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ADHD gurus like Russell Barkley and Ari Tuckman argue that problems with executive functioning are a core part of ADHD, and that these problems may explain many of the symptoms of ADHD. Executive functioning problems are actually quite common. They appear not only in ADHD, but also in a variety of other conditions, including traumatic brain injury, bipolar disorder, and even certain types of dementias. But what are executive functions, and how do they relate to ADHD?
Executive Functions: Just What Are They Anyway?
In a web video on this very topic, Barkley explains executive functions as, “those capacities for self-control that allow us to sustain action in problem solving toward a goal.” In other words, the steps we take to organize ourselves to plan for and complete a goal, whether that means planning a party, completing a work project, making dinner, or organizing a romantic weekend getaway. Citing Barkley in one of his chapters in the book The Distracted Couple: The Impact of ADHD on Adult Relationships, Tuckman similarly explains the executive functions as, “a set of cognitive functions which enable us to manage competing demands in the moment in order to create a better future.” So when they work, executive functions really benefit us.
Executive functions include a variety of tools we need to get through life a little bit easier. These include, for instance: planning, multi-tasking, sequencing and following through on a series of steps to complete a task, and shifting focus between various topics as needed.
So what does executive dysfunction look like? Well, it looks like procrastination, disorganization, lack of planning, being easily distracted, and impulsivity. And since these problems are common experiences for many with ADHD, experts like Barkley and Tuckman see a probable link between the two.
Although there is a link between ADHD and executive dysfunction, ADHD is not just another term for executive dysfunction. What I mean is that executive functioning problems do not automatically mean ADHD. I say this because executive dysfunction can be found in a range of problems and conditions other than ADHD, like schizophrenia, bipolar disorder, autism, and as a result of strokes and head injuries. In a similar way, memory problems do not only occur in Alzheimer’s disease; they might also show up in a traumatic amnesia or other conditions. Still, executive dysfunction does seem to be a common part of the ADHD experience for many adults and kids.
Executive Dysfunction and Relationships
So how does executive dysfunction influence close relationships for adults with ADHD? Well typically, in a variety of ways.
Tuckman suggests for instance that problems with multi-tasking (what he calls working memory) might show up as unfinished projects, forgetting key steps in completing a task, or misplacing important objects. Similarly, chronic lateness, missed bill payments, forgotten birthdays, and difficulty managing strong emotions, such as anger and frustration, may all be common natural consequences of reduced executive functioning.
These problems by themselves are mostly cognitive in nature. But over time, and with repeated instances, they can wreak havoc on relationships. The reasons for this are many: they are often misunderstood and misinterpreted (by both the individual with ADHD and his/her partner) as willful or lazy behaviors; they tend to induce entrenched resentments in the partner who does not have ADHD; and they increase stress and unpredictability in couples to the extent that these relationships are destabilized. These problems, when they fester, can seem insurmountable for a couple to overcome.
The Good News
The good news about executive dysfunction is that there is plenty of help available. For ADHD it can come in a variety of formats.
Medication, often stimulants like Ritalin, Adderall, and Vyvanse, can help with distractibility and reduced focus. Cognitive behavioral therapy (CBT) and cognitive remediation methods may aid in the strengthening of organizational and planning skills, as well as the development of compensation techniques, for executive and attentional abilities that are negatively affected by ADHD. Psychoeducation and support groups often help both partners to learn that ADHD is not an excuse for character flaws nor it is a choice to be unproductive. And couples therapy can help heal the long-standing wounds, resentments, and conflicts that often develop as part of the ADHD experience.
