I find that accomplishing things, for me, means juggling distractions: that is, I carefully select from the list of things to do at least one thing that needs doing vitally, urgently, NOW, and a few other things that not only don't need doing now, but may never need to be done.
I then throw them all up in the air and keep them all going until I get tired and have to take a nap.
This keeps me from the crushing, guilty knowledge that the Thing That Needs Doing hadn't been done when it should have been (and somehow it never, ever was), and allows me to focus on things that otherwise might never have gotten my proper attention -- which is to say, that sideways, peripheral attention that allows an honors student perfectionist to do something creative, despite herself.
Over the years, I've been in the process of realizing this. But in the fashion of the exact way that I'm describing, this way of doing things, I've only come onto the knowledge out of the corner of my eye, and slowly, and all while juggling.
...such that getting better at this juggling act has become a thing I'm accomplishing by itself, intrinsically, through apprenticeship -- through that strange and unfortunate self-apprenticeship that no non-perfectionist knows of, but that all arrogant, high-achieving types understand. We must re-invent every wheel.
An initial, accidental talent at juggling leads to more practice at it, which leads to more juggling. And crowds might sometimes gather and praise the achievements, without ever really understanding that I juggle because my hands don't work in other ways, because I've warped them to know only this task, because I can't hold things like they (apparently) can.
The only things that matter to me are the things that are still in motion.
My mind is nimble, but it never rests.