479- Executive Function Strategies to Externalize Time, Memory, Motivation

(upbeat music) Welcome to the Attention Deficit Disorder Expert Podcast series by Attitude Magazine. (upbeat music) - Hello everyone, I'm Carol Fleck and on behalf of the Attitude Team, I'm pleased to welcome you to today's ADHD Experts presentation titled "Executive Function Strategies to Externalize Time, Memory and Motivation." Leading today's presentation is Dr. Ari Tuckman. Dr. Tuckman has given more than 600 presentations and podcast interviews across America and in nine other countries. He's the author of four books, including more attention, less deficit, and understand your brain, get more done. He is the chair of Chad's Conference Committee and winner of the 2023 Hall of Fame Award. Executive Functions are the cognitive processes that help us self-regulate in order to pursue our goals. They help us plan, prioritize, manage time, and complete complex tasks, but as many of us all know, all too well, people with ADHD have weak executive function skills and this can affect our academic performance in school and our performance at work. Learning how to supplement internal processes with external tools can help us get things done more reliably. Today, we'll discuss how ADHD is fundamentally its deficit in executive functions and how to build strategies to maximize performance and productivity. We'd like to begin today's webinar by asking this poll question to our live audience. If you could have a superpower to improve your executive functions, what would it be? Please select your answers and comment in the text box under the video player to tell us more. For answers to common webinar questions about slides, transcripts and certificates of attendance, click on the FAQ tab of your webinar screen. 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Developed by leading clinicians, Inflow is a science-based self-help program based on the principles of cognitive behavioral therapy. Join Inflow today to better understand and manage your ADHD. Click the link on screen to learn more. Attitude thanks our sponsors for supporting our webinars. Sponsorship has no influence on speaker selection or webinar content. So without further ado, I'm so pleased to welcome Dr. Ari Teppman. Thank you so much for joining us today and leading this discussion. - Okay, my pleasure, it is good as always to be here. So I'm gonna be presenting a bit then we're gonna do some Q&A. And my hope is, I'm gonna talk a little bit about some theory, but really, really what we're gonna talk about is how to sort of apply it to your life to make your life better or your, maybe your partner or assuming they let you or your child or your student, client, patient, whatever. So let's just start out with some kind of basic ideas. So obviously life is pretty complicated and I don't know if it's actually more complicated than it used to be in terms of cell phones and all that stuff. But it kind of feels like it doesn't it, right? That there are more temptations, there are more distractions, there's more that we're sort of competing with when we're trying to get on this stuff that we need to get done. So the challenge and for each of us across kind of most moments of the day is to do the right thing at the right time, at least sort of most of the time. You don't have to be a hundred percent, but like mostly you need to be doing those right things at those right times. But to do that, to even know what the right thing is at that particular moment, there's a lot that needs to happen, right? There's always sort of stuff in the world around us. We always have sort of thoughts inside our head about all the different things that we could do. And we need to sort it out to decide right now what is the best thing for me to be doing or thinking about or whatever. And in order to know what the best thing is to do right now, we don't only look at what's happening right around us. We also sort of reflect back on the past, how do things work out before, what are the lessons learned? We might think ahead into the future. So, you know, as kind of a simple example, this morning when I got here, I got my mic and I put it on my desk and I got my headphones and I pulled them out because I knew I didn't want to be like, you know, running to the closet to get them before this, right? So, I'm kind of using the lessons of the past and thinking about the future, about what's gonna happen a few hours later when this webinar begins. Unfortunately, you know, the thing that's most important, the thing that you should most be paying attention to, like those stimuli aren't always the sort of the loudest, the stickiest meaning we sort of, our attention sticks to it, or even just the most interesting, right? Lots of things in life are important, but they're hard to kind of make ourselves pay attention to. That's true for everybody, but if you have ADHD, you really know that to be true, right? The, I don't know, text from whoever, but a buddy of yours or something on Instagram or, you know, trying out some new recipe or something is way more interesting than things like folding laundry and doing homework and, you know, thinking about life insurance. And yet, these are things that we still have to, you know, put some energy into. So this is then where the executive functions come in, that they help us kind of sort through all of this, right? All these possibilities, all these temptations and distractions and desires, all these plans, and to think about what is the best thing for me to do right now? Mostly the executive functions are about managing this present moment now, so that I can create a better future for myself or the people that I care about. So mostly then, the executive functions in order for them to kind of do what they do, we need to sort of like hold back and say nope, not that, nope, not that. I just had a thought of what I could do, nope, don't do that either. Right, let's pause and kind of consider and apply those executive functions. What the executive functions then ultimately do is they help us sort of coordinate our other abilities. So all the rest of your skills and abilities, all the knowledge and experience that you have to sort of take that and then do something productive with it. One other way of sort of thinking about it is that they help us do what we should and should basically mean stuff that's important but kind of boring, right? Let's be honest. Mostly the executive functions just sort of happen on the round, right? They just sort of run in the background. They're sort of like the operating system, but sometimes we can become really aware of them. So if like, I don't know, there's some like talkative cookies sitting in front of you and you're very intentionally like not looking at them, trying not to smell them and saying nope, that's not what I'm doing. Remember I'm trying to eat better and these are the reasons why blah, blah, blah. So in that moment, you're very aware that your executive functions are operating. Most of the time, we just kind of roll through our days. So this then brings us to a quote I use all the time, which is Russell Barkley's famous quote that ADHD is not a disorder of knowing what to do. It's a disorder of doing what you know. Folks of ADHD know very well what to do, right? Things like getting places on time, writing reminder notes, don't spend money that you kind of don't have, right? These are not hard concepts. So folks of ADHD know it very well. The challenge is that folks of ADHD, their batting average on doing that kind of right thing at the right time is a bit lower than the batting average of people who don't have ADHD. We're gonna talk a bit more about this knowing versus doing and why it's really kind of an important concept. So one of the ways that I'm thinking about it is if we were actually being more accurate, we wouldn't call it ADHD, right? 'Cause as you probably all know, it's about a lot more than attention and it's about a lot more than hyperactivity. Really, if we were gonna be accurate, We should call it EFDD, executive function deficit disorder, because fundamentally what ADHD does is impact the executive functions. Not necessarily in the sense that overall in every way, people with ADHD have less executive functions or less effective executive functions, but it's more about being consistent in using your executive functions and really what it means is with boring tasks. And that's a bit of, I don't know, it's kind of an unfortunate thing in the sense that if you're color blind and you can never tell the difference between red and green, then people will sort of come to accept that like you're not good at red and green and they're not going to expect you sometimes to be able to do it. The problem is when you have ADHD, you do awesome on the things that are interesting or novel, maybe they're sort of high-stem where there's some immediate consequences like, oh my god, this is doing an hour, folks with ADHD do great in those situations, which kind of raises the bar in terms of what people are going to expect of you. You did awesome there, why can't you do awesome there? This is kind of the awesome Bill Dodson's interest-based nervous system of how he kind of describes and explains ADHD. So not that any of us are perfect because certainly we're not, but folks with ADHD more often find themselves in situations where distractions sort of hijack your attention or impulses, kind of temptations, sort of hijack your intentions. I should really do this and lo and behold you want them to do something else. And the reason for this is that folks with ADHD have a harder time, and this is kind of gets into neurology stuff that's kind of too boring and not really necessary for this, but that folks with ADHD have less of an ability to sort of stop, cause, and think about what it is that they want to do. Right? Here's something hilarious, not for this audience, let me hold a moment. We're not in the middle of math class. Let me wait until I'm seeing my friends at lunch. Or, you know, let me just check on the real quick. Click. Oh, that's interesting. Click, click, click, click, click, click, right? Didn't finish the thing you're supposed to do. Right? That is the effect that ADHD has. It's harder to stop, pause, and then apply the executive functions. So one of the ways of thinking about it then is that ADHD is a deficit in reliably converting intentions inside your head into actions out in the world. The problem is, as I said before, right, it can look like that inconsistency is intentional, right? If only you cared more if only you tried harder or whatever, if you have only you cared about me more, then you, you know, would do something or other differently, which can be as disappointing for other people as it is maddening for you yourself, the person who has ADHD. So this then brings us to sort of my addition to Barkley's famous quote that, you know, ADHD is not as sort of knowing what to do. And that, you know, what I say is, in fact, people with ADHD know far better what to do because they've been told for more often what to do. If you're not doing the thing that someone thinks you should be doing, trust me, they're going to have something to say about it, right? So this is where you go from the neurological kind of the information processing executive functions stuff into the social, into the interpersonal and how someone relates to other people, which then comes back around to, you know, how do you think of yourself? If you're keeping told, don't do that. If you told it often enough, then eventually you begin to wonder what's wrong with me that I'm doing that. Why do I keep doing these things that I do? So let's talk then. And this slide here, this is where I'm going to maybe piss some people off. This is the slide that kind of like gave me the idea of contacting attitudes and saying, like, I really feel like I have to do a webinar on this. And this is a pet peeve of mine. And I'm going to try to be nice about it. I don't want to make anyone feel bad. I really don't want to sort of knock on anybody. But I do think it's an important thing to sort of get out there. And like I often see ads or whatever, you know, people's websites where they're like, I teach executive functions. And the truth of it is, is that executive functions cannot be taught. It's not a thing where you take someone with ADHD or whoever, right? And you run them through something or other, some sort of practice. And then they're better at whatever that executive function is that supposedly is being trained. The reason why it doesn't work is that ADHD is not about knowing, right? It's not about knowing what to do. It's about doing it. And, you know, so the analogy I give is, you know, this is why teaching someone healthy eating, I mean, like, it's fine. You know, there's some value in that. But teaching someone healthy eating does not equal them losing weight, right? Telling someone, eat more vegetables and drink less soda. It's great. Awesome. It's good advice. They're not going to lose weight just from that. And the reason is losing weight involves doing that better choice, making that different choice a thousand times, right? And maybe 900 out of a thousand, whatever. But like, it's about the doing it. It's not about knowing I should really order a salad and not their french fries. In the same way, the problem with the executive functions is they operate like in that flash of a moment. By the time you think to apply a strategy, your executive functions that'd be either done what they do or didn't, right? Like, so by the time this thing of I should do this strategy, it's sort of too late. Once you're distracted away, it doesn't work to say, oh, I should write that down. I should remember to write that on my to-do list or whatever. Now, a little bit in defense of some of these people who say I teach executive functions is when they what they call executive functions really is general organizational skills or study strategies or whatever. That's fine. They, you know, there could be some value in that. And I'm certainly in favor of good strategies. But let's also be clear in the true sense of it, that is not teaching actual executive functions. So really when we talk about managing executive functions, it's about setting up what's called the point of performance, meaning the time or place that you're supposed to do that thing that you're supposed to do. So therefore, because ADHD is all about performance, right, it's about doing not knowing, solutions or strategies that are actually likely to be helpful are really all about then the point of performance. It's all about setting up that moment in time or space where that better thing is supposed to happen. Those are the strategies that are actually going to make a difference. And the reason is this, right, to put it in another way. The problem with ADHD is, and frankly, a lot of other things in life, is by the time you feel it, it's too late, right? By the time you realize, oh crap, I should have left 20 minutes ago. It's 20 minutes ago, right? So if you get lost in time, if you're locked in on something, if you forget when it is that you're supposed to leave or whatever, it's done. The die has been cast by the time you realize, oh, I'm in trouble now. So that's the problem with this idea of teaching executive functions. It just doesn't work. So let's talk about what does work. That's actually why we're here. So here's some ideas based on that that are, I think, more likely to be effective. So the first idea is this idea that kind of chaos begets chaos. So the more chaos, the more disorganization, the more sort of a mess or kind of like you're just not on top of your stuff, right? The more likely, the more of that there is, the harder it is to manage the rest of it. That it becomes a little bit of this sort of like self-reinforcing process. If your life is kind of chaotic and disorganized, it's harder to stay on top of everything. So more things fall through the cracks and then life gets more chaotic and disorganized. You're probably not getting so much sleep. You're probably not working out. You're probably not eating as healthy. So you have less time to kind of like relax, let alone do any kind of mindfulness or whatever, right? So just things are just harder and harder and harder. And it becomes a situation where it takes a lot more willpower to kind of like force yourself through and to get things done because everything takes more work and more time. So that's the bad news. The good news is if you can, anything you can do that creates a bit more order in your life, or at least a bit less chaos, puts less work on to your executive functions. Right? If you say like, oh, I have to take this one, I go tomorrow, I'm going to put it over here next to the door. You don't have to remember in your head, remember to take that thing. But if you got a whole bunch of random crap next to the door, you may not see the thing that you're supposed to bring. Right? So you forget it, you walk past it, you're halfway there, and then you got to come back. So in whatever ways that you can, in terms of, you know, making your physical space more organized or a bit more conducive to being effective, looking at your schedule and all the things you have in it, your commitments and whatever. And the more you can simplify stuff down, even if it's not perfect, the better you're going to do. Now, the thing about it is, you're not doing this as a favor to anybody else. You're not doing it so you can get more of a Stuart Seal's approval. You're not doing it. So grandma is going to, you know, say, good job. Well done. Right. You're doing it because you will be more effective. You will feel better. You'll be less overwhelmed, less stressed out. Maybe a bit more efficient and effective at getting things done. So you can accomplish what matters to you, right? That is the reason to do it. And I say that because folks at ADHD get a lot more of other people kind of forcing their opinions and priorities onto them. So that's what we don't want. That's a terrible motivator. Let's talk for a moment about medication. So, you know, obviously it's a personal decision, whether you want to take medication or not. But generally speaking, the medication for ADHD, meaning mostly kind of the accentive release stimulants, they tend to work pretty well, right? They tend to do a good job of the things that they're supposed to do. The side effects and risks are really pretty manageable. And most people, not everyone, but most people can find a medication regimen. It really does make a difference in their life. That's worth something. And, you know, you know, again, you don't have to take medication, depending on your circumstances and what else is going on and your supports and demands and whatever. But the problem is all these awesome strategies, they tend to, frankly, the only work when you do what, right? So having a planner is great, but only actually helpful if you put things into your planner then look at it occasionally. So, you know, this is definitely a thing that I see is that the clients who come in who have not yet taken medication or not yet been diagnosed, they know a lot of the right strategies. But it's, again, it's that application. It's the performance. It's doing the right thing in that right moment. Quick aside, I guess this is the second slide that's going to piss some people off. BDHC has more than its fair share, fair share of kind of alternative treatments, meaning things that are going to be a little bit more effective and having things that are not the kind of standard stuff. And just the bottom line truth of it is none of these alternative treatments, whether it's nutritional supplements, dietary changes, natural remedies, whatever that means, brain training programs, like none of that stuff has been shown to be effective for the treatment of ADHD, like if they just haven't been. And if they claim they have research, most of that research, if not all of it, is just kind of junk research. It really doesn't prove what they claim it's proving. So, you can do anything you want, but my opinion is based on the research is, there's no reason to think any of that stuff is going to help your ADHD. Now, there are some folks who say, well, you know, look, I just want to try this, and then if it doesn't work, I'll try something else. That's fine. Like, I took, you know, whatever, like everyone makes their own choice, I don't vote on what you do. However, I do think that there needs to be a recognition that there are times where delaying treatment that's going to be actually effective, there is a cost to that. So, if you say, I'm going to do this like dietary thing for three months. Well, what it means is you got three months where your ADHD is probably not going to be as well-managed as it could be. Maybe that's not that big a deal. Fine. But I don't know. Maybe it is. Or maybe you are paying a high price for that. I think if we're talking about kids are adolescents who are kind of like not so psyched about treatment, if you waste their time for a while on something that isn't going to work, you may have less kind of chips to play. So, to speak to get them to then try something that really would be effective. You know, basic stuff, regular exercise, getting enough sleep, generally healthy eating, certainly we can add mindfulness, right? These are good for all people. I don't think we can call them an ADHD treatment. They're just good stuff. So, like, definitely do those things. But otherwise, in terms of any of this other stuff that's claimed, that claims to treat ADHD, I can't support any of it. Like I just don't know. I'm willing to be convinced as of yet I haven't been. Here's another whole kind of cluster of strategies is either seeking out a better environment, or if you can kind of building a better environment. Right? So, this is like the classic thing of like the college kid, you know, I get distracted in my room because of my roommates making noise or whatever. Okay, well, go to the library or, you know, go to the coffee shop or whatever. Or as my friend, Roberto Alvaro did, you know, ride the tea in Boston, the subway, ride the subway train back and forth while you sit there and get your work done. So, you know, where do you do your best work? Or where do you best work of this kind of work right here that you're trying to do? You know, what really helps to keep you on track? And I say here, no, seriously, meaning not just the obvious surface answer, but no, like really, really actually what is most helpful for you, right? And to really try to identify what that is. And it may be frankly that sometimes it's the variety. Like I'll work here for a while and then I get bored. So, let me go over there and I'll work there and then I get bored there. And then it goes somewhere like fine moving places, musical chairs. If that helps you, then do it. When do you do your best work? And again, like no, seriously. So if you say, oh, I do my best work at midnight or something. I mean, maybe like that can certainly be true if you're kind of a night owl. But it might also be that frankly, you do your best work at midnight because you haven't done anything before that. And now you have to do your best work then. But, you know, if you find that you're like, let's say most effective after working out. Okay, plan your biggest brain power work for that time. The hardest most cognitively demanding tasks should be done at that point or if you're taking medication and when the medication is most effective. Not when it's sort of half worn off. I think it's helpful also to sort of think about signal to noise ratio. So signal meaning here's the stuff I should be paying attention to. Make that big and loud and obvious. Noise is distractions and other stuff that's going to pull you away. So how do we quiet out the noise and distractions so it doesn't sort of ping your attention quite as often. Let's talk about productivity drains, right? This is the stuff that sort of like these are the temptations and distractions that sort of pull you away from the thing that's most important to be doing. So I sometimes I mean using this line more and more of like don't over rely on willpower. Some all in favor will power and discipline like those are admirable qualities to have, but the problem is. They never work as well as we hope they will, right? Like we like the idea that we're going to be able to kind of resist something and you know what sometimes we do. But if you're being kind of overly optimistic, then it's probably not a good idea, right? So you know sometimes a line that I use with a client is yeah, I don't know, would you bet a thousand bucks on that right? So in other words, I can just do my work in my room or you know if you're working in an office where there's people banging around and making noise rather than kind of wandering off to the conference room that nobody's using. You know like well, would you bet a thousand bucks that if you're sending your desk, you're actually get that report done. I mean if the answer is yeah, I bet a thousand bucks, then you should totally do it. But if at the same time you're like, I don't know, I mean I guess probably yeah, probably I should go somewhere else. So what pulls you off cast, right? What are those situations or temptations or whatever that sort of pull you away from the task that you like should be doing? The thing that you feel like yeah, that's really what I, you know that would indeed be the best use of my time. And I've kind of thought I've kind of more and more come to this idea that if we know what pulls us off and then later we don't like that outcome. But then we don't do anything different beforehand. I think what it kind of reveals. is that like, you know, we're accepting the risk, right? They were accepting not doing the thing. It's sort of like, um, if you're struggling with drinking and you keep going to the bar and then predictably you keep drinking, I think I'm going to begin to kind of get an idea. I sort of think you're still okay with drinking. I know you say that you want to stop, but I don't, I don't actually think that you do. I think at this point in time, drinking is still acceptable to you or to bring it back to ADHD. You keep winding up on, you know, Instagram or whatever. I think you're okay with that. Like, I think that that is actually a thing that you're okay with. Um, so, um, you know, which kind of brings us then to this other strategy. And this is a bit hard ball, but like, that's okay. Um, but you need an internet blocker, right? So one of these programs that limits when you can go on to certain platforms or how much time in total you can spend, like they're often used kind of parents using with kids, but frankly, sometimes adults need to use them themselves. And, you know, if the answer is that you tend often to spend too much time messing around on fun, but not that helpful thing is online, then maybe you do need some sort of an internet blocker. Um, because let's face it, the internet is really interesting. There's lots of fun, exciting things online, but they're not always the most productive things. So, you know, really consider it. And by blocker, I mean actual blocker, something that says you've now spent four hours on social media swipe. That's not a blocker. That's just like an alert, which you will easily ignore. Um, another set of strategies involves basically externalizing any sort of executive function related tasks to better tools, right? So internalized meaning I'm going to do it in my head externalized meaning I'm going to do it out here. So scribbling a note to yourself, that's externalizing it because it's now out here in the world, not up in my head. So this is all those kind of good ADHD friendly strategies. So anything like, you know, reminders of various kinds alarms, lists, schedules, you know, sort of auto pay rather than paying, you know, the electric bill every month, have them pull it out, using air tags or other things that will sort of keep track of your items, your belongings, maybe a key padlock that you punch in the code rather than having to remember where your key is. Um, any stuff that you can do like that is probably more reliable than internal skills, right? Anything that is going to be more consistent is probably going to be helpful. And just in general, kind of like as I say, reducing friction and potential off ramps. So, um, you know, one example like is use a password manager. So then you don't find yourself in that situation. I don't know, I had a client, I was talking to him, he was like, oh yeah, I was going to, you know, pay the bills online. So then I go to the bank website and he realized like crap, I don't have the password. So he goes, click password reset. Then he goes into his inbox. Of course, while he's waiting the six seconds for the email from the bank to show up, he sees another email. So he clicks, there's, oh, I should really, you know, boy, and then he's writing on that and he sends it and then he's over here and then he's doing the next one. And then you go, right, and like you never reset the password, he never paid the bill, right? So having a password manager besides the obvious like security reasons, it also means one less thing that's going to kind of pull you off of the task that you should be doing or just getting rid of closing out as many of those tempting tabs, the fun ones. So they're not there and tempting you. If there's certain things that you have to have to do a certain task, right, clamp them all together so that you don't have to go hunting for things. So it just doesn't, you know, it doesn't add more time to what needs to be done. I think in general kind of another set of strategies that's more helpful in terms of managing executive functions stuff is to speed up the consequences, right, to make the consequences much more specific, much more certain and much more immediate. So I saw this quote, I don't know, not the long ago, is talking about kind of like, you know, people being punished for crimes. But the quote was that it is not the severity of punishment that's most effective. It's the certainty of punishment, right? If you know you're not going to get away with it, it's going to be much more effective. Because of course, we all like to roll the dice and be like, oh, I'm feeling lucky. I think this one's going to work out, right? I'm not going to do my math homework, but the teacher won't check it. Or I'm not going to do the prep work for the meeting, but hopefully the boss doesn't call, you know, ask me and then I can sort of fake it if they do. So, you know, any vague consequences not helpful, anything that you can potentially avoid or something that doesn't kick in until long down the road, right? At the end of the year, or boy, you're going to be unhappy. You didn't do your monthly reports or whatever, right? It doesn't activate most people, but it really, really doesn't activate people with ADHD, right? So if you have a big project to do, I don't know, like for example, doing regular check-ins with your boss, not just all the way at the end. I'll hand it all in, but every week or every twice a week, let's sit down and we'll just do a five-minute check-in. In general, as much as I'm all in favor, natural consequences for some things, the problem is natural consequences sometimes don't show up or they take too long to show up, right? So the natural consequence of smoking is 40 years from now, you were 30 years from now, you die of lung cancer, right? That is not an effective deterrent. So, you know, some sort of artificial circumstances might be a whole lot more effective. So, for example, telling a kid or a teenager, you can get yourself on back after you finish your homework. If that takes a half hour, it's a half hour, if it takes four hours, that's four hours, but like if you want your cell phone, here's what you need to do. That also eliminates the nagging chase of like, do your homework, have you done your homework? Where are you at in your homework? Come on, come on, come on, come on, right? Like this way it sort of puts the motivation into them to figure out what they need to do. And then coming down to the very end here, how to maintain motivation. In general, you know, ADHD's lifelong, I mean, life is lifelong. So it's not just about what's something I can do like one time and then everything is going to be lovely. It's more about day after day after day, you know, hour by hour, minute by minute, how do I continue to set myself up to do the things that are better to do? And I think in general, it's much better to focus on your process rather than just on the outcome. This kind of fits into the whole like growth mindset stuff, but the reason is in general, outcomes take too long to show up. So, you know, if you're a student and you're saying like, okay, I'm going to start doing this differently and boy, your migraines are going to be better. I mean, they will be probably, right? Presumably, but it's not like all of a sudden your grades are better because for two days, you know, you reviewed your notes from class or something, right? It doesn't change that quickly or, you know, definitely, you know, I'm going to start eating better and working out and then I'm going to get into better shape. I mean, you will, but let's face it, it's not in a day, it's not in a week, it may not even be in a month or three months, right? Like, that is a process that takes time. So, my big advice for stuff like this is if you can, to whatever extent that you can, find a way to make that process more enjoyable, right? If you hated, you're just not going to be consistent about doing it. Let's just be honest, or to the extent that you are, it's going to be a total slog. It's going to take too much willpower to like force yourself to keep doing it. So, um, whatever you can find some way to make the process a bit more enjoyable, or add in sprinkle in some little rewards along the way, or something that keeps you showing up and applying some good effort. I think also, especially because folks at ADHD get a lot more kind of criticisms and corrections, right? All those comments where you're not doing the thing that someone thinks you should be doing at that moment, um, to really be intentional about kind of taking some pride in what you're doing, right? So, for example, every time you, you know, put something into your schedule rather than saying like, "Ah, I'm just going to remember it." Or, you know, for a college student every time they say, "You know what? The dorm is too loud. I'm going to the library." Or every time you, you know, chuck your gym bag into your car in the morning and then stop the gym on the way back. We're frankly even just chucking your gym bag into the car. Um, great, noticing those moments, noticing like, yeah, that's good. Like that, that is a good thing. Like, I'm proud of myself for doing it. I don't say you throw yourself a parade because you read something in your schedule, right? But, but to kind of take a moment and notice it and to kind of Give yourself a little bit of credit of like, yeah, I can do this. Like I am doing things that are going to make my life better. I have some agency here to improve my life. And when the setbacks come and they absolutely will, guaranteed, you're not going to bat a thousand, you're not going to be 100%. Right. When the setbacks come, don't beat yourself up. Don't say like, well, there it is. Of course, it wasn't going to work out. I don't even know why I bothered at all. Right. Back on the horse, right. Whatever happened yesterday, what can you do today? Right now in this moment, what is one thing I can do to get myself back on to make my life a little bit better? And to really sort of remind yourself to hold in mind, especially when you don't feel like doing it, to remind yourself that the good outcome, the thing that's important to you, that goal that's meaningful and matters. Right. What you get there is just by using a good process. One step after the other, you just keep focusing on using that good process. So hopefully this has been helpful. Hopefully it's given, I mean, obviously in, you know, 37 minutes, I'm not going to cover every single strategy in every single situation. But hopefully it gave you some kind of a bit of a kind of conceptual idea. I gave you some kind of big ideas to then apply to the specific situations that you're going to find yourself in. I would also just really quick put a plug in. It's now November 9 in three short weeks. The big ADHD conference sponsored by Chad, Adda in ACO is going to be down in Baltimore. So Thursday, Friday, Saturday, November 30th, December 1st and 2nd. And it's also a completely separate, all different presentations. Online conference is going to be the week after that December 5th and 6th. So if you go to CHADD.org, you can get some information there. It tons of great stuff going on. So highly recommend it. But on that note, let's go to the Q and A. Okay. Great. So thank you for that. Before we start the Q and A, I'd like to thank you and Flow once more for sponsoring this webinar. I'd also like to share the final results from today's poll question. If you could have a superpower to improve your executive function, what would it be? Here's what you said. 30% said motivation boost. 27% said memory enhancement. 22% said time manipulation. And 8% said the power to multitask. So about time manipulation, we have a lot of questions about time management. And as you can imagine, and they're regarding adults and children. This one is from an adult who says, "I'm late for everything. Is there a way to change my perception of time? Could hypnosis help? Are there techniques or other exercises to change my sense of time? I'm desperate." Sure. Yeah. This is definitely a common situation. So hypnosis, no. I think this stuff that's going to be most helpful is it's going to be a lot of stuff that basically sets a better foundation. Then there's going to be some stuff that's more specific in the moment. So, better situation is things like putting a bunch of clocks around and not digital clocks, but the old fan should analog that has a hand that moves. So you can literally see that progression of time. I think that's some of it. I think, so you're just generally a bit more aware of time. I think having less going on, like when you're overwhelmed and scrambling, you're not paying attention to time. So try to put in a bit more breathing room. I think being a bit more intentional about your scheduling and how you set things up in maybe in particular what comes before what. So if it's something that you're likely to get stuck in, that may not be the best thing to transition to like, "Oh, got to get up and go here." I think some specific things like setting a bunch of reminders on your phone. So not just, you know, got to leave, but also 15 minutes before and maybe 10 minutes before and 5 minutes before. And to really sort of honor that and to not talk yourself into a whole other presentation, what are your favorite lies? Right. I'm just going to finish. Just take two seconds. I'm just going to finish this and then I'm going to get up. No, you're not. I mean, maybe you might, right? There was that one time. But probably not. Like mostly you're not. So let's not sort of lie to ourselves that that's going to happen. Maybe then what you do is you snooze the alarm for a minute or two rather than turn it off. You don't turn it off until you're literally standing up and walking away. I think also being really intentional about like when do I actually need to leave? I've got a two o'clock appointment. How long is it going to take to get there? I probably need to park also. Let's add in 15 minutes because it just is somehow you always need more 15 minutes. So add that in there for one 15 is when I'm actually like walking out the door. So when do I need to set the alarm? Also things like, you know, what's the phone number of the place or what is the address? What do I need to bring? So you're not getting up at 115 and realizing like, oh crap, wait, where am I going? Where is this again? Right? And then you're googling or you're like going through emails. So things like that to set you up to actually be able to be more effective in that moment. Okay. So when asked are there emotional components with the problem of visualizing time? There absolutely can be. I mean, certainly there can be emotional responses to having problems, right? Emotional responses that follow struggles with time, you know, from stress of like, oh my god, I'm behind here to all the feelings that you might have about yourself of like, God, why do I keep doing this? Why do I keep messing up? You might, you know, feel defensive about others kind of maybe even before they do anything. You might feel defensive like they're angry at you. But also certainly anxiety and depression and just other strong feelings like that can also impact our sense of time or ability to like pay attention to time in the moment. So, you know, that stuff that maybe therapy could be helpful with in terms of like managing that emotional piece. I don't think therapy is going to change your inherent sense of time, but it's at least going to address this other part that kind of like interacts with it. A therapist says that a lot of his clients have shame and a negative self concept because of their lack of motivation and lack of success. And he says that they're a big barrier for a lot of his clients with ADHD and EF difficulties. What approaches are most helpful for supporting these clients struggling with the weight of shame and low self esteem? I mean, and that, you know, sadly, this is true, right? This is not an uncommon situation that, you know, again, like if you're more often off-task compared to what someone else thinks she should be doing, if you're going to get a lot more of those comments and criticisms and that does begin to affect, you know, a few million of those, you begin to sort of wonder, you know, how am I doing here or who am I as good as I need to be? So like that is definitely an easy place to go. So, you know, I think the way it is kind of like improved that, I think some of it is legitimately improve your batting average, right? Fagicate yourself about ADHD, maybe get some medication, maybe see a therapist or a coach or an organizer, kind of find the way to get on top of your ADHD and reduce the impact that it has on your ability to do what you need to do. That's some of it. There's also some of it, which is especially if you're more kind of late to the diagnosis, right? So you didn't get diagnosed at 8 and now you're 25, but maybe even that. But, you know, to sort of integrate an understanding of ADHD into how you understand your path and what that tells you about yourself, right? So for example, to be able to look back and say, you know what, I did generally mean well. And also sometimes I was impulsive and I shot myself in the foot. That's not really who I am. And I understand why people responded to me the way they did. But again, it's not really who I am. Like I can understand myself in a different way now through the lens of ADHD. So I think that that is an important part of it as well. And then finally, I think some of it is, it's coming to some acceptance, right? Meaning I don't have to be perfect. I don't have to be like everybody else. I don't have to, you know, whatever. Like this is who I am. There's a lot that's good about me. There are things I like. There are things I would change. But like there's a lot that I like. I can be okay with it, right? And some of that might mean, for example, you know, like telling a friend, like, look, I work really, really hard at being on time and I still suck at it. I suck less than I used to. But if you need a friend who was always on time, I think you need to have someone else's your friend. I can't be that friend to you. Now it's not being cavalier and irresponsible, right? You do need to show that you're making the effort. But I think like at some point, like you do have the right to say, This is who I am. You can kind of take it or leave it. Right? Like I'm not going to try to be something I'm not. I'm not going to feel bad about the fact that you have unrealistic expectations for who I am or what I can do. - We have a couple of questions around managers or bosses in the workplace. One question is, do you have any recommendations on how to approach my boss about cultivating executive function skills and what they can do to support our success in the workplace? - I think, you know, kind of like I said before, I don't think it's about cultivating executive function skills per se, so much as setting up sort of systems and back stops to kind of support the existing executive function. So for example, if I don't know, there's a regular meeting to send, preferably, you can auto-generate this that, you know, like you get an automated email or text that has the information, especially if it's like a zoom link or something, you know, so that way people are in sort of scrambling to find the link for it or putting up like big whiteboards and people can write notes on that or, you know, being open to other ways of getting work done. So it could be simple things like, look, I need to use noise canceling headphones because all this chatter, like I don't get sunless effective, I will do less work for you if I can't use the headphones or if nobody's in the conference room, can I go and work in there? Or can I, instead of being here from nine to five, can I do like 10 to six or something? You know, being flexible in how the work gets done as long as you're kind of hitting the mark on the quality that's needed. - Okay. Someone writes medication helps my team with focus and attention, but it doesn't help her with motivation to get started in the first place. What can I do? - Yeah. And that is a thing, right? Like it might be that under the best of circumstances, your daughter isn't really that motivated to do this stuff, right? Like I don't understand why I'm reading history. This isn't now or whatever. So that might be too much to ask that it's going to make her motivated, but, you know, what I would say is, first of all, eliminate the competition, right? If it's time to do homework, let's take away the things that, you know, basically win in the attention contest against homework. So, you know, if messing around on her phone means she's not getting stuff done, sorry, honey, I think we need to put your phone in the other room. Now, if you can use it and get work done, awesome. Knock yourself out. But if, you know, evidence to showing us work is not getting done when the phone is in the room, I think we need to take it away. I think, you know, generally starting work earlier, not later, right? So having some hard cutoffs on things like bedtime. And, you know, maybe setting up some small rewards, asking her what's going to help her be more motivated to get it done, you know, including what are the benefits that come from getting it done? Maybe what are the benefits in terms of grades in thinking about like what colleges might she want to go to and is her current, you know, way of getting work done, getting it get her there. So to really kind of look for the things that are going to motivate her. But at the end of the day, it may just be like, well, honey, you just need to do this. I know you don't want to do it. Trust me, I do things I don't want to do. Sometimes you just need to find a way to get it done. So let's talk about what will be helpful to just get it done. - Okay. Someone writes, "How do we help our life partners understand that we're not being careless or lazy?" - Yeah, that is a good question. So I think it's a matter of showing your partner that you're trying, right? That you may not be, you know, hitting the bulls eye every single time, but show them that you're taking it seriously, show them that you're putting in the effort, that you're doing the things that might prove to be helpful. It's sort of like, I've got this line, free passes are earned, right? So once in a while, you're going to mess up as we all do. But, you know, can you show your partner that it's important to you to do the things that are important to them? I think some of it is frankly about kind of setting the right expectation. Don't agree to do something that you don't think is going to work out. So don't say, "I'll be home at six" when you think about it. Like, I would like to be home by six, but I can't guarantee it. Then don't say, "I will definitely be home by six." Maybe say, "I might be home by six." Maybe say, "Call me at 530, see where I'm at." But don't sort of like, "Does it temptation to dodge the conflict of the moment and hope it works out better later?" And let's be honest, mostly it doesn't work out better later. So, you know, I think also sharing with them the things about ADHD, they're really kind of resonating to feel helpful for you, you know, might help them understand a bit better and not kind of take it so personally. Someone writes, "I know I have to do things. I can't bring myself to do." Isn't that a discipline issue? Maybe. It might be. It might also be. This is not always going to be the case. And I don't want you to sort of get out of something you really should do. But sometimes if you're not getting to something, it's because you don't actually really want to do it, right? It's sort of a thing of like, "I feel like I should." Or it's somebody else's goal, or it feels like someone else wants you to do it, so therefore you should do it. Now, sometimes maybe you should. Like, if it's someone who matters to you, sometimes we do need to just bite the bullet and do it as a generous act. But I don't know. Maybe it isn't really a thing that you're that motivated to do. On the other hand, if it is a thing that legit is worth doing, then to sort of figure out what is it going to take to get this done. Maybe it's sort of an external accountability thing. Maybe I got to tell someone that I'm going to do this. Or maybe I just really need to kind of set it up and bite the bullet that like, "On this day and at this time, this is what I'm going to do." Here's the first piece of what I'm going to do to get this done. Or maybe I'm going to gather up what I need, reduce some basic preliminary research, and then set it up so when the time comes, I'm ready to rock and roll. And if you need to set up some sort of a NICELAR award for yourself on the other side of it. Someone writes, "My home is disorganized, and I'm wondering if there's research on physical clutter and disorganization in the home, and whether that has a negative impact on kids and their executive functional abilities?" I don't know if there is research, but I think that probably we could all agree that it does. I mean, clutter, depending on what degree, but the problem with clutter is it's sort of distracting, and things get kind of swallowed up by it. And the things that are most important don't stand out as much, or you can't find what you need when you need it, which adds extra time and frustration. So, in terms of clutter, I mean, my opinion, my wife doesn't entirely have this opinion, my mother-in-law definitely does not have this opinion, but my opinion is, first and most important is functional. Does it work? Can you do what you need to do? Then number two is, how does it look? So the aesthetics, second, if you're actually getting things done. Okay. Um, um, um, a mom says, "What's a good way to set up my child's study space for school?" I think I would start by asking your child, "Okay, what do you think? Like, what is going to be most effective for you?" Now, I'm not saying then you do everything they say, but at least you start the conversation, and maybe you try some things out, right? If there's something where you're like, "I will bet a million dollars that will not work," but, you know, they're not on the cusp of failing out. Maybe you say like, "You know what? We'll try that for a week, let's see." See if it works. If somehow it does, doing it another week. If it doesn't, then you go, "Uh, you know, that was worth a shot, but, you know, unfortunately, I don't think it's really that helpful, so I think we need to do something different." And it's really going to be, again, about signal to noise ratio. It's about reducing the distractions and temptations and making the bigger, the more important stuff kind of bigger and more obvious. So, like, putting up big posted notes or using a whiteboard or breaking stuff out or having like, "Here's all your books and papers and pens," which I probably nobody actually uses anymore. Here's your iPad charger. And, you know, just really making it as smooth and streamlined across the place to do the work as you can. Okay. Well, unfortunately, that has to be our last question, because we're out of time. But, Dr. Tuckman, thank you so much for joining us today and for sharing your expertise with our ADHD community. We really appreciate it. Got my pleasure. It's always fun to come out. Thank you. And thank you to today's listeners. We hope to see you again next week. Make sure you don't miss future attitude webinars, articles, or research updates by signing out. to receive our free email newsletters at attitudemag.com/newsletters. If you're listening in Replay or Podcast mode, visit attitudemag.com and search Podcast 479 to access the webinar resources or simply click on the episode description wherever you stream your podcasts. And if you support the work we're doing here at Attitude to strengthen the ADHD community, be encouraged to visit attitudemag.com/subscribe and sign up for Attitude magazine. Attitude magazine is having a two-for-one sale, so subscribe today for yourself and you could share with the teacher or loved one who could benefit from greater ADHD understanding. Thanks everyone, have a great day. For more Attitude Podcast and information on living well with attention deficit, visit attitudemag.com. That's ADDITUDMag.com.