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

 

 

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

Categories: ChildhoodDisorders, MentalHealth, SelfHelp