What To Do When You Can’t Seem To Get Started

A few years ago, I was humbly asked to be the officiant for my brother’s wedding.  Being asked to take on such an important role in a family member’s big day was a huge honor and I wanted to make sure I did the role justice.  So naturally, I added this task to my to do list and set on writing it in parts so as not to be overwhelmed with a large task in a short amount of time.  Spoiler alert: I went weeks (ok months) without doing a blessed thing even though I had intended to take it on bit by bit.  I still got it done (and quite well I think!) but the process was a little more stressful than it needed to be.

I’m sure we all have a story like this.  There’s something important in our lives, and we intend to work on it in a reasonable timeframe, and yet we don’t.  While this pattern can be very common for many, those with ADHD seem to find themselves in these positions more often than they would like.  There are several reasons why problems with task initiation develop and in my executive skills coaching sessions, I often spend time working with my patients to uncover what might be getting in the way.  The following are some of the approaches I tend to offer as options for those who just can’t seem to get started.

Thoughts – Feelings – Behaviors

Before getting into strategies, it may be important to highlight how the cognitive model helps us understand the process that leads us to avoidance.  An example I use often is of two people waiting at a movie theater for a friend who is arriving late.  Person A in response to their friend’s absence may begin to think “something terrible must have happened to them,” and start to feel very nervous.  This nervousness then leads them to quickly call their friend in an attempt to reassure themselves that the friend is, in fact, OK.

Person B’s response is different in that they may think “that’s strange, let me go inside and give them a few more minutes.”  Person B might feel somewhat concerned, but not excessively.  They also do not feel the urge to contact their friend when they don’t have to.

This example demonstrates how our feelings and behaviors are not necessarily the product of situations, as much as they are products of our perceptions of those situations.  Person A and Person B were in the same exact position, though because they drew different conclusions about the situations they were in, they felt (anxious vs. mild concern) and acted (panicked phone call v no action) differently in response.

How might this be relevant to problems with task initiation?  Say you’re walking by your kitchen, and you glance at the dirty countertops and unwashed pans and dishes in the sink.  You could think to yourself “ugh, I don’t want to spend all evening cleaning this up, that would be horrible!”  This kind of thinking may lead a person to feel discouraged, frustrated or hopeless.  In response to these uncomfortable feelings, the simplest response may be to avoid cleaning the kitchen.   Avoiding the task means less distress in the moment, even if it’s a self-defeating strategy in the long-term.

Forming To Do’s When You Don’t Know What To Do

One of the first skills I review with patients in executive skills training is the formation and strategies to maintain a functional to-do list.  The suggestion of forming a to-do list may seem like a predictable first step, but one that might easily be overlooked.

Let’s go back to our dirty kitchen example.  Our initial reaction to seeing the pots, pans and countertops that need cleaning could be “oh, this is going to take forever and I’m too tired,” leading to feelings of dread.  A more rational response to this initial thought could be the forming of a brief to do list.  Listing out the steps needed to complete a larger, complex, multi-part task has the possibility of making each step seem a little more manageable.  If these steps seem more manageable, then it is less likely we have feelings of dread that will lead to avoidance.  It’s a nice and relatively simple first step to counter the initial and sometimes exaggerated conclusions we might be drawing about a task.

Again, while this might seem like a simplistic solution, I usually caution folks against quickly dismissing it and trying it out on their own first.  I like to use this streaming analogy to help make my case: How would you feel if I asked you to sit down and watch a 10 hour movie?  Would you feel different if I asked you to sit down to a couple 60 minute episodes of a 10 show series?  If the latter option feels a little more manageable to you, maybe taking a moment to form a to-do list might have some benefits!

When the To Do’s Still Seem Too Big

A common response I hear from my patients is that they will have items sitting on their to-do list for days, weeks or months.  They stare at these items, knowing they’re important to some degree, but still can’t seem to get them started.  One of the first strategies I work on is making sure that these items on the to-do list are broken down sufficiently.

A good rule of thumb I recommend is that “if it seems easy enough, it’s broken down enough.”  Usually, a reflexively negative reaction to a to-do list item can be a good indication that the to do list item is too vague, too complex, or too ambitious.

For example, it may be your turn to make dinner for the family, and so you jot “make dinner” down on your list to ensure you remember to do it.  However, “making dinner” can involve many steps.  Have you decided what you will make?  Do you have all of the necessary ingredients for dinner?  What prep might make the process go more smoothly?  In what order should these tasks be completed?  Answering these questions can help you come up with sub-tasks that when viewed on their own merits seem more achievable than the larger process does.  “Identifying 1-2 recipes to make” often seems more reasonable than just “making dinner.”

Catching Unhelpful Thoughts

Returning to the concept of how our perceptions contribute to the way we act and feel, another strategy I often use encourages patients to try and identify the thoughts/predictions/characterizations that are contributing to their avoidance of a task.  It’s possible that these thoughts are either inaccurate or unhelpful and contributing to some measure of distress and fueling avoidance.

A good sign that monitoring these thoughts could be helpful is any time you notice yourself avoiding a task.  This might be a good time to ask yourself “what do I believe will happen if I start this task?”  Might you believe that the task will take too long?  Might you believe you don’t have the skills or knowledge to be able to complete the task?  Might you fear you won’t do a good job?  Might you believe that it will be hard to coordinate with others to get the task done?  These are common conclusions that could stand in the way of initiating a task.

The next step would then to gauge how accurate these conclusions or predictions might be.  I like to encourage patients to ask themselves a scaling question such as: “On a scale of 0-100, with 100 being this prediction is COMPLETELY TRUE and there is NO OTHER WAY to look at the situation and 0 being there’s absolutely NO TRUTH to this prediction at all, how accurate do you believe this prediction to be?”  If the answer is anything less than 100% true, why?  What are some of the reasons that your prediction is less likely?  What are some of the other ways that this task could play out?  Walking yourself through these questions can help you catch yourself in an unhelpful and inaccurate line of thinking and develop a more rational response that leads to less distress and more action.

Conclusion

These are some common strategies I often use in executive skills training to help individuals overcome problems with task initiation.  They demonstrate the many ways that problems with task initiation occur.  They are sometimes due to an ambiguous sense of the task, in which case specifically breaking the task down into its more reasonable and achievable goals can be helpful.  They are sometimes due to inaccurate perceptions about the task, in which case training in thought monitoring and cognitive restructuring (or changing the way you think) could be helpful.  Executive skills training can help develop a personalized plan to help you improve your coping skills and increase your confidence in your ability to approach your problems.