More Attention, Less Deficit

It came out in 2009 from Specialty Press, under the A.D.D. Warehouse imprint. Its full title is More Attention, Less Deficit: Success Strategies for Adults with ADHD. About three hundred and eighty pages.

Ari Tuckman is a clinical psychologist; he has a doctorate in psychology and a master's in business administration. He works on the diagnosis and treatment of ADHD in children and adults. When the book came out he was introduced as vice president on the board of the Attention Deficit Disorder Association (ADDA).

I could not find a verified Turkish edition; I write it under its English title.

The book with tear-off corners

The first thing that sets this book apart from the others is its format.

The book consists of short articles of about two pages each. Each article can be read on its own. The publisher's promotion presents the book as the only ADHD book built around the tendency of adults with ADHD to jump between pages.

And there is a small, odd detail: the page corners are perforated. You tear off the corner of the article you have read, and you can see from the edge of the book which articles you have read.

When I first heard this idea it seemed a bit like a toy to me. Then I thought: as someone with ADHD, where do I most often abandon a book? Because I forget where I left off. Because I do not remember which chapters I read, so I start from the beginning and read the same first fifty pages for the third time.

The page corner is a solution to this problem built into the book's physical design. While writing the site's article why reading books is hard in ADHD, I had this kind of solution in mind.

At the start of the book there are two short sections titled "How to read this book" and "What makes this book different." Reading the two is enough to understand how to use the book.

Four parts

The articles are gathered under four big parts.

Understanding ADHD in adults. The first article is on executive functions and its title says everything flows from here. Then diagnosis, ADHD and the brain, why ADHD affects life so much.

Starting with effective treatment. Medication, therapy and coaching, non-traditional treatments.

Building the necessary skills. Self-esteem and effectiveness, memory management, time management, organization, tools and goals.

Improving specific areas of life. Housework, relationships, friendships, parenting, college and work.

At the end there is an epilogue titled "The pain of ADHD," a resources appendix and a bibliography.

The logic of the order is, I think, the book's hidden strength. The reader can start from any article, but the book also draws a recommended path: first understanding, then getting treatment on track, then building skills, last carrying these skills into the areas of life.

A million things

The introduction's title speaks of a million things that will make life better. When I first read it I flinched.

On the site I wrote an article criticizing ADHD books made up of unsourced lists of advice, and this title looks very much like that pattern. Hundreds of short articles, a few strategies in each. On paper, exactly the kind of book I recommend staying away from.

Two things set the book apart from that kind, and to be fair I have to say them.

First, it builds a framework before the strategies. The executive function and treatment sections give a ground explaining why the skill articles may work. When a strategy does not hold, you have a model to think about why it did not.

Second, it puts treatment before strategies. The book's order suggests the reader first stand on solid ground about diagnosis and treatment, then build skills. Most unsourced lists of advice reverse this order or never mention treatment.

These two features make the book more than a collection of tips. Even so, picking one of the million things and trying it is worth more than reading them all.

Executive functions first

Giving the book's opening to executive functions was a good choice for 2009.

Instead of describing ADHD as an attention deficit, Tuckman describes it through how information is processed and how behavior is regulated. This is like Barkley's theory carried to the general reader. He also ties why some strategies work and others do not to this framework.

There is an idea repeated through the whole book: in ADHD the problem is often not knowing what to do but doing what is known.

This idea explains why the advice "just try harder" does not work. If information were lacking, more information would be enough. What is missing is the system that brings the known information into play at the right moment.

The space given to treatment

The second part is the section that best shows the book's credibility.

Tuckman describes the treatment of ADHD as a whole in which several components work together: learning about ADHD, medication, coaching and therapy. He does not present any of them alone as the solution.

The medication part takes stimulant medications seriously and treats medication as a tool that can shorten the distance between intention and action. That the rest of the book is given to building skills also shows that medication is not seen as enough on its own. The decision on medication is always made with a doctor.

The distinction between therapy and coaching also helps. Coaching focuses more on building skills, strategy and coping with everyday demands. Therapy deals with the negative beliefs and sense of self accumulated during the years before the diagnosis. Knowing that the two answer different needs makes it easier to choose which to turn to and when. I covered coaching separately on the site in the article what is ADHD coaching.

Reading the section on non-traditional treatments, you need to pay attention to the date. Since 2009 some of these methods have been tested in more rigorous studies. For example, the 2016 meta-analysis by Cortese and colleagues found that neurofeedback did not show a significant effect in blinded assessments. It is healthiest to read every method in this section by comparing it with a current source.

Skills

The third part is the thickest of the book and the place I used most.

Self-esteem and effectiveness. Opening the skills part with self-esteem seems a deliberate choice. Someone who has thought for years that they fail may be unwilling even to try a new strategy.

Memory management. In a brain with weak working memory, instead of trying to hold information in the head, writing it down outside, using timers, putting reminders in visible places.

Time management. Calendar, routines, breaking tasks into pieces.

Organization. Things and papers having a place, the system not being complicated.

Tools. The tools of the period when the book was written. As you would expect, the place that has aged most.

Goals. Tying long-term goals to everyday steps.

The shortness of the articles is a big advantage here. It is possible to read a single article on time management one morning and try one thing that day. Without feeling obliged to finish a long chapter.

Areas of life

The last part is given to housework, relationships, friendships, parenting, college and work life.

The relationships and friendships articles are written so that they can be read also by those who live beside a person with ADHD.

The housework articles worked better than I expected. In ADHD books housework is usually either absent or squeezed in among productivity advice. Here it is a subject in its own right.

The epilogue

The part of the book I remember most is the epilogue.

The title "The pain of ADHD" is unexpected for a strategy book. After telling for hundreds of pages what to do, closing the book with this title means openly admitting that ADHD really causes pain to people.

This admission mattered to me. Most strategy books keep pushing the reader to the next step, and sometimes a person only needs to hear that they are tired and that the loss accumulated over the years is real. That the book puts this at the very end is meaningful too.

Seventeen years later

2009 is a long time ago for an ADHD book.

The diagnostic criteria changed. The book was written in the DSM-IV period. DSM-5, published in 2013, brought the concept of presentation in place of subtype, raised the limit for the age of symptom onset from 7 to 12, and lowered the number of symptoms required over age 17 to five. You need to read the diagnosis articles in the book knowing these changes.

Research advanced. The JAMA study by Safren and colleagues showing the effect of cognitive behavioral therapy in adult ADHD was published a year after the book, in 2010. On heritability too the picture has become clear: the 2019 review by Faraone and Larsson gives heritability at about 74 percent. The book's general direction does not conflict with these findings, but it does not contain these data.

The understanding of ADHD in women changed. Topics such as how women get overlooked, how hormonal periods affect symptoms, and masking have been discussed far more since 2009. I did not see a section in the table of contents given to these topics.

The tools aged. Smartphones were only just beginning to spread when the book was written. Some of the tool suggestions look odd today. The principles are valid: write it outside, make it visible, put the reminder at the right moment. You also need to be careful in choosing tools, because app hunting can turn into another form of procrastination.

The cost of the short article format

The format's advantage is big but it has a cost too.

Two-page articles open up a subject but often cannot deepen it. Why a strategy works is told briefly; where it does not work or in which situations it needs adapting is not always said.

For them to be readable independently, each article has to rebuild a certain context. This makes it inevitable that someone reading in order meets repetitions.

At the end there is a bibliography. But the short article format leaves little room for tracing, within the text, which study each claim rests on.

Its place on this list

Looking at the books I reviewed together with this article, Tuckman's place becomes clear.

Barkley's ADHD and the Nature of Self-Control gives the theory but does not offer a single practical page. Ramsay's books build the link between thoughts and skills, but within a therapy framework. Zylowska focuses on a single method, mindfulness.

Tuckman takes a bit from all of these and turns it into a reference book. It is the book with the least depth, but also the one covering the widest ground and the easiest to open and close.

For whom

A good second book for a newly diagnosed adult. If the first book is for recognizing the picture and reducing shame, this book eases the move to what to do.

Perhaps the most suitable book for those who cannot finish long books. Its format is designed for exactly this reader.

For spouses and family members living with someone with ADHD, the relationships and housework articles are also useful.

For someone looking for a deep theoretical framework or a current research summary, it is not enough. In that case a more current and source-dense book is needed.

My suggestion: first read the two short reading guides at the start, then the article on executive functions. Then open the table of contents and go to the article on the subject that challenges you most that week. Tear off the corner. The next time you open the book, the book will tell you where you left off.