When we say “executive dysfunction”, I think it’s important to acknowledge to ourselves (and make clear to those who don’t struggle with it) that we’re talking about a basket of different struggles that we’re labeling with one name for convenience. One person’s executive dysfunction may not look like another person’s, even though the outcome (not being able to complete a task) may look similar from the outside.
Some people with executive dysfunction struggle to break down tasks into their component steps. Others struggle to connect cause and effect (’if I do this, this other thing will likely happen’), which makes daily life a confusing and sometimes terrifying black box. Still others can break down steps and parse out cause and effect, but they can’t start the first task (hello anxiety my old friend), or they get partway through and get distracted by a tangent or forget what the next step was because there were more than three (ah add i never miss you because you never leave), or they run out of energy before they can finish (tons of situations can cause this, both physical and mental). Sometimes people have a poor sense of how long it will take to do tasks, never seeming to budget enough because they don’t track time internally well. Others can only complete a task when they have sufficient adrenaline to spike their brain into focus, which usually means working in panic mode, which associates those tasks with Bad Feelings and further reinforces any anxiety the person may have.
And this isn’t just a few people. This is large-scale, across many groups struggling with different issues, from heavy metal poisoning to autism to add to chronic illness to anxiety to schizophrenia to mood disorders to traumatic brain injury, and more.
What we need, as a society, is to build better structures for supporting those with executive dysfunction, structures that acknowledge the multiple different types and causes. Because we cannot keep throwing the baby out with the bathwater here. We throw away incredible human potential that could help all of us because our society is set up to require a single skill which a large percentage of our teen and adult society doesn’t have and can’t easily develop (or they would have, trust me), or previously had by has temporarily lost due to injury or illness.
Instead of treating executive function as something that some people have developed and others haven’t, like artistic skills or a talent in maths or the ability to visualize systems or managing people, we treat it as a default that some people haven’t mastered because they’re [insert wrongheaded judgment here].
What if we treated the visual arts that way? If you can’t draw skillfully, you must be deficient in some way. How can you not draw? Anyone can draw. You start as a young child with crayons, what do you mean you can’t do this basic task?
Never mind that it’s a really complex skill by the time you’re expected to do the adult version, rather than the crayon version. Never mind that not everyone has been able to devote energy to developing that skill, and never mind that not everyone can visualize what they want to produce or has the hand-eye coordination necessary to accomplish it.
Now, I have friends who say that anyone can draw, and maybe they’re right on some level. But it’s hard to deny that it helps that drawing is optional. That you can opt out and no one thinks any less of you as a person. Executive function is treated as non-optional, and to some extent, since it’s involved in feeding and clothing and cleaning and educating oneself, it’s not entirely optional. But we make all of those tasks much harder by assuming by default that everyone can do them to an equal degree, and that no one needs or should need help.
If we built a society where it was expected that I might need timed reminders to eat, I would probably remember to do it more often. I certainly did as a child, when the adults around me were responsible for that task. Now that I’m an adult, the assumption is that I somehow magically developed a better internal barometer for hunger. Many people do. But I and many others did not. Recognizing that there are many of us who need help and treating that need as normal would go a long way toward building support into the basic fabric of our society.
But then, I guess that’s been the cry of disability advocates for decades; just assume this is a thing people need help with and build the entire structure with that assumption in mind.