Brain health · Sanctum

Getting started and following through

You can see exactly what needs doing. You know the steps, you mean to do it, and still the distance between intending and starting feels impossible to cross, often until it becomes a crisis and the pressure does it for you.

This is executive function, the brain’s system for starting, planning, organising and seeing things through. When it runs differently, knowing what to do and being able to begin are two separate things, and willpower does not bridge them. It is not laziness. The engine that turns intention into action is the part that struggles.

Because the intelligence and the good intentions are obviously there, the not-doing gets read as a character flaw, by everyone including you. So people try harder, feel worse, and never find out that the difficulty is mechanical, not moral.

We look at where the breakdown actually happens, between knowing and doing, because that is where the real difficulty sits. None of this is a diagnosis. It is what we explore with you.

Written by Dr Asad RaffiConsultant Psychiatrist · Founder & Medical Director