How to Handle Problems With Executive Function

Many people are plagued by executive functioning issues. It is not uncommon.

Such problems can grind away at self-esteem and the confidence of being an agent in your own life. Simply put, executive function is the capacity to listen, plan, self-organize and execute the things one must do.

Most commonly, it comes to the surface as academic requirements in school, college, or graduate school become more demanding. But executive functioning affects non-academic spaces as well, like the tasks of upkeeping a home or self-care.

• Sometimes it’s too easy to let things go.
• Sometimes the mind is not up to all this self-organizing—or simply needs help.

The cost of not working on executive functioning issues as they appear is direct damage to self-esteem and a loss of a sense of competence in the world that can have real psychological fallout.

Breaking It Down

There are a number of ways to break down what is going on as the brain attempts to organize all the things that must get done. Important issues include working memory, self-talk, emotional regulation, and the capacity to self-organize. Each player in this story helps or undermines the other, as the case may be.

The following is a synopsis of how I sometimes break this down in my work. Please note that a number of psychological habits and issues can be synergistic with executive functioning to make it more difficult to treat. The proverbial chicken or the egg issue comes up often.

• Is the student struggling with an avoidant style in dealing with stressful requirements, or has executive functioning issues demoralized him or her—leading to an avoidant style?
• Is the use of cannabis meant to reduce anxiety associated with feeling flooded by work, or does it kill off the healthy anxiety required to get things done?
• Does the patient’s attention deficit disorder make it impossible to focus on self-organization, or has the executive functioning problem led to more distractability because the patient has lost agency with all that is required in taking on multi-step tasks?

You can imagine that this all makes for fascinating and useful psychotherapy, which, in and of itself, begins to give the patient or student more confidence as he or she begins to understand what is happening and what can be done.

These can be gratifying cases when done thoroughly.

A 10-Step Analysis

Step One: First, hear or read about the task that requires a deadline to be done.

• Hearing and reading must be intact just to start the process. Executive functioning issues often involve handling deadlines, so it is something to know right from the beginning.
• In college, for instance, you may need to review the syllabus or request notes in order to make sure you understand what is required and when. This may not come naturally, but one can develop more vigilant habits to get the ball rolling correctly.

Step Two: Register what needs to be done in your head.

• You can write down what needs to be done or task it in your mind. Whatever works most efficiently. The key is not to float off and miss the importance of noting the task that is required and the deadline that may be involved.

Step Three: Hold the task in your head with other tasks to be done.

• This is where academics and psychologists will note the problem of working memory. It is the capacity to hold ideas temporarily in your mind so you can then decide what to do with them. If working memory is poor or influenced by factors such as recreational drugs, it is tough to improve executive functioning. For some people, writing everything down manually or using cell phone functions can make a difference.

Step Four: Assess the time you have to get all the tasks done.

• If you have four or five things to do, it is important to ask yourself how much time it takes to do each one. This gets better with practice. Some folks do this intuitively without much effort. Others really have to do some self-talk and ask themselves, based on past experience, what each task will require.
• This can be daunting, but, in my experience, it is a skill that can be developed. Once again, avoidance may kick in, undermining the whole project.

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Step Five: Prioritize what you need to do.

• This is related to step four. What is urgent? What can wait? Once again, this is a skill that can be learned. As a child and adult psychiatrist, I have walked this walk with many patients. It is like going to the gym and exercising a muscle. You improve over time. And, like before, avoidance can present itself at any time. This then becomes a therapy issue.

Step Six: Executing the task (while monitoring time).

• Learning disorders can interfere
• Inattention can interfere
• Excuses can interfere:
  • Hungry, bathroom, text messages, urgent personal issues
  • We are remarkably good at gaming ourselves

Step Seven: Monitor What Comes 1st, 2nd, and 3rd while doing a task.

• To granulate this further, each task, assignment, or job has a way of getting done efficiently.
• You can get lost reading a book or stuck on a problem that interferes with getting to the rest.
• Without a doubt, we all get better at this with experience. Self-talk, writing things down, and talking to a coach/therapist/tutor to overcome the rough patches can make a big difference.

Step Eight: Resting your mind—and then taking on the next task

• Take a breather between each task. This can be a reward for accomplishing what was required. But, just as importantly, it gives the mind a respite in preparation for the next thing to do.

Step Nine: Remembering to hand in an assignment

• Some of you are smiling as you read things.
• Yes, folks with executive functioning can forget to hand in the assignment. They may have ADD in addition or being self-destructive.
• Yet, just as commonly, they are already onto other things and have forgotten to register that just because the job's finished does not mean that you are done. The professor, mentor, boss, or family member must see that you are finished. That doesn’t often happen until the person you are responsible for signs off on it.

Step Ten: Big Sigh.

• Self-explanatory.

Closing Notes:

Executive function is a brain capability that involves many sub-components, including those not mentioned here. They include the capacity to attend, remember, to self-organize, use self-talk productively, understand how time plays out with each task, the ability to prioritize, and the ability to execute—to have agency and make things happen.

And the ability to monitor what one is doing in real-time and make adjustments to make sure too much time is not spent on one particular task.

Some people can do all this intuitively. For that, they should be grateful. For the rest of humanity, there can be a breakdown in any of these steps, which can lead to avoidance, injured self-esteem, and other responses.

Of course, attention, mood, anxiety, and chemical dependency issues can interfere as well. Also, some folks have discreet learning issues in domains such as math or reading that will also play a role in executive functioning problems.

The challenge is to make an effort to identify where along the way, things break down. Once you have a handle on this, it becomes easier to get on track. Without help, demoralization often kicks in, which can affect development overall. We can do much better.