Here's a set of things I have done on occasion, some work when others don't try and see what will work for you this time and be prepared to adjust as you change.
Originally Posted by seraphim
Set an arbitrary and small number of projects you will work on, do a detailed review of everything that is currently active and carefully decide whether it warrants one of your precious slots. Put everything else on hold in someday/maybe.
Split someday/maybe into sets based on timeframe or likelihood so you don't feel bad about putting things there. Possible choices include RSN (real soon now), this season, this year, this decade, in my lifetime, use whatever terms work for you. Remember S/M is not purgatory, it's a bench for those projects that are not in the game of life right now.
Make sure you have one and only 1 next action for any given project. Ignore the ones you could do in parallel, trim your lists to the single next action only.
Pick a single context and stay in it until everything in that context is done as a focused work. Rinse and repeat until all contexts have been tackled and then do a massive review to clean up the loose ends and reset projects.
Pick a single project and stick with it, changing contexts as necessary until that project is done and off the list as complete. Pick another one and do that one. Again then do a complete review.
Declare project bankruptcy, move everything into someday/maybe and then very carefully pull a few projects into active status. (Similar to the first one but with a different focus, sometimes one approach works better than the other.)
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