May 20, 2010

Goal: Remember So As To Do

The last couple of weeks have been tough, but easier than the hundreds of weeks that went before in my life. I am amazed at how I am becoming aware of how impaired my working memory is. I forget shit all the time. I don't just forget stuff, but I forget shit.

All. The. Time.

Everyone gets distracted. Everyone's attention is diverted by compelling stimuli. If we weren't distracted, we would risk being hit by a car, or be seen as socially inept when someone tried to get our attention, etc.. etc...

And it is our working memory, the theoretical construct within cognitive psychology that refers to the structures and processes used for temporarily storing and manipulating information that allows us to recall that which we were initially doing, and return to it. What differentiates ADHDers and non-ADHDers is the poor quality or deficit of working memory. After a distraction has redirected their attention, ADHDers do NOT return to task, whereas non-ADHDers do return to task - e.g. the document they were writing, or the clothes they were folding, or the food they were cooking.

For example, I go downstairs with the express intent to get a pair of pliers from the tool chest. I notice some batteries on my desk. I remember that my Motorola camping walkie-talkies need new batteries. I insert them and feel good. Then I see a book on camping near where I had stored the walkie-talkies and pick it up, because I intend to read it later on. I come upstairs again with the book, excited at the thought of sitting down later outside in the sunshine and reading through it. But then I recognize a lingering suspicion within me that I've forgotten something. It takes me a minute or so to mentally retrace my steps, and actually talk to myself quietly to figure out what I'm missing: the pliers.

My wife asked me the other day to pop downstairs to grab a print-out from the printer we've networked across the house. She prints a document upstairs and the print-out appears downstairs. I went downstairs. On my way to the printer, I changed my socks quickly, as I had a hole in one of them. I then noticed my garbage can needed emptying so I quickly emptied it into a garbage bag. Then I went to the washroom. Then I thought it would be a good time to trim my goatee with my new fancy trimmer. Then I saw a T-shirt that I wanted to wear. So I returned upstairs with my nice T-shirt, feeling good, and got back to making the tea I'd started on when she'd initially asked me for the print-out.

Now that she is realizing (I believe) that my ADHD plays havoc with my working memory, she sort of smiled, and asked me gently where the print-out was. I told her (thinking quickly on my feet) that I needed my special T-shirt first so that I could go get the print-out. I'm clever that way. I skulked back downstairs and fetched the print-out.
"[...]most patients with ADHD continue to struggle with a substantial number of symptoms and a high level of impairment.

For example, adults with ADHD are thought to have deficits of working memory as exemplified by less ability to attend to, encode, and manipulate information. Such deficits in working memory may decrease the ability to filter out distractions, which contribute to further symptoms of inattention in adults with ADHD. Although less defined within ADHD, organizational difficulties and procrastination also appear common.*"
My new motto and new mantra is something that Dr. Russell Barkley said in a presentation - that a very important goal for ADHDers is to "remember so as to do".

So now when I forget to grab that print-out or grab my T-shirt, or close the garage door, or forget to close the kitchen cupboard, or forget my security pass for work, I am kinder to myself than I've ever been. Normally I have chastised myself and told myself that I'm 'such an idiot', and when appropriate apologize and apologize to whomever is blaming me for leaving something undone.

I now remind myself that I am working hard at developing new habits and coping skills, and learning more and more of the ADHD limitations that I can work to overcome - including with the help of medication. And I remind myself that my new goal is to more effectively "remember so as to do".

Cheers,

Mungo

*Seidman LJ, Biederman J, Faraone SV, Weber W, Ouellette C. Toward defining a neuropsychology of attention deficit-hyperactivity disorder: performance of children and adolescents from a large clinically referred sample. J Consult Clin Psychol. 1997;65(1):150-160.


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6 comments:

  1. Wonderful post. Awareness is always the first step.

    ReplyDelete
  2. I am also combined type, so I get a lot of what you are saying. Incidentally, I was also at a presentation by Russel Barkley recently. I brought a close friend along who works with me. I think that because she gets what is going on in my head now she is a lot more patient with me. She also helps me keep myself on track so that it's easier for me and everyone else. :P I think that having people who understand and are there to support you is essential to actually succeeding with this disorder.

    I also loved the part about being easier on yourself. I keep having to tell myself, "It's ok. Just try again." But it's getting easier. :)

    ReplyDelete
  3. I love the story about the pliers... that happens to me every day and it's nice to see others go through it as well.

    ReplyDelete
  4. Since you tweeted this article again, I was wondering if after these months on Strattera your working memory on this is improving.

    Understanding that my ADD is foremost a working memory deficit instead of only a nasty byproduct of my attention deficit, it seems to me that it is easier to handle and I'm more aware of the moments of keeping in mind what I was doing.

    These days I also start to recognize in what ways my working memory affects me. Last week driving home from a medication appointment with the psychiatrist I was wondering what to get from the groceryshop. That meant remembering what I liked to eat. Such a simple question but for the first time I realized that I first went in my mind trying to remember what was the last nice meal I had.

    I first started - I noticed for the first time - that I was looking back on nice dinners I had with my former girlfriend a couple of weeks back. Too much hassle. What simple meals I realy like? Went on to the alphabet on vegetables and food to wait if something pops up as nice and simple. It took me to the Y of yoghurt to let me remember chickenbreast soaked in yoghurt with koriander.

    I just couldn't get a simple answer to a simple question straight from my memory into my working memory. It took so much processing power out of my brain for something a 'normal' person would only take a second.

    Realizing that tears filled my eyes so much I had to stop alongside the road

    ReplyDelete
  5. Since you tweeted this article again, I was wondering if after these months on Strattera your working memory on this is improving.

    Understanding that my ADD is foremost a working memory deficit instead of only a nasty byproduct of my attention deficit, it seems to me that it is easier to handle and I'm more aware of the moments of keeping in mind what I was doing.

    These days I also start to recognize in what ways my working memory affects me. Last week driving home from a medication appointment with the psychiatrist I was wondering what to get from the groceryshop. That meant remembering what I liked to eat. Such a simple question but for the first time I realized that I first went in my mind trying to remember what was the last nice meal I had.

    I first started - I noticed for the first time - that I was looking back on nice dinners I had with my former girlfriend a couple of weeks back. Too much hassle. What simple meals I realy like? Went on to the alphabet on vegetables and food to wait if something pops up as nice and simple. It took me to the Y of yoghurt to let me remember chickenbreast soaked in yoghurt with koriander.

    I just couldn't get a simple answer to a simple question straight from my memory into my working memory. It took so much processing power out of my brain for something a 'normal' person would only take a second.

    Realizing that tears filled my eyes so much I had to stop alongside the road

    ReplyDelete
  6. I love the story about the pliers... that happens to me every day and it's nice to see others go through it as well.

    ReplyDelete

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