Time Pressure Management

I didn’t try to multitask right after my concussion. It took enough energy to walk from my bedroom to the bathroom or try to process a simple conversation. But multitasking is as automatic as scrolling through Instagram while waiting in line and soon I found myself trying to do more than one thing at a time.  

Even simple multi step tasks were a problem. You wouldn’t think that it would be hard for one adult to get themselves out the door in the morning. But from the time I thought that I was “almost ready” to the time I actually got in my car it took about 45 minutes. I soon realized that any task with more than one step took much more time and energy than it did before my concussion. 

I felt like I was constantly scrambling. I wanted to get as much done as I could but had limited energy and time as I tried to fit everything into my old habits and schedule. 

I learned to give myself more time but it was still draining even when everything went as planned. 

Of course, just like the concussion itself, things did not always go as planned. When something unexpected came up my brain went into automatic shutdown mode where everything was hot and fuzzy and dark. I could not make flexible decisions. 

Slowly but surely it got better. Life is much more predictable now but it took a lot of trial and error. 

I know enough about concussions to realize that my story is not unique. 

Slowed processing speed is a common problem after a concussion which makes it hard to multitask. It also makes it hard to think and make decisions especially when time is limited. 

A few years ago I learned about a cognitive strategy called Time Pressure Management. Time Pressure Management was created to help with these very problems. 

Time Pressure Management teaches you to decrease multitasking and think ahead so that life is less stressful. 

Here’s my version of the process:

1. Think Ahead

   • Think through the steps you need to take to complete the task from start to finish. Visualize yourself doing them and/or say them out loud. Write them down if you need to.

   • Ask yourself if you have enough time to do the things you have planned. If your plan feels rushed or stressful, change your plan.

   • Ask yourself if you are trying to multitask. Common examples are gathering the things you need for the day while walking out the door or looking up where you are going while driving.

   • Eliminate multi-tasking as much as possible.

     
     

2. Anticipate challenges. Make a Plan B.

   • Think through reasonable challenges that might come up. For example, what if you find out you are low on gas on your way? What if there’s an unexpected car accident? What if the store you want to go to is closed?

   • Decide what you will do if that happens. 

     
     

3. Execute the task. 

   • Put your plan in place. Use plan B as needed. 

     
     

4. Ask yourself how it went. 

   • Analyze how the task went. Was it smooth or stressful? Was there anything different you could do next time?

Next Steps:

• Practice using Time Pressure Management sometime this week. Practice making adjustments so you feel less overwhelmed. For more ideas on modifying your plans to decrease stress, read this article on reducing to-do list stress.

• Sign up to get a Time Pressure Management worksheet to make it easier to practice.

• Ask your doctor for a referral to a cognitive therapist if you recently had a brain injury. You might see a speech-language pathologist or an occupational therapist depending on where you live.

• If you’ve already seen a cognitive therapist but need a little extra support, check out my cognitive coaching program.

Sources and additional resources:

Time Pressure Management as a Compensatory Strategy

TBI: Cognitive-Communication Rehabilitation

Cognitive Rehab Tools for Living Better

Training Patients in Time Pressure Management