Tuesday, April 1, 2014

More on executive function...

Decision making, To do what with which and when, to plan, organize, execute, be flexible for contingencies... all these areas are difficult for me.  Think of it as "ADHD on steroids. I hold a lot of "fact bites" but still have significant cognitive impairments in other areas.  Basically, I am capable of great things, but frankly I need prompting and supervision and support for that to happen.

The amount of thought and information swimming around in my brain (unfiltered) would astound most people.  I live inside the free associative, intuitive, emotional way of things, to an extreme.  Simply having a human touchstone, someone to redirect me, keeps me more grounded in the here and now without all that window dressing...the human touch can be magic. The subconscious dialogue that most people are unaware of, that comes as images, and feelings; the stuff of dreams...going on during every waking moment that I am not sitting in meditation...quite maddening really. 

These are not hallucinations, but the imagination unfettered...

All of this while "at the same time, on the other side of the room" (so it seems to me) navigate the world of people and things and "solids" and "facts" etc...

Think of the ADD kid mind wandering out the window

now multiply that to the 24th power and this comes close to a glimpse of a moment in between my ears...

ADHD, so called, is not actually an attentional  disorder.  If one is diagnosed with it or knows someone who is it's observed that ADD folk can hyperfocus if they show interest in the topic.  So it isn't whether or not the individual can "pay attention", at issue is whether or nor one can regulate attention, moving it as needed, keeping it long enough on a specific task as needed, etc...at will, and consistently...  This is the area of executive function.

Take for example, the common experience of "walking downstairs to get something, but you've forgotten what it was you were going to get, you go back up stairs and you remember..." but imagine this occurring dozens, even hundreds of times in a day.   I can read a book, learn a subject well, but to put it into "practice" is an entirely different matter...to translate it into real world experience, to generalize over, as it were, into the real world, doesn't quite work with me as it does with the average bear.

At age 51, I was clearly unaware this was happening, until the age of 45 or thereabouts when I discovered I was born with ACC.  That having been said, there is no "treatment" for this, it is a cognitive dysfunction that is part of my neurology...acceptance of it, personally, has gone farther to "heal me" than would any "cure" ever concocted by humankind.  The only other alternative is to hate and despise God's creation, and how can I possibly do that?

Executive function is also all about  execution and regulation...

When I "plan" something, for me it always remains general, I have difficulty "putting myself in the plan."  If contingencies occur, unexpected events, they simply derail my course and direction, my forgetting where it was I was going to begin with.

Planning for me, when something has more than three variables, is a dubious affair.  If I am engaged with, or prompted by an other person I don't usually have as much of a problem, but left to myself I have trouble initiating even well planned activities, unless they have been broken down into the smallest parts and only those parts are presented to me.

It is strange, I have a brain, filled with facts, but in real life for me, less is more.  I thrive under structure...I thrive when none too many options are put before me.  Ask me "door #1, door #2, or door #3?" I can intellectually make a choice but the variables are so many that I am forced not to (or so it seems to me.)  Apparently part of my cognitive problems is the learning of new behaviors (generally.)  Such has to be reinforced and rehearsed countless times for me to finally adapt the behavior. There is also no guarantee that I'll be able to consistently repeat the behavior over a long period of time, having to start all over again.  I know that "average" people don't experience anything like this.  Just imagine how frustrating it is then.., for me.

A friend commented recently on "how well I compensated" given my disability.  I do not disregard her words in the kindness they were meant, but there is another level to this as well.  People only think I compensate well, because you see the outside of it, you are not living through my eyes, walking in my shoes.  The old notion of a "blind person get's super hearing to cope with being blind", is none-sense.  Now I have known legally blind individuals some having excellent hearing, another deaf as a rock....point being, we tell these stories to feel better about ourselves, but they are not (generally, only specifically) true.

Certainly the turning point for me was late in 2008 when I discovered I was born with ACC, I was like the cartoon character with the light bulb gone off over his head.  It was the singular missing piece (there are still other pieces not in place) that when recovered caused all of my history to make sense.

Knowledge is power.

~j

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