Chronic catatonia? Order yourself into action

There isn’t a magic bullet to life with chronic catatonia. But over the years I’ve picked up on a number of techniques for getting myself to move more often, from turning on an audiobook to scheduling something ahead of time with a friend to prompt me into action. A number of those techniques leverage a feature of autistic catatonia: Automatic obedience.

While catatonia prevents me from initiating movements on a regular basis, it usually leaves me with the ability (and sometimes compulsion) to go along with other people.

The people around me are far too polite to actually boss me around, so this might look like being stuck in a pose until a friend walks close enough that I can follow them, or agreeing with someone in a conversation where I’m otherwise mute.

It turns out that there are ways for me to be the one giving myself orders instead. Harnessing the energy of automatic obedience can, on a good day, transform chronic catatonia from a weakness into a strength.

The techniques

Mental commands

This is the simplest and easiest method: Instead of, say, telling my foot to move in the ordinary way my brain tells my foot to move, I tell it to move via words in my head. Breaking down complex tasks into simple motions works best.

For instance, if I need to get up and go somewhere, I might be stuck catatonic next to my shoes for a long time. I might think “right hand” so I can start moving, grabbing a shoe with my right hand. There’s variety in how much detail I need to go into and for how long before I build the momentum to just move normally.

Spoken commands

An upgrade on mental commands, this technique works if speaking is possible. I find that, when talking out loud, I can order myself to do more-complex tasks than would work with just a mental command. For example, “I’m going to get my shoes on, get ready, and go outside.”

To-do list

I make a to-do list each night, unless I’m in some sort of downward spiral. Without one, I likely won’t be able to muster up any sort of focus the next morning. The day will pass by with me lying around in pajamas. But even if I don’t do everything on the list, just having one makes it easier to initiate goal-directed activity.

Habit-tracking app

I use Habitica, where I have a list of “Dailies”––a checklist of tasks to do every day. I have to be vigilant about updating how I use the app so I stay motivated and don’t get overwhelmed, but it’s been a gamechanger. When it’s working well for me, I feel wonderfully freed from the struggle to initiate every new part of every new task. I feel like an automaton launched into motion, going through a whole list of tasks I’d normally never have the executive function to do.

Scheduling activities on a calendar

Since figuring out I could do this a week and a half ago, I have learned that everyone else has been doing this their whole lives. In case you were out of the loop like I was: You can put arbitrary tasks in time blocks on the calendar in your phone. You don’t have to know the “right” time to place each task, or how long it’ll take, or whether you’ll feel like doing it at the time.

Just make reasonable guesses about, e.g., how much rest, play, and exercise you’ll need vs work, and move or adjust tasks when you have to. And those things go on your calendar too: Read a novel from 6 – 7:30. Go on a walk at 2:30. Blank hour between studying and cooking for unstructured time or to move other tasks into as needed.

Scheduling things also lets me plan and cope ahead for tasks that I know are likely to be catatonia triggers. For me, that’s mostly social stress or things that are sensory-overloading or new. I can ask people for help, schedule time to meditate or psych myself up beforehand, or use other techniques to maximize my chance of actually doing the thing.

Using a timer

Part of catatonia can involve the inability to stop a repetitive task once started. For me that means a lot of types of internet and media addiction, among other things. Using a timer to limit these never worked before I had techniques to get myself to initiate a different action afterward––I’d just ignore it. Alarms can even make me catatonic with their strident, overwhelming sound. But with careful choice of alarm and structures in place to redirect my attention, I’ve been able to build the habit of actually obeying a time limit.

Timers can also be used to prompt the start of an action I do want to do! But that’s part of the next item on this list.

Pomodoro method

If I’m catatonic, the ability to use my phone is something I lose last or recover first compared to other motions. So having a pomodoro app helps (as would using a timer). The pomodoro method is just setting a timer to work on something, followed by a timer for taking a break, then the timer for working again.

My brain seems to interpret the start of the timer as an order to get to work. I can then keep going when the time is up, but for many tasks I’ve found I’m better off not doing so. Pushing too hard for too long can lead to fatigue and make it less likely I’ll be able to do other tasks afterward––for example, chores and art instead of a YouTube binge after several hours of working.

The break times are also convenient for chores, playing with tasks, lifting weights, practicing mindfulness, and a host of other things that might not otherwise get prompted throughout the day.

Thoughts on using techniques

Using any of these techniques is a skill that you can practice or get out of practice at. I used to always think productivity techniques were an either/or––I try it and if it doesn’t work at first or stops working after a while, I just lack some intrinsic quality necessary for using it.

Now, I start small with new techniques, put effort into practicing them with consistency, and scale back how I’m trying to use them when stress or other factors start causing them to fail. I think hard about what makes them work and what makes them fail, and adjust as needed. I start this process all over again if a technique I used to use seems like the best one to try for my current situation. If I have to abandon a technique for now, I make a mental note to return to it when I can.

One frustrating truth: Some techniques can seem like a magic bullet because they greatly improve functioning for a while. But chronic catatonia is, well, chronic, and it’s likely there’ll be times when that technique doesn’t work anymore.

I wasted years of my life giving up for good when that happened. Don’t be like me. Find out why it stopped working, and fix it when you can.

In the meantime, accept your limitations. You’re stopped in your tracks anyway; better to smell the roses than keep mentally beating your inner dead horse with a stick. I’m using techniques from Acceptance & Commitment Therapy to better balance these somewhat-contrary needs to both accept limitations and limit how limited I am.

Stressing out about techniques failing, about being imperfect, about having to admit I’m actually disabled is as much a drain on quality of life as the catatonia itself.

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19 Responses

  1. I really identify with the internet and media addiction and being unable to stop those tasks. For example right now I was supposed to be in bed and asleep 2 hours ago but I though “ok I just drank a glass of water I’ll sit up and go on my laptop for a few minutes while it digests” and now I’ve been telling myself to lie down for an hour and a half…. when you say “structures in place to redirect my attention” what structures do you use? Timers have historically been of little use to me because I just turn them off, or if I make them inaccessible in some way I just ignore them. But I’m curious to try them in combination with this new strategy of adding a structure to redirect my attention.

  2. I just started using an app called Tiimo that was made with neurodivergent people in mind, and it’s honestly been helping me a lot with these things, specifically scheduling my days out. I still struggle a bit though.

  3. I have a coping method for when I get stuck. It’s about building momentum towards the action I need to do, focusing first on imagining the action, then “downloading” the action (like programming your body to do that action when it’s ready? It’s an advance order. I order you to move, but not right now, I just know that you’re going to move in this way soon), then doing the action. These are my pushes forwards, and I do them many times each, but between each push I add a pull: saying “oh, actually, I’m not going to do that” (to get your mind to relax and stop thinking that you’re fighting it), then pushing again (“hah! No! I am going to do it”). The pulls are the most important part! I think of the momentum building as like being on a swing. You can’t suddenly levitate towards the highest position the swing can go to. Instead, to work up to that, you need some little backwards movements and little forwards movements that grow into bigger movements until you’re where you need to be.

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  12. To improve my chances of actually doing the thing, I can get help from other people, plan time to relax or get excited beforehand, or use other strategies.

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