Ellie Pike:
If you've ever stared at a simple task, answering an email, folding the laundry, starting that project you've put off for weeks, and felt an unexplainable heavy resistance, you are definitely not alone and you're not broken. Today we're talking about executive functioning, the brain's management system, the behind the scenes skills that help us plan, prioritize, remember, and get things done. Because when that system glitches, even the smallest task can feel like a mountain. I'm joined in this conversation by a special guest who has a gift for translating neuroscience into real life language. Meet Dr. Leslee Marcom.
Dr. Leslee Marcom:
I'm Leslee Marcom. I'm a psychologist and I'm the regional clinical director over our south region at ERC Pathlight. I'm really excited to be here today to talk to you guys about executive functioning.
Ellie Pike:
Dr. Marcom will help us understand why executive functioning challenges show up, not just for people with ADHD, but for anyone dealing with anxiety, depression, learning differences, chronic stress, grief, or even just a bad week of sleep. Together, we unpack common myths, explore what daily life actually feels like when executive skills are lagging and talk through practical, evidence-based strategies, from tiny momentum building steps to using external tools as your brain's scaffolding. So whether you're someone who struggles to start tasks, someone who loves a good checklist, or someone supporting kids, students, or employees through these challenges, this conversation has something for you. You're listening to Mental Note Podcast. I'm Ellie Pike.
We're so happy to have you, and I have a lot of questions for you because executive functioning is a topic that I think maybe more people know about than I do, but it is really truly one that I would like to learn a lot more about. So let's go ahead and just jump in. So for all of us, can you share what executive functioning is in just simple layman's terms?
Dr. Leslee Marcom:
I like to think about our brains in terms of having an upstairs and a downstairs brain. And a lot of that comes from Daniel Siegel's work. And it's really helpful, I think, for us to think about it like that because our downstairs brain is really responsible for basic functioning that we don't have to tell ourselves to do, like blinking our eyes or taking a breath. It's also where our motion centers are stored, but we have our upstairs brain and a lot of our upstairs brain is where when I'm thinking about executive functioning, I think about the upstairs brain because executive function is like the brain's management system. It's really a set of mental skills that we use to organize, to plan, to remember things, to manage time and control our impulses.
So if you think about your brain being like a company, our executive function would really be the CEO. And the CEO is not the person who does all the work, but they're responsible for directing traffic, making sure that things get done in the right order, making sure the right people are in the right jobs. And so without a good CEO, the whole company can really feel chaotic. And without strong executive functioning, everyday life can sort of feel the same way.
Ellie Pike:
I can really appreciate thinking about it as the CEO and how much this can influence prioritization and getting things done in a day. So maybe you could help out by giving us some real life examples of how executive functioning might be at play, like at home or at school or a workplace.
Dr. Leslee Marcom:
Yeah, sure. At home, it's remembering to take out the trash. It's remembering that our trash days are Tuesday and Thursday and planning ahead to take the trash out of the trash can, put it in the trash bin outside, making sure that you put the trash in front of your house or out in the alleyway. It's those planning steps to get things done. At school, it can be really about breaking a big, huge project down into more manageable steps and not procrastinating, starting early, doing a little bit at a time so that you're not panicked at the end with an assignment that's due the next day that you haven't even thought about starting.
At the workplace, when I think about work, it's emails coming in and you look in your inbox and you have a hundred emails and you have to sift through them and decide which one takes priority, which ones should I answer first? It's managing your day and showing up to meetings on time or staying focused even when a task gets boring, but you know it has to be completed. Those are some things that I think about in terms of school, home and workplace examples.
Ellie Pike:
You said the ability to stay focused even when something gets boring. And I think that that one is really interesting, so that tells me it's easier to go towards novelty and newness and something exciting than something more boring. So for example, someone with low executive functioning skills might find that putting away a dishwasher full of dishes is way more boring, even if it's necessary than opening a new package and putting together the new XYZ for the house, like these new shelves, right?
Dr. Leslee Marcom:
Yes.
Ellie Pike:
So that is maybe a way that it might play out with lack of prioritization, but also this gravitation towards, well, novelty and newness because it's a lot more fun and also more easy and probably that gives the brain a whole lot more dopamine shots than just unloading the dishwasher.
Dr. Leslee Marcom:
Yeah, absolutely, because there's something enjoyable about it versus more mundane things that have to get done. And people that struggle with more executive function challenges, if you will, they sometimes will struggle with getting those day-to-day tasks done, partially because of what you just said. I mean, the mundane feeling about it and it not having that new feeling or that exciting feeling of a task that needs to get accomplished, but really it's an everyday life task that has to be done.
Ellie Pike:
So who struggles with executive functioning? I know on this podcast we've talked some about folks with ADHD and that is a characteristic of ADHD. Who else or how does that play out?
Dr. Leslee Marcom:
I'm actually really glad that you brought up this question because I think a lot of people do think automatically, or maybe it's just my world, I'm a psychologist, but a lot of people go towards just, "Oh yes, ADHD." That's an area where individuals struggle with executive functioning. And while it is, and it is a really well-known condition tied to executive function struggles or challenges, it's not the only one. People with anxiety or depression or brain injuries, learning differences, even people that are under times of high stress in their life can struggle with executive functioning. So honestly, anybody who's sleep-deprived or overwhelmed can really notice dips in their executive function skills, even without a diagnosis. So more than just people who are diagnosed with ADHD or struggle with ADHD can struggle with executive functioning as well.
Ellie Pike:
Another word I might add to that list is someone who's in deep grief.
Dr. Leslee Marcom:
Yes.
Ellie Pike:
Right?
Dr. Leslee Marcom:
Yes.
Ellie Pike:
Anytime I know that I've experienced that, I'm like, "My brain can't really think about a grocery list and how to put together a recipe right now because I'm just trying to figure out how to cope or survive." And that's similar in any stressful situation or even high anxiety. And so that is actually really beneficial for me to think about because while I don't struggle with ADHD and I would say I have pretty good executive functioning skills on a daily basis, there are times when I look back and I'm like, "Wait, I used to not. What was that about? " And in college when I would procrastinate on my 25-page senior seminar paper until the last day, I may or may not have really done this, why was I procrastinating until the last day on this piece? Was it because I couldn't put things in order or because I was so anxious about it and maybe not willing to accept that to slow down and break it into smaller pieces?
Dr. Leslee Marcom:
Right, exactly. And your stress was probably higher as well.
Ellie Pike:
Yeah. But I acted like, "It's fine everyone. It's fine, I'll just get it done later," right?
Dr. Leslee Marcom:
Yeah. Yeah, absolutely.
Ellie Pike:
So what are some of the most common misconceptions that people have about executive functioning?
Dr. Leslee Marcom:
I think one of the biggest misconceptions that people have is that these individuals are lazy or unmotivated, and that's just simply not true. Most people want to succeed, but their brainwiring makes things like organization, time management and follow through a bit harder for them, so it becomes more challenging.
Another misconception is that these individuals just don't care. And in reality, many of them care very deeply they're just stuck in this frustrating cycle of, "I know what I need to do, but I cannot seem to make it happen." And that cycle keeps them frustrated. And also they can get really frustrated by feeling misunderstood because of these misconceptions that are out there.
Ellie Pike:
I think about what you mentioned of someone who's dealing with depression and then now thinking about the cycle. And so I'm thinking about that person who's like, "Well, I know I need to clean my whole house." And then they're like, "But I only have 30 minutes." And then it feels overwhelming. Therefore, it's all gone to hell and I can't do it and I failed. And then it continues in this cycle. And it all depends also on that perception and the belief system. And if we were to slow it down and really work on that executive functioning piece, if I was with this individual, I might say like, "Well, what can we do for five minutes?"
Dr. Leslee Marcom:
Right, exactly.
Ellie Pike:
And yes, we have to readjust our expectations of what can actually get done, but we're not going to clean the whole house in 30 minutes, but can we do five minutes at a time and still celebrate those small steps? And so those are some of the ways that I can picture it in real life. Maybe you can also paint the picture in a little bit of some of the ways that we can build skills around this. But first, I would love to just ask what a day might look like for somebody who struggles with executive functioning skills.
Dr. Leslee Marcom:
Yeah. I mean, somebody struggling with executive functioning, it might start with them oversleeping, just them hitting the snooze button because they just weren't ready to get up and they're just delaying that. Then maybe they rush out the door and they realize that they left their laptop at home or they didn't grab a notebook that they needed. At work or at school, they might stare at a big task, but not really quite know where to begin so they procrastinate. Later they get distracted halfway through folding laundry and suddenly it's midnight, the clothes are still in the basket and tomorrow feels overwhelming already for them. So by the end of the day, they're not just tired, they're mentally exhausted, they're mentally drained. And it's not for lack of effort, it's really because every little thing takes extra mental energy for them.
Ellie Pike:
I can appreciate what you said, that it's not for lack of effort. And then it's at the end of the day still kind of draining. And in the morning when you're doing it again, it can feel really overwhelming and then it can affect relationships because it's complicated, it affects other people when someone is late or forgot the things or forgot to schedule this thing or forgot that it was scheduled and missed an appointment. There's just certain things that will have that ripple effect. And so this is where I think it'll be really beneficial for us to talk through strategies and some coping skills. And these are not necessarily one size fits all. And every individual has to find out more about themselves and what really motivates them to make those small steps towards systems or changes that might be beneficial. But what do we know in science that are practical evidence-based strategies that people could use to actually strengthen this frontal cortex, this executive functioning part of the brain?
Dr. Leslee Marcom:
Yeah. I mean, earlier when you were talking about cleaning a whole house and that can feel overwhelming, one of the best things that individuals who struggle with their executive functioning can do is break bigger tasks down into smaller, more manageable concrete steps. So instead of clean the house, for example, it becomes, "Hey, let me start in the living room. Let me pick up all the shoes and everything on the floor, or let me start in the kitchen and wipe down all the countertops." And it's just breaking down, if you think about cleaning your whole house, I mean, I have pretty stellar executive functioning if I say so myself, but I can get overwhelmed by that. So imagine somebody that has challenges with that, that's a big task. So that idea of, okay, how can we break it down? How can it be more manageable? And that makes the task less overwhelming and gives the brain quick wins where it's like, "Okay, I did that. I accomplished that."
Other evidence-based strategies that I think about might include things like checklists, practicing time blocking, having a chunk of time that you're going to maybe set a timer to accomplish or work on something. And then building routines is really important for these individuals because once a routine is built, decisions become more automatic. So think about brushing your teeth, for example, you don't debate when or how to do it, it's a habit, it's something that you do, it's a part of the routine. So the more habits that you build, the less mental energy that you waste.
Ellie Pike:
So when someone is overwhelmed, say by a long to do list or the idea of cooking a meal or a messy room, what's the very first small step they can take? Because I want to be really clear in this, sometimes when we say, let's make a small step, it still doesn't feel small. So I do want to be very sensitive with that word and it's still the only word I can think of.
Dr. Leslee Marcom:
I know. And you know what comes to mind for me is even smaller, like start tiny. If the room looks like a disaster zone, pick one category. I'm going to gather all of the dishes in this room and put them away in the dishwasher or set a timer for five minutes and commit to working only until it goes off. Usually once somebody gets started on something, that momentum will carry you forward and so the trick is really lowering the mental barrier so the first step feels more doable.
Ellie Pike:
Is executive functioning something that can really be developed in kids? Or is it something that you're just kind of given this genetic like, "Well, that's just the way your brain is." Or is it something that if you grow it and practice it as a child, you'll have stronger executive functioning when you're older?
Dr. Leslee Marcom:
I think that it's not an easy answer because I think it's a little bit of both. I mean, there's been tons of studies on the brain and different diagnoses and ADHD is one that comes to mind because of the executive functioning tie there and they do think differently and their brains are used differently. It oftentimes makes me think of kids in school and how sometimes the way that school is designed, it can be very rigid unless there's an IEP in place or a 504 plan and it's like, "No, this is the way we teach." And then you have those stellar teachers that are like, "No, I'm going to modify for these kids that learn maybe this way." Or there's pullout groups for kids to go and learn a different way. So are there strategies that individuals can start to work on and the younger that they start working on that will set them up to be adults that can function a little bit better despite the way that their brain is working and operating? Yes. But is that neurotypical brain and neurodivergent brain the same? No.
Ellie Pike:
I think that really helps. And it's really interesting that you talk about, it's like practicing skills and using different tools and different approaches. And so what are some of the tools that someone with executive functioning deficits might just find beneficial to them?
Dr. Leslee Marcom:
When I think about tools, really, those tools can act like an external brain for them. So having a planner, having a calendar that they go off of, because for me, for example, I have a pretty photographic memory. I can think about my calendar and I can sit here and visualize it and tell you exactly my kids' events tonight, tomorrow night, next week. I know we have a family dinner. Would somebody that struggles with executive functioning be able to do that? Maybe, but likely not. Likely they're going to live by their calendar. And so having that plan or having that calendar means that they don't have to rely on their memory.
Another tool could be timers. Timers can help to keep you on track, whether it's 25 minutes of work and then resting for five minutes, or just a reminder that, "Hey, I need to switch tasks now. I've been working on that task for too long. I have another priority that I need to switch over to." Timers can be really helpful in that. We're in a digital world, we're in a world that's filled with technology, there are a ton of different apps that can automate with reminders and remind you of your routine, making life a little bit more predictable.
If you think about how that could work, if you imagine a class, I was talking about school earlier, imagine a teacher who starts class every single day with the same warmup activity, students know what to expect and their brains can focus on learning instead of adjusting like, "Hey, what's this teacher doing?" Or, "What is this activity?" It just becomes a routine for them. So those types of tools, planners, calendars, timers, different apps to help people get organized, having routines written out and following them, those are the things that can really help those that struggle with executive functioning.
Ellie Pike:
One of the things that someone told me recently is there's some apps out there for executive functioning where you put in this like, "I need to clean my house and make dinner tonight, but somehow I need to also pick up my kids and take them here and then do this errand." And the app will help actually break it down into smaller steps and order it so that the individual can then not have to try to prioritize it themselves, but actually roll with that. Yeah. I like to think of myself as somebody's personal app at times where I'm like, "Do you want to talk it through?" It's fun for me to order the things.
Dr. Leslee Marcom:
Me too, I love that.
Ellie Pike:
I'm like, "Okay, this is like a puzzle." But not everyone finds the puzzle fun and that is totally okay. And so we just have to look in different corners to find the right tools. And I think it's important to recognize not every tool is going to work for everyone, right? It might take some focusing on one and then you realize, well, I forget my planner everywhere, but my phone I keep, so maybe I'll use my phone as my organizational tool.
Dr. Leslee Marcom:
Exactly. And that's really why technology ... That's a pro of that. A pro/con list that's on the pro list for these individuals because they're not going to ... I mean, they might forget their phone, but a lot of people are so tied to their phone. So having those things digitally and on their phone with apps or timers that are set up can just be so helpful.
Ellie Pike:
Which as we say that, I'm like, "Yeah, there are lots of pros, but then how easy we can get sucked into our tiny little light box of a phone." And then how important it is if we are going to use our phone as a tool for executive functioning to also minimize the noise and the distractions in other ways. So whether that's just setting ... I have my timer that tells me after 15 minutes of Instagram a day, it's like, "That's enough."
Dr. Leslee Marcom:
It's enough.
Ellie Pike:
And I have to actually listen to it for it to work. So there are challenges in that because it's also easy just to click not now. But I do want to mention that I think that that's really important.
Dr. Leslee Marcom:
I agree.
Ellie Pike:
If we're trying to minimize the noise, we have to create systems that also minimize the noise so we can stay focused.
Dr. Leslee Marcom:
Yeah, I couldn't agree more.
Ellie Pike:
So what role would you say therapy or coaching or even medication could play in with supporting executive functioning?
Dr. Leslee Marcom:
Yeah, they each play a different role. Therapy can be really helpful, and I know I'm biased, I'm a psychologist, but I do think therapy can be helpful with underlying issues such as anxiety or depression or self-esteem that often make executive functioning harder. Coaching to me is more skills focused, think about it like a personal trainer for organization and time management, which are two things that people with executive function challenges really struggle with. And then there's medication, especially for people with ADHD, it can level the playing field by helping the brain regulate attention and impulse control. And often the best results really come from combining these supports together. I mean, if somebody's going to start with one, then great, but I am a big believer that doing these things together can be really, really helpful.
Ellie Pike:
So I'm going to put myself in someone's shoes that might be struggling with executive functioning, and I would listen to this podcast and be like, "Okay, yeah, okay. Well, I'm going to start this new list." And then the list gets really detailed and then it gets overwhelming and then I might be back at square one where I'm like, "Wait, that system didn't work for me. This is still really, really hard." For some people, that might be the case. And so I'm wondering what is that tipping point or what are some ways that we can be aware that it's like, okay, maybe I'm hitting this tipping point where I might need that additional support of that coach or that medication or that therapist.
Dr. Leslee Marcom:
Yeah, that's a great question. I think that we reviewed a lot of different tools, we talked about a lot of different strategies and those are places to start. And if individuals start there and they realize, "Oh my gosh, I'm making checklists and my checklists have checklists," and then it feels like they're not able to get those wins that we were talking about, like giving their brains those wins and not able to effectively do it, then that might be time where it's like, "Hey, I need some additional support. I'm going to need somebody walking me through this," whether it's a coach or it's actual going into actual therapy and really having somebody work alongside you.
Another big indicator is when it starts to impact relationships. A lot of times people might not understand fully what it's like for these individuals and they might have expectations that are just continuing not to get met. And remember I talked about it not being for lack of effort and it might be viewed as, "Hey, I don't care." So those are times where, hey, that might be indicators that we need to seek out a little bit more support to get started, to get on track, to get the tools being effective, to making sure that all the things we talked about today are things that can actually be put into practice.
Ellie Pike:
In addition to that, our environment really matters. So we have support people on this call, teachers, family members. What are some tools or just tidbits that we hope that they could take away so that they could support their loved one who struggles in this way?
Dr. Leslee Marcom:
So environments matter. Environments make a huge difference. So at home, if there's parents on the call, parents can really work hard to support in ways by creating clear routines and visual reminders for their loved ones instead of feeling like they're constantly nagging them verbally to do things. So they can set up ways to help them stay on track by doing those things.
Teachers, as I mentioned before, they can modify how they teach. They can get them in different small groups. They can break down assignments into steps, give students different checklists that they can check off and make sure that they stay on task, or even allow extra time if that's needed.
When I think about work as well, employers can help out a lot by setting clear expectations, very direct and clear expectations. There's tons of different project management tools, tons of different ways in which they can help support them through different systems. Checking in with them regularly is really important as well. And I want to make sure that I note that it's not about lowering the standards for these individuals. It has nothing to do with level of intelligence, they are very capable individuals. It's really about building scaffolding so that people can reach those standards more effectively.
Ellie Pike:
I hope that that's the takeaway that everyone gets on this podcast, is that struggling with executive functioning has nothing to do with intelligence or ability even. And I love what you said about creating scaffolding. So thank you for hitting that point home. And if anyone is listening to this podcast, I really hope that you one, just feel more compassion for an individual who struggles in this way and can help notice those signs when you're like, "Hey, you seem a little stuck. Is there something that would be helpful to talk through? I would love to support you."
And then secondly, if you're the one struggling, I think just knowing that you're not alone and that also this says nothing about who you are as an individual or your overall passion, abilities, motivation. And that this is also just really hard and we can empathize with that piece.
So thank you so much, Leslee. You've just been such an incredible and informative guest and I look forward to more interviews with you in the future.
Dr. Leslee Marcom:
I do too. Thank you, Ellie.
Ellie Pike:
As we wrap up, I'm struck by something Dr. Marcom said, struggling with executive functioning isn't about intelligence or motivation, it's about how the brain is wired and how much support we've built around it. When we understand that, compassion becomes the starting point, not the afterthought. Today, we heard that executive functioning skills can grow and improve, especially with the right mix of structure, tools, practice, and sometimes coaching, therapy, or medication. And for supporters, parents, teachers, partners, bosses, your role isn't to lower expectations, but to create the scaffolding that helps someone reach them. If this episode made you feel seen or gave you new ways to support someone you care about, you're in good company. Executive functioning touches all of us in one season or another.
Thank you to Dr. Leslee Marcom for sharing her expertise and thank you for listening to Mental Note Podcast. Our show is brought to you by Eating Recovery Center and Pathlight Mood and Anxiety Center. If you'd like to talk to a trained therapist to see if in person or virtual treatment is right for you, please call them at 877-850-7199. If you need a free support group, check out eatingrecovery.com/support-groups and pathlightbh.com/support-groups.
Also, could you do us a quick favor? Leave a glowing review for us on iTunes, Spotify, or wherever you're listening. Don't forget to sign up for our e-newsletter and learn more about the people we interview at mentalnotepodcast.com. Doing these things really helps our show grow, and we are so grateful for your effort. Mental Note is produced and hosted by me, Ellie Pike, edited by Carrie Daniels and directed by Sam Pike. Till next time.
