Long story short- my sister has OCD, and one result of this is that it's very hard for her to do anything. Like, for example, get out of bed or leave for work on time or make decisions about where to go for lunch. This makes life more difficult for her (who suffers from it and is shamed for it), my parents (who have to ensure she can still function in society), and me (who worries about her and is left on the sidelines dealing with secondhand stress). I believe this is referred to as executive dysfunction. I don't have this problem unless I'm having a particularly bad day, so I can't relate well. How do I help her deal with this problem?
Sounds like executive dysfunction to me. And it's tricky cuz different things work for different people. For me, I compromise in my own mind. Like if I want to shower, but my brain says "no it's too hard", I'll say "Okay but what if bf cooks dinner can we shower then?" And my brain is like "yeah okay that works" I think my bf just bashes his head against the metaforical wall until he can do the thing, which sounds exhausting but it seems to work for him. So I would say try a couple things with her and see what works, let her know you can help as much as you can when she needs it. Being supportive and loving is also really helpful even if you can't be there all the time.
I want to be helpful, we all do, but we all have limits. I want to somehow help her get to the point where she doesn't have this problem anymore.
Not regularly, and she doesn't really want to talk to her about any of the problems she has. For example, her therapist has talked to her about getting cognitive behavior therapy but my sister refuses because... reasons. (Not sure which reasons)
would she be open to maybe trying to go to a different therapist? it sounds like she and the current one dont click well together
I'm not sure that not having executive dysfunction issues anymore is a reasonable goal. I would aim for making it manageable for her and your family. If she isn't willing/able to talk to a shrink about it maybe you can help her find solutions for individual problems? Like if she has trouble being on time for stuff set alarms and reminders? But keep in mind if she is unwilling/unable to work on it there isn't much you can do until she is in a place she can work on it.
Nope - executive dysfunction is not a matter of being reminded to do something, it's a matter of working through the steps to actually do it. Get up and take a shower is a big thing - too many parts. You sit up on the bed and think of all the things needed to get through the process and your brain says "nope, not right now, thanks." You lie back down 'for a few minutes'. Breaking each thing into little pieces can help. Morning routine: Get up out of bed. No, nothing else required, just get out of bed. Sit on the side and look around. Get bearings. Do not think about if you're going to shower or not, just be content that you have got up. At that point a note to say "put on dressing gown" might be helpful, or a person tell you that if reading notes when you first wake up is hard. Once that is done a pointer of some sort to showering - with step by step instructions. Anyway, that is how it generally works. A series of small steps rather than a task.
Okay, that we can't do. If she has to do something, it's usually time-sensitive, like going to work or taking medication or running an errand. There are exceptions, but mom and dad usually aren't okay with them being exceptions, and want those done now anyway.
Why is breaking things down into steps something you "can´t do"? If you know she has executive function problems, and your parents know, why can´t they plan for her needing a bit more time for these things? This is not a complete solution, because to be blunt there isn´t one. Executive dysfunction is one of those things you need to treat the underlying problem to treat, and that takes time.
I was actually thinking like setting multiple alarms. One for a warning like you have an hour before thing, then like you have 30 minutes, you have 15 minutes. Less a ok time to do the thing, but as a time marker? Cuz I find I can do the thing more with warnings. But if you have tried something like that and it didn't work then you can ignore this.
@Codeless I meant we can't let her skip steps or save them for later, not "we can't break tasks down into steps."
Well breaking things down is a start. However, not letting people skip things or do it later will just increase the pressure and may make the execitve dysfunction worse. Pressuring the person in general tends to make it worse ime.
You can't go to work "later." Some things can be done later. I'll try talking to mom about this, but honestly I don't know if it will work.
"Going to work" is a monumental task with dozen of different steps. That one case Is time sensitive, but that is where skipping steps comes in. For example, one can shower in the evenings, thereby removing on task of many small steps from the morning routine. You could help her have as many things done the day before, have it so breakfast is something that can just be eaten for example, and clothes picked out the day before. THEN: Stuff like showering and picking out clothes and pre-prepping breakfast are things that can happen later if need be. It takes a lot of the pressure off and means going to work, which is time sensitive, is now a much smaller task.
Like for an example, I have some executive dysfunction issues, I deal with these by taking approximately three to four hours to get ready in the mornings, because time crunches make everythign much worse and I have a weak stomach and blood pressure issues, as well as meds to take in the mornings, so I need the time to manage meds+coffee, then breakfast, picking out an outfit, then showering, getting dressed, dealing with my hair, putting on my makeup, packing my stuff together... it's a lot of steps and i'm lucky that I can take the time in themornings and still have a decently reasonable wakeup time because my classes right now are in the afternoon. If I had them earlier I'd have to do some stuff in the evenings or eat ready made stuff for breakfast. When you split the routine into distinct seperate tasks you can figure out which actually have to be done in the mornings, and which order is easiest to manage.
