My Life and Executive Dysfunction

A conceptualisation of Executive Dysfunction that also looks like Angelina Jolie was created in the world’s most complex game of Jenga (Credit: jaci XIII CC-BY-2.0)

“One of those days.”

We’ve all had them, you barely manage to wake up, your brain is a complete fog, you try to wipe your arse with your toothbrush and brush your teeth with toilet paper. Even though the sun is shining outside, everything looks dark to you and curling up in the foetal position, in the womb-like comfort of your duvet seems like just about all you can manage.

Your brain, at that time, exists in this void-like moment. You can’t remember anything you were supposed to do, you can’t plan what needs doing, indeed the very notion of ‘doing’ seems alien. Every task you see or consider is like an unscaleable brick wall, you can’t climb it, and you can’t run through it. You’re frozen.

We all have days like that and on those days we are exhibiting the cognitive, behavioural, emotional condition known as ‘executive dysfunction’.

It stands to reason, then, that ‘executive function’ is the complex of cognitive, behavioural and emotional systems that helps you see tasks, set goals, act upon those tasks to achieve those goals, plan and execute them all accordingly, and feel rewarded for having done it.

It is intrinsic to cognitive pathways involving work/reward behaviour as well as functioning memory. Thus, people with dysfunctional reward pathways will find themselves at increased risk of difficulty functioning, as will people with worse memories. For example we see an increase in executive dysfunction in the elderly population who, due to old age, have poorer working memories. Or those who have suffered brain damage due to stroke.

Unlike a lot of the previous neuro-psychological phenomena we have discussed ‘executive dysfunction’ is not a simple cognitive bias, a heuristic, a brain’s rule of thumb, like the Halo Effect. Nor is it a conditioned response like Learned Helplessness.

It’s actually an incredibly complicated, interlinked series of processes and pathways so there’s no quick or easy explanation for it, no one condition that causes it, and no single, easy way to fix it.

Ahh, the brain. The cause of, and solution to, most of life’s problems! (Credit: VSRao via Pixabay)

As mentioned in the intro, everybody gets it. We all have ‘those days’, but some people are more inclined than others.

Depression and other mood disorders have high co-morbidity (basically the two conditions existing together) with executive dysfunction. As do Attention Deficit Hyperactivity Disorder (ADHD) and Autistic Spectrum conditions (ASD).

In my case I can only speak from an autistic anxious-depressive’s point of view.

The thing is, if you read the literature, if you read the wiki page, you will find out all about what’s ‘lacking’ in autistic people that makes this a problem. In fact if you read anything much into autism, as an autistic, you will feel like you’re the problem. What I think these studies are all failing to take into account is a wall of autistic voices telling them what they’re over-abundant in.

I like to think of life’s sensory information as, predominantly, rubbish. Now in most people, in what we would call ‘neurotypical’ people, there is a regular collection of rubbish and recycling. Whatever you don’t need gets tossed aside, whatever you need can be filed away for re-use later.

In autistic people our rubbish collectors are on a sort of slow-work strike. That rubbish does not get emptied so quickly. Information goes into the same size storage containers, but is not emptied as quickly. Therefore it takes slightly longer to process than it does in a neurotypical person.

This information can be anything from the image of that bee you saw flying into a flower, to quite what your mum meant when she said that thing to you last week, all the way up to grief punching you in the face weeks or even months after your bereavement. It’s weird but that’s certainly the best way I can describe it working in me.

In the middle of this you have stuff that needs doing. Functions that need executing! Whether it be something as simple as doing the washing up, or a work related project. It takes mental effort to consider the task, plan the solution, perform the task, feel rewarded and thus create a positive-feedback loop of behaviour.

A stock image of something being overwhelmed. Funnily enough I also have a habit of putting my hand on my head when I am overwhelmed (or have a headache) but I use a palm-up gesture, as if I’m a fainting lady! (Credit: RobinHiggins via Pixabay)

But what if, as a result of your head being full, you only get so far as to see the task?

How does it appear? As a result of your head already being quite full of information, the notion of adding even a small thing to the top of the pile could be enough to make it seem insurmountable.

That Everest of dishes you have piling up, when your brain is full, is not something you can plan to climb because you see no end to it. Well then suddenly you’re feeling like a failure, it just gets worse, you create a negative-feedback loop, which is not good.

But say you do get it done, you manage to consider the tasks, put it to action, complete it – but your head is full. There’s no space for you to squeeze any sort of reward or satisfaction out of it. Uh-oh! We’ve got another negative-feedback loop. I did it, but it didn’t make me feel any better, so why bother doing it!

So do you see that despite the fact that the pathways seem relatively simple, the brain, especially the non-neurotypical brain, has pathways for making these things complex? Knock one of those parameters out of sync and the whole chain of execution is disrupted.

It is unfortunate because often what is needed is understanding of the underlying conditions to allow people to thrive. People with ASD, ADHD or Bipolar, for example, might just need someone to take care of the little things to allow them to thrive at the really big stuff, but because there is an expectation that a ‘normal’ person should be able to handle it all they are actually left struggling. That or there is an over-focus on getting these people to focus on achieving the smaller goals, leaving them lagging behind in the worlds of work, achievement and giving them lower social status (and vicariously, lower social-worth to others).

Especially when you factor in that, to most people, and even though we have all had ‘one of those days’ executive dysfunction, particularly as a regular occurrence due to an underlying condition, is often attributed to lack of effort or laziness.

Particularly with autism I feel the executive dysfunction system and the demand avoidance system play into one another. We will talk properly about demand avoidance another time but it is pretty self-explanatory, it is an expressed discomfort at performing what could be otherwise, to a neuro-typical, everyday expectations.

So say you are autistic, you have a day of limited executive function, then someone – a partner, a parent, a carer – points out you haven’t done ‘X’ thing so suddenly doing ‘X’ thing has become a big deal, causes you great distress and anxiety and you come up with a million and one excuses why you haven’t done ‘X’ thing and, this, likely, will negatively-feedback making you less likely to do ‘X’ thing than had it not been mentioned at all.

Procrastination might be the most commonly known executive dysfunction. Procrastination is literally just the delaying of something. Most studies seem to indicate the same complexes involved in executive dysfunction (i.e. an inability to plan the task, set goals, work towards those goals and feel reward) all lead to procrastination. It is an executive dysfunction. (Credit: Ludie Cochrane CC-BY-2.0)

It all paints a remarkably complex portrait of characteristics we can so easily define as ‘laziness’, in what could be some of the most hard-working people there could be, had they the proper care and support.

I should know, I’m one of them!

I can’t tie a fucking shoelace properly.

Yet I am single-handedly running ‘We Lack Discipline’.

I have a pile of dishes in my room that need to be taken downstairs and washed but frankly, when I look at them I cannot even begin to fathom how that process takes place.

In the meantime I have studied the origins of the myth of Orion the Hunter the legendary Hellenic figure and star constellation, written an article (in as simple terms as is possible with Orion) and edited it.

I have an empty sparkling water bottle on my floor from as long ago as when I started reading ‘Tess of the d’Urbervilles’ which I have since completed reading, provided approximately 25,000 words of analysis on, as well as an article of unintentional innuendoes from it.

Clearly I am able to execute certain tasks better than others.

Clearly I am driven towards goals in some directions and not others.

Clearly completing some tasks is a goal in and of itself, whilst other, more basic tasks, provide no satisfaction whatsoever.

And it all ties in to a complex of cognitive, behaviour and emotional mechanisms. To think of a task, act upon it and feel good having done it.

I think this comic really sums up executive dysfunction, as I experience it, so well. (Credit: Steve Asbell @steve_asbell on twitter – Currently used without permission, but you can give him some tip money here.)

Simplicity and complexity rolled into one. That’s the problem with simple systems, though, isn’t it? When they break, they REALLY break and everyone’s got their own, special way to fix it that might not work for your system, but everyone assures you it worked for them.

After all, it’s just easy. You just get up and do it!

Yeah, right.

To explore other Neuropsychological concepts see;
My Life and Learned Helplessness
and
My Life and The Halo Effect

Published by Karl Anthony Mercer

An overly curious lovechild of Grumpy of the Seven Dwarfs and the kitsch pen section of Paperchase. Karl is on a mission to expose the seedy underbelly of academia, and thus making it appealing to wrong 'uns.

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