One of the most positive changes I made to my programming / design was to start taking notes that looked like a stream of consciousness conversation with myself.

I was doing a fair bit of pair programming and I found that talking to my pair about whatever issue we were facing was helping me clarify the design in my head. When I started working on a few solo projects, I found that taking notes worked almost as well, despite lacking the other side of the conversation.

One of the biggest benefits was that I find it cathartic, where once I've written down all of the arguments for a particular design decision, I am able to move on without revisiting it in my head constantly.