ADHD & The Checklist Manifesto

Checklist Manifesto

My friend Katy, a legal secretary, swears by using a checklist to keep ADHD chaos at bay at a busy law practice.  Physician, surgeon, and writer Atul Gawande likes checklists so much, he wrote a popular book about it.

In The Checklist Manifesto, Gawande dissects a problem that plagues every quarter of the modern world. That is, how can we streamline the increasing complexity of our responsibilities—in the operating theater, in the cockpit, and anywhere else professionals strive to “get it right.”

This book excerpt, below, reminds me of  a common complaint from my friends with ADHD: They can’t imagine adhering to any system so “boring” or even “like being in prison.”

Will Using Checklists Really Feel Torturous?

Like an expert CBT therapist, Gawande acknowledges the fear that many of us harbor about using checklists—and scrutinizes any basis for truth behind it:

The fear people have about the idea of adherence to protocol is rigidity. They imagine mindless automatons, heads down in a checklist, incapable of looking out their windshield and coping with the real world in front of them.

But what you find, when a checklist is well made, is exactly the opposite.

The checklist gets the dumb stuff out of the way, the routines your brains shouldn’t have to occupy itself with (Are the elevator controls set? Did the patient get her antibiotics on time? Did the managers sell all their shares? Is everyone on the same page here? etc.), and lets it rise above to focus on hard stuff (Where should we land?).–The Checklist Manifesto, by Atul Gawande, MD

In my experience, people don’t change until they challenge their underlying beliefs.  If you have adult ADHD and consider yourself “allergic” to checklists, you might find this an important read.

I’d love to hear your experiences with checklists. Feel free to leave a comment!

Also Put This On Your ADHD Reading Checklist

What are other ways to transform ADHD chaos to order throughout your life?

In my experience, the first step comes with recognizing the pain that disorganization is causing you or your loved ones.  The next step: Adopting a meaningful philosophy of life that guides all future actions.

You’ll find posts on the ADHD Roller Coaster that tackle organization from all angles. Yet, here is a particularly good one:  an excerpt from a captivating and inspiring new book from Jaclyn Paul: Order from Chaos: The Everyday Grind of Staying Organized When You Have ADHD.

Jaclyn’s is a decidedly thoughtful and intelligent voice on many aspects of ADHD, shared through her blog, The ADHD Homestead. We met many years ago—when I discovered a review of my first book (Is It Me, You, or Adult A.D.D.?) on her website.


11 thoughts on “ADHD & The Checklist Manifesto”

  1. Hi Gina,

    Thanks for your message. I was diagnosed in 2008 and have been on time-release Concerta plus top-up mini-pills, which do help. Also tried CBT but got so bored with all the logging of endless details.
    I’m not unhappy, and I can often function extraordinarily well. Being self-employed and working from home helps because it means I can usually work at my own pace and to my own time schedule. Naturally there are certain “gun to the head” deadlines such as sending tax returns on time and there are always solutions and tactics for dealing with any problem, including missed deadlines, government departments, etc.
    Like the old saying: When I’m good, I’m very very good and when I’m bad…I find creative ways to deal with it. 🙂
    Love your book btw (will finish reading it one day real soon anytime now 🙂

    1. Hi Josie,

      I’m glad to hear that!

      And kudos for swinging self-employment.

      Tax returns….I know what you mean. There’s gotta be an easier way!

      take care,

  2. Ah yes, those checklists. Staying organised, Getting Things Done, increasing productivity and staying on track.

    I’m 62 and have run my own small business since 2006. I’ve lost track of how many “checklists” I’ve explored, how many reviews of checklists I’ve read, how many To Do lists I’ve tried and how many lists I’ve made of my lists.

    What do I do now? I continue to revert to scribe and papyrus and continue to lose my lists and make lists of my lists. Meanwhile I have reminders in my Calendar, also in my Tasks, also on my phone, and of course lots of paper lists.

    I file “helpful” information in Bookmarks”, also in online Folders, and I spend a daft amount of time trying to remember where I filed all this information. I have multiple “Project Planners” and all my many projects have been works in progress for years.

    Hold a gun to my head and I’ll do it. Motivate me with sufficient interest and I’ll do it for hours and hours to the exclusion of anything else.

    Otherwise it will go on a Checklist, with a “due date” that bears no resemblance to earth time. One of my best (and patiently understanding) friends calls it “Evil Twin time”. I’m thinking I might start a new “Procrastination Project” to track my progress…. 🙂

    1. Dear Josie,

      You wrote: I’m thinking I might start a new “Procrastination Project” to track my progress…. 🙂

      haha! I love dark humor. It’s the only way some of us survive this world. 🙂

      And I can also appreciate the pain from which it springs.

      Here’s the thing: It seems your challenge is not “accepting” that checklists can be helpful. It’s ADHD symptoms that are getting in your way.

      Motivation. Managing focus (“hours and hours to the exclusion of anything else” is just the flip side of no focus, that is, deregulated focus).

      You don’t mention if you have tried medication. It’s not a panacea, and it can take some trial and error to find the right fit — not to mention, it requires self-educating and self-advocating.

      But it might be very helpful to you.

      Thanks for your comment,

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  4. Yes that is the one.
    I often do feel invisible. I have this ideal self that I try to strive for, but the results never match the expectations, and often seem to have mixed feedback.
    When I look at other peoples goals, I see more clearly, with a longer term overview and an always shorter, what can I do right now perspective. That perspective is not cluttered by my own short and long term, everything at once thinking. When I look at my goals, they are often vague, “immediate situation evaluated” and acted on or often put aside for a more “in my face”, immediately compleatable task.
    Check lists help, but making them for myself and sticking too them is often my greatist challenge as I cannot stop tweaking them in my head, on paper, or worse: understanding (remembering) how I developed them in the first place at a different time and in a different frame of mind. (What seemed important then versus what seems important now.

    1. Hi PB,

      Yes, checklists aren’t the answer to everything.

      But once you do have a goal, just the process of breaking it down into “action items” can help you re-assess. It helps you to “think it through” and even decide if the goal is worth pursuing.

      Sometimes a goal might sound desirable, until we see exactly what it’s going to take to achieve it.


  5. after years of undiagnosed ADHD, I find myself over reliant on check lists as a coping strategy. Just make sure that you go by the ‘everything in moderation’ manifesto too! 🙂

    1. So true, Claire! A reliance on checklists can be helpful when you don’t know what you’re dealing with (ADHD, and perhaps anxiety?), but once you do, other strategies (including perhaps medication) can help you put checklist in the proper balance.


  6. Katy at in this post #ADHD: Invisible Self/Magnified Other
    captured the essence of me.

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