Dr B. Malavika Archives - Promises Healthcare
ENQUIRY
Overwhelmed At Work?: Demystifying Executive Functioning Deficits

Overwhelmed At Work?: Demystifying Executive Functioning Deficits

by | Aug 18, 2020 | ADHD, Articles, Dr B. Malavika, Mental Wellness, Psychological Testing

Written by Dr B. Malavika, Psychological & Educational Therapist

Have you met Michael recently? He’s the bright, young, dynamic person at our office… I always thought of him as the person who’s the life of the party, and he genuinely seems to care for his colleagues… Aah, yes, the same person who unfortunately missed out a promotion this year… I heard his boss say that he definitely had the potential,  but it wasn’t showing up in his work. He would initiate tasks with enthusiasm but would lose interest quickly; turned up late for meetings, or even forgot about them, and frequently misplaced important files as his table was often cluttered.

Does this seem familiar? Do you recognise similar signs in yourself or someone else you know? These issues might be due to something known as Executive functioning deficits or disorder (EFD). Though symptoms start in early childhood,  the challenges might have been seen as the individual’s behaviour problems and not as a syndrome. Even as adults, many of those with EFD aren’t aware they have it — they just know that even everyday tasks can be challenging. 

 

What is EFD?

Executive functions are the set of higher-order mental skills that allow us to analyse, plan, organise,  make suitable decisions, manage time, focus attention and execute the plan. No matter how smart or talented one is, not much will get done well without these key capabilities. The human brain comprises of two systems: the automatic and the executive.  While the automatic system guides 80 to 90% of our activities every single day, the executive system guides the remaining 10 to 20% and requires purposeful, regulatory effort.1

 

What causes EFD? 

 Experts don’t know exactly what causes this and a 2008 study found that differences in these skills are “almost entirely genetic in origin due to differences in brain chemicals” 2

People who have executive functioning deficits might have problems with many of these functions:

  • starting, organising, planning, or completing tasks on deadline.
  • multitasking
  • listening  or paying attention
  • remembering tasks or details
  • problem-solving
  • time management
  • decision making
  • controlling emotions or impulses
  • prioritising

But it is important to note that EFD is not associated with low IQ.

Almost everyone has some symptoms similar to EFD at some point in their lives but It isn’t EFD if the difficulties being faced are recent or occurred only occasionally or intermittently in the past. If you’re curious to know if you do have EFD, you could take the test given below. 

https://www.additudemag.com/executive-function-deficit-adhd-symptoms-test-for-adults/

Even if you’re not sure if EFD is indeed the cause of the problems experienced, or, if you do not want to give it a label, you could still use the tips/ strategies given below to enhance your general skills and productivity at work. 

One surprising way found to improve executive function in adults is aerobic exercise. Many research journals have published that regular aerobic exercise in older adults can boost the executive functions that typically deteriorate with age, including the ability to pay focused attention, to switch among tasks, and to hold multiple items in working memory.3

If you think that the feeling of the constant deluge at the office is largely the result of so many things clamouring for attention at once, a tool like Stephen Covey’s Quadrants can be used. Each quadrant (Q) has a different property and is designed to help prioritise tasks and responsibilities. These  are: 

  • Q 1 – Urgent and important
  • Q 2 –  Not urgent but important
  • Q 3 – Urgent but not important
  • Q 4 – Not urgent and not important

Another useful technique is the Pomodoro technique of time management developed by Francesco Cirillo in the late 1980s. It uses a timer to break down work into 25-minute intervals, separated by 5-minute breaks. This method not only helps you remove distractions and enhance focus on your task, but it also factors in time to take a short breather.  

Those who are tech-savvy can find these as smartphone apps. Other technology tools that can help are File-sharing software like Dropbox to keep notes handy,  digital sticky notes or reminders, and password manager software to keep track of passwords. Those who are not  comfortable with technology can compensate for working memory deficits by making information external — using cards, signs, symbols, sticky notes, lists, journals, clocks and timers.4

Other simple  workable strategies are: 

  •  Break large tasks into smaller individual tasks and put them into a linear order or flow chart. This helps provide clarity and allows you to monitor your progress
  • Keep a routine
  • Know yourself and get your best work done according to your own biorhythms
  • Give it a positive twist – make the activity a ‘want to do’ instead of ‘should do’.

Games can help to improve executive function skills. Games like Checkers, Monopoly, and Clue use planning, sustained attention, response inhibition, working memory and metacognition. Games like Zelda and SimCity help with problem-solving and goal-directed persistence. Managing  fantasy sports teams also use executive skills like task initiation and time management while having fun.4

Positive emotions reduce the impact of stressful events on the self and help build resilience. They make us more flexible, allowing us to be more open to options of problem-solving. Studies show that people feel and do their best when they have at least three times as many positive emotions as negative emotions.5 It is, therefore, most important that you periodically reward yourself when you have met the goals you have set.  Equally important is positive self-talk which is a powerful tool for increasing your self-confidence and strengthening your resolve to make these healthy new habits a part of your personal and working life. 

 

 When to seek help?

Diagnosis of EFD can be difficult because certain symptoms are similar to those caused by other conditions, such as ADHD, LD, depression, anxiety, mood disorders or OCD. If any of the symptoms listed above continually disrupt your life, talk to a mental health professional. There is a variety of strategies recommended by experts to help strengthen the areas of weakness that EFD creates. Treatment options could be medications and therapy such as occupational or speech therapy, Cognitive behavioural therapy (CBT).

 

References:

1 https://www.additudemag.com/working-memory-powers-executive-function/

2 https://www.understood.org/en/learning-thinking-differences/child-learning-disabilities/executive-functioning-issues/executive-functioning-issues-possible-causes

3https://www.pbs.org/wgbh/nova/article/the-science-of-smart-surprising-way-to-improve-executive-function/

4https://www.additudemag.com/executive-function-treatment/?src=embed_link

5 https://kidshealth.org/en/teens/power-positive.html

https://www.medicalnewstoday.com/articles/325402#summary

https://www.additudemag.com/executive-function-disorder-adhd-explained/?src=test

Photo by You X Ventures on Unsplash

 

 

 

 

Demystifying Play therapy: Play ought to be taken more seriously

Demystifying Play therapy: Play ought to be taken more seriously

by | Jun 26, 2020 | Articles, Children and Adolescent Services, Dr B. Malavika, Mental Wellness, Our Services

Written by: Dr B. Malavika, Psychological & Educational Therapist

Play is a critical part of a child’s development from birth. It boosts healthy brain development that is conducive for physical, cognitive, and emotional growth. It encourages imagination and creativity, and improves social skills and confidence. It is therefore not surprising that psychologists realised its power and tapped into it as an instrument of healing.

Challenges are a part of life. But in childhood, they can be harsher as children haven’t developed the capability to understand or deal with what they are going through.  In their tender minds, loss or pain could be something as small (to an adult) as a broken favourite toy and range up to a major loss in the forms of death, separation from a loved one,  hospitalization, abuse or other personal/family crises. While some children might manage to some extent by voicing their displeasure or through negative behaviours, others might just suppress their emotions. If the setbacks are beyond the coping skills of the child, the trauma can manifest as psychological or emotional disorders.

Parents often ask how they can know if their child needs counselling.  Some signs could be that the child is being more angry, nervous, defiant, sad, or withdrawn than usual, or than is reasonable. The child could also be showing changes in eating and sleeping patterns, a decrease in school grades or reduced interest in previously favoured activities. When in doubt, it is better to err on the side of caution and seek help.

Play therapy is one of the prominent forms of therapy for children and is practised by a variety of mental health professionals, like counsellors, psychotherapists, clinical psychologists, psychiatrists and social workers. It is an intervention which allows children who are experiencing emotional or behavioural issues to open up their emotions in the safe space of the ‘playroom’.  They are given toys to play with, and the children play as they wish, without feeling interrogated or threatened.  For the children themselves, play (therapy) is familiar and fun and they are thus able to work out their undesirable experiences and resolve their emotional and behavioural difficulties. What materials the child chooses to play with and how they play all have meaning.  The therapist watches their play to get an insight into their emotional or mental health problems. 

Depending on the issues faced by the child and their own training, therapists conduct non-directed or directed play therapy and provide play materials accordingly. Non directed play therapy is free-play and very similar to the free association of adult psychodynamic therapy. While in the latter adult clients are allowed to talk and ventilate to gain insight and resolve their problems, free play with limited conditions and guidelines, allows the child to express their feelings just through their play. Their verbal expression might or might not be as important.

Directed play therapy includes more structure and guidance by the therapist and several techniques are used to purposefully engage the child. These could be engaging in play with the child themselves or suggesting new topics, themes for play. Parents might or might not be included in the sessions. Materials may include art and craft materials, sand and water, clay, dolls, toys, blocks, a family of dolls, miniature figures, animals, musical instruments, puppets and books. While traditionally Play therapy is considered to be beneficial for children ages  3 to 12,  it has been modified and customised by researchers and therapists to help adolescents and adults also, and some mental health practitioners have started including video games as therapeutic tools. Apart from being used at counselling centres, play therapy is also being used at critical-incident settings, such as hospitals and domestic violence shelters to help children deal with deep issues. 

In regular lives, parents can encourage their kids to play indoors and outdoors and especially in nature. Lawrence J. Cohen has created an approach called ‘Playful Parenting’, in which parents are encouraged to connect playfully with their children through silliness, laughter, and roughhousing to enhance relationships and general well being.

Challenges are a part of life. While the purpose of therapy is to solve problems, playing for the sake of fun can prevent them. This can be applied not only for children but for the inner child in every individual to make life happier and more meaningful. As the proverb goes – All work and no play makes Jack a dull boy.

 

Photo by Caleb Woods on Unsplash