Thursday, June 17, 2010

Getting There from Here: Easing Transitions with ADHD

A large part of my coaching is to help people identify their ADHD challenges and devise strategies to meet them. In order to do this, I explore the reasons why each person gets stuck. I have found that what appears to be procrastination or distraction may actually be a problem with making smooth transitions. The cues that it might be transition trouble is when my client says, “I get stressed and overwhelmed when I have to stop one task and move to the next” or “I can never seem to make it anywhere on time without having a meltdown in the process.”

Transitions require the brain to shift its focus and attention. The ADHD brain often overreacts to this discontinuity by going into a “startle” state, making the person anxious and stressed. Since I was young, I too have struggled with transitions, especially those that require me to travel. So I identified with Judy’s story when she came to me for help.

Judy loved her job, except when she had to travel. The thought of having to pack brought on panic attacks. She found it hard deciding what to take with her on a trip. She stayed up all night packing and repacking, a routine that repeated itself before each trip. Judy was so frazzled and exhausted with each transition that her performance at work suffered.

Through coaching, we developed some strategies to help make travel easier for her. First, we posted a calendar and wrote out her travel schedule so she could prepare her mind for the trip. By seeing when her next trip was, she was able to visualize the process and plan ahead. She developed a routine of putting the suitcase in the middle of her bedroom three days before each trip, which forced her to start packing. She also purchased a second set of toiletries and identified a standard set of “travel clothes,” so she didn’t have to make last-minute decisions about her wardrobe.

Timeliness was also a hurdle for Judy. She found it hard to go from one environment to another. She continually arrived late to work and became disorganized and anxious when leaving her office to attend meetings. Judy also found it hard to pull herself away from a task at the end of the day, fearful that if she stopped working on it, she would never “get her head back into the project.”

Her trouble with transitions was pervasive, and it was also affecting her home life. Her husband was tired of her not being home for dinner and not participating in making plans for the weekends.

The antidote for transition troubles is to first identify the struggle, understand the underlying ADHD causes, and develop strategies to minimize the brain’s startle response. Strategies for making smoother transitions focus on making the transition more gradual and lessening the panic. Many of my clients have adapted the following strategies to their particular needs:

Recognize the problem

Know that you struggle with transitions, and take time to determine the causes of it. Whether it’s difficulty going from work to home, or adjusting to guests in the house, there are always ways to make life more manageable. Develop strategies to make your life, and the lives of those around you, less stressful.

Use the Power of Visualization

When making transitions, no matter how big or small, do “dry runs” in your head. Visualize every detail you can in making the transition. Sketch out times for ending each activity and starting the next. You need not follow the times exactly, but have an idea of when you will need to be switching gears. Visualize each action in as much detail as possible. See yourself moving from one activity to the next.

Learn to Let Go

To transition successfully from one project to another, you need to learn to “let go” of the first and move on to the next. Many of my clients are perfectionists when it’s time to move on to another project, and they find it hard to wrap up what they’ve been doing. If you do this, set a specific stop time, then allow yourself 15 more minutes. No more! You can go back to the first project later, but the idea is to keep moving forward.

Plan Ahead

Always plan out the next day before going to bed. This way you’ll have in your mind what you are going to do, when, and how. You will wake up more directed and centered.

In order to have smoother transitions, you must be able to see beyond the moment. I even suggest to clients to sketch out detailed plans for three days at a time. This can help you (1) see more clearly what is coming up and (2) identify priority items. Remove items from your schedule that can wait, and adjust accordingly when “unexpected” things crop up.

Create a “Wind-Down” Routine for Transitions

This strategy is particularly useful for those who have assistants. Ask your assistant to call you two hours before your scheduled meeting. Have him or her call again an hour and a half before, and then an hour before, telling you exactly how long you have until the meeting.

If you don’t have an assistant, use a stopwatch and set “wind down” goals for each time juncture. For example, two hours before your meeting, start wrapping up whatever you’re working on; an hour and a half before, prepare your files for the meeting; an hour before, finish everything you need for the meeting. If necessary, write out this plan on paper with designated times, and check off each step as it comes up.

Separate the set-up from the task

If you are having difficulty approaching a project, your coach can help you learn to set up for the task before actually beginning it. Set-up is usually brief--10 minutes or less—and is done as a separate activity in advance--the night before or before a break which precedes beginning the actual task. This helps eliminate the confused feeling of “Where do I start?” For example, the set-up for cleaning your desk might be setting out file folders and putting them next to the desk; the set-up for ironing is getting out the ironing board and laying out the clothes to be ironed. Doing the set-up as a separate task can break through the grip of procrastination, giving you the mind-set of being ready to begin. This strategy can be very effective if you are facing a particularly anxiety-provoking task.

Make it a routine

Turn tedious chores into a routine. Lay out your clothes for the next day the night before. Make sure your presentation for tomorrow’s meeting is saved on your laptop. The little things you do today, pay off tomorrow.

Stay a step ahead of yourself

Know your tendencies. Do you find yourself checking your e-mail five minutes before you have to leave the office—and winding up returning 20 e-mails you should have left for the next morning? Shutting down your computer a half hour before you plan to leave might solve the problem. Recognize what gets you in trouble, and find preventative strategies to bail you out.

By understanding that her challenges with transitions was due to her ADHD, Judy was able to identify the situations that triggered problems and devise practical solutions to help her move more smoothly through her day.

Nancy A. Ratey, Ed.M., MCC is a strategic life coach specializing in coaching professionals with ADHD. Nancy lives in Charlestown, Massachusetts.