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ADHD Executive Functioning Tools – Part 1

Tools and Tricks to Improve Your Executive Functioning –

Part 1: External Memory

Would you like to get better at managing your attention and daily choices?

In this and my next post, I will describe practical tools and tricks that can help you manage your time and tasks better, especially if you have ADHD. I’ll explain why these practices are particularly essential for people who struggle with ADHD symptoms. However, many of these self-regulation tools are also good practice for everyone else.
Tools and Tricks to Improve Your Executive Functioning - Bionic Brain

Some Misunderstandings About ADHD

In order to understand how people with ADHD might benefit from specific tricks and tools, let me first address some common misunderstandings about ADHD.

1. The Scope of ADHD – a Deficit in Executive Functioning

The label “Attention-deficit/hyperactivity disorder” (ADHD) has long been criticized for being misleading and insufficient at best [47]. It highlights two specific symptoms, but falls short in describing the core or scope of ADHD.

While our understanding of ADHD as a complex phenomenon is still developing [16, 22, 26, 30, 35, 47], a big part of its core problem seems to be a deficit in self-regulation, or “executive functioning” [7, 13, 41]. This includes inefficient use of working memory, and poor engagement of reward circuits, especially for delayed rewards [39, 44, 45, 47].

Executive functions can include the following aspects [3, 6, 23], all of which ADHD can disrupt to varying degrees:

  1. self-inhibition, or self-restraint
  2. nonverbal working memory, or visual imagery
  3. verbal working memory, or self-speech such as your mind’s voice
  4. emotional self-regulation and motivation
  5. planning and problem-solving, or mental play
  6. self-managing with regard to time; anticipating and preparing for the future
2. The Cause of ADHD – Mostly Genetic

Individual differences in executive functioning are almost entirely genetic in origin, in fact it seems to be one of the most heritable psychological traits [18, 31]. ADHD, too, is highly heritable, although there are also some environmental factors, mainly of the biohazard type (such as brain injuries or toxins during pregnancy) that contribute to the risk of developing ADHD [36].

Contrary to popular belief, there is no evidence that ADHD is caused by social or other environmental factors, such as modern technologies, lifestyle, poor parenting, or not enough “rough and tumble play”.

3. The Spectrum of ADHD

Lastly: ADHD is not a pathology, in the sense of a qualitatively distinct category from neurotypicality. Instead, the differences between those who do and don’t have ADHD are quantitative and come on a spectrum. As such, there are also people on the other end of that spectrum, who have exceptional abilities to self-regulate (motor, cognitive, and emotional). A cutoff within the spectrum is needed only for practical purposes, such as qualifying for disability benefits.

How ADHD Affects All Areas of Life

If we consider how essential it is in our adult lives that we are able to manage our thoughts, as well as our emotions and behaviors, it is not surprising that poor self-regulation has far-reaching consequences throughout all areas of life.

An abundance of studies shows that people with ADHD experience more negative outcomes across many domains, including:

  • academic and professional underachievement [1, 17, 24, 27]
  • financial distress [10, 24]
  • higher divorce rates [10]
  • lower ratings of their friendships, social and leisure activities [10]
  • driving accidents and citations [5, 8, 17, 34]
  • substance abuse [1, 11]
  • arrests, convictions and incarcerations [32]
  • psychiatric disorders, including antisocial, addictive, mood and anxiety disorders [11, 12, 46]
  • recent negative life events as measured with the “Life Experience Survey” [20]

Furthermore, ADHD severity seems to be associated with negative life events, even when adjusted for – in other words, independently from – confounding factors such as psychiatric comorbidities, substance use, education, and income [10, 20].

As reflected in these studies, people with severe ADHD struggle in ways that are hard to even imagine for the rest of us, even though I’m sure we are all familiar with some degree of struggles with self-regulation. I trust we all know what it feels like to be distracted or disorganized, to be overwhelmed by a task or by too much information, to cope poorly with strong emotions, to run late for a meeting because we have misjudged or lost awareness of time, or to disappoint someone because we forgot about a commitment we made. For the luckiest among us, those are rare occurrences. For people with severe ADHD, this is every day, all day long.

But since probably all of us would prefer to become better – rather than worse – at regulating our own thoughts, emotions and actions, many of the skills and habits that make life with ADHD more manageable are good practices for all of us.

What Practical Tools and Tricks Can Help You Improve Your Executive Functioning?

ADHD Hacks – Part 1: Get Yourself a Bionic Memory

People with ADHD often experience deficits in working memory [2, 25], which is the ability to actively use or process information held in short-term memory. This impacts many everyday tasks, such as problem-solving, understanding and following instructions, or organizing and prioritizing to-dos.

Working memory capacity also suffers as we get older [14, 43], and it seems safe to say to say that we would all prefer our working memories to be better, rather than worse.

Therefore, the practice of externalizing memory as much as we can is good advice for everyone. Instead of relying on your brain, it is good practice to offload and organize all task-related information outside of our minds – on paper or electronically. If we don’t do that, we are all prone to forget things, lose clarity of what we’re working on, and become chronically stressed by all the “stuff” in our minds.

Here are some practical examples of how to externalize memory.

Calendars

You are probably already using one, or several. Are you already maximizing its usefulness, or could you put more things out of your mind if you put them into your calendar?

Physical reminders

Sticky notes or actual objects in strategic places can remind you what you of need to do when you see them. If you want to make sure you won’t leave the house forgetting that it’s trash day tomorrow, you might stick a note to the door saying “take out trash”. Make sure to remove those physical reminders as soon as you don’t need them anymore, otherwise you will very quickly stop noticing any of them.

Physical reminders as external memory (ADHD Executive functioning tools)

Worried you might forget to clear out the fridge after a night in a motel? (It’s happened to us. Oh, the sadness!) To avoid that, put an ultra-cool beer-cooler – but really anything works – as a place-holder in front of the door, to serve as a physical obstacle/reminder.

Writing things down

This one is obvious, but it goes beyond writing to-do lists. For example, one of my clients had troubles staying focused while reading. She already had made good experiences with journaling in the mornings to clear ther mind, so she decided to also try journaling right before reading. She was happy to report that this enabled her to stay focused on the plot and enjoy a novel in a way she usually couldn’t.

I also find that writing down intrusive thoughts helps many of my clients put those thoughts literally “out of their minds”, and enables them to re-focus on the task at hand.

Decision tools

For important decisions, use decision support tools that help you visualize the problem, rather trying to juggle all your thoughts and feelings in your head. This might be particularly beneficial for people with ADHD, because in tasks that measure analytic decision making competence, adults with ADHD show deficits that are no smaller than their attention deficits [28, 33]. Importantly, low analytic decision competence truly matters in real life: even when measured with hypothetical decisions, low decision-making competence is related to real negative life events [14a]. Therefore, learning how to make good decisions seems like a very worthwhile skill to acquire, not only for people with ADHD.

Task management systems

A classic example is David Allen’s “Getting Things Done” method, which proposes a system of how to offload and organize all task-related information externally. There’s no shortage of other books, programs and apps with similar purposes, and no particular system that I would recommend over any other. Try whichever you find appealing, or create your own system. Keep using whatever works and fine-tune what doesn’t. Don’t try to find the perfect app that will solve all your problems at once. Also, don’t use too many apps, especially if their purposes overlap.

You can go very high-tech, or very analogue. Whatever works for you, as long as it’s outside of your own brain.

Alarms

Again, you’re probably already using those. However, could you use a larger variety of them to start and end different kinds of tasks? If the word “alarm” sounds harsh, choosing a pleasant sound or motivating song can make a difference. But perhaps more importantly, consider how wonderful it will be to NOT have to pay any attention to the clock at all in the meantime. You can fully relax, focus, or be free, until the moment the timer goes off.

You might also consider non-auditory timers. For example, my husband and I wanted get to sleep at a more regular time. (By the way, that is also one of the most often named changes my clients want to make). So he programmed one of our lights to switch off at the same time every night. It is is not a disruptive „light’s out“, just a decorative light clicking out. But it works, since it’s a reminder of something we want to do anyway. The difference between wanting to do something and consistently doing it is sometimes just an programmed light switch.

What other tools and tricks help with executive functioning if you have ADHD?

In this post, I focused on the practice of externalizing memory, since it is such an essential part of managing ADHD. However, deficits in working memory are not the only challenge for many people with ADHD. Another hallmark of ADHD is a difficult relationship to time, especially the future [15, 30a]. This includes poor time estimation [6, 30a, 40]. But also includes a tendency towards impulsive choices, and with that, difficulties to get motivated when consequences are delayed [6, 21, 29, 37, 38].

In my next post, I will discuss these problems in more detail. I’ll provide practical examples of tools that help with delaying gratification and managing time. Whether or not you have ADHD, these practices will help you take better care of your future self.

Stay tuned!

by Ursina Teuscher (PhD), at Teuscher Decision Coaching, Portland OR

References:

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Time Management for Mortals – Book Recommendation

Four Thousand Weeks: Time Management for Mortals, by Oliver Burkeman (2023).

Four thousand weeks – Burkeman reminds us – is about all we get in life, if we live to be eighty. In the big picture of the universe, this is an “absurdly, insultingly brief” span. Clearly, it is not enough to do everything we want, even if we maximized our productivity with every trick ever invented.

That is the backdrop of this book, which offers guidance on constructing a meaningful life by acknowledging our limits.

I’ve enjoyed reading it, but am having difficulties passing on its advice. I feel a similar ambivalence toward its wisdom as towards the wisdom we sometimes hear from survivors of near-death experiences. Seemingly only having acquired this insight after almost dying, the survivors tell us that life is short and can end even sooner than we think, and therefore we should appreciate it even more. For example, why not marvel at the wonders of a sweet-smelling rose, instead of picking a petty fight with your spouse? It’s not that I disagree. On the contrary. It’s that those insights seem – well – not new, exactly.

That said, probably no great wisdom is truly new. (This itself would not be a new insight by any stretch.) Passing on old words of advice, even just as reminders, might be a good idea anyway. Most likely, people have been doing just that with memento mori art and related concepts, which seem to appear throughout human history and throughout different cultures.

Memento Mori, obraz

So here are some of Oliver Burke’s points I found worth reflecting on.

My top three selection of time management tips for mortals
  1. Neglect the right things. Sadly, some of the things you’ll need to neglect will be important things. Make peace with those losses. It’s not your fault that you can’t do everything that would be important. Two particular lines of thought might help you decide what to let go of:
    • Limit your works in progress.
    • Resist the allure of middling priorities.
  2. Get real not only about how little time you have, but also about the fact that most things take longer than you expecteven when you take into account that most things take longer than you expect. Plan for enough buffers and breaks, slack and transition time. Since you can’t do everything anyway, you might as well cut out one more thing and instead show up early enough and be present for what you do choose to do.
  3. And my favorite – cosmic insignificance therapy: Remember how little you matter, on a cosmic timescale. Even the most impactful people in human history don’t make a dent in the universe. Truly recognizing this fact may feel like setting down a burden we didn’t realize we were carrying in the first place. Seen with this perspective, appreciating how little time we have in this life doesn’t mean resolving to “do something remarkable” with it. On the contrary, letting go of an over-demanding standard of remarkableness may help us appreciate the impact we do have on the people close to us, and to not discount the significance of this.

Lastly, this song goes out to (only, I’m afraid) my loyal Swiss-German readers, who might enjoy it as a collectively treasured memento mori:

Picture Credit:

[1] Jendex, CC BY-SA 4.0, via Wikimedia Commons

 

by Ursina Teuscher (PhD), at Teuscher Decision Coaching, Portland OR



Temporal Construal Levels: Seeing the Big Picture in Daily Choices

How does knowing about temporal construal levels help us make better choices?

An interesting but not widely known framework for dealing with self-control and daily decisions is the theory of temporal construal levels.
The theory and many subsequent research studies (here’s just one example by Fujita, Trope, Liberman, and Levin-Sagi) suggest that we think quite differently about events depending on how far in the future they are. When we think about a distant event, we represent it in a more abstract and coherent way, and we connect those future events with our goals. This would be a high-level construal. As the event gets closer, we become more concerned about the concrete and incidental details of the events and about the experience itself. This would be a low-level construal.

As an example: When I plan to hike next weekend, I’m thinking about the big picture and have goals in mind such as leading a healthy life, making beautiful memories, or enjoying good company.
In the moment of the event itself, from the alarm clock going off way too early, to the strenuous climb and descent, I am likely to focus on the specifics of the experience, including all the discomfort that comes with it.
After the event, I will likely look back at it again from the big picture perspective, happy about the memories and achievement.

Climbing a Mountain as Illustration of Temporal Construal Levels

The fact that we represent future events differently from the present has very practical implications for our decisions: it means that we often make different choices for our future selves than for our present selves.

When we’re further away from a choice, we find it easy to focus on the big picture and know what’s best for us.

For example, we know that we want to be productive, eat healthy, work out, and so on. However, as we get closer to the moment when we should actually do those things, we’re more likely to choose what feels good in the moment – for example, watch the funny video, eat the chocolate cake, and generally seek instant pleasure and avoid discomfort.

Two practical tips to deal with changing temporal construal levels:

1. Beforehand: “zoom in” to plan well

Since we tend to think about our past decisions on the same high level construal as about our future decisions, planning ahead helps us make choices that we won’t regret in the future. The more detailed your plan, the more decisions are you are making before the event, rather than during it. However, while you’re in the planning phase, remember to be kind to your future self! Try to envision difficulties ahead of time, and set your future self up for success by removing as many obstacles as possible. In that way, a realistic plan – one you’re willing to commit to – will give you a priceless advantage by freeing you from too many decisions later on.

2. In the moment: “zoom out” to reconnect with goals and values

As the event gets closer, and in the heat of the moment itself, remind yourself of the big picture and the original plan. When things get hard and uncomfortable, think about the reasons why you are doing this. Since there is no longer any temporal distance, one very good trick is to increase the psychological distance to get back into a high-level construal. For example, before deviating from your plans, think about what you would advise a friend to do in your situation. This helps you see your decision from more distance – similarly to the way you will likely judge your own decision in the future, when you look back at it.

by Ursina Teuscher (PhD), at Teuscher Decision Coaching, Portland OR



Skills coaching group for executive functioning

Executive functioning skills group offered through ADHD-NW Treatment Center

Would you like to improve your abilities to plan ahead and meet goals, manage your time, stay focused despite distractions, or display self-control more generally? Or do you know someone else who could use help with any of these so-called “executive functioning” skills?

I’m offering a new weekly skills and support group in collaboration with the ADHD-NW Treatment Center. This course is open to all (with or without ADHD)! The group is ideal for adults who struggle with procrastination, time management, and developing and maintaining healthy routines of life organization.

Topics covered in this group include: scheduling strategies, learning how to reward yourself for working toward difficult tasks, techniques towards better focusing abilities, establishing a productive work environment, among others.

Groups will begin with a check in, mutual accountability on progress toward goals from the previous session, and discussion of weekly topics. We’ll discuss relevant findings from neuroscience, psychology, behavioral economics, and choice architecture in relation to the topic of the week, and how you might apply those concepts to make your own life easier. We’ll end each group end with sharing a personal plan and commitment to action for the coming week.

Coaching Group: Developing Healthy Work Habits and Skills
Start Date: Tuesday, October 24, 2023
Tuesdays 8:00 to 9:00 AM
Minimum Commitment: 6 Weeks
Open Enrollment – You can join this group at any time
Format: Virtual
Cost per Group Session: $29.99 – $39.95

You can find more info and enroll here:
https://nw-adhd.com/community-groups/

If you have questions, feel free to text or give me a call at (858) 200-6887.

Thanks so much for sharing!

by Ursina Teuscher (PhD), at Teuscher Decision Coaching, Portland OR



Multitasking: How Bad is it Really?

You’ve probably already been warned to stay away from multitasking. In recent years, there have been many articles, blog posts etc. dissuading us from it. Why?

  1. Multitasking doesn’t exist. Instead, when we do try to pay attention to two tasks at once, what we end up doing is switching our focus rapidly between different tasks.
  2. This kind of switching makes us less productive than if we focused on one task only, and then moved on to the other task later.
  3. People who are most likely to attempt multitasking – and who think they are good at it – have the lowest actual multi-tasking abilities.

This is all relatively uncontroversial and based on many experiments measuring task effectiveness and brain activity, and I believe it is important knowledge.

However, the implications are bigger than that.

Why multitasking is even worse than you thinkHere’s a sketch to illustrate an additional problem. The blue and green areas show brain activity that is specific to certain tasks, whereas the orange area shows roughly what extra brain activity is required just for the switching between those two specific tasks. The point of the sketch is to show how the switching itself is actually a third task that consumes a lot of brainpower. Importantly, this switch cost occurs in the frontal areas of the brain, which are involved in decision making and planning – and that are, as I discussed in a previous post, very susceptible to fatigue and glucose depletion.

In other words, by switching tasks when we are trying to multitask, we are using the part of our brain (the pre-frontal cortex) which is most easily exhausted and uses up the most resources (glucose). Developmentally speaking, the prefrontal cortex is our latest achievement: it is the last part of the brain to fully develop in young adults, but also the most recently evolved part in our history as a species, and the part of our brain that looks most radically different from the brains of other animals.

In that light, it shouldn’t be too surprising that it is the least efficient part of our brain, and not as essential for survival as the older and more established parts. However, it is also the very part that enables us to focus, exert self-control, be kind and patient, delay gratification, and just overall make smart decisions.

What I’m arguing here is that by switching tasks (by trying to multitask, or by having too many distractions instead of focusing on one thing only), we are wasting the best part of our brain power. By the end of the day (or even the hour) we will have less self-control, make more unhealthy choices, eat the wrong kinds of foods in the wrong moments, spend money that we didn’t want to spend, get angry at our loved ones — in other words, are simply being more stupid than necessary.

So, in order to remain smarter for longer (throughout our long days), we should practice focus and avoid multitasking wherever we can. (Well, and take breaks. I still stand by that too.)

Here are some small practical steps you can take to increase focus:

  • Make a conscious choice at what times of the day you want to be social. Don’t let others decide that for you by interrupting and distracting you.
  • Turn off all notifications from all apps that are not absolutely essential.
  • Close all those browser windows and programs you’re not using right now.
  • Play just as hard as you work: think of being present as a skill and a habit that you want to practice everywhere, not just at work.

by Ursina Teuscher (PhD), at Teuscher Decision Coaching, Portland OR


Selected References:
Fuster, J. M. (1988). Prefrontal Cortex. In Comparative Neuroscience and Neurobiology (pp. 107–109). Birkhäuser Boston.
Fuster, J. M. (2001). The Prefrontal Cortex-An Update – Time Is of the Essence. Neuron, 30(2), 319–333.
Gopher, D., Armony, L. & Greenspan, Y. (2000). Switching tasks and attention policies. Journal of Experimental Psychology: General, 129, 308-229.
Meyer, D. E. & Kieras, D. E. (1997a). A computational theory of executive cognitive processes and multiple-task performance: Part 1. Basic mechanisms. Psychological Review, 104, 3-65.
Meyer, D. E. & Kieras, D. E. (1997b). A computational theory of executive cognitive processes and multiple-task performance: Part 2. Accounts of psychological refractory-period phenomena. Psychological Review, 104, 749-791.
Rubinstein, J. S., Meyer, D. E. & Evans, J. E. (2001). Executive Control of Cognitive Processes in Task Switching. Journal of Experimental Psychology: Human Perception and Performance, 27, 763-797.
Rogers, R. & Monsell, S. (1995). The costs of a predictable switch between simple cognitive tasks. Journal of Experimental Psychology: General, 124, 207-231.
Sanbonmatsu, D. M., Strayer, D. L., Medeiros-Ward, N., & Watson, J. M. (2013). Who Multi-Tasks and Why? Multi-Tasking Ability, Perceived Multi-Tasking Ability, Impulsivity, and Sensation Seeking. PLOS ONE, 8(1), e54402.

 



Effects of sleep deprivation on decision making

How does a lack of sleep affect our judgment? Does it really lead to poorer choices?

"Drowsy drivers use next exit": warning sign on Interstate 15 in Utah Unfortunately, the answer is many times yes. In my research into the topic, I’ve found at least eight ways how a lack of sleep affects different aspects of our judgment and decision making.

Sleep deprivation affects us both physically and mentally, and decision-making is a complex process that requires the orchestration of multiple neural systems, such as emotion, memory, and logical reasoning. It is therefore not too surprising that sleep deprivation would take a toll on many fronts.

Here are eight effects of sleep deprivation on decision making:

1) What’s perhaps best known is that it impairs attention and working memory, leading to slower reaction times, reduced vigilance, and more mistakes. This is why the risks of driving while sleepy are considered at least as dangerous as the risks of driving under the influence of alcohol [1]. For example, being awake for 17 hours leads to impairments equivalent to having a BAC of 0.05%, and being awake for 24 hours to having a BAC of 0.10%.

For people with ADHD, sleep deprivation leads to even more focus-related problems, such as disproportionately more errors and slower reaction times. In addition, lack of sleep decreases the effectiveness of some ADHD medications [2]. (Unfortunately, ADHD also makes it harder stick to a good sleep routine. Here are some tips on how to deal with this problem.)

2) But it also affects long-term memory. Sleep deprivation affects the brain’s ability to learn and recall information [3]. In fact, lack of sleep seems to be a risk factor for (not only correlated with) dementia, probably for a number of reasons [4; 5; 6]. For one, during REM sleep the brain processes information and consolidates memories from the previous day. Sleep also plays a large part in regulating the availability of neurotransmitters. Lastly, sleep deprivation leads to an increase in beta-amyloid. This is the protein that occurs in abnormally high levels in brains with Alzheimer’s disease, where it clumps together to form plaques that collect between neurons and disrupt cell function.

3) Logical reasoning ability also suffers. Namely, sleep deprivation increases rigid thinking, perseveration errors, and difficulties in processing and using new information [7]. In other words, complex tasks and innovative decision-making do suffer from a lack of sleep.

4) Self-awareness is another aspect of our judgment that’s essential for making smart choices. Unfortunately, self-evaluation of cognitive performance is also impaired by sleep deprivation. In one study [8], during 36 h of sleep deprivation, research participants became more confident that their answers were correct as the wakefulness continued. Confidence was even stronger when the answer was actually wrong.

5) Lack of sleep makes us more risk prone. For example, in gambling tasks, sleep deprivation led to both higher expectations of rewards for risky choices, as well as diminished responses to their losses [9].

6) In addition, many studies show that sleep deprivation leads to more impulsive behavior and a lack of inhibition [e.g., 10; 11]. Note that impulsivity is not the same issue as the risk attitude from the previous point. These two aspects of decision making are independent – you can be deliberate about taking high risks (e.g., choosing an aggressive investment portfolio), and you can be impulsive about avoiding risks (e.g., giving into irrational fears or shying away from discomfort). But of course the combination of impulsivity and risk-proneness is a particularly dangerous cocktail that can lead to reckless behavior.

7) Sleep deprivation has negative effects on many aspects of mood, such as depression, anger, and anxiety [e.g., 12 – 15]. While some studies only show correlations over time [12]., others do show a causal effect [13; 14]. One study examined the effects of sleep deprivation in healthy adolescents, comparing depression, anger, confusion, anxiety, vigor, and fatigue across days. They found that all mood states significantly worsened following one night without sleep. Female participants showed a greater vulnerability to mood deficits following sleep loss, with greater depressed mood, anxiety, and confusion [14]. Another study examined a cohort of medical residents over their first postgraduate year and found that mood disturbances, lowered empathic capacity, and burnout increased over the year, and were associated with decreases in sleep amounts and increases in sleepiness [12].

Here, too, if we keep in mind that increased impulsivity will be added to this mix of bad mood, it won’t be surprising to learn that bad behavior follows. For example, one study looked at abusive supervisory behavior in managers across a variety of industries. They showed that daily sleep quality was negatively related to leaders’ self-control, and that those who were more sleep deprived were rated as significantly more abusive and toxic in interpersonal interactions [16].

8) Finally, sleep deprivation affects our hormones and metabolism. It leads to decreased glucose tolerance, decreased insulin sensitivity, increased evening concentrations of cortisol, increased levels of ghrelin, and decreased levels of leptin [17]. While cortisol is a biomarker of stress, ghrelin and leptin regulate our appetite. Ghrelin increases our appetive, while leptin decreases it. In other words, sleep deprivation leads to increased hunger and appetite on both the ghrelin and leptin fronts. Add to that again a lack of inhibition, and it becomes clear that our eating choices will be affected by a lack of sleep. Indeed, there is growing evidence both from epidemiological and laboratory studies showing an association between sleep loss and increased risk of obesity [18].

How can you get enough sleep in your busy life?

Most of all, make sleep a priority. This will most likely require some sacrifices, because it means giving up some of your waking hours. But if you’re taking into account how much better those waking hours will be if you’re fully rested, the trade-off will be well worth it.

For practical tips as to how to get into a better sleep routine, google “sleep hygiene” and follow all the advice you’ll find. As an example of that, a recent study at a boarding school found that a regular routine and no mobile devices at night helped teenagers get more sleep [19].

If your have troubles falling asleep despite good sleep hygiene, here are some interesting tips. Or, google “visualization falling sleep” and you’ll find cornucopias of techniques. I’d encourage you to try one after the other, until you find one that works for you.

All this is easier said than done of course! If you’d like to get some help along the way–from deciding how to shift and re-balance your priorities, to developing strategies, and getting support as you’re putting your priorities into practice–I’d be excited to talk to you.

"Get in Touch" Button to Schedule a phone call or coaching session with Ursina Teuscher

by Ursina Teuscher (PhD), at Teuscher Decision Coaching, Portland OR

 

Picture Credit:
Phil Konstantin. Photo released into the public domain via hhttps://commons.wikimedia.org/wiki/File:UtahSignByPhilKonstantin.jpg

References:

[1] Powell, N. B., Schechtman, K. B., Riley, R. W., Li, K., Troell, R., & Guilleminault, C. (2001). The Road to Danger: The Comparative Risks of Driving While Sleepy. The Laryngoscope, 111(5), 887–893. https://doi.org/10.1097/00005537-200105000-00024
[2] Waldon, J., Vriend, J., Davidson, F., & Corkum, P. (2018). Sleep and Attention in Children With ADHD and Typically Developing Peers. Journal of Attention Disorders, 22(10), 933–941. https://doi.org/10.1177/1087054715575064
[3] Alhola, P., & Polo-Kantola, P. (2007). Sleep deprivation: Impact on cognitive performance. Neuropsychiatric Disease and Treatment, 3(5), 553–567. https://pubmed.ncbi.nlm.nih.gov/19300585/
[4] Berglund, J. (2019). The Danger of Sleep Deprivation. IEEE Pulse, 10(4), 21–24. https://doi.org/10.1109/MPULS.2019.2922564
[5] Lack of sleep may be linked to risk factor for Alzheimer’s disease. (2018, April 13). National Institutes of Health (NIH). https://www.nih.gov/news-events/lack-sleep-may-be-linked-risk-factor-alzheimers-disease.
[6] Lack of sleep in middle age may increase dementia risk. (2021, April 27). National Institutes of Health (NIH). https://www.nih.gov/news-events/nih-research-matters/lack-sleep-middle-age-may-increase-dementia-risk.
[7] Harrison, Y., & Horne, J. A. (1999). One night of sleep loss impairs innovative thinking and flexible decision making. Organizational Behavior and Human Decision Processes, 78(2), 128–145. https://doi.org/10.1006/obhd.1999.2827
[8] Harrison, Y., & Horne, J. A. (2000). Sleep loss and temporal memory. The Quarterly Journal of Experimental Psychology. A, Human Experimental Psychology, 53(1), 271–279. https://doi.org/10.1080/713755870
[9] Venkatraman, V., Chuah, Y. L., Huettel, S. A., & Chee, M. W. (2007). Sleep Deprivation Elevates Expectation of Gains and Attenuates Response to Losses Following Risky Decisions. Sleep, 30(5), 603–609. https://doi.org/10.1093/sleep/30.5.603
[10] Anderson, C., & Platten, C. R. (2011). Sleep deprivation lowers inhibition and enhances impulsivity to negative stimuli. Behavioural Brain Research, 217(2), 463–466. https://doi.org/10.1016/j.bbr.2010.09.020
[11] Demos, K. E., Hart, C. N., Sweet, L. H., Mailloux, K. A., Trautvetter, J., Williams, S. E., Wing, R. R., & McCaffery, J. M. (2016). Partial sleep deprivation impacts impulsive action but not impulsive decision-making. Physiology & Behavior, 164, 214–219. https://doi.org/10.1016/j.physbeh.2016.06.003
[12] Rosen, I. M., Gimotty, P. A., Shea, J. A., & Bellini, L. M. (2006). Evolution of Sleep Quantity, Sleep Deprivation, Mood Disturbances, Empathy, and Burnout among Interns. Academic Medicine, 81(1), 82–85. https://doi.org/10.1097/00001888-200601000-00020
[13] Scott, J. P. R., McNaughton, L. R., & Polman, R. C. J. (2006). Effects of sleep deprivation and exercise on cognitive, motor performance and mood. Physiology & Behavior, 87(2), 396–408. https://doi.org/10.1016/j.physbeh.2005.11.009
[14] Short, M. A., & Louca, M. (2015). Sleep deprivation leads to mood deficits in healthy adolescents. Sleep Medicine, 16(8), 987–993. https://doi.org/10.1016/j.sleep.2015.03.007
[15] Pires, G. N., Bezerra, A. G., Tufik, S., & Andersen, M. L. (2016). Effects of acute sleep deprivation on state anxiety levels: A systematic review and meta-analysis. Sleep Medicine, 24, 109–118. https://doi.org/10.1016/j.sleep.2016.07.019
[16] Barnes, C. M., Lucianetti, L., Bhave, D. P., & Christian, M. S. (2015). “You wouldn’t like me when I’m sleepy”: Leader sleep, daily abusive supervision, and work unit engagement. Academy of Management Journal, 58(5), 1419–1437. https://doi.org/10.5465/amj.2013.1063
[17] Leproult, R., & Van Cauter, E. (2010). Role of Sleep and Sleep Loss in Hormonal Release and Metabolism. Endocrine Development, 17, 11–21. https://doi.org/10.1159/000262524
[18] Beccuti, G., & Pannain, S. (2011). Sleep and obesity. Current Opinion in Clinical Nutrition and Metabolic Care, 14(4), 402–412. https://doi.org/10.1097/MCO.0b013e3283479109
[19] Lushington, K., Reardon, A., & Agostini, A. (2022). O025 Boarding school students sleep better than day-student peers. The positive effects of bedtime routine and restricting technology use at night. Sleep Advances: A Journal of the Sleep Research Society, 3, A9–A11. https://doi.org/10.1093/sleepadvances/zpac029.024



Does Positive Thinking Help You Reach Your Goals?

Can “positive thinking” really help you change your life for the better and reach your goals? Many motivational speakers and writers seem to believe so, but empirical studies reveal a more complicated picture.

If you want to reach your goals, positive thinking seems to come with some pitfalls.

In particular, in her research spanning decades, Gabriele Oettingen and her colleagues have discovered a powerful link between positive thinking and poor performance [e.g., 1 – 5]. Oettingen’s book “Rethinking Positive Thinking: Inside the New Science of Motivation” [6], and her website detail many of these findings. For example, in one study [2] they asked college students who had a crush on someone to engage in future fantasies about them and a person of their romantic interest. Six months later, the students who had engaged in positive future fantasies were less likely to have started up a romantic relationship with the person. The authors found a similar effect with academic performance: the more students engaged in positive phantasies about their performance on an upcoming exam, the poorer their performance was at the time of exams.

As her book [6] and website detail, Oettingen and her colleagues have performed such studies with participants from different demographic groups, in different countries, and with a range of personal wishes, including wishes related to health, academic and professional success, and relationships [1 – 5]. Consistently, they found correlations between positive fantasies and subsequent poor performance. The more people “think positive” and imagine themselves achieving their desired future, the less they achieve. The reason for this may be that positive thoughts and fantasies can trick your brain into feeling like you have already succeeded, thereby sapping you of the motivation necessary to work hard enough to realize your dreams [1].

So if positive thinking isn’t the best strategy to help you reach your goals, then what is?

Instead of positive thinking, Oettingen suggests “mental contrasting”. This method combines dreams and reality. As Oettingen writes in her book [6], the method brings positive thinking up against a visualization of the challenges that stand in our way. The method is explained in more detail on the website woopmylife.org.

Similarly, in her book “The Positive Power of Negative Thinking” [7], Julie Norem suggests “defensive pessimism” as a cognitive strategy. By imagining worst case scenarios, we can improve problem-solving and make our worries work for us. This can help us manage anxiety and as well as perform better.  

Does mental contrasting – instead of simple positive thinking – really help you reach your goals?

On her website, Oettingen cites a number of studies that have tested the effect of this mental exercise. This page provides a list with links to each study.

More recently, an independent group of researchers conducted a meta-analysis, including a total of 21 empirical studies. They evaluated the efficacy of mental contrasting in combination with implementation intentions for goal attainment [8]. They did find some publications bias, with published studies showing on average a larger effect size than unpublished studies. This is a phenomenon that’s often revealed by meta-analyses, and it is one reason meta-analyses are so important to consider. The authors therefore caution that the actual effect sizes may be smaller than the published studies suggest. Nonetheless, their analysis showed that overall, mental contrasting is an effective strategy for goal attainment.

Do you want to try some mental contrasting on your own goals?

If you’re ready to try this method, check out the many resources (videos, worksheets, and even a free app for Android or iOS) on Gabriele Oettingen’s website. If you think you could benefit from continuing support as you move towards your goals, let’s discuss how I might help.

Contact Ursina Teuscher for help with reaching goals

by Ursina Teuscher (PhD), at Teuscher Decision Coaching, Portland OR

Picture Credit:

[1] Photo released free of copyrights under Creative Commons CC0, Public Domain via https://pxhere.com/en/photo/539762

References:

[1] Kappes, H. B., & Oettingen, G. (2011). Positive fantasies about idealized futures sap energy. Journal of Experimental Social Psychology, 47(4), 719–729. https://doi.org/10.1016/j.jesp.2011.02.003
[2] Oettingen, G., & Mayer, D. (2002). The motivating function of thinking about the future: Expectations versus fantasies. Journal of Personality and Social Psychology, 83(5), 1198–1212.
[3] Oettingen, G., & Wadden, T. A. (1991). Expectation, fantasy, and weight loss: Is the impact of positive thinking always positive? Cognitive Therapy and Research, 15(2), 167–175. https://doi.org/10.1007/BF01173206
[4] Thinking positive is a surprisingly risky manoeuvre | Aeon Essays. (n.d.). Aeon. Retrieved September 16, 2022, from https://aeon.co/essays/thinking-positive-is-a-surprisingly-risky-manoeuvre
[5] Oettingen, G. (2012). Future thought and behaviour change. European Review of Social Psychology, 23(1), 1–63. https://doi.org/10.1080/10463283.2011.643698
[6] Oettingen, G. (2014). Rethinking positive thinking: inside the new science of motivation. New York: Penguin Random House.
[7] Norem, J. K. (2001).
The positive power of negative thinking. New York: Basic Books.
[8] Wang, G., Wang, Y., & Gai, X. (2021). A Meta-Analysis of the Effects of Mental Contrasting With Implementation Intentions on Goal Attainment. Frontiers in Psychology, 12, 565202. https://doi.org/10.3389/fpsyg.2021.565202



How to Monitor Goal Progress

Best Ways to Monitor Goal ProgressIf you want to achieve goals, one of the most effective things you can do is to measure and track your progress.

There are many ways to monitor goal progress, and it turns out they are all helpful. However, some techniques are more effective than others, as was shown by a large meta-analysis, which included findings of 138 experiments. Three things in particular will make it more likely that you achieve your goals:

1. Measure frequently. The more often you monitor your progress, the greater your chance of success.

2. Share your information. You don’t have to make your information public; even reporting it in private to one other person helps. If you’re really not into sharing though, don’t despair – you’re in good company. This last point is still for you and becomes all the more important:

3. Record your information physically, such as in a written diary or spreadsheet. As an example, here’s a spreadsheet template for tracking your caloric deficit or surplus over time, and here are some insights from a guy who lost weight with a spreadsheet. Or, one of my clients was able to overcome her writing paralysis when she started to simply log how many words she wrote every day. For her, it was particularly helpful to have a spreadsheet (shown below) with some conditional formatting, where the cells changed font or background color when she reached certain thresholds – in her case: two hours of (focused) writing time, or 1200 words written per day. That gave her logging the character of a game and made the process more rewarding.

How to monitor goal progress - example of a writer's word count spreadsheet

All that said, does it even matter whether we are successful in the pursuit of our goals? Will it make us happy? That was the topic of another meta-analysis, which included 85 studies. They found, perhaps not so surprisingly, that successful goal pursuit was linked to greater well-being. However, what’s interesting is that this relationship was stronger when success was defined as progress towards the goal, rather than as reaching a goal. Does that mean that the path is indeed the goal, as wise people have suggested before? No. The goal is still the goal, but moving towards it seems to be more tightly related to our well-being than reaching it.

Would you like to get help with your own goals? Schedule your first online coaching session or a brief phone call to discuss options.

Set up an appointment with Ursina Teuscher

I’ll be excited to talk to you!

by Ursina Teuscher (PhD), at Teuscher Decision Coaching, Portland OR


References:
Klug, H. J. P., & Maier, G. W. (2015). Linking Goal Progress and Subjective Well-Being: A Meta-analysis. Journal of Happiness Studies, 16(1), 37–65. https://doi.org/10.1007/s10902-013-9493-0
Harkin, B., Webb, T. L., Chang, B. P. I., Prestwich, A., Conner, M., Kellar, I., … Sheeran, P. (2016). Does monitoring goal progress promote goal attainment? A meta-analysis of the experimental evidence. Psychological Bulletin, 142(2), 198–229. https://doi.org/10.1037/bul0000025



Event Series: Procrastination and ADHD Follow-Through

Free webinar series with Vicki Lind (MS) and Ursina Teuscher (PhD) on Procrastination and ADHD.

Banner for Webinar Series on Procrastination and ADHD with Vicki Lind and Ursina Teuscher

Do you procrastinate? Do you have ADHD? Stalled on a project? 

Start 2023 with a clear plan and support by joining my colleague Vicki Lind and me in a webinar series and support hub. Do you struggle with procrastination or ADHD, or know someone who does? Learn more about procrastination and how to beat it, and get the support you need to follow through on your plans.

Vicki and I will teach three free interactive webinars together in January. Each week has a different focus:

Tue Jan 10, 9-10am PST: Support from Your Heart & Head
Tue Jan 17, 9-10am PST: Support from Others: Co-working, Bookending & Rewards
Tue Jan 24, 9-10am PST: Support from Your Tools: Your Calendar, Lists & Rewards

Following this series, Vicki will offer a February Support Hub, beginning on Jan 31st, Tuesday at 9 am. If you attend two webinars (in the past or now), you are invited to join Vicki and four other members in regular co-working sessions and ongoing encouragement as you carry out each clear, concrete task.

In our first webinar on January 10th, you will:

  • Identify the thoughts that get you off track and learn how to replace them
  • Understand some things about the brain, and what they mean for best practices
  • Get support for one or two essential action items that fit you
Are you ready to spend an hour with us to move ahead?

​Reserve your spot: vicki@aportlandcareer.com or 503-575-8217 or sign up with the form above

Vicki Lind, MS, Speaker at the Webinar on Procrastination and ADHD Ursina Teuscher, PhD, Speaker at the Webinar on Procrastination and ADHD

by Ursina Teuscher (PhD), at Teuscher Decision Coaching, Portland OR



How to Tackle Stubborn Goals: Implementation Intentions

What to do with those stubborn to-dos?

Tackling stubborn goals with implementation intentions. Picture credit: Sarah McMillan (https://www.flickr.com/photos/essjay)Do you have items on your to-do list that never get done? Tasks you meant to have crossed off ages ago, but instead they linger and get pushed back forever? Or how about those “little” things you want to do regularly (daily sets of push-ups, perhaps? connecting with friends?), but somehow they keep falling through the cracks?

In general, do you find some of your goals particularly hard to put into practice?

Try “implementation intentions”

A technique that helps is to “script” our intended actions in more specific terms by deciding exactly how, when and where we are going to accomplish each of our tasks. Peter Gollwitzer, a psychologist who has done a lot of research on this, calls those plans implementation intentions. It may be an awkward term, but it stands for a very powerful strategy for self-regulation. The idea is that we should not just form goal intentions (“I intend to achieve X”), but form implementation intentions instead (“I intend to perform specific goal-directed behavior Y when I encounter situation Z”).

Goal intentions

(more general)

“I want to do more push-ups.”

“I want to get in touch with this employer.”

Implementation Intentions  

If situation, then behavior (more specific)

“If I feel cold while I’m sitting at my desk, and before I put on a sweater, I’ll do a set of push-ups”.

“Tomorrow, right after breakfast and before my second cup of coffee, I will look for possible connections on LinkedIn and will draft a message asking for a brief chat with one of them.”

We can also think of implementation intentions as action triggers. As an example, I could tell myself “whenever I’m home and I feel cold, I’ll do a set of push-ups or jumping squats. Only after that will I put on a sweater or turn up the heater”. In that case, “feeling cold” would serve as an action trigger for a quick workout.

Do implementation intentions really work?

Action triggers like these can be surprisingly effective. For example, experiments with interventions have been successful in improving exercise behavior in firefighters, or in helping people establish a healthier diet. One study looked at older patients who were recovering from hip or knee replacement surgery. Some of them were asked to set action triggers for their recovery exercises—something like, “I’ll do my range-of-motion extensions every morning after I finish my first cup of coffee.” The other group did not receive any coaching on action triggers. The results were dramatic: the patients who used action triggers recovered more than twice as fast, standing up on their own in three and a half weeks, instead of almost eight weeks for the others.

Those are just a few examples, but an analysis of findings from 94 independent tests showed that implementation intentions overall have very positive effects on goal attainment.

They are particularly effective for two types of goals:

  • Goals that are associated with disagreeable tasks, such as phone calls or job applications.
  • Goals that are easily forgotten, such as taking medication.

They are also particularly effective for people for whom realizing plans is especially difficult. For example, people suffering from depression, anxiety or addictions, seem to benefit greatly from this technique.

 A side-note: Because implementation intentions are really just action scripts, I always thought they sounded very much like a simple form of self-hypnosis. It turns out that these two techniques actually work well together: implementation intentions enhance people’s responsiveness to hypnotic instructions.
You’re probably already using lots of implementation intentions.
But if or when not:

For many of your everyday tasks, you may already be using implementation intentions without knowing it. For example, having a regular schedule is already an implementation intention (e.g., “at 8am, I will be at my computer and will start with my most important task.”). You may therefore not need to think about this very often. However, keep it in mind as a helpful technique for tasks that are particularly difficult to get started with, or that you’re likely to forget.

In other words, here’s my suggesting of a meta-version – the mother of many more implementation intentions:

“If I notice one of my to-do’s has been on my list for too long,
I will form an implementation intention.”

Implementation Intentions

by Ursina Teuscher at Teuscher Counseling, LLC


Selected References:
[1] Gollwitzer, P. M., & Brandstätter, V. (1997). Implementation intentions and effective goal pursuit. Journal of Personality and Social Psychology, 73(1), 186–199. http://doi.org/10.1037/0022-3514.73.1.186
[2] Gollwitzer, P. M., & Sheeran, P. (2006). Implementation intentions and goal achievement: A meta-analysis of effects and processes. Advances in Experimental Social Psychology, 38, 69–119. San Diego, CA, US: Elsevier Academic Press.
[3] Gollwitzer, P. M. (1999). Implementation intentions: Strong effects of simple plans. American Psychologist, 54(7), 493–503. http://doi.org/10.1037/0003-066X.54.7.493
Hammer, R. (2010). The Effects of Implementation Intentions on Volunteer Firefighter Exercise Behavior: A Randomized Controlled Study. All Graduate Theses and Dissertations. Retrieved from http://digitalcommons.usu.edu/etd/753
[4] Schweiger Gallo, I., Pfau, F., & Gollwitzer, P. M. (2012). Furnishing hypnotic instructions with implementation intentions enhances hypnotic responsiveness. Consciousness and Cognition, 21(2), 1023–1030. http://doi.org/10.1016/j.concog.2012.03.007
[5] Verplanken, B., & Faes, S. (1999). Good intentions, bad habits, and effects of forming implementation intentions on healthy eating. European Journal of Social Psychology, 29(5-6), 591–604. http://doi.org/10.1002/(SICI)1099-0992(199908/09)29:5/63.0.CO;2-H
[6] Wang, G., Wang, Y., & Gai, X. (2021). A Meta-Analysis of the Effects of Mental Contrasting With Implementation Intentions on Goal Attainment. Frontiers in Psychology, 12, 565202. https://doi.org/10.3389/fpsyg.2021.565202



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