EXECUTIVE (DYS)FUNCTION: Demystifying decision-making and focus challenges
Written by Kim Jenkins, LMSW, Licensed Therapist
Sometimes it’s really hard to do things!
With the winter holiday season upon us as I write this, it feels to me like we’re at a perfect moment to think about executive (dys)function. This particular stretch of weeks can be extremely demanding and overstimulating, not to mention charged with complex emotions, memories, and relationship dynamics. Facing down tasks like visiting with family members you don’t often see, navigating various social expectations, buying groceries during the busiest retail season of all, and generally tying up the loose ends of the year can be utterly exhausting. For these reasons and more, maybe it’s become fairly socially acceptable to voice feelings of overwhelm and burnout during this time of year.
But what about those of us who experience these kinds of feelings year-round? What happens when we struggle to complete “everyday” tasks of living that many people seem to take for granted? What does it mean when even the things we know we want to do consistently feel too difficult to engage with? These are hard questions, and the cultural landscapes we move through can easily make shame and self-blame feel like the only reasonable answers. When things feel insurmountable, maybe self-criticism can offer a strange kind of comfort by providing us with a clear target to direct our frustration towards. But when we simply label ourselves as “lazy” and call it a day, could we be missing out on useful information?
What is Executive Dysfunction?
In the language of psychology, these kinds of routine difficulties with “getting things done” can broadly be referred to as executive dysfunction. This category of symptoms represents various challenges with the executive functions, a set of “top-down” mental skills that generally involve concentrating, playing with ideas, and paying attention. Executive functions take effort to pull off, and people vary widely in our capacity to use them. Mental and physical aspects of our health can play a huge role in determining how we engage with these skills. For instance, depression, anxiety, trauma, ADHD, autism, and chronic pain or illness are just a few examples of experiences that can be associated with their own flavor of executive dysfunction. Importantly, social factors such as experiencing oppression or being disabled can impact how we navigate the executive functions as well. Each person has their own unique relationships with “everyday” life tasks, and from my experiences working with clients, I firmly believe that way more people struggle with these “normal” things than it seems.
So what can we do when we’re having a hard time?
To start, I think that taking a stance of curiosity towards the particular ways things work for you is always a good idea. When we resist jumping to shame ourselves for potentially embarrassing thoughts like “I absolutely hate to brush my teeth,” maybe we can find some more room to ask ourselves questions about our experiences and come to a richer understanding of what’s really going on. Sometimes being open and curious in this way can lead us to try out new, kinder, more personalized and sustainable systems for doing the things we want and need to do. This kind of process can look different for every person, and it’s certainly not always easy. Therapy can be one useful tool for folks looking to address their executive dysfunction, as it ideally provides a nonjudgmental environment for exploration and engagement with new concepts and strategies.
By breaking down which specific pieces (or combinations) of these skills seem to give you trouble when completing a given task, you may be able to find those openings where new approaches can be introduced. I’ve found that the internet is full of creative solutions to executive dysfunction dilemmas. I myself am always trying to finetune and better align my routines with my wants and needs, to varying degrees of success. I feel very privileged and grateful to get to explore these topics and the stories around them with my clients.
The worlds we live in can often feel unkind in the demands placed upon us in order for us to simply get through the day. Maybe, then, it can be worthwhile for us to take seriously the baggage that even the “simplest” of tasks can carry with it. When we accept that we can struggle with what the dominant culture takes for granted as “normal” and “uncomplicated,” opportunities for greater compassion and solidarity with other people can begin to take shape.
Kim Jenkins, LMSW has had the pleasure of working with folks around executive (dys)function across multiple states and healthcare settings. Her perspective on this area has been widened by movements for disability justice and the works of Dr. Devon Price, including Laziness Does Not Exist and Unmasking Autism. Kim sees a particular urgency to understanding the topic of executive functions in a world where marginalized people face disproportionate barriers to accessing necessary resources. You can learn more about Kim’s work here.