Q: I find that with my ADD almost any kind of structure gives me a claustrophobic feeling and the feeling of wanting to run the other way. Is this a normal feeling? and what does one do about it?

A: It is normal for a person with ADHD to feel constrained by structure. Your energy, spontaneity and creativity all work against you when you try to structure whatever you are doing. To counter this tendency try to break your activity into small, readily digestible chunks. Then take time between the chunks to do something fun. It can also help to pair a structured activity with a rewarding or fun activity, like watching t.v. while you exercise, or going shopping during the afternoon you set aside for a doctor's visit. Finally, whenever you have to structure yourself, try doing it with someone else. The energy of the relationship can power you past the routine of the structure.

This year, brush up on your interpersonal skills - here's how! - by Robin Roman-Wright, M.A.

Interpersonal skills have a profound impact on how you get along with others in your life whether family, friends, teachers, managers or colleagues. So it makes sense to identify the effective ways that you interact with others, and minimize the behaviors that rub people the wrong way. You can do this on your own or through work with a coach.

Let's address interpersonal skills at work first. Usually the people who are successful in the world of work - those who rise to the top - have good interpersonal skills.

Research indicates that strong communication skills are important to employers. Back in 1991, the U.S. Departments of Labor and Education formed the Secretary's Commission on Achieving Necessary Skills (SCANS) to study the kinds of competencies and skills that workers must have to succeed in the Global economy. The results of the study showed that two critical skills are listening and speaking. More recent studies have confirmed these findings. In fact, the Center for Creative Leadership published a 2007 White Paper titled, "The Changing Nature of Leadership," in which they state that over the last five years there has been, and will continue to be, an increasing need for leaders to exhibit advanced communication and relationship skills. In order to be effective organizations are "asking leaders to focus more energy on creating an environment where others can help them succeed." They go on to say those skills such as, "participative management, building and mending relationships and change management," are top skills required for success in today's work world.

If you want to improve your interpersonal skills, how do you do it? First, identify what you do that works when interacting with other people. Next, reflect on situations that went awry and figure out what behaviors are best not repeated and need to be changed.

How do you identify your interpersonal skills?

• Purposely reflect on interactions at the workplace. Journaling, after situations involving conflict, can be revealing.
• Ask trusted advisors - while this is not standard practice in our workplaces - it can be empowering. If you have a mentor, trusted friend, or coach, ask him or her about how you are coming across in specific situations. For instance, you can ask a mentor to debrief with you after a meeting. What did I do that was effective? What did I do that did not help my cause? What could I have done differently
• Get a coach and specifically review interpersonal interactions. Role-play alternative ways of handling uncomfortable or difficult situations.
• Take an interpersonal assessment or inventory. Make sure it is valid and reliable - in other words the assessment itself has been tested to actually measure what it is saying it measures. I use two or three different assessment instruments with clients depending on their specific goals.

Enhancing your understanding of your communication skills can enhance family relationships as well. One of my young adult clients was having a lot of conflict with his parents. He saw the world differently than his parents. He also responded to the situations in his life differently than his parents would. Sounds like a lot of people, doesn't it? The problem was that he was well meaning but his parents saw his actions as willfully contrary to their "way of doing things."

He took one of the personal style inventories that I use and, in reading the multi-page report, was amazed at the accuracy of the description. Most of the statements in the report were true about how he saw the world, what motivated him, and what was important to him. He had never been able to talk to his parents about these things - he didn't have the correct language to describe his way of thinking and acting before. Using the report he wrote out all of the things that he wanted to say in order to explain his behavior to his parents. He saw taking the inventory, and having the words to talk to his parents about the way he thought and acted, as a breakthrough in his life.

I encourage you to brush up on your interpersonal skills this New Year. The effort that you put into it, and the results that you achieve, could make a difference in your life for years to come.

Interested in learning more about coaching, particularly focused on enhancing your communication and relationship skills? Please contact the Hallowell Center Sudbury at 978-287-0810 and ask for a 15 minute complimentary inquiry session with Robin Roman Wright.

There was a great deal of press coverage in November about the results of a long-term study of children with ADHD in the U.S. Many articles made it sound as if the long-term use of drugs such as Ritalin with children with ADHD was not effective.

This finding did not seem to be complete or ring true, so Dr. Hallowell went directly to one of the co-authors of the study, his friend Dr. Peter Jensen, to find out the "news behind the news". Dr. Jensen responded to his query in Q&A format for our newsletter, and we include the complete text here:

Q: I have heard about results from a large, federally funded study, the MTA Study. Didn't that study show that medication doesn't make any difference after 3 years?

A: No, the study actually showed that high quality medication treatments made a big difference in kids' outcomes, but only for so long as the quality treatment was continued. The study was designed to compare high quality medication treatment for a period of 14 months. When medication was given this way (with optimal doses carefully selected for each child, and ongoing regular follow-up), children did much better than if the medication was not carefully dosed and monitored. It was also much more effective than a special form of parent counseling, called behavior therapy. But after 14 months, all treatments reverted to "community standard" treatment, which tends to not get the same level of careful follow-up.

So if someone says, treatment doesn't make any difference, that would be like saying diets don't make any difference. Yes, if children get a year of a great diet, and then get two years of fast food, it is possible that the benefits of the good early diet might no longer be apparent. But the solution is not to only offer fast food, but to continue good diets past one year! This is also true for high quality treatments for ADHD. The MTA Study showed that ADHD treatments that also use high quality medication strategies do make a difference! But if you don't keep with the careful diet, and slip back into fast food, you may lose those benefits.

Q: Weren't there long-term effects on children's growth?

A: In fact, the MTA Study showed that children who received the benefits of carefully managed medication for 14 months, by 3 years there were no differences in height or weight compared to children who did not get this quality treatment. But there was a small subgroup of children who remained on medication year-round for 3 years. Among these children, at 3 years there was a slight difference in height compared to children treated with either no medication or medication for part of the 3 years. In fact, children on year-round medication for 3 years grew about ½ to 3/4ths of an inch less than the other children. Other studies have shown that even though there may be a growth delay in some children, such children still eventually attain their expected adult height. The MTA investigators are continuing to follow these children into adult, to see if in fact that finding holds for these children as well.

Telecommuting Lowers Stress: The American Psychological Association recently announced the results of a study of almost 13,000 employees that showed that telecommuting has an overall beneficial effect on employees. Telecommuters reported more job satisfaction, less motivation to leave a company, less stress, improved work-family balance and higher performance ratings from supervisors. For more information, go to this link: APA Study

Spark: The Revolutionary New Science of Exercise and the Brain by Dr. John Ratey
Science overwhelmingly supports the idea that exercise is GREAT for your brain. It improves your focus (ADDers take note!!) as well as your memory, reduces anxiety, and works better to combat depression than Zoloft!

Though Spark gives you plenty of science, it is an easy and engaging read. Worried about your kids' academic success? Read about the incredible successes found by the 19,000 student Naperville school district with their move from P.E. to a new kind of fitness schedule for their students. Worried about memory loss and aging? Find out how exercise is one of the best ways to fend this off.

Dr. Ratey covers the overall concepts, and then devotes chapters to specific topics - stress; anxiety; depression; ADHD; addiction, hormonal changes and aging. Once you read this book you'll never think of exercise the same way again.

The Open-Focus Brain: Harnessing the Power of Attention to Heal the Mind and Body by Les Fehmi, Ph.D. and Jim Robbinsreviewed by Rebecca Shafir of the Hallowell Center
Did you know that there are different attetional styles? The basic premise of this book is that if we are flexible with our attentional styles we can attain a higher level of efficiency, happiness and well-being. Based in the science of brain waves, the book includes exercises which focus on objectless imagery to open the scope of attention and teach how to access and maintain alternative styles of attention.

Each style of attention is unique and can occur more or less equally and simultaneously. Many of us operate within one dimension of attention - narrow-objective attention. We strive to focus on one or a few important things in the foreground and dismiss everything else in the background. As the authors describe, the narrow objective type of attention is an emergency mode that can be helpful in some situations, but an overuse of it results in a tense state with high reactivity to people and situations. It is a mode of hypervigilance, used to suppress feelings of fear and anxiety. Other realms of attention available to us are diffuse, objective and immersed states. When each style is emphasized it can have significant impact on our physiology, mood and behavior. Diffuse attention is panoramic and similar to a mindful state when one is walking through the woods and experiencing the surrounding sensory stimuli with a sense of timelessness. Objective attention is a state of evaluative attention, sometimes cold and calculating, but necessary in critical decision- making. Immersed attention is a mode experienced in a state of rapture to the extent of forgetting oneself while becoming absorbed in the activity. Artists or athletes are well familiar with this state of attention.

Although this book is written with adults in mind, I can imagine some older children and teens able to benefit from these techniques. The authors comment on ADHD in children saying that "it's not that these children can't attend, it's that when they become anxious or focused in a narrow focused manner they perceive this tension as boredom which compromises their ability to attend." Video games reward narrow objective focus, which when overused, create more arousal and over-reactivity.

The book includes chapters on depression, physical pain, relationships, learning and peak performance. Although these techniques can be used in isolation, Fehmi uses these techniques in combination with neurofeedback to improve brain synchrony. As I write this article I have started using them with my adult LENS neurofeedback clients before their feedback session with good results. Readers can practice the basic series of techniques with a DVD that accompanies the book.

Some readers have found the exercises a bit quirky, and the particular focus (creating space between body parts) may be hard to imagine at first, but I found the visualization effective and a refreshing change from other types of relaxation CDs. The exercises are easy to follow and logically tie theory to life. As with other self- improvement methods, the reader will find benefits equal to the frequency and quality of the effort put into practice of the methods presented. However, the theory behind the Open Focus methods makes sense and can enable the reader to build skills that potentially change the way he or she functions in life.

For those of you who are interested in reading what others write about their ADHD relationships (and perhaps posting some of your own thoughts!) we have a new forum dedicated to the topic of ADHD relationships. Come join the conversation!

This winter's groups at the Hallowell Center in Sudbury include one for 20-somethings, one for spouses of people with ADD and one for men.

The Center is also collecting names of those interested in starting a group for parents of children with ADHD

email: morlov@hallowellconnections.com

phone: 508-545-2250 Hallowell Connections or 978-287-0810 Hallowell Center (medical)

web: http://www.drhallowell.com