What is executive dysfunction?
- Executive functions are things like making plans, following through on plans, controlling impulsive actions, internalized self-talk, changing activities, and, yes, paying attention or focusing on the things we need or want to attend to. There are others, but these are the ones I know the most about and they seem to be the ones that plague us the most.
- Making Plans. You get up in the morning and you have to decide what you’re going to do that day. Whatever list of activities you choose, that’s making a plan. Here’s another one: you need to clean up your room, so you stand in the doorway and decide what to do first. That’s making a plan.
Executive dysfunction (ADHD) makes this really hard for a lot of people. Because we tend to see the whole picture better than the little parts, tasks like “clean your room” can be overwhelming. We need it broken down into smaller steps, like “put the clean clothes away and the dirty clothes in the hamper, then put the books on the bookcase.” For some people, even that is too much at a time. They need it broken down to “pick up the first piece of clothing you see and figure out if it’s clean or dirty; if it’s clean, put it in the correct drawer of your dresser or hang it up in the closet, and if it’s dirty, put it in your hamper.”
Difficulty with this kind of thing can cause a lot of anxiety, and it’s why we tend to freeze up when faced with large, complicated jobs. We simply don’t know where to start, because making a plan is not something we are good at.
- Following through on plans. Once you have a plan, you start at the first thing and you work your way down the steps until you’ve completed them all, right? Right. Well, executive dysfunction makes it really hard to do this.
Part of it can be overwhelm: we look at the list of steps, see how long it is (big-picture thinking), and conclude that it’s impossible so we can’t do it. Other times we might not think we can do any of it right, or we might not know how to complete the step we’re on. Or we get distracted, or hung up on one of the steps (a lot of us are perfectionists).
- Controlling impulsive actions. Most people are able to keep from saying every little thing that pops into their heads. They don’t buy things just because they like them without thinking about whether or not they’re too expensive or something. They control how they react to their emotions and save angry outbursts for whatever they think is an appropriate time and place.
Executive dysfunction makes this really hard.
ADHDers don’t have much of a “filter” unless it’s been drilled into us through behavioural conditioning (usually done by society in response to the stuff we say or do). So we think something and we say it, even if it’s hurtful. We buy stuff we like and then can’t pay our bills but hey we have a hot tub! We act out in anger and then wonder why people are afraid of us or mad at us five minutes later, because once we’ve raged we’re good and not mad anymore. As a general rule, we always intend to do the right thing… it’s just not always possible because our brains like to follow every impulse they have.
- Internalized self-talk. Everyone has what’s known as “self-talk.” For people with low self-esteem, this is pretty negative. But it’s not just about what we tell ourselves about ourselves. It’s also how we get through situations (“Five more situps and we’re done for the day!”) and work through problems (“Next time Jimmy says that I’m going to tell him to go jump in a lake!”). By about age seven or eight (I forget exactly when; it could be older but I’m pretty sure it’s sometime in elementary shcool), most people are really good at keeping all of this silent and in their heads.
Not so for those of us with ADHD. Executive dysfunction means that we don’t internalize our self-talk until much later, assuming we ever do. I still talk to myself out loud most of the time, though I do internalize a lot (especially in public).
- Changing activities. You know the law of physics that says that an object that is at rest will remain at rest until acted upon by an external force, and that an object that is traveling in a particular direction at a particular speed will not change direction or speed unless acted upon by an external force? That’s called inertia, and that’s basically what we’re talking about here. (This is like the one thing about physics that I find truly useful in my everyday life. Kinda sad.)
Basically, once we’re engaged in an activity, we’re in it until something happens to get us to move on. That’s why alarms work for some people - they jolt them out of their current activity and trigger them to move on to the next thing. (Of course, an ability to ignore alarms is also part and parcel of inertia. Yay!)
- Paying attention or focusing on the things we need or want to attend to. So, the whole “attention deficit” part of “ADHD” is pretty ludicrous, because it’s not really a deficit of attention that we’re dealing with; it’s more an inability to control what we pay attention to. So we can hyperfocus (focus exclusively on one thing for hours on end) or we can jump around from one thing to another, and we don’t really have a lot of control over that. I’m sure you can see how all of the other aspects of executive dysfunction contribute to our lack of control over our attention.