Chapter 4 How to (Executive) Function

How to ADHDAn Insider’s Guide to Working with Your Brain (Not Against It)By Jessica McCabe

Another Insider's Book Review, Summary, and insights Chapter 4

How to (Executive) Function

ADHD New Year’s

Jessica begins this chapter by explaining the ADHD fantasy of new beginnings. When something new is near beginning, she is sure she is going to get it "right" this time. This time, she will be the person she is supposed to be. A week of buying and setting up new planners, new binders, and everything else she could ever need to stay organized. She would get everything planned and organized under the fantasy that this time will be different. Two weeks later she couldn’t find anything and everything was a mess. She could pull it off as long as life didn’t happen. 

What she learned

The ADHD truth is not what we’ve been told. We aren’t disorganized which snowballs into the inability to function because we haven’t found the right system or we don’t stick to it. We have trouble with executive function.

What the heck is executive function?

Executive function is the CEO of the brain. It is the top down cognitive process that helps us self regulate. It gives us the ability to plan, prioritize, and sustain effort in order to progress toward goals. This happens in the prefrontal cortex. It becomes fully developed in most people by age 25 and helps with adulting.

Executive Function is impaired in ADHD brains

ADHD struggles are more broadly due to executive function difficulties than attention difficulties. These are the functions that can be impaired.

Response Inhibition- the ability to suppress actions created by mental and temporal space between stimulus and action. The impairment in the ADHD brain does not make this space, therefore we react to stimuli without the in between space typical brains utilize.

Working Memory-the ability to temporarily hold information, process it, and produce an action. The impairment makes it difficult for us to do this. She will give this a whole chapter later on in the book.

Set-Shifting-the ability to shift tasks with different cognitive demands. We may be slower to shift and if we try to rush it, mistakes are made.

Executive functions work together to function. 

Executive Function develops more slowly in ADHD brains.

Our executive function development could be delayed up to 30%. Which means we do not have the ability to follow instructions or understand information others do at our age. 

There are hot and cool executive function systems

Hot- affective and motivational processes with high emotion or stakes.

Cool- low emotional process usually more logical

Problem solving uses the cool system for logical decision making and the hot system provides the motivation. The ADHD brain can do pretty good with immediate reward for doing the thing but we aren’t well motivated by long term reward. Research has demonstrated using the cool executive functions by reflecting, contextualizing, and analyzing abstractly make it easier to pull in our emotions and motivation to become less impulsive. We can learn these skills.

THE TOOLBOX

Have less stuff to manage

Delegate areas of responsibilities. Give the entire area to someone else to manage and do. Delegating a task takes brain energy, instead of using the energy to make a list for someone to go to the grocery store ask them to take responsibility for making sure there is food in the house.

Keep systems simple. Elaborate organizational systems can be fun to set up and look so pretty. Yet, it's the maintenance that makes it functional. Make functionality priority with simplicity. Just put the books on the bookshelf, clothes in a drawer or basket to be able to know where they are when you need them. No color coding, alphabetical order, perfect folding and other brain energy drainers.

Practice minimalism. Owning less stuff means less stuff to clutter our physical environment and brain. Less to clean, manage, remember, lose, means better functionality mentally and ease to life. This goes for projects, too. Limiting the number of projects takes the pressure off.

Say No. “ The stuff-we-could-do-in-life buffet is unlimited. Our capacity is not. If your plate is full, don’t get another plate.”

Doing less, having less, is not a forever thing. It is the first step, handling your current demands helps build the experience to level up as time goes on. Stop the cycle of overwhelm.

The Cycle of Overwhelm

Take on more than you can - fail - try to catch up by taking on more - fail - effort becomes frantic and panicked - fail - experience burn out, depression, and anxiety - fail - take on more than you can and go back through the cycle.

Accommodate Yo’self

There is no shame in using glasses to see better, using a ladder to reach high places. The same should be for accommodating ADHD. And, putting them in place prior to the need is effective time management.

Add scaffolding. Put on the training wheels until you can navigate the bike alone. Body doubling is great. Have someone sit nearby, even if it is virtual, until you can do it alone. Timers, reminders, sticky notes, checklists and anything you need right now does not have to be forever just like the training wheels.

Self advocate. Speak up when you need help. Let others know what you need when you need it.

Ask for formal accommodations. In the U.S., students and workers are legally entitled to reasonable accommodations. Individual Education Plans (IEP) and  504 Plans protect these entitlements for students. The Americans with Disabilities Act (ADA) protects those out of school. ADHD is a disability protected by these laws. The Job Accommodation Network”s website (askjan.org.) can give you the guidance to know and set these up.

Account for the ADHD tax. This term is our community’s reference to the price we pay for having ADHD in a world that doesn't account for our challenges. Generally it is in terms of financial losses occurred by lack of planning, remembering, and mistakes. However, the loss of time, energy, and other resources is extremely great. It’s expensive to have ADHD! Investing up front can lower the tax and make life easier. 

Examples of ADHD tax:

Late fees

Rush shipping fees

Forgotten and unused subscriptions and memberships

Replacing lost items, food and drinks that went bad

Last minute travel expenses due to lateness, forgotten ID, missed flights, wrong airport, wrong road, 

Opportunity missed by not following up on information

Car accidents, tickets, passing up the exit due to distractions

Time looking for everything and anything

Loss of potential income 

AND the list could go on forever

Use services for tasks that are error intolerant. Hire someone to do the taxes, legal documents, anything we can mess up. Go to the people specializing in the area for help. 

Set up shortcuts. Reduce the mental demands on things you do often. Coat racks by the door reduce the steps of putting your jacket up when you get home and leave again. Having items within reach of use reduces steps of finding it and putting it up.

Invest in tools that help. Bluetooth trackers to find keys and phone, medicine reminders, colorful stickers and items, whatever catches your attention to find it or remember. 

Build what works for you

Start from the ground up where you are now! Build your system for now with your habits, your preferences, your aversions, your strengths, and what you know works and doesn’t work right now in your life. No past you or future you, not anyone else's systems.

Look at what worked before. Tweak what worked in the past to fit life now.

Look at what you currently do. Be aware of what you do now that works for you. If you need to talk things or brain dump before a meeting or after let someone know or take the time to write it out. If it takes you an hour to wake up and get moving in the morning, plan that in your day.

Consider your preferences. Motivate with what you like. If you love a certain character, get things with that character to motivate you to do what you don’t necessarily like to do.

Remember that you have ADHD. It is and always will be there, work with it. Future you will not be neurotypical. Deficits and impairments can be managed some days better than others. There will always be trip ups. 

Manual Mode

We can go on autopilot when we get the hang of things we do often. It makes life function well. Pay attention to what you do in manual mode and leave it be. Updates and reprogramming can wreck everything. There is enough added to our plates by changes forced on us outside our control levels, we can stick to what works within our realm of control.

This Insider’s Insights

WOW! Thank you Jessica McCabe. This chapter helped me see things I knew and have researched in a better light. I did know that I work differently than others. I knew my understanding is different. I knew that was bad and good at the same time. I knew what works for me does not work for others. I know I am slower in some areas and faster in others. I now have a better understanding. I am learning to accept this without negative judgemental thoughts. It is and will be exactly what it is. Sometimes, it makes me hopeless and other times hopeful.

My main insight is within the research that suggests our brains have a delay in developing executive function. This is a big deal because once it has reached maturity we were given information at times we did not have what we needed to process and store that information in the way it should have been. That is why we have to learn things we “should” have known. There is no way for us to even know what we missed. 

In my southern upbringing, I heard and probably said “Well, anybody with any sense should know that!” a million times. It made me feel inadequate and small. I did not a frame of reference to form the words to say in my defense. Now, I feel bad for the times I may have said that about or to others. I have reframed that in my mind and hope that you will too. Those of you with ADHD and those who love them remember that anyone with any sense will remember that not all have had the same experiences in learning life “shoulds” and “should nots”. Just because we didn’t learn the first time does not mean we will never learn it. Always remember, we have multiple talents and characteristics that are beyond the capability of typical brains to comprehend.