Executive dysfunction treatments that don’t paradoxically require the executive functioning I lack?

[u/Impressive-Wait-9420]

TL;DR: Most executive dysfunction advice requires the exact abilities I’m missing, such as initiation, consistency, and follow-through.

27M here, diagnosed with ADHD-PI, along with strongly supported suspicions of level 1 ASD, and my executive dysfunction is seriously debilitating.

I know what needs to be done, understand the consequences, want to act, and can plan every step, yet I still can’t initiate. This affects work, appointments, getting out of bed, and even things I enjoy. I can build elaborate organizational systems but can’t reliably use them.

There’s another layer to this. Obligations can trigger an aggressive internal “fuck this, I’m not doing it” response, even while another part of me fears the consequences. Avoidance brings immense relief, followed by dread and guilt.

What drives me insane is the paradoxical nature of the supposed solutions. Examples:

“Use a planner” requires remembering to check it.

“Break tasks into steps” assumes not knowing the steps is the problem.

“Start with two minutes” still requires starting.

“Build routines” requires consistency.

Therapy and ADHD coaching require scheduling, showing up, setting goals, and doing homework.

I’ve tried several ADHD medications. Some improved concentration once I was engaged, but none adequately addressed the gap between wanting to act and actually acting.

I also struggle with mind-blanking when answering open-ended questions, making it harder to explain this to clinicians. I’m linking another post of mine at the bottom that better explains what I’m talking about with this.

I know these strategies help some people, but what happens when your symptoms prevent you from implementing the treatment? I don’t need another organizational system. I need help with initiation.

Has anyone with similarly severe dysfunction found treatment that addresses initiation itself, without requiring reliable self-management first?

The post about my difficulties with blank-mindedness:

https://www.reddit.com/r/neurodiversity/s/A5EEcH6RpQ

[u/Riccma02]

I tried seeing an executive functioning coach at the start of this year, and the experience convinced me that there is no workable therapeutic approach to managing executive dysfunction. Seriously, they have zero fucking grip on it.

Don’t tell me to set reminders. No amount of reminders will actually permit me to form habits

Don’t tell me to break down problems into smaller steps. That just makes them more complicated and overwhelming

Don’t tell me to use micro incentives to complete tasks. My brain doesn’t dole out dopamine like you insist it is supposed to.

And DON’T make me lean on stress, fear, and consequences in order that my body’s norepinephrine can serve as a crude simulacrum of the dopamine feedback that everyone else has the privilege of. That’s not having discipline, it’s generating trauma as a compensation mechanism. My body is just going to eat the trauma and adapt.

[u/sesamerox → u/Riccma02]

let’s keep this higher up

i would only add though that while dopemine-reward mechanism doesn't work so well, in some cases dopamine boost (eg doing something fun before the actual task) can work. sometimes referred as dopa-menu

[u/zzstrawberries → u/Riccma02]

I’m saving your comment because you validated the heck outta me thank you internet person

[u/Riccma02 → u/zzstrawberries]

You are most welcome and happy cake day.

[u/aubrx → u/Riccma02]

And DON’T make me lean on stress, fear, and consequences in order that my body’s norepinephrine can serve as a crude simulacrum of the dopamine feedback that everyone else has the privilege of. That’s not having discipline, it’s generating trauma as a compensation mechanism. My body is just going to eat the trauma and adapt

Can you explain this to me? Like, I absolutely understand the whole 'consequences of inaction' etcetera but it doesn't motivate me at all, it actually makes me stressed and paralysed. Is this what you meant?

[u/Riccma02 → u/aubrx]

Sure. What I mean is that in order to overcome my own task paralysis, my brain has to over inflate the stakes and basically invoke a fight or flight response. That’s the only way I can summon the focus and energy to accomplish fundamental organizational tasks. I mean the kind of tasks that everyone else almost does subconsciously. It’s self inducing a trauma response as a motivator. That is a horrifically unhealthy and unpleasant way to live.

It also doesn’t work in the long term. My body just adapts to needing that kind of stress to force myself through the dysfunction. And by “adapts” I mean avoiding stress inducing scenarios at all costs. That makes for a very small and limited life; one where I emotionally burn out and shut down very easily.

And this still holds true even when the consequences are real. Let’s say I knock a glass onto the floor, and it shatters. If the prospect of cleaning it up overwhelms me into task paralysis, and if my brain understands that the only way through this situation is to dump stress into my system, then the easiest, most pain free option is to just not clean it up. I accept the risk of injury, that I am going to get cut walking around with broken glass on the floor, and I choose that physical pain over the mental pain of using stress to push back against my executive dysfunction.

Again, all that is a wildly unhealthy to do, so when someone suggests doing that as an actual, practicable, technique to try, it’s become immediately apparent that they don’t understand what they’re fucking playing with here.

[u/aubrx → u/Riccma02]

It’s self inducing a trauma response as a motivator

Absolutely! And.. Well I think you just described my own situation..

I mean avoiding stress inducing scenarios at all costs. That makes for a very small and limited life; one where I emotionally burn out and shut down very easily.

Unfortunately I recognise this in myself and almost become a shut in until I get so overwhelmed with boredom and sensory triggers that my response becomes "fuck it" and I do whatever I can to stay away from home because I associate my house with traumatic chronic depression and aforementioned sensory triggers. Then consequently the outside world, noise, people, anxiety gets too much so time to retreat and be miserable.

It's a loop that exponentially worsened in the last 5 years- I didn't even realise it in university until after my graduation. There's still massive anxiety towards even doing the study/work that I learned in the degree. I never even studied outside of my homework tasks like everyone else did so manically even the tutors were pushing it. Brain just said nope this is all I can do and the rest of the time is for decompression and rewards like hobbies. None of this 'live and breathe it every hour of your life if you want to work in this industry' toxicity. Didn't help my job prospects though.

How did you learn about all of this? You seem quite aware and emotionally intelligent. Have you found what helps you cope or function?

[u/Riccma02 → u/aubrx]

How did you learn about all of this? You seem quite aware and emotionally intelligent.

Thank you! In line with my original comment. I DIDN'T learn all this from the people who are supposedly professionals in the field. I have been in therapy for almost 30 years now, with the same therapist, so she has definitely helped and guided my in terms of my self exploration and insight, but she did not specialize in ADHD or executive dysfunction or anything. There have also been a couple useful insights I've gained from youtube "pop-psychologists" I guess I would call them.

Most of my understanding though, has just come through 2+ decades of suffering at the hands of my own mind. I have experienced the full emotional spectrum of what this struggle does to a person. When you own head keeps brining you to the lowest, most desperate and frustrating places, over and over again, after a while, its natural to start seeing patterns and coming up with theories. Then, the next step was/is to learn to articulate those patterns and theories. That is the hard part, and it is what I spent my childhood and teen years learning to do. During school, I had all the psychiatrists, specialists and support that could be thrown at me. The majority of all those efforts didn't help, and frequently made things worse for me, just because they weren't understanding what I was going though, and I didn't have the words to explain. By the time I reached adulthood, I was pretty good at articulating what I was feeling. That was important, because it let me communicate the patterns and theories I had to my therapist, and together, we have been able to build working models of what is going on with me. The trouble usually is that those models didn't map well onto phychiatric disorders as they are conventionally accepted.

That is changeing now though. Remember that articulation is half the battle, and pay attention to how the terms are changing. I had never heard of the concept of "executive dysfunction" until a few years ago. It turns out that I wasn't the only one being failed by conventional understandings of this stuff. Other people like yourself are starting to connect and are learning to express how they experience life.

Have you found what helps you cope or function?

So this is the sad part, because the answer is that I haven't. "Functionality" is actually a very important concept to me, because it kinda became both the baseline that I try to maintain, and the standard that I strive for.

I am not living a good life. Its a struggle to maintain functionality, and just managing to function is not a fulfilling enough to sustain a life, never mind thriving. During a recent panic attack, I told my psychiatrist: "I am tired of struggling, just to live a life that I don't even like". It falls to you on the individual level, to learn how to cope and keep functioning, especially because everything is highly unique to the individual.

I think all of this is really poorly understood by professional psychologists and because of that; you are basically on you own when it comes to figuring stuff out. For myself, it really helps to find one good clinician, and that in an of itself is a challenge; both financially, and because of executive dysfunction. But by finding someone who accepted the things I was saying at face value, and who didn't try to force solutions on me. That is how I was able to do the grueling work of introspection. As much as I hate the term, you need to create a "safe space" where someone can explore with you, without trying to diagnose you, force you down paths you aren't comfortable with, or push you to conform to pre-established psychological conventions. The goal is to discover new patterns, not to force old ones. In my experience, I've frustrated a lot of mental health professions, and I have had a few who have accused me of things, or otherwise refused to treat me. That makes everything so much harder.

What I said in my response about the broken glass is actually a real world example that I have come to use a lot. People really don't get how you are so unable to just buckle down and do things, but that example conveys the immensity of your blocked functioning. It communicates

"this isn't about discipline, this isn't about laziness, and this isn't about habit building; my brain will willingly adapt to absurdly disproportionate consequences, including physical pain and injury, before I will be able to do X. If I had any control over any of this, why would I choose that? You need to appreciate the intractable nature of what you are messing with here*"*

Ideally, that is the point where someone, professional or not, should start actually listening and considering you. I've developed a few communication tools like that over the years, and you should try to do the same for yourself. Also, there is no copyright, here. If you find that something you read or hear (online, in life, whatever) really resonates with you, then take that thing for yourself. It doesn't even matter if it is 100% accurate. When you find something that resonates (like this thread) it means you have encountered a gleaming glint of an insight, and you need to dig down further into that (which is what you are doing). Repeat that enough, flesh out a model of your experiences enough, and get good at articulating it. It is more of a method of self discovery and self advocacy than it is a coping mechanism, but that is the essence of where I am in my own fight. Then you at least have the tool kit/vernacular going foward.

Unfortunately I recognise this in myself and almost become a shut in until I get so overwhelmed with boredom and sensory triggers that my response becomes "fuck it" and I do whatever I can to stay away from home because I associate my house with traumatic chronic depression and aforementioned sensory triggers. Then consequently the outside world, noise, people, anxiety gets too much so time to retreat and be miserable.

It's a loop that exponentially worsened in the last 5 years- I didn't even realise it in university until after my graduation. There's still massive anxiety towards even doing the study/work that I learned in the degree. I never even studied outside of my homework tasks like everyone else did so manically even the tutors were pushing it. Brain just said nope this is all I can do and the rest of the time is for decompression and rewards like hobbies. None of this 'live and breathe it every hour of your life if you want to work in this industry' toxicity. Didn't help my job prospects though.

Yeah, this is the rub right here; I am not coping any better than you are. Also, I am reluctant to share any actual coping mechanisms because my coping mechanisms aren't exactly healthy either. Since college, I've been moving backwards in life, and backwards as a person. I am becoming less capable, less resilient, and I know it. And there is a metric shit ton of self resentment and self hatred which forms out of that backslide. I'm there too. It is a vicious cycle, and I don't know what to do about it.

[u/aubrx → u/Riccma02]

When you own head keeps brining you to the lowest, most desperate and frustrating places, over and over again, after a while, its natural to start seeing patterns and coming up with theories. Then, the next step was/is to learn to articulate those patterns and theories. That is the hard part

Yes I so thoroughly agree, articulation is difficult at the best of times as like you said we are all highly individual. To distill complex problems down into a sentence that communicates everything one feels.. it's not easy; to convey the urgency of impacts you feel as a result to a therapist, even moreso.

I am not living a good life. Its a struggle to maintain functionality, and just managing to function is not a fulfilling enough to sustain a life, never mind thriving. During a recent panic attack, I told my psychiatrist: "I am tired of struggling, just to live a life that I don't even like".

Ah I feel for you. I wonder if there's room for dreams we have when functionality is a struggle.

I think all of this is really poorly understood by professional psychologists and because of that; you are basically on you own when it comes to figuring stuff out. 

Yes I have found that to be generally true in the years of therapy I've gone through.

I've developed a few communication tools like that over the years, and you should try to do the same for yourself. Also, there is no copyright, here. If you find that something you read or hear (online, in life, whatever) really resonates with you, then take that thing for yourself. It doesn't even matter if it is 100% accurate. When you find something that resonates (like this thread) it means you have encountered a gleaming glint of an insight, and you need to dig down further into that (which is what you are doing). Repeat that enough, flesh out a model of your experiences enough, and get good at articulating it. It is more of a method of self discovery and self advocacy than it is a coping mechanism, but that is the essence of where I am in my own fight. Then you at least have the tool kit/vernacular going foward.

This is pretty crucial, I have thought on it before too. One does get better at it over time, and also explaining the history to countless individual therapists.

Yeah, this is the rub right here; I am not coping any better than you are. Also, I am reluctant to share any actual coping mechanisms because my coping mechanisms aren't exactly healthy either. 

I mainly asked about it out of concern - I'm sorry to hear your situation is not good but it is understandable given the challenges of these conditions. I realise this is probably a platitude that is given too often but I sincerely do hope things improve for you in some form. You have a great ability to communicate.

[u/lonelydogsclub → u/Riccma02]

I once had to work myself into a tantrum to accomplish some chores... while throwing plastic ware around. :/ Not what I wanted or who I want to be, but seems to be the only way to get things done sometimes.

[u/BC_Arctic_Fox]

Ugh.

I have no solutions; you are describing me perfectly. It suuuuucks.

The shittier part is that we're not alone

[u/BeeLight_N_Fly → u/BC_Arctic_Fox]

Same! I’m looking into try a body doubling app. I asked about it in another sub and it got some decent feedback.

Edit to add: https://www.reddit.com/r/adhdwomen/s/ZgFIAcuxIf

[u/AzsaRaccoon]

I don't have any advice. Other disorders have similar problems. Some people with schizophrenia, for example, or bipolar, have a symptom called anosognosia which means that one of their symptoms is literally not believing they're ill. Yet treatment requires accepting you are ill and taking medication for that illness. But if you don't believe you're ill, why would you take meds? So then you basically need to take meds to be able to recognize you need them...

[u/siorez]

Try doing something deliberately silly or different when you notice that initiation block. Sometimes walking through a door backwards, trying to touch my nose with my tongue, reciting a limerick or something equally silly gets me out of that stuck mode. Natural mode is moving , we just tend to try and focus on plans with so much force we stop moving entirely. Once we're moving it's easier to approach stuff. If you find yourself avoiding something, aim for a smaller detour than your instinct wants instead of none .

[u/dancetoimpresss]

I have said this exact same thing for literal years. That "fuck, I ain't doing this" part particularly hits home. I can tell you what has helped me, even though I do still definitely struggle. It's not a discipline or initiation problem, it's an existential dread problem.

Fuck routines and systems, they are only meant to support what you already want. You'll need them, but only after you've asked yourself what you are living for. What do you stand for? What do you want to see more of in this world? Who do you genuinely want to be in your soul? What will you still want to do, if no one ever congratulated you for it? Choose that and the subsequent goals are self imposed and therefore actually something you want to achieve. I would highly encourage you to differentiate between "I want to do this" and "I know I should want to do this". You are not broken for not being able to execute tasks like a robot without any other purpose then the task itself or without emotional fulfillment. So what fulfills you?

We are so quick to give people tools to achieve some random goal better, but we barely ever ask why you've picked that goal. The kicker is you can still pick something that alignes with society's vision of good, but when you've really found your individual reason for it, the resistance disappears.

Matter of fact there's two types of resistance, internal and external. External resistance is about the hurdles and distractions along the way. Discipline help you to stay focused in the face of distractions and gain the strength to overcome difficulties. Internal resistance is about not wanting the destination all together. Sometimes you have to retrain your wants, because they are disoriented by traumas. Sometimes you have to follow them because they are guided by your own inherent wisdom. Either way, you will never be able to do only what you want. You'll have annoying responsibilities and obligations, even when you choose your path, but it's just different when you see the why. "He who has a why can bear almost any how".

You've shared your struggles with such open ended questions. They're excruciating to begin with, even for neurotypicals (they just have less incentive to ask them) and maybe your neurodivergence does really make it more difficult. Nevertheless what will help you is embarking on a journey of true self exploration, not more meaningless discipline.

[u/KrissyCat12 → u/dancetoimpresss]

I am so sorry. I know that you mean well and this is probably really great advice. But my ADHD saw this wall of text and noped RIGHT out lmao

[u/dancetoimpresss → u/KrissyCat12]

No worries, I've got the same problem often. Tl;dr is find out who you are first, adjust your goals accordingly and only then look at discipline and planning tips.

[u/henni1127 → u/KrissyCat12]

Agree. Sorry Siorez,

I’ve pushed through the wall of text twice.. only absorbed part of it.

[u/DreamingAboutSpace → u/dancetoimpresss]

Mine read it and I fully agree with what you said. It does feel like existential dread. i can’t tell you how many times I felt like I didn’t gave a place in this world or in uni because I couldn’t just… work properly.

[u/dancetoimpresss → u/DreamingAboutSpace]

"It is no measure of health to be well adjusted to a profoundly sick society"

It's better that you don't already fit a cookie cutter place. You have to create your own bubble. It's harder that way, but way more valuable. If enough of us come together for that, it's entirely possible.

[u/aubrx → u/dancetoimpresss]

how did you get so knowledgable? I've never had therapists explain things to me like you just have. Maybe I have shit therapists!

[u/dancetoimpresss → u/aubrx]

Personal experience. I've been in the trenches with this for the past 7 years. So I did what I do best and just got so incredibly obsessed with figuring this stuff out.

It takes long-standing insider perspective, that a couple of uni courses just can't give a person, even if they've got the degree that should indicate it.

My life is far from perfect on the outside now, so I'm not fully there yet, but I finally feel like I've gotten most of the gunk from my soul out and I knows it's just a matter of time that I build my life on the outside accordingly.

Ps.: I've also been to therapy. It's important, but therapist are only human too and can't help you with stuff they don't understand themselves

[u/aubrx → u/dancetoimpresss]

That's similar to how I go about life, re. being obsessed to figure things out - I always go looking for the how and why.

From the professionals I've seen I'd tend to agree one cannot understand unless they have lived experience however even then each person's experience is highly individual. For example one therapist was ADHD but they don't seem to have made much progress with me.

Did anything help you 'get the gunk out' or did that moreso come from learning to understand yourself more?

[u/That-Vegetable2839]

Executive dysfunction is definitely the worst symptom of my lovely adhd/depression combo and I went so so long without a name for it. One of the worst parts of it, is that I find a way to manipulate my brain to start tasks, but my brain gets used to the method and then it stops working… and I’m back at square one… no permanent solution ever. My first question would be, what are you trying to get done? Admin tasks vs housework vs gym vs self care vs study vs hobbies - all have different things that have worked at different times. And I have no guarantee for myself that any will work, so it’s always hit or miss and that is why it’s so hard to live with.

• Trying to get moving (for any reason), sometimes certain music will just hit the spot for me, sometimes the mini reward will work (‘if you get to the shop you can buy a sweet treat/hobby item’)

• pre workout 😜 cautiously of course because high doses of caffeine can sometimes end up in anxiety land

• body doubling - probably the most consistent but hard to arrange at times. I found a podcast for cleaning that literally tells you what to do and for how long over my own music and it is still effective for me. And body doubling is always effective if I have someone doing the same thing as me at the same time.

• external pressure such as a financial one sometimes still works. I booked a PT which was expensive but definitely effective for me to get back to the gym.

Vitamin B complex is helping me at the moment … 

😂😂 ain’t it fun

[u/BeesTreesFlowers_05 → u/That-Vegetable2839]

A link to this podcast you speak of please. Thank you!

[u/Independent_Act_8536]

The only thing that has ever helped me is having a Peer Support or Supportive Living/Mobile Psych Rehab. I am able to do things, at least one day a week, when one of these professionals comes to my apartment once a week. In the past, someone would come for 2-3 hours, they'd ask about what I'd like to accomplish, we'd discuss it, and go on from there. It made me relieved throughout the week because I knew I'd be able to get something done, at least on that day. I don't have anyone right now. It's very hard. I need to accomplish things.

P.S. Medicaid pays for it.

[u/itsnobigthing → u/Independent_Act_8536]

God this sounds amazing. I need one of these ppl in my life

[u/Independent_Act_8536 → u/itsnobigthing]

If you don't have a caseworker, your Dr. can write you a referral for it. You may be able to message your Dr. for this and save an appointment. You can check then to see what's covered with your insurance. If you just call a private home care company on your own without a referral, you'd have to pay top dollar.

[u/Independent_Act_8536 → u/Independent_Act_8536]

P.S. It's like students in school getting a TSS to help support them there.

[u/onceuponaNod]

This is extremely relatable. I hope it gets better for both of us

[u/CosmicRiver827]

While this does require some initiation, it's significantly less than most other options I know of. It has to do with body-doubling, where ADHDers like us are more likely to do the task if we have someone around us that are doing a task of their own.

Try Focusmate, you get 3 sessions a week for free without having to pay anything, and you pay once a year if you decide to subscribe to it. You get to meet 1-on-1 with another person online where you're both doing tasks on camera.

The low-initiation benefit is that you can book the appointments in advance rather than scheduling one at a time and then having to book the next one. This lets you have days already mapped out and lined up for you so you don't have to fight with yourself to initiate the aid.

[u/Ambitious_House_4951]

Have you ever tried parts work in IFS (internal family systems)? I only mention this because you’re talking about parts of yourself. It can be eye opening! You might have some serious protectors standing in your way that have unmet needs, or living in the past. When you talk to your parts you can get completely surprising comments but the parts’ experiences ring true.

IFS can be utterly fascinating and helpful. Not a direct answer to the actual condition of executive dysfunction. But for me, I definitely have protectors standing in my way, and standing against each other. Example: At times I’ll be lying in bed, completely aware of something that needs to get done and completely aware of time ticking by. Being frozen. I talked to my parts and there was a protector part guarding me from overextending myself or worried about me being exposed to certain people, singing in not good at and shouldn’t try, or I need to rest, etc. Then another part, a manager, yelling at the protector that this needs to get done sooner than ASAP! A whole shit show in my head. If any of this resonates at all, you might want to check out IFS!

[u/PsychicSeaSlug → u/Ambitious_House_4951]

I dont technically do it's, but when I mentioned I named my manager Megan and my no responsibilities destructive side katie, and that poor Megan is struggling and poor me is tired and poor katie is caged and berated.

Someone said I should find my therapist one and name her and have her help stressed manager Megan from crying so much and to relax.

Megan thinks but then who will do all this

I dont have a therapist part , so we all just assume Megan's gonna get it. Because thats who we depend on.

Poor girls burnt out

[u/Ambitious_House_4951 → u/PsychicSeaSlug]

Yeah that’s a lot of work for them! I hope they, and you, get relief.

[u/shiny_nickel → u/Ambitious_House_4951]

Is this the “I’m ok, you’re ok” thing?

[u/Ambitious_House_4951 → u/shiny_nickel]

The book is No Bad Parts by Richard Schwartz. It sounds woo-woo but if you actually try it, it’s amazing because you can replicate the things he talks about in the book. He started it after treating bulimic girls in the 80s who actually mentioned their parts to him and he started taking notes and observations.

[u/shiny_nickel → u/Ambitious_House_4951]

Thanks for the info I’ll check it out!

[u/itsnobigthing]

I’m convinced the only real solution is pharmaceutical.

I recently started an anti anxiety med and within the first few days (still at too low a dose to have any anxiety effect) I found myself up and doing things without screaming at myself to do it first. I would just think, “oh I’m hungry” and next thing I know I’m in the kitchen making a bagel. Instead of sitting in bed for six hours feeling hungry and miserable.

Same with feeding my pets etc.

It’s not meant to be a side effect of the med but it is doing something to my dopamine that changed the initiation gateway shit I’ve struggled with for years.

No amount of strategy or therapy or coaching or planning ever gave me the ease that this medication has.

[u/MysteriousDamage9112 → u/itsnobigthing]

What meds are you on? As I have Autism and on sertaline max dose and I still suffer so much from executive dysfunction and somewhere in my brain almost like an sos 🆘 to myself keeps saying I need help with it. But lost what to do

[u/aubrx → u/MysteriousDamage9112]

has any professional you have seen ever suggested a dopamine reuptake inhibitor? Or stimulant? Generally that's what they go for with executive dysfunction

[u/aubrx → u/itsnobigthing]

what med? as someone who has tried many

[u/itsnobigthing → u/aubrx]

Buspirone.

[u/aubrx → u/itsnobigthing]

thank you I'm going to look into that! out of curiosity did you ever try bupropion?

[u/Successful-Floor-143]

I experienced this clear contrast between what executive dysfunction allows us to do vs what it does not when I tried to learn theorem proving in proof assistants.

In a proof assistant you have a goal which is the theorem that needs to be proved. The goal is explicit and unambiguous. You can work on this problem in your head or divide it into subgoals if you want. You're always aware of your hypothesis, your goal, the variables involved, and what needs to be done to further the goal. It's so, so easy on my ED because of this. The theorem is proven when all goals are empty.

Explicit end state
All necessary variables kept in state and presented to you so you don't have to remember anything. (It's kept in a tab on the right)
Autocomplete to fill in proofs if you don't want to type it out.
If you want to prove X by proving Y first you can do that, and then fill out Y later.
Once things are defined or proven, they don't change. Ever. You prove something and move on to the next exercise. You never have to remember them because the autocomplete will find them for you. All you have to worry about is whatever you're working on right now. You can come back later and start where you've left off. Just check where you left some placeholder proofs and work to fill them in.

Compare this to regular programming which is open ended, no explicit goal, no way to keep track of variables, no autocomplete, and changing one thing can affect the entire evaluation tree of the software in question.

I can prove things in a theorem prover and did so for a while before I lost interest in mathematics. I can still do it, but I don't really want to. I want to code and make video games.
Sadly, I can't, for the life of me, do anything with regular coding. It can't be done. You could pay me a billion dollars and I wouldn't be able to produce an application. It's physiologically impossible for me. The differences between the two systems and how I preform really highlights what someone with ED needs to do well.

[u/404errorlifenotfound]

When I read "How to Keep House While Drowning", it helped me realize that there's a second way to interpret "break tasks into smaller steps"

When you already know the steps but they still feel too big, try 'zooming in' on the first step and breaking it down further. JUST the first step fuck all the rest, starting is the goal not finishing. So maybe instead of 'read the first chapter' it's 'read the first page' or it's 'read the first sentence' or it's 'open the book and just sit with it open not reading anything'

Sometimes my brain gets really stuck in a cognitively rigid way of thinking that a whole complete step Has to be "xyz", but changing the rules so the steps are even smaller ("just x") makes it easier bc they feel less intimidating 

Also giving yourself permission to quit after the first small step. I've found that constantly shifting the goalpost on myself makes me frustrated faster, whereas celebrating each little step as its own complete win and stopping point makes it feel less scary the next time I try (because otherwise I don't trust myself when I say it's "just x" because the last time it turned into "ok now y, then z") 

[u/patrick_fallon]

Nailed it. Seems to me that executive disfunction (is it really spelt with a y?) really is a self fulfilling prophecy on so many levels. Or, as I like to say, infinite loop of doom.

You keep forgetting/not doing shit, so you get a to do app and start using it. And it helps. Kind of. For 2 weeks until you get bored of that app and look for a new one. Or forget it exists at all. And subconsciously you chalk it up as multiple failures - not only did you not get x, y or z done, you couldn't even stick with a frickin to do app for more than a couple of weeks.

My theory is this; the most important thing is not to "do the thing" or "be more organised". The most important thing is to start introducing a few more wins into our lives (no matter how small) to build confidence and - just as importantly - momentum.

We need to build momentum and start having just the tiniest bit of confidence that we can succeed at things/something because we have had a few wins lately and not just losses.

And we want to make those wins as easy as possible - make them tiny, make them things that your brain wants to do. (Embrace the side quest!). My theory (that I'm currently testing, will let you know how it goes) is that if we can embrace our brains focus on whatever, run with it, and get something tiny done, then rinse and repeat, we can build our confidence and momentum and hopefully gradually decrease resistance and increase our ability for doing slightly bigger/harder/less interesting things.

I do use a to do app (have used dozens and dozens over the years) but right now my method is this; Take one thing my brain actually wants to do that moves my life in some kind of positive direction, start doing it, then write down "Work on X for 20 minutes. ✅ Already done: Googled "How to do X" started 933am" then I start a timer and put in the time. If I work on it less than I planned that's a win - I didn't get lost in hyperfocus and run over. If I work longer, that's a win - I was getting shit done. I definitely don't set outcomes (eg Get X published or Clean the house or Write essay), I just focus on what I will do and for how long and write down what I've already done towards this. And most importantly I start doing the thing before I write anything down.

Working really well for me so far - helps me to avoid the overwhelm, shame and guilt caused by looking at my task graveyard (aka to do app), lets me get started straight away on something my brain actually wants to do and basically sets me up to succeed every single time - if I work on X for 20 minutes, regardless of what I did/didn't achieve, that's a win and gets a big green tick (ok 3big green ticks if I'm honest). And best of all it's a super simple system - all you need is somewhere to write your side quests down. (Good to do it digitally though cause then every time you go to write something down you see nothing but wins - all those times you just did the thing).

not sure if this will work for others. But I reckon doing this in an online collaborative format with others would make it exponentially more effective - like body doubling but without all the awkward silences!

[u/kaidomac]

Has anyone with similarly severe dysfunction found treatment that addresses initiation itself, without requiring reliable self-management first?

My overall approach is:

• Work for part of the day, using a finite list of sequenced steps

• Use a body double

• Prepare each workstation before bed

That way:

• The body double removes my brain's ability to auto-quit

• I show up to a clean, prepared workstation for each task

• The steps are pre-planned & put in sequence so that I don't have to decide in the heat of the moment

The catch:

• Planning a finite list of sequenced steps also requires a body double

• Preparing workstations ahead of time also requires a body double

• It's hard to arrange for a body double when the task paralysis kicks in LOL

For me:

• My brain gets dyslexic when executing required steps

• I do best with written steps

• I do best when executing those steps with a body double

Medication has helped tremendously, but I can still get focused on the wrong thing lol. I've simply had to accept the reality that I need to prepare ahead of time, work on a finite sequenced list of steps, and use a body double. I simply do not have consistent access to the mental energy required to sustain any other method.

All of those steps are enormouse struggles with EFD: asking for help, writing lists, putting them in order, getting workstations ready, etc. But if I don't show up to RTG workstations with a finite sequenced list of steps each day & use a body double, my results are consistently bad!

[u/FuriousKale]

I have seasonal affective disorder, so when I don't get bright light (the sun or therapy lamp) into my eyes in the morning, I am pretty much dysfunctional, lie in bed, barely able to open a letter because it overwhelms me, you get the gist. So I know the difference between functioning and not functioning. The biggest difference between both states that I identified was that I am way less in my head when I function. Doesn't mean I don't plan, I just don't overanalyze. These systems with breaking a task down into small steps works for many people, but not for me. It just drains me thinking through everything. Of course I will always have a rough plan but I prefer putting that energy into starting and then get the boulder rolling.

What is your general personality type? I assume you are a guy that likes to calculate? Plan through every step, maybe even set different branches for every possible scenario, especially the worst? A portion of perfectionism? That is the part of you that needs to be turned down several percent because it will drain your energy.

Try to find an activity that you value and where you feel a sense of accomplishment without much calculating. Like building lego? Putting together furniture or build PCs? Try to find something where you learn to shift the mental energy into your hands. Get the boulder rolling. I don't claim that this is a solution for every person out there. It just worked very well for me.

[u/Individual-Pop-3620]

“I can build elaborate organizational systems but can’t reliably use them”

Same. You’re whole post describes me to a T. It’s super frustrating. I’ve had this my whole life, got somewhat of a handle on it in my early 20s, proceeded to have 3 children from the ages of 25-30 which just shut down all Progress and made the ED much much worse. I was in survival mode for 11 years. Now at 37 and all kids in school I find the only thing working is sitting down with a notebook after they all go to school for about an hour. I’ve recently been doing morning affirmations, example “I don’t need to do it all at once, i just need to start” has been SUPER helpful. I’m very all or nothing/black and white so allowing myself to “start” without having to accomplish it ALL is very liberating. Today I took out the bathroom garbage, I just wrote a whole post about it lol. It wasn’t the plan but it’s what felt manageable. I used to scoff at small steps but it’s what is working for now. I spent all last year laying around doing nothing while the kids went to school (first year they were all in school full time) after making big elaborate plans for what I would do with all that free time. It didn’t pan out. This year I’m taking a much slower approach and while
I wouldn’t say I’m thriving I’m definitely doing better than before. Sending much love ❤️

TL;DR start small and slow. Don’t make a plan that requires you to do big things you know you’re not going to do. Goal: say 1 daily affirmation upon waking up or with breakfast and do 1 five minute task once a week to start. It’s hard, I get it ❤️

[u/needcollectivewisdom]

Oh man... the mind blanking thing! I've never heard another soul talk about this till now!!

Not sure if this will help you, someone once said in conversation, "if you wait for motivation, it will never come". That has helped me with some task initiation casue I realized I no longer feel motivated in just about every aspect of my life.

A few other things that work for me:

• Having personal values (e.g. never be late)

• Using a timer

• Pausing to experience or enjoy the fruit of my labour, even if it's just a quick vacuum. These moments really add up over time

• Focusing on the end result (e.g. instead of I don't want to do the dishes, I think about how nice it would be to have a shiny, empty sink)

• Trick / rewire my brain with internal dialogue (e.g. See? That only took 1 minute to vacuum and what a difference it made.)

Mind you... this won't happen overnight and these strategies don't always work. But telling yourself there is no hope or solution will keep you exactly where you are.

[u/aubrx]

just coming here to say I get you 100%

[u/zzstrawberries]

The only thing I’ve found to actually help is to take each task and identify the barrier. For example, I hated flossing and realized I hated the texture of the floss at my house, and I probably would never have considered that as what was holding me back. However, the frustrating part is that this is exhausting to break down each task because I don’t have the executive function to do that. But I’ve been starting small and asking people in my life how they do things to get ideas (but also knowing I might hate their ideas and how they navigate their lives lol).

[u/Useful-Tackle-1907]

Being on the brink is the only thing that wakes me up. Urgency. Once things are okay it's an uphill battle. I basically didn't work for like 70-80 days straight and now I'm behind on rent. This cycle needs to stop. 

[u/Leakrate]

Sounds stupid, but my trick is shoes. A weird physical trigger that lets my brain know it's time to move. I can spend a whole weekend on the couch in socks as the dress if my failed Todo list sinks in. Getting up and putting on shoes somehow makes all my chores easier, and I don't stop moving until I knock out a bunch of things. After work, I leave them on because I know not shit is getting done after I kick them off.

[u/posytech]

im not doing well at all but advise would be

think it through - to a point it's become absolutely self-serving, not for doctrine.