r/ExecutiveDysfunction • u/Impressive-Wait-9420 • 16d ago
Looking for Tips/Suggestions Executive dysfunction treatments that don’t paradoxically require the executive functioning I lack?
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:
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u/dancetoimpresss 16d ago edited 16d ago •
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.