Reframing ADHD and "Executive Dysfunction"

If you’ve read any literature, articles, or come across memes about ADHD, you have probably seen the terms “Executive Function” and/or “Executive Dysfunction” pop up many times. Specifically, you likely would have come across explanations from experts in the fields of psychology, psychiatry, and ADHD Coaching claiming that people who have ADHD suffer from “deficits” or “challenges” when it comes to Executive Function.

But Executive Function is not the end-all be-all that many would have you believe, even (perhaps especially!) when you have ADHD.

You might be wondering why on earth I, particularly as an ADHD Coach, would make that claim. After all, many in the field of ADHD Coaching have plastered all of their websites that they work with people who have Executive Function “deficits.” It probably would help my SEO if I were to add that to this website.

However, there is something really important missing from the mainstream analysis about Executive Function.

WTF is Executive Function, anyway?

Simply stated, Executive Function (EF) is a construct. That means that EF exists because people agree that it exists, and not because it is part of some sort of objective reality; this doesn’t mean EF isn’t “real,” but it is subjective and changeable. Other notable examples of constructs are the concept of money, the invisible borders of nation-states, and the social construct of race. Executive Function is a particularly subjective construct, however: there is no consensus as to a definition for Executive Function in either the literature about ADHD and EF, nor among “experts” in general.

Therefore, it has never made sense to me to be told that we ADHD-ers have Executive Function “deficits,” given that there isn’t even an agreed-upon definition for it. Moreover, the level of importance assigned to Executive Function within mainstream society is often biased and discriminatory.

My perspective: “Executive Function” CAN be a potentially useful conceptual framework for those of us with ADHD when it is clearly defined and its limits are acknowledged, AND when it is not used as yet another way to make people with ADHD feel bad about who we are and how we do or don’t do things.

Defining and Reframing Executive Function

In my own practice, I use a conceptual framework that is essentially a modified version of the Thomas Brown Model of ADHD, which defines EF with the following components:

Activation
organizing, estimating time, prioritizing, getting started on tasks

Focus
focusing, sustaining focus, shifting focus between tasks

Effort
processing speed, regulating alertness, sustaining effort

Emotion
managing frustration and modulating emotions

Memory
utilizing working memory and accessing recall

Action
monitoring and regulating self-action

Instead of using language like “deficit” or “dysfunction,” I use language like “internal vs. external” to describe the differing ways that ADHDers and neurotypical people engage in Executive Function. I’ve come to think of it this way: neurotypical people tend to engage in the components of Executive Function internally, almost at the level of intuition or instinct.

Those of us who have ADHD don’t usually engage in all components of Executive Function in an internal or automatic way because our minds prefer to internally engage in other things; for example, we tend to have many threads of thought going on at once, we are good in an acute crisis, and we are often highly creative. Unsurprisingly, many of the activities included in descriptions of “executive function” — e.g. organizing, estimating time, planning, getting started on tasks, sustaining focus, emotion regulation, working memory — are considered essential for “success” in a societal structure akin to late capitalism.

But guess what?! We don’t actually NEED an internalized Executive Function, because there are plenty of strategies out there to externalize the components of Executive Function that will actually work for us. Once we externalize EF, we unburden ourselves from the heavy pressure put upon us, both by others and ourselves, to /internally/carry out “Executive Function.”

This frees up our internal bandwidth, so that we can engage in more interesting “functions,” such as creativity, introspection, and otherwise making our day-to-day lives more meaningful.

How ADHDers can externalize Executive Function

Below are some examples of externalizing Executive Function:

- Checklists for e.g. morning/evening routines, travel packing lists
- Establishing certain rituals that help you “work up” to doing a particular type of task
- Using whiteboards and different colours of whiteboard markers to colour code and highlight different types of information.
- Highly visible wall calendars/schedules
- Journaling
- Putting important agreements with your partner in writing, so that you’re both on the same page and can reference or reread it to jog your memory, etc.
- Setting multiple alarms that use different types of feedback (auditory vs. vibration vs. visual) as reminders to yourself
- Fidgeting to Focus

Bear in mind that the effectiveness of any given strategy will depend on certain factors, such as how you best process information. The foundational assessments that I use with my coaching clients help us zero in on the strategies that are most likely to be effective for them as individuals.