Initiation: Strategies to get started
My parents helped me out a lot after my brain injury. I ended up moving back home a few months after my fall. I needed help getting to appointments and making medical decision. But, I also needed help doing everyday things.
Just thinking about cleaning the bathroom made me anxious and overwhelmed. I couldn’t get started. My mom helped me in the beginning. Eventually she had to make color-coded index cards telling me what to clean and which products to use so I could do it on my own.
I didn’t need index cards to relearn how to pay my bills. But, my motivation system was broken. I would sit on my bed with the bill in hand and just not pay it. This happened 4-5 times with each bill. I finally paid it just before or after the deadline.
Executive Functions
Stories like these are common after brain injury. People have a hard time setting goals, sequencing the steps to accomplish their goals, staying focused, and completing each task until the goal’s been met. These skills fall under executive functions. Executive functions are the mental processes that help us each our goals.
The past few posts have been about list making. Lists help you remember what you want to do. But, they don’t guarantee that you will get the tasks done. One major barrier after a concussion is task initiation
Roughly 75% of my patients tell me they have a hard time initiating tasks. I understand the feeling because it was a big problem for me, too. Sometimes people can’t initiate tasks because they don’t know where to start. Sometimes the motivation system is down.
A neuropsychologist and/or speech-language pathologist can help you figure out what’s causing your initiation problem. In the meantime, keep reading for strategies to help you get started.
Initiation Strategies
In my experience, there are five main problems that keep people from starting their tasks.
Poor planning
You might feel overwhelmed by how many things you have to do. Or, you have a vague idea that you should get something done, but no plan to actually get that done. Planning strategies help you know what to do and when to do it.
Make a master task list.
Prioritize your list.
Commit to a plan. Decide what you will do, and when/where you’ll do it.
Confusion
Slowed processing speed and memory problems change your ability to figure out how to do something. You might be confused about what you need to do and how to do it.
Understand the task and any supplies you need before you start.
Break the tasks into smaller parts.
Distractibility
Distractibility derails the best intentions.
Work at a time of day when you have the most energy.
Work in an environment that’s helped you be productive in the past.
Set reminders and timers to keep you on track.
Take breaks.
Stress
Avoidance is a big reason why people don’t start tasks. You might feel too stressed to start something else. Or, you might feel a general sense of stress about the task itself.
Learn to identify specific sources of stress.
Use strategies to decrease stress.
Have a Plan B ready to go.
Do a little every day. For example, do a little laundry every day.
Don’t have an all or nothing attitude.
I used to have an all or nothing attitude. I wanted to do something perfectly, how I wanted, or not at all. Mindset holds you back during chronic illness. If you can’t show up 100%, can you show up 20% and keep moving forward?
Poor motivation
After brain injury, the brain center actually in charge of motivation can get damaged. Changes in energy levels and emotions, stress, pain, etc. also impact your motivation.
Don’t wait to feel motivated. Brain injury can really affect your mood. Try to stick to your plan even if you don’t feel like it.
Take care of your health. Good sleep, healthy eating, socializing as you can, etc. improve your mood.
Get accountability.
Invite someone to work alongside you.
Attach difficult tasks to something that you’re already doing.
“Objects in motion stay in motion”
Schedule a Power Hour.
Visualize yourself completing the task.
Take the next step towards doing the task (e.g., open the computer, get up, etc.)
Additional Resources:
Initiation Strategies for Kids
Self-Regulation and Task Initiation for Kids
Initiation Templates for Students