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Executive functioning is your ability to engage in goal-directed behavior: it includes self-control, planning, intrinsic motivation, emotional regulation, working memory, and focus. Executive function impairments can really fuck up your entire life.

The good news is that, for many people, non-medication coping mechanisms for executive function impairments work really well. The bad news is that the list of non-medication coping mechanisms for executive function impairments looks something like this:

  • Put your keys in the exact same place every time.
  • Use a to-do list.
  • Use a planner.
  • Write down events in your calendar along with when they occur.
  • Work in a place without distractions.
  • Do pomodoros.
  • Have a morning and afternoon routine.
  • Schedule a specific time to do the thing.

That is, it’s literally all things adults lectured you about when you were a kid and forgot about an important form– again— or didn’t do your homework– again— or can’t find your shoes– again. (Pomodoros are an exception but I feel like they have a certain offputting spiritual similarity.)

It makes sense that that’d be true. Presumably non-medication coping mechanisms for executive dysfunction were independently discovered many times and spread until they became conventional wisdom. Many people have subclinical issues with executive functioning; for genetic reasons, people related to people with serious executive functioning problems are particularly likely to have subclinical issues. They’re trying to  give advice that actually does work.

But it also means that using those coping mechanisms feels like admitting to the people who lectured you as a kid that they were right and actually the problem is that you’re Insufficiently Virtuous and if you only acquired More Virtue then you would be able to solve the problem.

I’m not sure there’s a solution to this problem other than training parents in motivational interviewing, or at least convincing them to give advice at literally any time other than immediately after your child failed to do the thing when they are already full of shame and self-hatred. Seriously, guys. You’re going to give your children lifelong planner-related trauma and they’re going to miss way more doctors’ appointments than they would otherwise.

One problem with non-medication coping mechanisms for executive dysfunction, at least as communicated via parental lecture, is that the things that work for people with moderate to severe executive function issues are usually very very specific. I know several people whose lives literally fell apart when Google shut down Google Inbox,  because they were using those features, and no you can’t just replace it with Gmail Gmail does a different thing. I know a person who can only use Habitica as a to-do list app, because the gamification aspect gives them the internal motivation they would otherwise lack.

I have several times attempted to find One Place Where My Keys And Wallet Live, Such That I Will No Longer Lose Them. However, my first attempts all failed, because I got clever and tried to put my keys and wallet in some place other than the counter next to the front door, which is literally the first flat surface I encounter when I enter the house. If I have to take more than three steps in order to put my keys and wallet in a place, I will not put them there.

People with executive function problems also often have to defend their coping mechanisms with a fervency that seems anal-retentive to people without executive function disorders. For example, many people have to enter a plan into Google Calendar immediately the second they think of it, because if they delay for even five minutes they will never enter it into Google Calendar and they will miss their appointment. Some people have to carry their planners around with them everywhere no matter what, and losing their planner is an emergency of a similar urgency to childbirth. Those who have a routine might have to do exactly the same routine in exactly the same order every day, because if they feed the dog before they drink their tea everything will fall apart and they’ll be in their underwear at 2pm.

(This is another subject on which the parents of children with executive function problems could improve. If your teenager finds something that works for them, things that disrupt it are emergencies and they cannot ‘just do it anyway’. Either prioritize getting them the things they need to handle their executive function problems or don’t lecture them when they forget to do their homework.)

Finally, unless you are very very lucky, non-medication treatments for executive function issues are not going to get you to a neurotypical level of functioning. This is often a grave disappointment to people with executive function problems and their loved ones; what’s the use of all that work if you’re just going to miss appointments and fail to run errands anyway? The answer is that successfully running nine out of ten errands is actually way better than successfully running two out of ten errands. It’s a tremendous improvement in your quality of life and your ability to do things, even if a normal person would be able to do all ten errands. It’s important to compare yourself to where you used to be, not to where other people are right now.

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