support grou ps a nd pa rtne rs. See

,II",

l'''rLners hip

clutte r, 222

di , Lrac ti bility, 182 , 183

exercise, 226

impul sivity, 150, 158-59, 162

nu tritio n, 230

procrasti nJlio n, 123-2 4, 13 1, 133, J 35

slee p iss ues, 229

time manage me nt proble ms, 106

S ussm a n, Su sa n , x i

impulsivity, 159

di stra c tibility, 176. 180-8 1

financial res ponsibiliti es, 2 19

str uc ture, 9

283

thankfu lness, emoti onal response , 240

time manageme nt, 89- 108. See also ca lendars; notebook(sl: sc hedules; timers ADl-ID ,8 9

bra in fun c Lion . 20 5

expec tat io ns, J 95- 96

pro ble ms of, 19 1 .':;I()

slee p iss ues , 228-29

strat egies for fa mil y p rob le ms, 209- 10

strategies fo r in di vidua l prob le ms,

204- 7

strategie s for re lati unship prob le ms.

207- 9

vacat ion s, trans iti ons, 208- 9

ViSUfl li Ld tion

d istractibi li ty, 177

Gn ,lI1 cial respons ibiliri es , 2 J 9

tra nsitions. 204- 5

Vy\'3nse, 23 J weekly goa ls, tim e manage me nt probl e ms, 106-8

A· '\I -S·W E· R tool, 9 1-101

We llb utrin , 23 1

prob le ms in , 89-9 J

we ll ness. See e motional response;

st rategies for, 101-8

time meas ureme nt

distractib ili ty strategies, 186

til"ne manageme nt pro ble ms, 104-5

ti me-out strategy

e motional res po nse , 239

tra nsitio ns, 208

timers

distrac tibility strmegies, 186

protra' tin ati on. 132

slee p iss ues , 229

rime manage ment problems. 98

ti mi ng. See readJl1€ss toxic e motions. See also e motional response

phys ica l hea lth ; tox ic e motions

,,·inding·dow n stra tegy, tra nsitio ns, 201 - 2,

20 6

working the p lan

A- '\I· S·\V·E- R tool, 70- 74

di strac tib ilit y, 181-82

impu lsivity, 15 3- 54

p rocrast in ation. 12 6- 27

tim e man ageme nL probl ems. ':19- 100

transi ti ons. 203

workp lace. di strac tibility strateg ies .

185-86. See " I,,, admi nistra tive dss ista nts; profes siona l rela tion , hlps worksheet self-coaching notebook.

3 5-4 3

About the Author

N ANCY A. Rnl·:v, ED.M ., \LCC, SCAC , is a strategic life coach who specializes in coaching high-achieving professionals with ADHD. She ea rned her master's degree in administration, planning, and social policy from the Harvard Graduate Sc hool of Edu ca tion and is certified as a Master Certified Coach by the International Coach Federation and a Senior Certifled Coach for the Institute for the Advancement for ADHD Coaching For the past two decades, Ms. Ra tey has been ac tively coaching, teaching, and writing about her strategic coaching methodologies. She has coauthored two previous books, has written a home-study curriculum on ADHD for nurses, and has contributed to num e rous lay and acade mic texts . Known for her high energy an d directedn ess, the author has served as president of the Nat.ional Attention D eflci t Disorder Ass ociation an d has been on many advisory boards, including the Professiona l Ad­ visory Board of Children and Adults wi th Attention D e ficit Disorder. As one of the founders of the ADHD coaching fi e ld , Na ncy Ra tey is internationally recognized as one of th e foremost authorities on the topic. Her work has been featured in The New Yorio Times, Newsda y, Wired, and Vogue and on th e ABC and CBS networks and National Public Radio . Nancy Ratey currently practices in Well esley, Massachusetts, where she resides with her husband, Dr. John J Rat ey. For information and resourc es on ADD coachi ng,

visit the author's Web site

www. nancyratey co m