In a recent viral social media reel, Dr. Russell Barkley can be heard describing the disconnect that people with ADHD experience between knowing what needs to be done and actually doing it. Dr Barkley states: “You have a brain. The front part of it is where you learn, the back part of it is where you do… But ADHD splits them apart. I don’t care what you know, you won’t do it. Brightest kid in the world? You won’t use it. [That’s the problem!] You can know stuff, and you won’t do stuff. …That’s called a performance disorder. … You’re going to have time blindness. You won’t be able to aim your behavior toward the future [or] to care for yourself as effectively as other people are able to do. You have intention deficit disorder. You have a disorder of performance, not knowledge. You know what to do but can’t do it. You have a disorder of the ‘when’ and the ‘where’, not the ‘what’ and the ‘how’. Your problem is NOT with knowing what to do. It’s with doing what you know.”
As much as I hated this sound-byte when I first heard it, it started to make sense soon enough. (Admittedly, I do still kinda hate it. I think it’s a little too harsh in tone.) But, I think it was helpful for me to be able to understand why I put things off so frequently. Let’s take working out, for instance. I’ve had the passing thought a thousand times, “I need to work out today.” I’ve even taken it as far as “I’m going to work out today,” yet I’ve rarely actually worked out any day. Don’t get me wrong, I’ve impulsively hit the streets to walk off some anxiety pretty frequently, but I’ve rarely effectively executed a plan to work out at a certain time in my daily routine.
I had the beginnings of intent, but I had no intention of working out.
Those of us with ADHD can be masters at heaping guilt upon ourselves for what was not done. (See my previous blog post on the Default Mode Network.) I want us to be careful to not repeat this error here. When I hear the word “intention” in this context, I think of someone being confronted in a high-conflict situation. “You said you were going to do it, but you never had any intention of following through! You’re a liar!” (My default mode network loves some drama!) Please hear me, though, this is NOT what I mean to suggest. The “intention” I am discussing here is a much more innocent concept that is simply skipped by a brain that functions differently than the next person’s brain. Not forming the intention is not malicious or for purposes of misleading. It’s not even lazy! Not forming the intention is merely skipped, omitted from the process in error. That’s called ADHD.
My ADHD-affected brain knows the ‘what’ and the ‘how’ of working out. It knows I need to get up off the couch and do it. It even knows the basic routines to do. I’ve been doing these routines since high school (…er, not doing them, mostly). However, in this particular case my brain doesn’t know the ‘when’. It hasn’t looked at the day to build a schedule that included a work-out at a specific time. I didn’t know ‘where’ in my routine I would create space for the work-out. So, I do what I’ve always done and leave it to chance that the magical work-out fairy will come inspire me to action. (She doesn’t.)
People with ADHD can learn to be mindfully aware of what their brain is struggling with at any given moment. This helps us be more present in the moment and helps us to bolster our executive functioning (to an extent) as needed. Part of the solution to a lack of intention is to realize when we are being affected by this lack of intention. I suggest that the things we feel the most frequent self-condemnation for not doing are the things that most badly need our focused intent. Try making a special effort here to assign one of those tasks a realistic ‘when’ and ‘where’ today. Decide and plan for this task to be accomplished. It may hurt your brain to do this. It hurts mine most days, but planning is a mental muscle that gets stronger with practice. Then, when the time comes, actually follow through with completing the task. You’ll feel so much better, but what’s more - the thing will actually be DONE! [Special Note: Do not allow yourself to revel in any self-condemnation you may feel about these things. Merely start fresh where you are today. And if you mess up, start fresh tomorrow. And again the next day until a new routine is created.]
As always, I suggest working with a psychiatrist and a counselor to best manage ADHD. You absolutely can take back control and become an effective goal-setter who is even pretty good at follow through. If you’d like to set up an appointment to see me and work on this sort of thing, use the link on my website here: www.altmancounseling.com and click “Book Now”. Or, call 770 615 6300. Georgia residents only.