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Organize Your Mind, Organize Your Life
Harvard Health Publications
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Organize Your Mind, Organize Your Life
Harvard Health Publications
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CHAPTER 1
The Rules of Order/Dr. Hammerness
IT WAS A THURSDAY, AROUND 6:00 PM, and I was sitting in my office in Cambridge, Massachusetts, located along a tree-lined stretch of Alewife Brook Parkway, a few miles outside of Harvard Square.
The four-story brick building, an annex of Massachusetts General Hospitalâs psychiatry department, is where I see patients as part of my research and teaching responsibilities at Harvard Medical School. They span the age and occupation spectrumâelementary-school children, grandparents, lawyers, salesmen, housewives and house-husbandsâbut they have one thing in common: they are coming to see me and my colleagues with familiar complaints and concerns. âI know I could be doing betterâ is a common one; as is, âI canât go on like this.â
While the complaints may vary slightly, the symptoms they describe are the sameâand consistent with the condition we treat. Youâve probably heard of it: attention deficit/hyperactivity disorder (ADHD).
One of those patients, weâll call her Jill, is late for her appointment.
As I sit catching up on e-mails, the door bursts open and in she flies, out of breath from climbing the two flights of stairs to my second-floor office. She is flustered and clearly upset.
âSorry Iâm late!â Jill says, as she plops down on the chair facing my desk. âYou wouldnât believe my day.â
âTry me,â I say. âTake a deep breath and tell me whatâs going on.â
Jill is in her late thirties and a highly educated research scientist, one of the many âknowledge workersâ who labor in Cambridge, home of Harvard and Massachusetts Institute of Technology. She takes a moment and launches into her story, which begins a few weeks earlier when she temporarily moved into a friendâs apartment while her own house was being renovated.
âLast night, when I came in,â she says, âI put my keys down somewhere, and this morning, I had not a clue where they could be.â
I nod. I have a feeling I know where this is going.
âI looked everywhereâthe usual places, which of course are not the usual places, as itâs not my place. My friend, she really is a good friend, but I am wondering if she has more trouble than I do. You think I am disorganized, you should see her placeâŠ.â
I know this is the right time to jump in and direct our conversation back to the issue at hand orâlike this morningâJill could continue running in verbal circles and not getting anywhere. âOkay, so, you were looking for your keysâŠ?â Jill smiles. âOh, right, yes, I was flipping out. I spent thirty minutes trying to find my car keys.â
Jill then stops, shaking her head.
âWell, did you find them?â I ask.
She nods ruefully. âEventually.â
âWhere were they?â
âRight on my friendâs kitchen table! And, of course, Iâd walked back and forth through the kitchen ten times while I was looking for them. All that time they were right thereâŠright there in front of me. Unbelievable!â
âSounds very frustratingâŠbut pretty believable, as those keys have eluded you before.â Jill smiles ruefully, and I press on. âThen what happened?â
âMy day was in shambles from that point on.â Jill went on to relate how the half hour sheâd spent looking for the keys set off a domino effect of tardiness and inefficiencyâproblems galore. She arrived at work late for a meeting and opened the door to the conference room just in time to interrupt an important point that one of her companyâs head honchos was making. Embarrassed and angry at herself, she returned from the meeting and finally got in front of her computer to find a barrage of e-mail reminders that further annoyed and overwhelmed her. She sent out a flurry of responses, including a snippy reply to the wrong person, who was not happy to get it (neither was the correct recipient, when she eventually cleared up the mistake). Dealing with her e-mail gaffe kept her from attending to a project due by noon. Her deadline blown, she skipped lunch, scrambling to get her work done, and what she did hand inâtwo hours lateâwas subpar and received with something less than an enthusiastic response by her supervisor.
In other words, it was a crummy day for Jill. It wasnât the first time such a day had begun with something misplaced or by an episode of forgetfulness, but the snowball effect of losing her keys still surprised and upset her.
âThis happens all the time,â Jill says, teary-eyed, angry and ashamed. âAt this rate, I could lose my jobâŠjust because I canât keep track of stupid things like keys.â
Iâm sorry to hear that Jill is upset, but her story is not unusual. Jill has ADHDâand she is certainly not alone. Itâs estimated that about 4 percent of adults and 5â7 percent of children in this country meet the medical criteria for ADHD. Itâs equally safe to estimate that at some point in their lives almost everyone has felt as if they have ADHD, too. The symptoms of ADHD include forgetfulness, impulsiveness, losing items, making careless errors, being easily distracted and lacking focus. Who hasnât exhibited one of these symptoms in the last few daysâŠor even hours? Who hasnât lost their car keys? Who hasnât been distracted in the car (once the keys are located), on the job or at homeâby a text, a tweet, an e-mail, a cell phone ring? Who hasnât been late for a meeting or missed a deadline or made a mistake because they were disorganized that day, lost focus that morning or were distracted that minute? That doesnât necessarily mean you have ADHD, but it does suggest you might be part of the distracted masses that now make up such a large part of our society. If so, youâve come to the right place because weâre going to show you how to get back on track.
ADHD or OBLT?
(Overwhelmed By Life Today)
If you answer Often or Very Often (on a ranking scale of Never, Rarely, Sometimes, Often or Very Often) to four or more of the following questions, it may be beneficial to consult with a health professional to see if you have ADHD.
In the last six monthsâŠ.
- How often do you have trouble wrapping up the final details of a project once the challenging parts have been done? (never/rarely/sometimes/often/very often)
- How often do you have difficulty getting things in order when you have to do a task that requires organization?
- How often do you have problems remembering appointments or obligations?
- When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
- How often do you fidget or squirm with your hands or feet when you have to sit for a long time?
- How often do you feel overly active and compelled to do things, like you were driven by a motor?
Source: World Health Organization
Whether or not you have ADHDâand chances are, you probably donâtâthe purpose of this book is to inform, inspire and organize your brain. Whether forgetfulness is a âsymptomâ of a disorder for a person like Jill or an âissueâ for someone else who doesnât have the same degree of severity, this book will approach it in a straightforward wayâand with equally straightforward and effective solutions.
What was first labeled the âDistraction Epidemicâ by Slate magazine in 2005 has now reached epic proportions, right up there with the obesity epidemic and is of no less import than that or other public health crises that have befallen modern society. In a 2009 New York magazine story on the attention crisis, David Meyer of the University of Michigan described it as nothing less than âa cognitive plague that has the potential to wipe out an entire generation of focused and productive thoughtâ and has drawn comparisons to the insidious damage of nicotine addiction.
âPeople arenât aware of whatâs happening to their mental processes,â says Meyer, âin the same way that people years ago couldnât look into their lungs and see the residual deposits.â The difference here is that unlike the âmad menâ of the 1950s and 1960s who went around merrily sucking up packs of unfiltered Camels, seemingly oblivious to the harmful effects, most of us today know that we are having problems staying focused, paying attention and maintaining some sense of order in our lives.
Unlike smoking (which you either do or donât do), itâs not just the people afflicted by the most serious and definable form of distraction and disorganizationâADHDâwho are affected by this epidemic. Ask friends, family members and colleagues how theyâre doing, and chances are, the responses will usually include words like âfrazzled,â âstressed,â âoverwhelmedâ and âtrying to keep my head above water.â In casual conversation, you often hear people talking about âbrain freezes,â âblanking outâ on something or suffering âsenior momentsâ (often, when they really arenât very senior). All of themâŠall of usâŠare affected to some degree by the epidemic.
To get back to my patient Jill in the four-story brick building in Cambridge, Massachusetts, I knew that the woman with the lost keys and the lousy day was not one of the millions complaining to each other about how crazed their lives have become. She has a clinical disorder; most do not. But, as I listened to Jillâs story, I also knew the potential power of a rather simple solution that could help her and many others.
A couple of weeks earlier, during one of our regular sessions, Jill and I had somehow gotten on to the topic of the Apollo lunar landing. We talked about the coverage of the fortieth anniversary of that historic moment, the spectacle of the great Saturn rocket that hurled the astronauts into space, how exciting it still was to see the old black-and-white images of Aldrin and Armstrong on the moon and hear their voices crackling over the television from Tranquility Base and about whether weâd ever go back.
The memory of that conversation about the space program and her interest in it gave me the language needed to help frame the solution for Jill.
âSo, I have a thought about how to start your day tomorrow,â I say. âAs weâve been talking about, we are working on bringing order into your life, changing old patterns that donât work with new ones that do.â
âRight, that sounds good,â she says attentively. âWhatâs your idea?â
âYou need a launch pad for your keys.â
Her eyebrows raise quizzically.
âA launch pad,â I repeat. âA place where you always put your keys and maybe your ID and glasses, too. That way, youâll know thatâs the place theyâre always going to beâŠand every morning, thatâs where youâll launch your day.â
Slowly, as if an unseen hand was drawing it methodically, a smile etches itself across her face.
âA launch pad,â Jill says, starry-eyed âYes, a launch pad. What do I have to use? A boxâŠa hookâŠa basketâŠa tray?â
I smile back. âItâs your launch pad. You can use whatever you like. You just need to make sure you know where it is and keep it in the same placeâŠso that the moment you enter your friendâs house, youâll leave your keys there and then every morning thatâs where theyâll be. On the launch pad, ready to lift off.â
This seemed to really resonate with Jill. First of all, it was an action-oriented solution, something she could do right away and without great difficulty. But more importantly, and Jill appreciated this, the launch pad served as an image, a reminder of how oneâs day can begin, not in confusion and distraction but with precision and predictability.
The next week, Jill arrived for her appointment on time. And she entered the room not in a huff but with a smile.
âGo ahead,â she says, âask me about my forgetfulness this week. Iâm ready to answer.â
âOkay,â I respond. âSo tell me, did you forget any items, appointments, things like that this past week?â
âNope,â she said triumphantly, âand hereâs why.â She reached into her pocketbook and pulled out a small, uncovered trinket box, one, she explained, that she hadnât used in years. âMy launch pad,â she says, proudly. âI have a spot for it right by the kitchen door.â Moreover, Jill went on to tell me, she had not neglected the area around the launch pad. In fact, you could say that a major redevelopment project had been undertaken in the area: the table cleared and the space near the door rearranged so that her launch pad had its ownâŠwell, space. That wasnât all, she reported. She built a launch pad at her office, tooâbut this one was project oriented for critical tasks to distribute to others. This, too, was accompanied by a cleaning and rearranging of her workspace.
That week, you might say, all systems were go for Jill. Is this an ADHD âcureâ? No, but itâs a small success to build upon. And she has. You could see the impact on her organization and on her self-esteem; she began to regain confidence, as she could now trust herself that her mornings would be a little less frantic and a little more consistent. Iâm happy to add that since she âlaunchedâ her launch pad, she has not missed a morning meeting again because of time spent looking for her keys.
My experience with Jill illustrates a few important points about organization. First, individual moments of forgetfulness and disorganization can have major consequences.
Second, just as one episode of forgetfulness triggered a series of negative events, so can one small step lead to giant leaps of improvement in the organization of oneâs life. The launch pad is a simple solution, but it has effects that go far beyond knowing where your keys are. You begin to think about other things you can organize. You have more time. You are less stressed before you leave the house in the morning. You enter a new environment more relaxed and thinking more clearly. And so on and so on.
Third, and this might not be something readily apparent from hearing the conversation with Jill, the simple remedy that I suggested is rooted in an understanding of the workings of the most complex organ known: the human brain.
THE ORGANIZED BRAIN: TAKE A LOOK
You may have heard about how neuroimagingâour ability to look at the structures and functions of the working brain through advanced imaging technologiesâis giving us incredible insights into our understanding of how the mind works. Thatâs true, and nowhere more so than in our ability to see how the brain is structured to help it function optimallyâin other words, its organization.
So just how is the brain organized? Well, at first glance, its complexity seems almost beyond comprehension. The human brain is composed of neural cellsâan estimated 100 billion neurons!âthat are connected into groups or circuits, communicating with chemicals called neurotransmitters. These groups form larger macrocircuits. The scale of it all is mind-boggling. But hereâs a good way to visualize it: Think about looking at your house on Google Earth. You can zoom in and see where you live and your neighborsâ housesâeach of them like a single neuron. Toggle back on your computer, and you can see a whole block. Go back further, and the blocks form a neighborhood, a community. Even further, and youâre at jet-plane level, looking at clusters of communities forming a metropolitan area. The brain is structured in a similar way. Put all those individual âhousesâ (neurons) together, and you go from something relatively simple into something enormously large and complex.
Now imagine itâs a hot summer day in your neighborhood, and you and everybody on the block cranks up the air conditioning. Folks on the adjoining blocks are doing the same. If the whole community and the adjacent communities are doing it, tooâresponding to the hot weatherâwhat do we have? An overload, maybe at the local level, but more likelyâif enough blocks or neighborhoods are involvedâa grid failure, a blackout, an entire community powerless.
What happened is that the syst...