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According to the Centers for Disease Control and Prevention, 80 percent of our medical expenditures are now stress-related.
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Seventy percent of employees work beyond scheduled time and on weekends; more than half cited “self-imposed pressure” as the reason.
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One specific category of disorganization or, to be precise, distraction has come to symbolize an era of divided attention: distracted driving. The Department of Transportation (DOT) has a special website dedicated to this problem (distraction.gov), in which readers are reminded about the perils of distracted driving, which is often thought of as just texting but also includes driving while talking on a cell phone, watching a video, reading a map or other behaviors that involve taking your eyes off the road or away from the safe operation of your vehicle.
The scope, effects and consequences of distracted driving are sobering, according to statistics compiled by DOT:
Using a cell phone while driving, whether it’s hand-held or hands-free, delays a driver’s reactions as much as having a blood alcohol concentration at the legal limit of .08 percent.
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Driving while using a cell phone reduces the amount of brain activity associated with driving by 37 percent.
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Nearly six thousand people died in 2008 in crashes involving a distracted driver and more than half a million were injured.
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The younger, inexperienced drivers under twenty years old have the highest proportion of distraction-related fatal crashes.
Drivers who use hand-held devices are four times as likely to get into crashes serious enough to injure themselves.
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Lest we assume, as many seem to do, that distracted driving is purely a problem of the young; teenagers and young adults who are checking their friends’ Facebook status while doing ninety miles per hour on the interstate, think again: almost half of adults who send text messages have sent them while driving, according to a 2010 study by the Pew Research Center (the same study found that about one-third of sixteen-and seventeen-year-olds admitted that they had done the same). According to distraction.gov, half of all people in the United States admit to cell phone use while driving; one in every seven admit to sending cell phone text messages while driving. These are also folks who should know better: 65 percent of drivers with a higher education text or talk while driving.
All in all, the distracted driving crisis—part of that larger Distraction Epidemic—seems to some a part of an even greater problem, suggesting that the human race has reached a point of information overload—or at least a point where we feel so overwhelmed by the demands of our lives that we would risk our lives for one more text or phone call. In 2010, The New York Times published a series of articles about the supposedly dire effects of technology on our brain. In a USA TODAY story on the issue, one researcher concluded gloomily that “people are multi-tasking probably beyond our cognitive limits.”
A DISTRACTED FACT OF LIFE?
Some say there’s little that can be done about all of this. The pace of life is increasing and the distractions multiplying. Get used to it. You’re powerless. To which we say, baloney! While we may not be able to slow down technological change or the speed with which life unfolds around us—and in some cases, why would we want to?—we very definitely can find a way to better manage ourselves, in order to not only deal with change and complexity but also thrive amidst it. This book is designed to show you how.
Remember: for every driver driven to distraction and for every stressed-out person who has lost an assignment, a job or a vital piece of information because he or she was disorganized and distracted, there are people on the opposite end of the spectrum. These are individuals who know how to use their brain’s abilities to organize their lives, to stay focused on the tasks at hand and to enjoy greater productivity—and pleasure!—at work and at home.
Some of them you probably know: athletes such as Derek Jeter or Tom Brady, famous for their ability to block out distraction and focus on the little white ball or the white line on the field ahead, public servants such as General David Petraeus, making life-and-death decisions in the midst of a foreign country exploding in religious civil war; Steve Jobs, a visionary who manages one of the world’s largest and most influential corporations; Hillary Clinton, patiently mastering the minutiae and intricacies of a seemingly intractable conflict as she engages Palestinians and Israelis at the bargaining table. And the ranks of the super-organized are not limited to government, big business or the pressure cooker of professional sports: how about J.K. Rowling, whose disciplined imagination enabled her to create the Harry Potter world? (Imagine how organized she had to be to keep track of, much less create, the Hogwarts faculty and their complex histories.)
There are numerous examples of famous people whose achievements lie, at least to some degree, in their ability to stay calm, focused and organized, especially in the midst of crisis. There are many other very successful people whose names might not make headlines but who have, through both innate and learned skills, managed to harness their cognitive powers in a way that makes them extraordinarily productive, both on the job and at home.
Let’s meet two of them.
ORGANIZED MINDS AT WORK AND PLAY
By 8:30 am most mornings, Rob Shmerling has already exercised for an hour, has caught up on world and national news, and is well into responding to his e-mails.
For two hours, he exchanges messages with colleagues and scours various websites for the latest medical news. Dr. Shmerling is a physician and the clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center in Boston.
It’s a big administrative job at one of the country’s leading hospitals—but it’s not all that he does. Shmerling, fifty-four, also writes and does research—he has authored a total of forty-one journal articles, book chapters or reviews, as well as numerous web stories for nonexpert audiences. He also teaches and mentors medical students and residents. He is a husband and a father of two daughters. He volunteers at a women’s shelter once a week. He and his wife belong to a book club (Janice Y.K. Lee’s The Piano Teacher and Kathryn Stockett’s The Help are two recent novels they’ve enjoyed). He also “hacks away” at the piano, is an amateur photographer and, on weekends, enjoys long bike rides in the Massachusetts countryside.
Oh, and he washes and folds socks, too.
“I’m the laundry guy,” he says proudly. “Everybody in our house has their job, and that one’s mine.”
Actually it’s one of many jobs, as you can see.
How does Shmerling cram it all into one day, one week, one life, and make it look easy?
He admits that he is a creature of habit and was always fairly structured. “I can recall organizing the crayons by color in those sixty-four-Crayola packs as a little kid,” he says with a laugh. But, he’s quick to add, a lot of the skills that help keep him organized he learned because he had to. And he’s still learning. “I’ve gotten better at ignoring things,” he said. For example, “We have this e-mail system where a quick preview of the e-mail comes up on your screen, and at first it was distracting. Now I’ve gotten better at sticking with the matter at hand. If it’s a really important message, I can attend to it, but I don’t let them distract me as they pop up.”
In the hospital, things come at Dr. Shmerling fast and furious. A patient’s condition might change. An administrative problem may arise. A resident or a nurse or a colleague may need an immediate answer. And sometimes the decisions really are a matter of life and death. “I used to get more easily flustered when several things were coming at me,” he says. “Now I’ve learned how to deal with it. Now I can shift pretty quickly from one thing to another and prioritize.”
The problems that do come up are often complex ones—what course of action to prescribe to someone with arthritis, lupus or osteoporosis; dealing with patient complaints or concerns; helping to mediate or referee internal problems that arise, whether with staff or fellow physicians. He knows how to act, but he also knows how to think before he acts. “I try to imagine the range of options for a given situation and figure out fairly quickly if this is something I’ve seen before,” he explains. “If not, if it’s something better done by someone else, or if I’m going to need someone else’s help solving this, I mentally file it away, putting it aside for later.”
Putting his attention on and pulling it off, deftly and smoothly, as the need arises—that’s a sign, as we’ll see, of an organized mind. Dr. Shmerling does it with a range of tools, some high-tech, some not. “If I have to jump off something, I’ll bookmark what I was working on,” he says. “Either with a mental or actual Post-it note so I can return to the right place quickly later on.” He also has a nice trick for keeping track of his reading (and in his job, he does a lot of it—reports, memos, articles). If he’s reading a Word document on the computer, “I’ll yellow-highlight the line I’m on so I can get right back to the page and the line I was on, without wasting time scanning through the document, going ‘where was I?’”
Shmerling uses a PalmPilot to keep track of appointments and to have other important information at a glance when he needs it, even though, he admits, “I’m regularly laughed at for using a device so ancient.” And while you might think someone being held up as an exemplar of efficient organization would have an empty, ordered desk at the end of each day, it’s not the case. Dr. Shmerling’s offices at home and at the hospital are filled with stacks of books and papers—but, he says, “While it might not look organized to you, I know exactly where everything is.”
The efficiency allows him some simple pleasures during the work day. People who feel overworked often claim they have no time to read anything but e-mails or work-related documents. Shmerling not only finds time to read The Boston Globe every morning online, he spends an extra few minutes doing the popular Sudoku numbers puzzle; and is a diligent fan of Doonesbury and Dilbert (“Another efficient office guy!” he jokes). Indeed, while he is a hard-working professional and leads a busy life, Dr. Shmerling is not some obsessed workaholic, constantly looking to squeeze another hour out of his life to devote to work. He likes to have fun, he likes to laugh, he has a rich and satisfying personal life and, oh yes, some of that time he manages to save by being efficient and organized, he likes to waste.
Here’s an example: “I like to stop sometimes on my way to work and have Starbucks. If I was really trying to be a time management-efficiency nut, I could save a few minutes by making the coffee at home or grabbing it at the hospital cafeteria. But I like stopping at the coffee shop. It makes the ride more pleasant. Nothing wrong with a little down time.”
A graduate of Harvard Medical School, Shmerling is obviously a smart guy. But he is quick to point out that his academic pedigree has nothing whatsoever to do with his ability to be efficient. “There’s nothing I learned at Harvard or anywhere else specifically that taught me any of this,” he says. “None of it requires any particular advanced degree. The measures I take to keep organized could certainly be adopted by others.”
Some of those are common sense and can be found in any of the dozens of books about organization. “Make a list of what you need to do tomorrow, at the end of each day.” Fine. Good tip. But there’s more at play here. The skills that Shmerling demonstrates—his ability to shift from one problem or stimulus to another, to sustain his focus, to attend to several things at once while prioritizing quickly the one that is most demanding of his attention and to do it with ease and grace while maintaining composure and good humor—speak to qualities that are linked not to the layout of his office but the make-up of his mind.
It’s an organized mind and, while he may have certainly nurtured it, nature created it that way. We all have the systems, the functions in our mind that enable us to become better organized, whether our job involves, as Dr. Shmerling’s does, people’s lives—or our life savings, as is the case with our next organized role model.
Let’s take a peek at a typical day for another organized person.
Catherine Smith starts her morning on the roads and trails outside her Connecticut home. Her daily, three-mile run is not only good for her heart but also her head. “It’s a re-energizing time,” she says, “but I also use it to clear my head, to think and to reflect.” Thinking! What a concept. Who has the time? But using that time to plan and reflect may be one of the keys to Smith’s success—and quite a success she has been. Until recently, she was one of the highest ranking female business executives in the global operations of ING Insurance. Headquartered in Amsterdam, ING is one of the world’s largest insurance and financial services corporations. Smith was CEO of the division that oversees workplace retirement plans in the United States. She managed a business that employs about 2,500 people and serves nearly 5.5 million consumers at more than 50,000 private, public and nonprofit employers throughout the country. (You may very well have your retirement money in the division of ING that Smith oversaw.) Their combined assets today: a staggering $300 billion, literally more than the gross national product of many countries. And it was her responsibility.
Smith was accustomed to traveling one out of every two working days. On a daily basis she made decisions that involved millions of dollars—many of them representing people’s life savings and retirement money. “ING is doing important things,” she acknowledged. But she had fun doing it. “I have a lot of passion and energy,” she says when asked how she managed to stay on top of everything she needed to do. (She has since taken this passion and energy to a brand new role—and one no less demanding—serving the state of Connecticut as Commissioner of Economic and Community Development, a position to which she was appointed by the state’s governor, Dannel P. Malloy.)
A former colleague who traveled with her on a daylong business trip in New England while at ING commented admiringly in an e-mail how effortlessly Smith seemed able to meet all of the demands and responsibilities hurled at her:
Early morning: in Quincy, MA, visited one of the company’s major sites
Late morning: in car on the way back to Hartford area—did a phone interview with major trade publication
Noon: arrived at golf course in Bloomfield to play in an LPGA tournament that ING sponsored. Won longest drive contest!!
Evening: after her gold round, came in and spoke to the crowd about ING’s commitment to community and its role as a good corporate citizen
Late evening: caught up on e-mails
In addition to her innate talents, she has a mind that is fully engaged, a mind that is organized.
In her new job, she adds, she’s putting it to good use.
“Organization is even more important in this role!” says Smith, whose job includes helping to create jobs and attract new business to the state. “It’s requiring me more than ever to utilize good time management skills.”
Interesting point: Smith doesn’t make to-do lists, a supposedly common trait among organized people. She does make the most of her greatest resource, which is between the ears. “I use my reflective time to consider what things I got done, what things I need to do,” she says. Smith has also learned how to put aside things and return to them at a more opportune time. These could be complex problems or problem people. Like we all do sometimes, she can get frustrated or angry. The difference is that she knows how to manage those emotions. “It’s better to wait until you can speak thoughtfully and calmly,” she says. “I’ll leave that part of my work alone for a day or two, to get perspective and calm down.”
This reveals another part of her cognitive make-up: a mental nimbleness that allows her to jump off of one task and onto another without losing balance. “It’s rare that I go through a full day without some interruptions and changed priorities,” she says. “You cannot ignore many of these issues and need to be flexible in addressing them.” Another thing about Smith: while many might hail her as a paradigm of “multitasking” or as a “juggler,” she rejects that very terminology. “I try very hard not to multitask,” she says. “Instead, if I can stay focused on the task at hand I find I’m much more effective in completing it. If I try to spread my energies among several things simultaneously, more often than not, I end up with several half-done things.” Again, as in the case with Dr. Shmerling, it is not necessarily a driven mind or a person so single-minded that he or she is an automaton, bereft of joy and focused only on work or success. Catherine Smith, too, enjoys what by any definition would be considered a well-rounded, balanced and satisfying life. She has been married to the same man for twenty-seven years, and they’ve raised two happy and healthy children. She is a passionate outdoorswoman, who enjoys biking and hiking, and also is active in various volunteer and environmental causes. She is on the board of directors of Outward Bound USA (which serves 70,000 students and teachers annually) as well as a former director of the Connecticut Fund for the Environment.
Balance. Flexibility. Poise. An ability to tamp down the emotions and to shift and set your attention on something else with grace and ease. As we shall see, these are all qualities of the well-ordered mind. That is, a mind that is organized and can focus and pay attention. A mind that can stay afloat and buoyant in a turbulent sea of change.
It’s a mind, or a mind-set, that can be yours as well. While you may not have the academic pedigree of Dr. Shmerling or the business resume of Catherine Smith, you do have the capacity to engage and enhance the same cognitive skills that can improve your life. Whether your goals are simply to better focus on your required reading for school or work, better manage your day in order to have more time for your spouse and children or make a quantum leap forward in your career, the ability is there in your mind and in the resources that exist in you, like unused features in your computer that you have but may simply not know how to use.
In the next chapter, Dr. Hammerness will explain the principles—or Rules of Order—and the science behind them by using some cases from his own practice.
In Chapter 2, Coach Meg will show you how to get ready to take the journey of change.
In subsequent chapters, they will examine each of the Rules of Order in depth, giving you both the science behind it—so you have a better appreciation of just how organized your brain is (although you might not feel that way at the moment)—and specific suggestions on how to integrate each of these organizing principles into your life.
Citizens of Distracted America! Men and women all over the disorganized world! Join us in becoming more focused and productive. You have nothing to lose but your car keys, which, by the way, you probably left on the kitchen table.
CHAPTER 1
The Rules of Order/Dr. Hammerness
IT WAS A THURSDAY, AROUND 6:00 PM, and I was sitting in my office in Cambridge, Massachusetts, located along a tree-lined stretch of Alewife Brook Parkway, a few miles outside of Harvard Square.
The four-story brick building, an annex of Massachusetts General Hospital’s psychiatry department, is where I see patients as part of my research and teaching responsibilities at Harvard Medical School. They span the age and occupation spectrum—elementary-school children, grandparents, lawyers, salesmen, housewives and house-husbands—but they have one thing in common: they are coming to see me and my colleagues with familiar complaints and concerns. “I know I could be doing better” is a common one; as is, “I can’t go on like this.”
While the complaints may vary slightly, the symptoms they describe are the same—and consistent with the condition we treat. You’ve probably heard of it: attention deficit/hyperactivity disorder (ADHD).
One of those patients, we’ll call her Jill, is late for her appointment.
As I sit catching up on e-mails, the door bursts open and in she flies, out of breath from climbing the two flights of stairs to my second-floor office. She is flustered and clearly upset.
“Sorry I’m late!” Jill says, as she plops down on the chair facing my desk. “You wouldn’t believe my day.”
“Try me,” I say. “Take a deep breath and tell me what’s going on.”
Jill is in her late thirties and a highly educated research scientist, one of the many “knowledge workers” who labor in Cambridge, home of Harvard and Massachusetts Institute of Technology. She takes a moment and launches into her story, which begins a few weeks earlier when she temporarily moved into a friend’s apartment while her own house was being renovated.
“Last night, when I came in,” she says, “I put my keys down somewhere, and this morning, I had not a clue where they could be.”
I nod. I have a feeling I know where this is going.
“I looked everywhere—the usual places, which of course are not the usual places, as it’s not my place. My friend, she really is a good friend, but I am wondering if she has more trouble than I do. You think I am disorganized, you should see her place….”
I know this is the right time to jump in and direct our conversation back to the issue at hand or—like this morning—Jill could continue running in verbal circles and not getting anywhere. “Okay, so, you were looking for your keys…?” Jill smiles. “Oh, right, yes, I was flipping out. I spent thirty minutes trying to find my car keys.”
Jill then stops, shaking her head.
“Well, did you find them?” I ask.
She nods ruefully. “Eventually.”
“Where were they?”
“Right on my friend’s kitchen table! And, of course, I’d walked back and forth through the kitchen ten times while I was looking for them. All that time they were right there…right there in front of me. Unbelievable!”
“Sounds very frustrating…but pretty believable, as those keys have eluded you before.” Jill smiles ruefully, and I press on. “Then what happened?”
“My day was in shambles from that point on.” Jill went on to relate how the half hour she’d spent looking for the keys set off a domino effect of tardiness and inefficiency—problems galore. She arrived at work late for a meeting and opened the door to the conference room just in time to interrupt an important point that one of her company’s head honchos was making. Embarrassed and angry at herself, she returned from the meeting and finally got in front of her computer to find a barrage of e-mail reminders that further annoyed and overwhelmed her. She sent out a flurry of responses, including a snippy reply to the wrong person, who was not happy to get it (neither was the correct recipient, when she eventually cleared up the mistake). Dealing with her e-mail gaffe kept her from attending to a project due by noon. Her deadline blown, she skipped lunch, scrambling to get her work done, and what she did hand in—two hours late—was subpar and received with something less than an enthusiastic response by her supervisor.
In other words, it was a crummy day for Jill. It wasn’t the first time such a day had begun with something misplaced or by an episode of forgetfulness, but the snowball effect of losing her keys still surprised and upset her.
“This happens all the time,” Jill says, teary-eyed, angry and ashamed. “At this rate, I could lose my job…just because I can’t keep track of stupid things like keys.”
I’m sorry to hear that Jill is upset, but her story is not unusual. Jill has ADHD—and she is certainly not alone. It’s estimated that about 4 percent of adults and 5–7 percent of children in this country meet the medical criteria for ADHD. It’s equally safe to estimate that at some point in their lives almost everyone has felt as if they have ADHD, too. The symptoms of ADHD include forgetfulness, impulsiveness, losing items, making careless errors, being easily distracted and lacking focus. Who hasn’t exhibited one of these symptoms in the last few days…or even hours? Who hasn’t lost their car keys? Who hasn’t been distracted in the car (once the keys are located), on the job or at home—by a text, a tweet, an e-mail, a cell phone ring? Who hasn’t been late for a meeting or missed a deadline or made a mistake because they were disorganized that day, lost focus that morning or were distracted that minute? That doesn’t necessarily mean you have ADHD, but it does suggest you might be part of the distracted masses that now make up such a large part of our society. If so, you’ve come to the right place because we’re going to show you how to get back on track.
ADHD or OBLT?
(Overwhelmed By Life Today)
If you answer Often or Very Often (on a ranking scale of Never, Rarely, Sometimes, Often or Very Often) to four or more of the following questions, it may be beneficial to consult with a health professional to see if you have ADHD.
In the last six months….
1 How often do you have trouble wrapping up the final details of a project once the challenging parts have been done? (never/rarely/sometimes/often/very often)
2 How often do you have difficulty getting things in order when you have to do a task that requires organization?
3 How often do you have problems remembering appointments or obligations?
4 When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
5 How often do you fidget or squirm with your hands or feet when you have to sit for a long time?
6 How often do you feel overly active and compelled to do things, like you were driven by a motor?
Source: World Health Organization
Whether or not you have ADHD—and chances are, you probably don’t—the purpose of this book is to inform, inspire and organize your brain. Whether forgetfulness is a “symptom” of a disorder for a person like Jill or an “issue” for someone else who doesn’t have the same degree of severity, this book will approach it in a straightforward way—and with equally straightforward and effective solutions.
What was first labeled the “Distraction Epidemic” by Slate magazine in 2005 has now reached epic proportions, right up there with the obesity epidemic and is of no less import than that or other public health crises that have befallen modern society. In a 2009 New York magazine story on the attention crisis, David Meyer of the University of Michigan described it as nothing less than “a cognitive plague that has the potential to wipe out an entire generation of focused and productive thought” and has drawn comparisons to the insidious damage of nicotine addiction.
“People aren’t aware of what’s happening to their mental processes,” says Meyer, “in the same way that people years ago couldn’t look into their lungs and see the residual deposits.” The difference here is that unlike the “mad men” of the 1950s and 1960s who went around merrily sucking up packs of unfiltered Camels, seemingly oblivious to the harmful effects, most of us today know that we are having problems staying focused, paying attention and maintaining some sense of order in our lives.
