ADHD: Nurture Matters

A recent press release announced: “Children in Foster Care Three Times More Likely to Have ADHD Diagnosis.” A study found that 25% of children in foster care had been diagnosed with ADHD, more than triple the 7.14% of all children in Medicaid who were not in foster care.

The obvious question is why this occurs. Clearly, neglect, abuse, attachment disruptions and emotional upheavals correlate with ADHD symptoms in this population of children in foster homes. In other words, their environment contributed to their mental health condition; the etiology of their ADHD was not strictly biological. If the above mentioned statistics are not pure happenstance, the ways these children were (and were not) taken care of caused them to develop ADHD.

A follow-up question, then, is: Why is the first-line treatment in these and so many other children most often medication? Why are there not more and better-known and used psychologically-based treatments that focus on mitigating abuse and neglect, repairing attachment disruptions, and healing emotional wounds? The issue is not restricted to children diagnosed with ADHD. Recent research reveals that poor children on Medicaid are four times as likely to receive antipsychotic medication as are kids whose parents can afford private insurance:

Some experts say they are stunned by the disparity in prescribing patterns. But others say it reinforces previous indications, and their own experience, that children with diagnoses of mental or emotional problems in low-income families are more likely to be given drugs than receive family counseling or psychotherapy.1

This is not only a mental health issue; it’s a public health and a social justice issue as well.

In the context of neurochemistry, medicating ADHD makes perfect sense. Studies have shown that people with attention-deficit symptoms have, for example, low levels of the neurotransmitter dopamine. If you’re a psychiatrist, and you have a patient complaining that she can’t focus, and you can give her a pill (Ritalin or Adderall) that will increase her dopamine, which will stimulate the “reward center”2 in her brain and increase her motivation, wouldn’t you write the prescription? There are so many cases in which medication has reduced symptoms (only while the drug is active in the body) that it has become by far the most established treatment for ADHD.

One potential problem with the prescription of stimulant medication, in particular, is that a recent study suggests dopamine actually may not be the neuro-culprit.3 But the main problem with this medical approach is not in the neurochemical imbalances that the researchers and the prescribers are seeing plain as day in the data. The problem is that the data lacks environmental context, which turns out to be critically, and therefore clinically, relevant. A wealth of research over the past decade has been bringing into focus a much more complex and sensible picture: apparently—shockingly—what we do with our children permanently affects their mental health! In an editorial titled “‘It’s the environment stupid!’ On epigenetics, programming and plasticity in child mental health,” Edmund J.S. Sonuga-Barke writes:

we are seeing fascinating examples of the power of the environment to shape disorder expression and the neurobiological processes presumed to underpin it. Powerful new concepts are being applied to help explain the ways that environments influence gene expression4 (Mill & Petronis, 2008), program biological systems (Swanson & Wadhwa, 2008) and promote both functional and structural plasticity during brain development (Rapoport & Gogtay, 2008).5 [Emphases added.]

ADHD (and many other diagnoses not included in the scope of this post) is neuro-developmental. The brains—or, more accurately, the entire nervous systems—of children and adults with attentional symptoms have been shaped by their experiences, primarily in early childhood. In “A Developmental Investigation of Inattentiveness and Hyperactivity,” Carlson, Jacobvitz and Sroufe observe:

In early childhood, quality of caregiving more powerfully predicted distractibility, an early precursor of hyperactivity, than did early biological or temperament factors. Caregiving and contextual factors together with early distractibility significantly predicted hyperactivity in middle childhood.6

The mental health consequences of neglect and abuse—as well as parent-child misattunements in fundamentally loving families that simply have normal family problems—can turn out to be lifelong. (Just ask adult ADDers who are struggling to cope with midlife crises.) Can the damage be undone? The short answer is yes. Recent findings in the fields of neuroplasticity7 and somatic-based trauma treatment are demonstrating that permanent healing is possible for those with disrupted nervous systems. Some of us have taken this view all along. The “Nurtured Heart Approach,” developed by Howard Glasser, is a powerful, effective treatment for ADHD, which consists in, essentially, holding the child in “unconditional positive regard”:8 connecting with the child exclusively in love and admiration for who the child is, and disciplining in clear, short, non-punitive ways.

I, for my part, am overjoyed that scientific research is finally proving that we are not biological machines but rather that which we mean when we use the word human. Nevertheless, more research is needed in order to begin to shift the prevailing paradigm, a paradigm in which most people hearing of the Nurtured Heart Approach for the first time find the concept either impossible or ill advised or both.

I do not think prescribing medication for ADHD is bad. I do agree with many critics that medications for ADHD are grossly over-prescribed. If we are just patient and resilient enough ourselves to look more closely at the experiences of young ADDers who are jumping from desk to desk and twirling their hair while gazing at a flower in a jar, we will find that in most cases what they need in their lives is something other than a pill.

  1. “Poor Children Likelier to Get Antipsychotics”, New York Times, December 12, 2009, page A1 of the New York edition. 

  2. There is no “reward center” in the brain. This phrase is a metaphor. The brain is not a county fair; no kewpie dolls are handed out. The human brain is organic, and while we’re alive, it’s alive (and vice-versa). 

  3. “Imaging study shows dopamine dysfunction is not the main cause of Attention Deficit Hyperactivity Disorder (ADHD)” 

  4. It is still commonly thought among the college-educated that genes are to living organisms what programming code is to computer software. It is not so. There is an excellent discussion in Stephen Talbott’s Biology Worthy of Life. Here is an excerpt:

    Picture the situation concretely. Every bodily activity or condition presents its own requirements for gene expression. Whether you are running or sleeping, starving or feasting, getting aroused or calming down, suffering a flesh wound or recovering from pneumonia—in all cases the body and its different cells have specific, almost incomprehensibly complex and changing requirements for differential expression of thousands of genes. And one thing necessary for achieving this expression in all its fine detail is the properly choreographed performance of the chromosomes.

    This performance cannot be captured with an abstract code. Interacting with its surroundings, the chromosome belongs as much to a living activity as any other element in its cellular environment. [Emphasis added.]

  5. Journal of Child Psychology and Psychiatry 51:2 (2010), pp 113–115. 

  6. “A Developmental Investigation of Inattentiveness and Hyperactivity.” Child Development, 1995, 66, 37-54. 

  7. See, for example, Norman Doidge’s book, The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity

  8. The phrase is not Glasser’s; it is from the writings of psychologist Carl Rogers. 


The Executive Functioning STOP Sign

What is executive functioning? Picture, if you will, an executive. Now notice some things about this picture. Most images of executives are lofty in a number of ways: working on the top floor, formally dressed (even on “dress-down Fridays”), with clean (not labor-soiled) hands; workers are under the executive; the population at large is held at a distance from the executive’s door, and can only get in for a consultation by making an appointment well in advance, not on the spur of the moment. These are not necessarily distinctions of importance: after all, an executive is of little value without workers. The distinction I’m pointing out is one of separation.

People with ADHD tend to have a whole lot of trouble with one executive in particular—their own inner executive. One leading theory is that the primary deficit in “Attention Deficit/Hyperactivity Disorder” is predominantly one of executive functioning (“EF” for short). One of the most highly respected ADHD researchers, Dr. Russell Barkley, offers this list:

  • Inhibition—self-restraint: having a response, yet deciding to hold it back
  • Foresight—projecting experience into the future: imaginatively seeing, hearing, smelling, tasting, touching, and moving at a future time
  • Hindsight—reflecting on past sensory and movement experiences and learning from them
  • Self-awareness—being conscious of what one is thinking, feeling, wanting, doing
  • Sense of time—feeling time passing; correlating self-movement with time passing
  • Working (short-term) memory—recalling multiple pieces of verbal and nonverbal information (i.e. speech and images) for work; e.g. hearing a ten-digit phone number and later dialing it accurately
  • Planning—hierarchically ordering actions
  • Problem solving—revising, reframing, conceiving multiple scenarios…in effect, self-directed playing
  • Self-motivation—harnessing one’s will, which is the motive force that drives one’s actions (unharnessed will, for example, can manifest as hyperactivity)
  • Emotional self-regulation—feeling strong emotions and letting them pass without becoming overwhelmed by them; self-evoking emotion in the service of one’s goals

The number one essential characteristic of executive functioning, from a usefulness point of view, is that it works with representations of the experiences with which it is concerned. That is, executive functions don’t handle down-in-the-trenches work directly; rather, they handle reports and projections of that work. Executives don’t respond to stimuli. They get a report that a stimulus has been received. They analyze the report. They make a decision. They call in their administrative assistant and instruct the assistant to respond to the stimulus, or delegate the response to a worker. Executive functioning isn’t the hands-on work itself; it considers what work has already occurred in the past, determines what work will be done in the future, plans the work, monitors the work, thinks about and assesses the work, solves problems that arise in the midst of the work, and weathers the ups and downs of the work by keeping the big picture and long-term goals in mind.

Consider the common ADHD symptom hyperfocus, the on-task equivalent of the word banana(nananana—easy to spell, but who knows when to stop?). In a state of hyperfocus, an ADDer can work on a task for—well, let’s just say well past bedtime. To use myself as an example, when I was doing the research on EF that in part resulted in this post, I got interested in the subject, and just kept going. I periodically noted the time, as hour after hour inexorably wheeled by, but I did not feel that the day—and then the night—was getting progressively later (time insensitivity). Instead, I felt a continuous, unchanging sense of being in the moment of doing what I was doing.

Most of the symptoms of ADHD have this in common: being in their own moment of doing whatever the ADDer is doing—daydreaming and not noticing that they’re daydreaming, tapping and humming without noticing they’re tapping and humming, blurting out “Egad, what happened to your face?” to the scarred woman in the elevator without noticing.… In the midst of doing there is no noticing, and thus no self-regulation of the doing.

Something else to notice about the executive: the CEO is responsible for the well being and success of the corporation, in this case the body of the self.1 If we ADDers are to empower our inner CEOs, we have to perform those executive functions. And the only way to perform executive functions is to STOP working.

Don’t worry (or don’t rejoice)—I’m not proposing going on strike from all work. I just mean we have to put up stop signs at important intersections, and actually come to a full stop before proceeding along our route.

(My cousin Sidney tells my favorite stop-sign story. Sid pulls up to a stop sign and sees there’s a cop around the corner, so he slows waaaaaaaay down, till he’s moving like a three-toed sloth, one M.P.W. (mile per week). Sid looks to the right. Sid looks to the left. He eases like a gentleman in a Cadillac through the intersection. Immediately—siren, lights. The cop pulls him over. Sid protests, “Officer, sir, what did I do wrong? I stopped at the stop sign.” The officer flips open his summons book and replies: “Sir, your wheels never stopped turning.”)

David Giwerc, MCC and Founder and President of the ADD Coach Academy, calls this kind of stopping “The Power of the Pause: The Difference Between Reacting Impulsively and Responding Rationally.” Even in the marathon of hyperfocus, ADDers have moments of self-awareness. The main difference between such self-aware moments in an ADDer and a neuro-typical is that for the ADDer these moments don’t automatically result in recoiling and saying, “What the heck am I doing?” Instead, we tend to blow right through those moments of awareness. Even if we slow waaaaaaaay down, our wheels never stop turning. We can take our summons one of two ways: either as a call to appear before the judgment of our external circumstances, which usually results in a hefty fine—a penalty of sleep or productivity or time with loved ones…whatever our hyperfocusing typically costs us;—or we can take the summons as a call to our own inner judgment. Stop and ask some executive questions: What has happened when I’ve done this before? Tomorrow, what will I wish I had decided to do right now? How much time is passing for other people close to me while I’m engaged in this activity? What goal did I originally set out to accomplish when I started doing this? Problem solve. Plan. What does your heart feel is the course of action most in alignment with your intentions and values?

These are not light questions, and the answers you give to them are consequential. Before getting into them, though, I recommend taking them into your office—the biggest, cushiest, highest-up, picture-windowed corner office you can imagine. Take a few moments. Breathe. Relax. Take as much time as you need to arrive at a decision in your head that feels right in your gut.

  1. “Corporate,” from the Latin corporatus, means “formed into a body.” 


Get Started on To-Dos Without Anxiety

It’s all in the cards

Using a to-do list can be immensely helpful. But maybe, just maybe, your to-do list might start to overwhelm you. If you find yourself struggling to scale a mountain of to-dos, starting to panic that you’ll never be able to reach the top or work your way to the bottom, and contemplating just hurling yourself off the mountainside back into bed for the rest of the day—then try this.

It’s a card game. For fun, I call it Priorities Deathmatch, or sometimes Project Thunderdome. If you don’t like those names, you can call it anything you prefer.

You will need blank cards or the equivalent; index cards, stickies, even cut-up pieces of paper.

  1. Write one to-do on each card, for all the ones you want to consider right now (i.e. if you have ten to-dos you’re considering doing, you should end up with ten cards). When you’re done writing all the cards, you may optionally shuffle them.
  2. Stack the to-do cards in front of you, face down.
  3. Pick two cards off the top and turn them over. Here are two to-dos. Choose one that strikes the best balance between (a) being important to do now, and (b) your feeling prepared and willing to do now. You must choose only one of the two. (You can see why I alternately call it Priorities Deathmatch and Project Thunderdome: two tasks enter, one task leaves).
  4. Put the losing to-do in a discard pile, and take the next card off the top of the original stack. Repeat step 3: choose one of the two to-dos.
  5. Repeat steps 3 and 4 until there is only one to-do left standing. Now, do your to-do. If you complete it, great! Do whatever you want with the card—toss it, frame it, give it to your dog to chew… If you don’t complete the task, write a new card for whatever remains to be done, and stick it back in your to-do deck.

When you want to tackle another to-do, play the game again (reusing the undone to-do cards), end up with one, and do it.

Why the game works

This game is based on sound psychological and neurocognitive principles.

Two is a choice, all is chaos

How many to-dos are in a long to-do list? All of them. Can you do all of them at once? No. And often that’s the feeling that comes with looking at the whole list: I can’t do all of these!

Looking at only two to-dos at a time is a straightforward choice between two things. That’s what a choice is supposed to feel like:

This one, or that one?

Simple. Not overwhelming.

Executive functioning is fundamental

The process of choosing between two items based on the specific criteria of importance and doability is essentially a complex discrimination task. You are differentiating which to-do is more important and which is less important (however greatly or slightly); which to-do is more urgent, which less (i.e. time-sensitivity); which to-do is easier and which is harder; which you feel better prepared for and which less prepared for; which more inclined to perform at this moment and which less inclined to perform. You are unitizing (seeing a whole rather than the parts) by determining that one to-do strikes the balance between importance and doability better than the other one. You are also thinking calmly about your feelings, which is a powerful way of regulating emotion without suppressing it.

In short, you are engaged in executive functioning, and lighting up your prefrontal cortex. When your prefontal cortex activates, your amygdala (which starts the fight-flight-or-freeze response) calms down. Executive functioning reduces anxiety.

One step at a time

Even simpler and easier is having only one task to do at a time. The human mind can only concentrate on one thing at a time, so give yourself one thing only to concentrate on and do.

The to-do card game is a simple way to replace a daunting mountain with a single cute mole hill—that you can easily whack!


Remedy for Hyperfocus

Try a Refreshing Palette Cleanser

Ever get engrossed in a perfectly innocent activity—such as looking up whether or not all sloths are three-toed—and then two hours later realize that reading endless reviews of toenail clippers is keeping you from getting started on that presentation that’s due tomorrow?

The term hyperfocus refers to being riveted in an activity; so riveted that prying yourself away becomes a real challenge. When hyperfocusing on shopping for toenail clippers, for instance, you might think to yourself, I should stop this and work on my presentation for tomorrow. You know you’re hyperfocusing when you have that thought and yet continue clicking on all the color variations of this toenail clipper: light blue, hot pink, rainbow (different hues for different toes!). A few minutes later (5, perhaps, or 45…) you have the same thought again. And again. And again.… One of my clients described the state of hyperfocus as analogous to being paralyzed.

Hyperfocusing is the body’s way of saying I’m busy! I’m not listening! Have you had the experience of mentally poking, nagging, even yelling at yourself to stop what you’re doing so you can start the next activity, all the while completely ignoring yourself?

Part of the problem is that researching toenail clippers is an easy way to avoid working on that presentation; in other words, hyperfocusing is a super-effective avoidance tactic. Even if there’s no presentation to work on, making the next click on the current web page is an effortless way to avoid doing virtually anything else, including the very process of deciding what to do next, which might involve those “executive function” thingies.

So let’s make interrupting hyperfocus the easiest, lowest-commitment thing to do, something that you have no motive to avoid. As soon as you become aware that you might be hyperfocusing, take a palette cleanser moment.

I was introduced to the concept of palette cleansers on my thirtieth birthday. I was given the gift of a gourmet dinner at a restaurant called the DePuy Canal House in High Falls, NY. It was, like, nine courses, including—I kid you not—both rabbit- and venison-based appetizers. Between the rabbit and deer, my wife and I were each brought a tiny dish of sorbet. I asked if this were some abstruse European custom of inserting a proto-dessert before the main course (after all, Europeans eat salad after the entrée—and the Canal House had adopted this un-American sequence). I was informed that the sorbet1 was a “palette cleanser”: it would, in effect, rinse off my taste buds, so that the flavor—pardon me: flavour—of rabbit would be completely gone from my mouth, and the venison would be a full, untainted gustatory experience unto itself.

This is either genius or unsupportably bourgeois, but in any case we can make good use of it as a way out of hyperfocus. We can put a tiny, flavor-neutralizing activity in between a hyperfocused activity and the next activity we might be avoiding. Here’s how.

Palette Cleanser Technique

  1. When you feel like poking yourself to stop hyperfocusing, perform a benign physical action that involves the use of at least three limbs—for example:
    • standing and patting your head (two legs + one arm)
    • hopping while touching your chest and back at the same time (one leg + two arms)
    • a split with jazz hands (all four limbs)
  2. Choose what you want to do next (and what you were just hyperfocusing on must be a valid option!)


Make the palette cleanser activity both easy to do and completely non-functional; i.e. it should require no special effort, and shouldn’t be useful for accomplishing anything. Thus, doing ten push-ups is great exercise, but a risky palette cleanser. Marching in place while touching your nose (left-right, left-right, halt!) is more like it. Going to your mailbox to retrieve the mail is too useful; instead, just walk to the other side of the room and knock the wall with your pinky-knuckle. All a good palette cleanser requires is that you unseat yourself and move your limbs.

Your choice of what to do next must be unconditional. You must be able to choose anything feasible. Flying to Saturn is out of the question, but doing laundry, writing a report, eating ice cream, making dinner, ordering pizza, and going right back to what you were just doing all have to be chooseable. If you rule out any option, then whatever part of you would vote (consciously or unconsciously) for that forbidden path will work to avoid the palette cleanser activity in the first place. The palette cleanser can have no fetters. To be a neutral activity it must come with no strings attached.

The client who described her hyperfocus as paralysis tried the stand-up-and-pat-head palette cleanser, and it worked. Most of the time she chose to start doing something else, often something productive. Sometimes she chose to return to the same thing she’d been doing, but found that she usually returned for a fixed period of time—say, another 15 minutes—and then stopped without needing a second standing pat on the head.

The palette cleanser technique works because it uses your body to interrupt itself. Hyperfocus is a human behavioral version of inertial motion,2 analogous to a runaway train: it can’t be stopped just by thinking about it; it needs physical brakes. Stopping the hyperfocused motion is the goal, even if only for a minute, even if you decide to go right back to it. The purpose and the benefit of the palette cleanser technique is not to get you to be productive, it’s to give you that vital space, that precious moment, in which you can choose freely. Stopping = Freedom.

A physical spoon of sorbet is a tasty, simple, and super-effective braking method.

  1. Wine is another commonly used palette cleanser. 

  2. The law of inertial motion: “Every body continues in its state of rest, or of uniform motion in a right line, unless it is compelled to change that state by forces impressed upon it.” — Isaac Newton. “Axioms, or Laws of Motion.” Philosophiae Naturalis Principia Mathematica. 1687. (Emphasis added.) 


Write Off Worries

Overwhelmed by too many things to do, too many situations to keep track of, too many worries about what could go wrong in all those situations? All these concerns can weigh heavily on your mind. Why not unload them? Here’s how.

  1. Get paper and pen (handwriting this is better than typing it), and make a list of everything that’s weighing and preying on you. Don’t worry about order or organization; we’ll take care of that in a later step. For now, put on paper each thought, task, nag in your head in whatever order they come in, like dealing cards off the top of a deck. When the stream slows to a trickle, add anything that’s missing. Done? Let’s do some annotating.
  2. In the margin, write “DO” next to anything that is a task you can physically accomplish.
  3. Next to anything you’re worrying about that is not a clear to-do, draw a worry-icon (a frowny-face, or a dark circle—anything simple). If it’s a task you’re worried about, you can alleviate your worry by doing it; not so with worries that have no clear DO that will make them go away. Keep DOs and worries separate.
  4. If there are any situations you want to do something about, but aren’t sure how to deal with, mark those with a “?” (or “Huh?” or “WTF”…). These are things you need more information about, to enable you to do something about them.

If you want, you can now put all the DOs, all the Worried Faces and all the ?s on their own individual sheets.

Separated from all the worries and question marks, DOs feel more doable, ’cause now they’re merely to-dos and nothing else.

Worries, when written down and separated from doable tasks, start to lose their mystery and menace: they’re merely thoughts, and often there’s nothing that need be done other than accept them.

Questions about situations are merely another kind of DO: get information. Knowing that you need to find something out is much less stressful than feeling like you have to do something but don’t know what.

Finally, notice if there are any recurring themes. You might discover that many worries are really about one or two things—work, for example, or money, or relationships.… What appear to be a multitude of worries often boil down to a few manageable categories of concern.

Worries are like hungry hyenas: they’re terrifying when we know they’re there but can’t see them; they’re still scary but less monstrous when they’re in front of us and we can keep an eye on them; they’re not so dangerous when separated instead of in a pack; and they’re harmless when they are mere words on a page. When you’re dogged by hungry hyenas, transmute them into ink on paper, and see who’s laughing then!


Heart Chart

Ever wonder where your motivation is? Your heart is an excellent place to look.

Tracking how you spend your time and where your money goes are well known techniques, so why not track your energy and passion? Coach Kris Moauro devised this simple and incredibly fruitful self-observation exercise.

Chart Your Heart

When you wake up, how raring are you to meet and start your day? Throughout the day track three key factors on a scale of one to ten:

  1. What activity are you engaged in? (Note: sleeping, navel contemplation, and standing bovinely in a field all count as activities.)
  2. How does your heart feel?
  3. How energized do you feel?

Kris recommends charting your heart’s course for a month, and I second that: the heart and the moon are old friends and tend to travel together, so best to let them complete a whole cycle.

At the end of the month, review your Heart Chart. What patterns emerge? How do you want to feel? What kind of energy do you want to bring to and have in your life?

So many of us want to follow our heart. Sometimes a map is just what we need.


How to Get the Reading Done (Enough): The UBER Method

Here is a tried and true outside-the-box method for doing course reading that works for people who feel weighed down by reading assignments.

Riddle yourself this: How often do you complete enough of your assigned reading to be able to go to class feeling confident that if called on you’ll be able to look the teacher in the eye and respond directly from your knowledge of the text? Restrict your answer to one of these two:

  1. Often enough to do as well as I want to
  2. Not often enough to do as well as I want to

If your answer is “a,” don’t mess with a winning streak. No need to spend time on this post; go do your reading.

If your answer is “b,” however, then the UBER method can change your academic life.

If you’re actively choosing not to read for class, then at least you’re exercising free will. But many of us don’t read (or not much), yet wish we could magically absorb books. We want to have done the reading, but somehow can’t manage to do it. When I played the “super-power” game for the first time in my life—“If you could have one super-power, what would it be?”—my answer was, “The ability to read a 500-page book in an hour with perfect comprehension.” All these years later, my answer is still the same.

My super-power wish betrays a common preconception: that reading needs to be done from beginning to end without skipping anything. Reading every word from start to finish is ideal, at least in the respect that most literature, fiction and nonfiction, is written to be read this way. If I’m reading for pleasure, I read from beginning to end (though not everyone does this; it’s a matter of personal preference). But reading for course work involves an important utilitarian consideration: if I understand the substance of the reading, who cares if I didn’t read every word? And what difference does it make if I read the pages out of order?

The essence of the UBER method is simple and practical. Be goal-directed. Read what you need to read.

Reading every word and following every thought in a text step by step is a beautiful thing. But when we’re having trouble getting reading done, we have to be willing to sacrifice beauty. We’re going to read in an ugly but efficient way. That’s the UBER method: Ugly But Efficient Reading.1

The first thing to do when using the UBER method is—don’t read the text!—at least not yet. Walk around it for a few minutes; survey it. You’re not going to dive into the reading, you’re going to figure out what you need to get out of it, and then go fishing in the best spots. You’re not going to wade slowly but dutifully through all the pages; you’re going to look things up.

The UBER (Ugly But Efficient Reading) Method

  1. Consider the context. What do you already know? How does this reading relate to the course material? (This latter question you can ask your professor outright, if it’s not clear to you.)
  2. Gather clues. Also known as “pre-reading,” this is when you read all the easy stuff and learn as much as possible as fast as possible. The first things you should read are:
    • the book cover
    • the summary on the back cover (or the abstract of the article)
    • the table of contents
    • pictures and captions
    • charts, graphs, tables, notes
    • questions at the end of the chapter; and then…
  3. STOP. What do you know now? More importantly, given what you’ve learned from the clues you’ve gathered, what do you now want to know about this reading? Ask questions.
  4. Find out where the text is going to end up. Read the last paragraph (or two). Then read the first paragraph to see where and how the text begins, and ask more questions: What is important in this reading? What is the last paragraph saying? What don’t you understand yet? What do you need to find out more about?
  5. Finally, read whatever parts of the text you need to in order to answer your questions. In other words, read to learn what you need to know.2

The key to the UBER method is making sure you have accomplishable goals in front of you at all times. Finding answers to questions you have, especially when you have the text that the answers are in, is an accomplishable goal. For some of us, the prospect of a dense 40-page article on a subject we don’t find interesting feels daunting enough that we avoid even starting it. Now compare having to read that article straight through to having an untimed open-book exam on it. Passing an open-book exam is an accomplishable goal.

So, open your books and get out of them what you need. Ugly But Efficient Reading is much more enlightening than perfect reading that doesn’t get done at all.

P.S. Try the UBER method out on this post. Read the title and the footnotes, the lists, and the phrases in bold type. Then read the final paragraphs, then the first couple of paragraphs. See how much you can learn just from these?

  1. The reading strategies in this post are not original on my part; in fact they’re well known among reading teachers. However, the acronym “UBER” for “Ugly But Efficient Reading” is my own invention. 

  2. Now, don’t be a dope: what you need to know is not defined by what you learn until you get bored; it’s what you need to know to participate intelligently and confidently in a class discussion. 


How to Manage End-of-Term Paper Pile-Up

It is a conspiracy. Your professors are trying to kill you. They have all made their term papers due within days of each other, and then come the final exams you have to study for.

Don’t die. You can’t give them the satisfaction. You must survive. Here’s how.

First, for some of you, things aren’t looking too bad until next week. DON’T BE FOOLED. This is part of their plan: lull you into a false sense of security, and then—WHAM, five different versions of 20 pages plus works cited and annotated bibliography and some new cover page format with something called an “abstract.” Not to mention overdue lab reports and “response” papers.

You need to start now.

Step One: Assess the Damage.

How much work do you have to do between now and the end of term? Make a four-column list of every single assignment:

Assignment | Due Date | Hours of Work | Instructor

“Hours of Work” is the number of hours it will take you to complete the assignment, including all reading, prewriting, writing, revising, proofreading, and packaging with ribbons and bows. If possible, estimate based on past experience with similar assignments: how long has it taken you? In any case estimate liberally; it’s usually a safe bet to multiply your initial guess by 1.5 or 2.

All right, now sit somewhere comfortable, grab a best friend or two and perhaps your favorite stuffed animal for moral support, and count up the total number of hours of work you have in front of you. Breathe. Drink some water. It’s going to be okay.

Step Two: See the Big Picture.

Make a large calendar that includes all the days between now and the end of the final exam period.—8½x11 is way too small; best to tape many 8½x11 sheets together, and put only 2–4 days on each sheet; the more space the better; make this calendar as big as your kitchen table. Write each assignment on a Post-It or small card or something, and place the assignments on their respective due dates; don’t stack: make sure you can see every single assignment.

Step Two-and-a-Half: Reserve Time Between Rounds

If you’re going into battle, be smart about it. Be rigorous about your conditioning. Especially during this period when you have to fire on all cylinders and go into double and triple overtime (to mix as many metaphors as possible), you must get plenty of sleep, eat actual food—you know, from nature—and take non-work breaks to refresh your energy.

For every day on your calendar, generously block out hours to sleep, eat, and chill. You can probably predict from past experience that you’ll end up crashing during those hours anyway if you become over-exhausted, so better to plan for them.

Step Three: Redistribute the Weight.

Now, if your teachers have colluded effectively, you will probably have two or more assignments due on top of each other, or so close together that it looks like you’ll have to work on two or more simultaneously. Proceed with caution.

You will now begin to see before you an illusion. It will appear that all you have to do is work on both assignments X and Y  for a couple of days and you’ll get them both done. Don’t believe it! It’s a mirage, a trick! Don’t try to multitask. Don’t try to be an academic superhero. It’s a fine tactic to move all your due dates back a day or two to give yourself some cushions, but you have to make it so that you can work on one assignment at a time.

Now, solve the calendrical puzzle. Here are the rules:

  • You may move assignments forward or backward on the calendar.
  • You may not let the work periods for multiple assignments overlap.
  • You must sleep and eat during your regular sleeping and eating times. (During this step, sleeping and eating take priority over finishing assignments by their due dates.)
  • You must chill for at least three hours (one or two in emergencies) between assignments.

Move assignments away from each other. When necessary, allow yourself to push some assignments past their due dates. When you do push an assignment past its due date, note that somehow (a red dot, a skull and crossbones…).

If you’ve rearranged your assignments so you can complete them one at a time and hand them all in on or before their due dates, you can skip to Step Five.

If, however, you now have some assignments that are scheduled to be done after their due dates, you must proceed to Step Four.

Step Four: Negotiate.

Ask for extensions on those assignments you needed to push forward on the calendar. It is perfectly respectable to ask for an extension if you ask for it in advance. It might help to fold up your calendar and bring it with you to show your teachers the work schedule you’ve made for yourself. It will show that you have taken control of this difficult but very common situation, and that you are managing it responsibly. This will warm your professors’ hearts, and they will gladly do what they can to help you succeed. Sometimes a professor will respond that a particular assignment can’t be handed in late for one reason or another. If that happens, enlist that professor’s aid in rearranging your calendar so that you can get everything done without fasting or losing sleep.

Step Five: Do Good Enough Work.

Finally, do your assignments, one at a time, and work on them in a goal-oriented way. No masterpieces when you’re under time pressure. Write good, solid, coherent, workmanlike papers. Here is a tried and true essay writing method and template you can use to make the process more efficient. I used to call it the “essay mill.”

Make sure you proofread! It would suck to put in hours of work on many papers and lose points all over the place for not following through.

Reminder: Make Clean Transitions.

Every time you complete an assignment you need to do three things:

  1. Mark it as done on your calendar.
  2. Celebrate its completion.
  3. Take a substantial break before starting the next one.

Marking the assignment done will clear it from your plate, and you’ll feel lighter and more hopeful of success. Celebrating will reinforce your accomplishment, your feeling that you’re getting somewhere, and that will have the effect of refreshing your determination to see this through to the end. Taking a break will act as a palate cleanser: you’ll be able to turn your thoughts away from the last assignment and focus on the next one.

Won’t it be satisfying, at semester’s end, to know that when your professors dished out their worst, you were strong and judicious and skillful, and successfully completed all that work? What a confidence-builder! And think how light and spacious it will feel to be finished and truly free from school, with the warmth and green of summer stretching out before you.


Protect Your Precious Resources with Reserves

How often do you find yourself facing an overwhelming combination of things you have to take care of—assignments at school, responsibilities at work, maintenance of children and other family—when you already feel spent? This could also manifest as a pile of bills to be paid out of a checking account that’s run dry; or a regular schedule with too many commitments and not enough time in the day to keep them all. When situations like these develop, it’s easy to feel tremendous pressure and anxiety. If they happen over and over again in one or more areas of your life, a typical and perfectly understandable response is to feel trapped on an unstoppable roller coaster that’s failed every safety inspection for the last ten years.

Step back and notice a pattern—an ecological pattern—in all of the above-mentioned anxiety-producing situations: in every one of them there is an overcommitment, and consequently an overconsumption, of resources. The resources are all yours: your energy, your time, your money, and (lest we forget) your attention. Often there are no quick fixes in an ecological crisis, but there are ways to slow the roller coaster, bring it to a stop, and reverse course back to ecological health. What is ecological health? The reverse of desperation: abundance; enough; reserves.

If all this is all too familiar to you, you’ve had ample experience of being overextended and exhausted. But you’ve almost certainly also had the experience of having enough of some things. What are you confident about? Most of the time when you feel confident about your ability to do something, reserves are involved. If you feel (not imagine, but feel) confident that you will pass a test, you probably have reserves of knowledge in that area. If you feel confident that you’ll be able to take a shower tomorrow morning, you probably have reserves of water to draw on. Superheroes are confident because they have reserves of power and agility, not to mention chic costumes. If you’re confident you can pay all your bills, you know where the money’s coming from.

Stop and think. In what areas of your life do you have reserves?

Think of something you make sure you always have enough of. It could be an intangible and inexhaustible wellspring, like respect for your parents or love for your children, or it might be something material that could run out but which you actively prevent from running out. How many ways to you have to check your e-mail or watch your favorite show or play video games? If one device breaks, are you sunk, or do you have reserves? What things to you actively keep in good supply?

When this concept of reserves was first introduced to me, I had a hell of time wrapping my mind around it. I was asked: “What would it feel like, Mark, to have reserves of time?” Now, for me, being early to an appointment usually means arriving before the second-hand on my watch has reached the apex of the dial. I really couldn’t imagine what reserves of time would feel like. I was in my kitchen at that moment, and I happened to glance up at my cereal shelf.

I eat plenty of cereal—no, not Fruity Pebbles; I like Cheerios (no generic replacements, please!) and Weetabix Crispy Flakes. Cheerios I can get at any supermarket. But Weetabix Crispy Flakes are a specialty item. Finally I found a supermarket, one that I regularly pass but which is a forty-five minute drive from home, that always has them. Not wanting to run out and have to drive nearly an hour to get more, I keep an abundant supply. At that moment when I looked up at my cereal shelf, I had about a dozen boxes. I have reserves of Weetabix Crispy Flakes.

It dawned on me that having as much extra time as I had extra cereal would feel very secure and comfortable.

Feeling that way became my goal. It’s a much easier goal to work toward and to achieve than striving not to be constantly in a rush, and beating myself up when I know, the moment I leave my house, that I’m already late and there’s nothing I can do to change that.

I now think about my time totally differently than I used to. I schedule things more carefully and responsibly. I no longer get too hungry, because I have time to eat in between appointments. I have plenty to do, but I no longer run myself ragged. Instead of constantly running to catch up, I am able to move from one activity to the next with full commitment and attention, which is not only better for me but better for my clients and students and family and friends.

Begin by appreciating what resources you have—how you keep them, how you replenish them, how you protect them. You can use the Successful Experiences exercise described in this post to take stock of your reserves, and reinforce the knowledge that this is something you do all the time, and can do in other contexts. Pay attention to your reserves, and you can develop reserves of attention, which you can then apply to restoring your own ecological balance.


ADHD Resources

What Is ADHD, Anyway?

First, some of the many positive symptoms common to ADHD:

  • Smart
  • Creative
  • Enthusiastic
  • Ethical
  • Loyal
  • Empathetic
  • Funny
  • Innovative
  • Spontaneous
  • Observant
  • Kind
  • Caring

ADHD stands for Attention Deficit/Hyperactivity Disorder. ADHD is characterized by difficulty in:

  • directing one’s attention
  • controlling one’s impulses
  • regulating one’s level of activity

Whereas in children hyperactivity looks like excessive fidgeting, running in circles, and climbing walls, in teens and especially adults it is more likely to manifest as mental restlessness.

More Information on ADHD

ADHD Self-Assessment Links

READ THIS FIRST: Self-Assessment vs. Proper Diagnosis

The below assessment tools cannot be used to diagnose ADHD.

A proper diagnosis of ADHD can only be made by qualified health practitioners, and ought to be made at the end of a very thorough procedure, including a detailed life history, as well as descriptions of observed behavior from third parties (parents, teachers, coworkers…). My own diagnosis was given by a doctor of clinical psychology after four one-hour-long sessions. I then chose to supplement that diagnosis with cognitive neuropsychological testing, which took an additional total of six hours. Both doctors were specifically recommended to me by other doctors who had earned my trust.

The purpose of self-assessment tools such as those that follow is to help people determine whether or not they might be exhibiting symptoms associated with ADHD. If you take one or more self-assessment tests, and those tests indicate a strong possibility of ADHD, the next step in obtaining a diagnosis would be to seek a qualified health care provider—one who specializes in ADHD for your age range.

I recommend, before choosing a licensed diagnostician, that you ask what steps they go through to arrive at a diagnosis. If the steps they recommend amount to little more than questionnaires similar to those below, thank them, say you want to think it over, and then continue your search. If you’re going to have someone examine your brain—the command center of your entire body—you should make sure you find the most qualified, most knowledgable, most careful health professional to do it.


Support for ADHD


Go Fish in
Streams of Consciousness:

absenceacceptanceaccomplishmentADHDaimsanalysisannotationanxietyAPAappearanceappleappreciationargumentartistaskingattachmentattentionawarenessBatmanbeingblank mindblissboatboring!brainstormingbraverycandlescenter of gravitychoicechoosing collegecognitioncommunicationcompassionconclusionconfidenceconsciousnessconversationcreative writingcreativitydawdlingdiagnosisdoorsdramadreamdrinkingecologyemotionenergyessaysessentialevidenceexamexcitementexecutive functionexerciseexperienceexpositionfailurefearfeelingfightfigurationflowfootballfrederick douglassfreewritinggamegedankenexperimentgesturegetting startedgoalgrammarhappinesshealinghearthonorhopehumanideasimaginationimagination_exerciseimplexinnovationinspirationinstinctinterestjubileekinestheticknifeknowledgelogicloudlovemagicmanagemasterymeaningmechanicsmedicationmeditationmetacognitionmilitarymindmistakesMLAmothermotivationmountainnontraditional collegenote-takingnotesorganizeout-of-the-boxparticipationpartspassionpatiencepeak-experiencepedagogyperseverancepersistencephysicalizeplanplayingplaywrightingplotpoetrypositive pointingpre-writingpreferenceprepositionpresenceprioritiesprocessprocrastinationprofessorsproofreadingputteringquestionsreadingrealityreflectionrelationshiprelaxationrepresentationreservesresourcesresponseresponsibilityrevisingsanctuaryself-actualizationself-assessmentself-relianceseptembershort storysocratic methodsoulspacestorystrengthsstressstudyingsuccesssummariessynthesistalkingtasksteachingtechniquetest anxietytest-takingThanksgivingthemethesisthinkingtimetolerancetomorrowtreetrusttruthunderstandingveteransvisualizationvoicewaldorfwelcomewholewillwillpowerwomenwordsworkingwriter's blockwritingyearningyesterday