Work Smarter, Not Harder.

Our brains are incredible machines, but sometimes we don’t allow them to be as efficient as possible.

You probably don’t think twice about most of the things you do on a daily basis; it’s just the way you do it and it gets done. Have you ever thought about how much cognitive load is required to complete just one daily task? Have you ever wanted to do things more efficiently and feel less mentally fatigued afterward? As an SLP, cognitive therapy has always been my favorite because it is extremely functional and it benefits the patient in all aspects of life. A part of cognitive therapy is finding compensatory strategies that support the patient to complete important tasks successfully while decreasing cognitive demands.

Think about driving a car. For most of us, it’s become almost an automatic process, which has been encoded into our procedural memory. Procedural memory is a type of memory that helps us tie our shoes, make a PB&J, and drive a car. Now, imagine you are leaving your house for work in the morning:

You unlock your car, open the door, sit down, close the door, turn on the engine, and buckle your seatbelt. You are completing multi-step directions before you even start driving. Time to back out of the driveway! You check your mirrors and look both ways out your back windows to ensure no cars are coming, then you put the car in reverse and slowly ease out of the driveway while you continue to look at all the mirrors and out the back windows. You are now engaging your brain in the highest level of attention, which is divided attention, using visuospatial skills and motor planning, and requiring increased processing speed. You are driving through your neighborhood. You see Sherry from down the street walking her dog and you wave. You are monitoring your speed as you pass the speed limit sign. WATCH OUT FOR THE SQUIRREL! Phew, you reacted fast enough to not squish him this morning. You see the stop sign and you stop, look both ways, then proceed. Oh no, you forgot your lunch on the counter, so you start thinking about what you’ll eat for lunch now… You are using divided attention, initiation, problem-solving, motor planning, pragmatics, processing speed, memory, language, and the list goes on.

It is because driving has become an automatic process that we are able to successfully multitask at such a high level, and this was a very basic example of driving. Remember when you were first learning how to drive? Not so easy back then. And what about the times when you didn’t know where you were going, or you had friends in the car? It becomes less automatic, and the cognitive load increases. You might miss a turn or miss what your friend was saying. But for some who have suffered a brain injury, driving a car becomes a nearly impossible task due to the high cognitive demands required. SLPs help patients strengthen those cognitive skills and determine compensatory strategies so they can be as independent as possible.

During my graduate internship at Reunion Rehabilitation Hospital, one of my first solo patients was a man who suffered a right hemisphere stroke. This type of stroke typically causes cognitive and executive functioning deficits. He had a very detail-oriented job that he planned to continue and he wanted to be able to drive again. He had difficulty with attention, organization, problem-solving, and initiation, so we spent therapy completing various functional cognitive tasks. He did fairly well with the standard cognitive tasks that required multitasking, such as meal planning and grocery shopping. His breakdowns occurred as we began to integrate higher-level attention and executive functions. This was because the cognitive load was increased, but he only had so much to give. This is common after a stroke because your brain is using its cognitive reserves for healing and less for thinking. There is less mental capacity available for a task than before. This is why we implement compensatory strategies! They help remove the additional cognitive load requirements to complete a task so that we can use our brains more effectively. To support his divided attention during a task, I would have him keep track of the time during a task (i.e. “Let me know when 5 minutes have passed”). He couldn’t successfully complete the task because he’d be too focused on the clock, or he couldn’t watch the clock because he was too focused on the task. I suggested he set a timer instead of having his brain use its cognitive reserve to watch the clock. He successfully completed the task AND let me know when 5 minutes had passed.

This is an example of what your cognitive reserves might look like before and after mental fatigue. Initially, you have a lot of reserves, but as you progress through the task, your fatigue increases, which decreases the cognitive reserves for the more important areas. Higher cognitive tasks will deplete your cognitive reserves more quickly.

Throughout my time in grad school and practicum, I found myself implementing the compensatory strategies I recommended for my patients. Below are some of the strategies I (try to) use every day so that I can decrease extraneous cognitive demands and increase my success where it matters! Yes, these strategies seem obvious – that's kind of the point. They are supposed to be simple because they are functional supports. It would defeat its purpose if the compensatory strategy required a lot of brain power. We don’t have to overcomplicate things to be successful. We want to work smarter, not harder!

1. Write it down in a central location. There is absolutely no need for you to remember everything required in a single day. You will forget at least one thing. The important thing to note is in a central location. It does not do you any good if you write it down and forget where you put it. By having a central location for notes and reminders you encounter throughout the day, you know where to go when you need to reference it or transfer it into your calendar. When you write it down, you open up that mental reserve for something more important than remembering what you need to grab from the store on the way home.

2. Keep a calendar. I live by this. I prefer an electronic calendar that I can easily add/subtract events. It helps me with my goal-setting, planning, organization, and problem-solving skills. Since I am a visual learner, I use my calendar to map out my day with chores and extracurriculars included when I am feeling very overwhelmed. It allows me to visualize how my day, week, month, and year will look as well as better prioritize certain things (ex. I have a birthday party Friday and I want to wear my favorite pants, but they’re dirty. So, I need to do laundry Wednesday since I have therapy late Tuesday and Thursday).

3. Set a timer or an alarm. This is something I am trying to get better at doing at work. I lose track of time so easily when I get focused on a task or during therapy because I forget to watch the clock. Setting a timer can help you set time constraints which can increase productivity. It can also serve as a visual reminder if you have it right in front of you. Alarms are also great tools since you can add a reminder to them, which I use on my Alexa all the time! I recommend using a phone or Alexa for helping patients remember to take medications or complete household tasks. We use Alexa to remind us to take out the trash the night before trash day, which has been a game changer because instead of me remembering to remind Wesley, Alexa does it for me!

4. Decrease distractions. Sure, we can complete tasks while we have music playing or the TV on. But, did we do it efficiently and to the best of our ability? Probably not. For tasks that require higher-level thinking, you need to use all your cognitive reserves, which you can’t do if you are constantly having your attention divided or alternating between stimuli. Attention is the foundation of all cognitive skills. If you can’t attend, the other cognitive processes fall apart.

5. Take a brain break. You don’t need to be the person who works on something for 4 hours straight without taking a bathroom break, snack break, or brain break. Our brains fatigue when engaged for too long, and it’ll let you know it needs a break. It’s important to listen to your brain! Some signs of mental fatigue are decreased attention and increased irritability and tiredness. Instead of struggling through mental fatigue and being less efficient and successful in your work, take a break! Personally, I find that a 5-minute brain break is all I need sometimes. I’ll get water, take a bathroom break, or switch my task to something less cognitively stimulating (printing and laminating therapy materials, checking email, etc.). By listening to your body and resting when you need it, you allow yourself to be more efficient and successful throughout your day.

Speaking of which... I think it's time for a brain break.