Calm down with sensory integration exercises

Here's a tip that might help you manage things like strong emotions, ruminations, and overstimulation. I think it can help a bit with concentration as well.

I think "sensory integration exercise" is the technical term for this, but autism resources often call this stimming, especially when the action is a repetitive motor movement. It's also got a lot of overlap with one of the numerous things pop psychology refers to as "mindfulness." A deliberate plan for regular exercises daily is called a sensory diet in resources about sensory processing disorder.

What are sensory integration exercises, and why do they help?

Stimulating one's own nerves is something pretty much everyone does for comfort. To some degree, it's one of those "everyone does it but no one talks about it" things, but some of us benefit from a wider variety of exercises done with a deliberate plan.

If you do an image search for "stressed," you get pictures of people doing things like

• Rubbing their head or face.
• Squeezing their head between their hands.
• Squeezing the bridge of their nose.
• Pressing their head against something (or banging their head against something, but those are usually jokes)
• Pulling their own hair
• Screaming or yelling
• Biting something
• Eating, or other references to food, hot coffee, and hot tea

A lot of the actions can be broadly described as "applying pressure to one's head."

Those actions are kind of "iconic" for stress. They're associated with stress because many people are inclined to do things like that when they feel stressed. Why?

Most of the stuff that's commonly considered legitimate "relaxation techniques" also involve self-stimulation: deep breaths and concentrating on the breath feeling, stretching/yoga, systematic tensing and releasing muscles, listening to music.

Those of us with sensory issues or other neuro-atypicalities end up doing more of this and/or uncommon actions, which is why stimming is considered weird when we do it, even though typical people do it too.

I think when people do self-injury, it's because of the same instinct, but they are so distressed that normal stimulation is not enough.

How do we do it?

It's hard to figure out the exact mechanics of how stimulation-vs-overstimulation works (and it probably varies a little from person to person) but I think the key point of helpful stimulation is that it's predictable and that you are in control. Repetition isn't strictly required, but it often helps make things predictable and easy to do.

Here are all the activities I can think up. (Sorry, some of the actions are redundant from my post on sensory issues, but I wanted the whole list in one place.) Don't consider these your only options; the potential list of actions is pretty much infinite.

List of sensory exercise ideas!

Breathing exercises: Breathe deeply enough that you feel some pressure (stretching?) in your torso. Counting is optional; I feel like it just distracts from the helpful part.

Listen to music. In order for this to help, it may need to be recorded music that you've heard many times before. (Avoid live music, unfamiliar music, or unfamiliar covers of familiar songs, etc.)

• In situations where you need to concentrate on reading, writing, or any other task involving words, you may find it better to use music without lyrics or lyrics in a language you don't know. Be careful of instrumental versions of songs that normally have lyrics, because it might make you imagine the lyrics in your head.
• Soft or slow music is widely considered more relaxing, but my preferred music is very upbeat and percussion-heavy, and preferably fairly loud. I don't think the type of music is very important. Familiarity is what matters. Just try to find something you like enough that you don't dislike hearing it over and over and over.

Draw or color:

• Color in a coloring book
• Just doodle randomly (Example activity: Spend a couple seconds making large curving scribbles on a paper, then fill in the resulting shapes with different colors or different geometric patterns. Or even just shade them all uniformly with your pencil.)
• Drawing an actual picture could be good, but only if it isn't too much work.

Look at fire (candle, fireplace, etc)

Look at some relaxing animations such as these.

Take a bath or shower. I feel like it's more effective for this purpose if it's slightly hotter than you would normally consider ideal.

Massage yourself, such as by rubbing your arms or wedging a tennis ball between your back and the wall.

Pushing on things to feel pressure in your arm joints or torso muscles:

• Do some basic exercises such as kickboxing actions or push-ups. (If you can't do normal push-ups, you can put your hands on a wall or chair so it takes less strength.) Some exercise machines can be good, but watch out that they don't make a weird noise or something that gives you bad stimulation.
• Press your hands together as hard as possible in front of your chest (prayer pose) for several seconds. I like this one because it's available in a lot of situations.
• Press your hands as hard as possible against opposite sides of a door frame.
• While driving, push against the steering wheel, so you are squishing yourself against the seat. Only available when you aren't actually turning.
• In the car but not driving (should be okay at red lights), push your hands against the ceiling.

Eating and drinking can work, but it can easily lead to unhealthy results, so be careful about it.

Chew gum.

Stretching, such as you would normally do before exercising. There's a few arm/shoulder stretches that you can casually do in most social or work situations without getting too many weird looks.

Sing or hum. Even humming the same note continuously. The key is the vibration in your throat.

Touch something that's pleasant or interesting to touch, such as petting a furry animal, squeezing a squishy toy, etc.

Repetitive motor movements or similar fidgeting.

• Hand flapping (example). If it makes your wrist hurt, keep your wrist stiff or partially stiff and do all the movement in your elbows (and/or shoulders).
• Bounce your knee. When I do this, I'm flexing my ankle.
• Rock back and forth. Often socially unacceptable... unless you are in a rocking chair!

Use an object specifically designed for fidgeting such as a fidget spinner, fidget cube, stress ball, worry stone, or worry beads. There seem to be all sorts of things in the category of "sensory toy" these days! Some objects are designed to be chewed. Some businesses, like Stimtastic, are based around selling stuff just like this, but you can also find things in conventional stores. In some cases you can also use objects that weren't intended for fidgeting. (A classic example is clicking a pen repeatedly.)

In extreme cases, pain might make you feel better, so you can try things like squeezing an ice cube. Another tactic is to put a rubber band on your wrist and pull on it so it snaps against your skin.

If you're feeling unintended physical pain, sometimes it's helpful to press or rub the sore spot. (For me, this tends to make it hurt worse, but somehow it still feels better than not doing it!) Of course, be careful you don't make your injury worse.

Example situations

When I wake up in the morning, I'm groggy and cranky and can't think straight. There is a sense of urgency because I need to be at work soon. I'm looking at my collection of pill bottles on the kitchen counter, wondering, "Guhhh, which ones am I supposed to take again?" Hand-flapping helps me get on track.

When I'm at my desk at work, trying to concentrate on my job, I find leg-bouncing helpful.

When I'm trying to push through initiation impairment and get something done, I find it helpful to listen to a few pieces of music on repeat.

I used coloring books a lot during my last depressive episode.

When I'm overstimulated or when I'm sad or stressed because of something bad happening, but I'm in a public place and can't be too weird, I tend to use deep breaths or push my hands together in front of my chest.

When I'm jittery (due to medication side effects or something I ate), I go for things like wall-pushups, shoulder stretches, pushing on a doorframe, etc. Somehow shoulder joints are the key here.

I tend to feel compelled to chew the inside of my mouth when I'm driving home from work. (Maybe because I can't use hand-flapping or leg-bouncing in that situation?) To avoid shredding the inside of my mouth too badly, I've started a habit of chewing gum instead.

If you're ruminating on something unhappy and want to stop, rather than trying to stop the thoughts directly, I think it's helpful to soothe the bad emotions with any kind of relaxation exercise, even something that has nothing to do with what you're upset about. The bad thoughts come from the bad emotions.

Often you might feel the urge to do a sensory action that is unhealthy or socially inappropriate. You may be able to resist such actions by substituting another action. Unfortunately, it seems like nothing is ever as satisfying as whatever you felt an urge for, which is why I eat so much junk food and drink so many carbonated beverages. Still, the second-best action is better than nothing.

I'd like to give you more research-based info on this, but unfortunately, there's not a lot. Sensory exercises get the most attention from SPD resources, but SPD is an unappreciated condition. A bunch of the info that's out there uses a bunch of different terminology. Some topics cover things with a lot of overlap but don't match up exactly (e.g. "mindfulness" often involves sensory things like breathing exercises and coloring books, but it excludes a lot of potential exercises, and sometimes includes spiritual or cognitive elements). So you may have to do a bit of experimenting.

Hope this helps.

Weird Biases, Jury Psychology

I recommend the blog of Keen Trial Consulting for anyone interested in psychology (or interpersonal self-improvement). It might seem weird to recommend a trial consulting web site for psychology info, but it turns out that "jury research" is a big complex field that involves doing a bunch of psychology research to predict things like what kind of biases jurors have and how they can be made more fair.

The blog has a lot of insights learned during through the company's own work, plus a lot links and summaries of other psychology research. It provides citations so you can read about the info in depth, but it tends to summarize info in a way that lets lazy folks like me learn a lot of new stuff.

Some of the info on the kind of biases people tend to have--and the results those biases can have in some unlucky person's life--can be pretty depressing. However, we all have those kinds of biases, and learning about them will help us overcome them, or at least compensate for them. Or to use a quote from the site...

We are all subject to bias– until we pay attention to it. Merely by being conscious of its potential, it can become a much smaller problem.

Teaching

Society has all kinds of weird ideas about how Bad Thing X is absolutely necessary for teaching children Good Thing Y. If they aren't subjected to X, they won't learn Y, and then they will be miserable and dysfunctional as adults!

Here's an extreme example that I've actually heard people advocate for on multiple occasions.

Kids need to learn not to steal from pet food dishes. In order to teach them this super-important lesson, toddlers should be placed in situations where they are tempted to steal pet food, then punished or otherwise dissuaded when they attempt to do so. This is very, very dangerous--since dogs are often extremely protective of their food and don't necessarily see the child as someone who is "allowed" to take their food, even nice well-behaved dogs may attack a child in this situation--but it's necessary!

No. That's stupid. It's not necessary. It's needlessly dangerous. Think of all the people who never had pets as children or who never wanted to take pet food, yet how many adults do you see going around stealing from pet food dishes? They were able to figure it out without this lesson.

ADHD brain cascade

Today, I had to go to my mom's house after work to pick up an important piece of mail. I was worried I'd forget, so I put a note for myself on my car visor. However, it was dark when I got in my car, so I didn't see the note and was not reminded!

However, as I started up the car, I was thinking about my workday, and my brain went down this path:

• I'm quite dissatisfied with my performance at work today.
• Lately my ADHD symptoms have been worse than normal. (Note: It seems some of the food I've been eating interferes with the effectiveness of my medication.) Although there was some improvement today, it was still very difficult.
• Today's improvement supports my hypothesis about which food is giving me trouble, because I haven't eaten it since Saturday.
• Good thing I've stopped eating that. (Alas, it was tasty.)
• I'll have to eat something else. I don't currently have any of the problem food in the house anyway.
• That reminds me, I don't have much other food either. I have to go grocery shopping.
• Speaking of the grocery store, I've been parking my car in the grocery store parking lot every night for the last week.
• The reason for that is because the management of my apartment complex threatened to have my car towed from the apartment parking lot. I have to park elsewhere to prevent that from happening.
• The reason they threatened to tow my car was because I didn't have the current registration displayed on my license plate. (I've already renewed my registration so it's legal for me to drive but apparently it's against "community rules" to not have the stupid sticker on there!)
• I need to obtain that sticker ASAP. My address with the Motor Vehicle Division is my mom's house, so it'll be mailed there.
• Oh, yeah! I was supposed to go to my mom's house tonight!

It seems really time-consuming when expressed as words, but that train of thought all happened in the space of about one second.

Thankfully my ADHD sometimes solves itself. If only it could do that more often.

Initiation, Motivation, Procrastination

I always have this weird urge to not do things.

That's the best way I've found to refer to it; it's kind of a hard problem to describe. It doesn't feel like a particular emotion at first, but when the mysterious urge to not do a task starts to conflict with my motivation for doing the task, that situation will make me feel bad. The result is that I feel sad, stressed, anxious, and/or frustrated when faced with almost any kind of task or obligation.

Obviously, everyone is reluctant to do things they don't want to do; that's the whole idea behind reluctance. So at first I thought I was just being wimpy when faced with unpleasantness. But a while back, I realized that my emotions in these situations are completely inappropriate for the actual level of unpleasantness.

After some digging, I finally found that this problem is called initiation impairment, or sometimes initiation deficit.

What is it?

It's a form of executive dysfunction. Or to put it another way, it's a secret ADHD symptom.

As background info, executive functioning is the cognitive functions that control your behavior and decisions. Different researchers/psychologists/neurologists will give different executive function categories, but it's generally stuff like...

• Attention control.
• Inhibition (impulse control).
• Working memory.
• Planning and organizing.
• Cognitive flexibility.
• Initiation of actions.

This weird urge to not do things is what seems to be what happens when you have impairment of the "initiation of actions" aspect of executive functioning.

Researchers like Russell Barkley have started to understand ADHD as impairments with executive functioning, but the diagnostic criteria of ADHD only really cover impairments attention control and inhibition. A lot--most? all?--people with ADHD have impairments with multiple areas of executive functioning. (Fortunately, most of us don't have severe impairments in ALL areas of executive functioning. The different problems tend to compound upon each other, so someone with all the problems would be in big trouble.) For people who have executive dysfunction other than attention and inhibition, it's quite possible that they can't be diagnosed with ADHD, even if it seems likely to have the same neurodevelopmental causes as ADHD.

Besides ADHD or similar neurodevelopmental causes, this problem also occurs in people who have executive dysfunction from traumatic brain injury (TBI) or age-related brain trouble. Alas, resources on TBI are pretty much the only places you'll see any acknowledgement of initiation impairment.

Example Situations

Here's the example that finally clued me in that I have a real cognitive issue: giving my pets medicine. I had rats, and they are really prone to respiratory infections, so I had to give them antibiotics and probiotics quite often. Both of these medicines were INCREDIBLY DELICIOUS according to the rats. They really liked taking the medicine, and it was really cute watching drink it from the syringe. The whole process of measuring, administering, and cleaning up probably usually took less than two minutes, twice per day, and was super-easy. But I HATED having to do it.

I was able to force myself to do it because my rats' lives depended on it, but why did I even have to force myself? Why wasn't it easy to get myself to do it?

To clarify this example: There was no physical pain or sensory problems during this task. It was not complex or mentally tiring. I didn't have to worry about my rats trying to escape their cage or anything inconvenient like that. They didn't have the kind of symptoms that made me sad to be around them. The medicine made them happy.

So it shouldn't have been so hard!

That was a trivial example, but it made me realize I'm like that with pretty much everything. It's pretty hard to make myself do anything unless I'm faced with short-term dire consequences. Taking out the trash, mailing my tax forms, changing the oil in my car, putting gas in my car, working toward my hopes and dreams in any way, calling my mom periodically, charging my cell phone. I do have some issues that make many tasks more difficult for me than they are for most people, but even if you disregard "most people" and look at how unpleasant a particular task is specifically for me, my emotional state still doesn't make sense. But just because I know my emotion isn't justified doesn't keep me from feeling it.

In another post, I linked to the Hyperbole and a Half post, This is Why I'll Never Be An Adult, which makes me feel less alone. I figured a problem like this might be why the author has relatively limited "capacity for responsibility," but the post focuses more on the results that happen if you try to fix the problem through sheer force of will. (Spoiler alert: It doesn't work.)

Since then, I was able to read her book, and sure enough, there's a chapter called "Motivation" where she describes this exact thing. I wish I could give a link to the book itself (here's the next best thing: an Amazon link), but instead I'll just copy the first couple paragraphs.

One of the most terrifying things that has ever happened to me was watching myself decide over and over again--thirty-five days in a row--to not return a movie I had rented. Everyday, I saw it sitting there on the arm of my couch. And everyday, I thought, I should really do something about that... and then I just didn't.

After a week, I started to worry it was never going to happen, but I thought, Surely I have more control over my life than this. Surely I wouldn't allow myself to NEVER return the movie.

Then the cartoon picture of herself, standing next to the movie and couch, looking glum, thinking, "...I wouldn't just... NOT do something this easy, right?" Then there's a few pages of cartoons of her arguing with herself about putting away a plate she had food on three days ago.

Sigh. This is totally me. I actually have a library book in my car that was due in September 2013. I put it in my car so I would remember it.

Alas, her technique for dealing with this problem is that she'll allow (or cause) the situation to get so bad that her fear of the consequences of not doing the task are worse than her feelings about doing the task. She doesn't seem to advocate this.

Implications

Having this initiation impairment leads to these problems:

Procrastination until anxiety

Not doing stuff obviously has downsides. For things with a clear deadline, we may get more and more stressed as the deadline approaches. Near the end, the anxiety may finally be enough to counterbalance the urge to not do the task. We still have the urge to not do the task, so we will do it with great reluctance and misery. The task gets done, but we hate it. In many cases, the procrastination probably makes the task even more miserable and unpleasant than it would have been otherwise. Thus, if we need to make ourselves do a lot of things constantly, it will have a hugely negative impact on our quality of life.

Just not doing stuff

What about things with no deadline? I want to start a home business, but I have trouble making myself do projects for it. In other words, I'm not making progress on my hopes and dreams. This sucks.

Doing stuff sometimes, kind of...

Then there's tasks that need to be done but don't necessarily have a particular deadline. A lot of housework and pet care falls into this category, which is especially frustrating because those tasks need to be done repeatedly. There isn't a distinct point where not taking out the trash instantly switches from being acceptable to horrible, it just gradually transitions between those points over time. Taking the trash out tomorrow is only slightly worse than taking the trash out today! Therefore, I might take the trash out a couple weeks after would be the ideal time. That probably means I have to take the trash out fewer times over all, but it also means I have to suffer with the trash in a not-taken-out state for weeks!

Reduced fun

Even though it's easier to make oneself do fun stuff than it is to do non-fun stuff, sometimes I still can't make myself get started on fun things. (Never mind the fact that all that procrastinating reduces how much time is available for leisure.)

Similar or Related Concepts

Inertia

This term is applied metaphorically to describe that inclination you feel to continue doing whatever you're doing. If you're sitting on the couch watching TV, you probably feel at least a little bit of an urge to continue watching TV, even if the show is boring. Most people probably have this to some degree, but some people have it worse. I've seen some discussion from people with autism that this is a common problem for them. Here's some info on inertia for typical people.

Paralysis of Choice or Paralysis by Analysis

When you procrastinate on something because it's hard to make a decision regarding it.

Procrastination

Lots has been written on the topic of procrastination. Sometimes authors even try to pass something or other off as the ONE TRUE CAUSE of all procrastinating, and by fixing that problem, you'll be happily productive. They almost never put something like this as the cause though.

Still, the waitbutwhy.com posts about procrastination (or the TED talk by the same author) have some advice that's probably worth your time to read.

Spoon Theory

The spoon theory refers to the idea that, even if an illness or disability doesn't completely prevent you from doing a task, it can still make it way harder, and that difference matters. I have certainly found that it's easier to make myself do something if I haven't already made myself do a bunch of other things today.

I was able to spend a lot more time working on my hopes and dreams when I didn't have a job.

Reticulating splines

The splines theory is built off the spoon theory and autistic inertia. It refers to the idea that it's easier (takes less spoons) to do a task that's already a common practice for us, even though the same task might be difficult in another circumstance. Quote from Luna Lindsey's blog:

... when I ran Sapioscape, an online retail business, I ran to the post office every day, shipping 3-5 boxes at a time. I was efficient, and it was even a pretty fun. Sometimes I still miss those days.  

Now, when I need to ship just one box? I procrastinate forever and the task seems impossible. Because I have to reticulate every single spline related to packaging a shipping and item. It's a rather complex task for me, because my memory has stored each step as a separate thing that I have to recompile.

I suppose this has something to do with executive functioning. I'm not sure, but I think this study regarding ego depletion (loss of willpower) and the cognitive control theory might be touching on the same idea.

Motivation

Sometimes when people write about having this kind of problem, other people write back saying that we actually just don't want to do the things we think we want to do. Sometimes they mean it some kind of laziness-related moral judgment, e.g. shame on us for not wanting to do our useless homework, but sometimes they're encouraging us to stop trying to do the tasks in question. Apparently, the secret to success is to give up on my hopes and dreams! Also, give up on having money, food, or housing.

Yes, it's easier to do fun things than it is to do miserable non-fun things. That doesn't mean that wanting to do something is all it takes to be able to do it without trouble.

Mood disorders

Depression can often cause "motivation" issues, in that you're too sad, apathetic, and/or tired to be able to make yourself do stuff. If you have some kind of anxiety or phobia, that can often cause "motivation" issues because your anxiety/fear of something about the task impedes you.

With initiation impairment, you may have a normal motivation to do the task but simultaneously have an urge to not do it FOR NO REASON WHATSOEVER.

Of course, it's possible to have all three problems at once, or any two of them. If nothing else, it's quite likely that the initiation impairment will cause you to feel sadness or anxiety just because this problem really sucks. Because of that, and because initiation impairment is so poorly understood, doctors are likely to just think you have some kind of depressive disorder if you try to tell them about this problem.

Counterwill

Counterwill is a completely normal reluctance toward doing stuff that other people are trying to make you do. (Maybe when you were a kid you experienced some situation like this: You were about to get started on some household chore or homework. Then your parent, who doesn't know that you were about to do that task anyway, comes by and commands you to do it. Then you think, "Geez, now I really don't want to...") This develops around age three or so, and though it may be super-annoying to our parents, it would actually be pretty unhealthy if you didn't have this trait at all.

Generally, other than small children, we can all resist counterwill when it behooves us. We'll still do the task; we'll just be grumpier about it.

Unlike counterwill, initiation deficit applies toward tasks that no one else is trying to make us do.

Related term: reactance.

Other keywords?

If you're itching to do more research on this, here are some terms that might be relevant: behavioral activation, salience, task saliency, volition, ego depletion.

I will add more as I find them, or possibly give them their own detailed paragraph.

Help or Solutions

Unfortunately, I don't know how to deal with this.

Medication

I take Adderall for ADHD, and it's not perfect, but it helps with this problem quite a bit. I have also heard some anecdotes about Strattera helping with "motivation," which is probably the same thing.

Alas, since this problem isn't officially an ADHD symptom, it's quite possible for someone to have this problem and further life-ruining levels of executive dysfunction and still not meet the diagnostic criteria for ADHD. As far as I know, there is no condition in the DSM or ICD that entails this problem in any way. (I don't know of any proposed conditions that entail the problem either, although pathological demand avoidance syndrome comes close.)

Actually, I feel like it's possible for you to twist the explanation of initiation impairment so that it sounds like an attention problem. (Trouble concentrating? Anyone would have trouble concentrating on a task when their soul is screaming at them not to do it.)

I get the feeling that it's not a high priority for drug researchers to even try to fix this. The problem is really subtle; I keep thinking that all I need to do is try harder. Compared to the other ADHD symptoms, this one is less of a problem to the authority figures of ADHD kids. The fact that it's not clearly spelled out in the DSM symptom list doesn't help.

Minimize other problems

There are all kinds of factors that might make a task unpleasant or difficult. This initiation impairment combines with those problems, i.e. it will still be easier to make yourself do a mildly inconvenient task than it will be to make yourself do a task that's legitimately unpleasant in its own right. Thus, if you can't reduce the initiation impairment, you may still benefit from reducing other obstacles.

Some generic ideas:

• Listening to music while you do a task might make the task less unpleasant. (If the task involves reading or writing, pick music without lyrics.)
• Higher quality tools might make the task less difficult.
• If you have ADHD, you'll benefit from treatment and coping techniques that address your other symptoms, even if they don't help with initiation.
• Even if you don't have ADHD, minimizing any distractions might help free up more "brain power" for the task. (In some cases, this might mean you can't listen to music.)
• For overwhelming or vague tasks, think of concrete individual steps and make a to-do list of those steps.

There are often cases where you can choose between a large number of small tasks or a single large task. (For example, you could wash your dishes after every meal, or you could wait and do them all once per week.) Conventional wisdom says that frequent small tasks is preferable, but that may be harder for us since it means initiating more often. However, the larger task may be unpleasant enough that it is too hard to initiate, so you may have to do some experimenting to find out what works best for you. Just don't assume what works best for you is what works best for everyone else.

Timing

I've found that the problem affects me a little less right when I first come home from work, so I can at least get some household tasks done by scheduling it for that time.

I think the key feature of this time period is that it's a point of transition but it's not a transition to anything in particular. I have to stop the "commuting from work to home" activity and start another activity regardless of what that activity is, so the new activity might as well be taking out the trash or something. (However, my crap EF skills couldn't handle taking the trash out right before going to work in the morning.)

In order for this to work, I need to plan out the task previously. I guess my right-after-work self isn't really up for both planning and doing.

Do less

I'm sad to say this is my number one coping technique: try to set your life up to have as few tasks as possible.

I use disposable cutlery, paper plates, and microwaveable food so that I almost never have to wash any dishes. I buy clothes that can all be washed together on the same washing machine setting so that I don't have to do any sorting, additional laundry loads, or other special treatment. When my laundry comes out of the dryer, it goes haphazardly into a basket, and it stays in that basket until I wear it.

I have my pay check direct-deposited. I pay most of my bills by automated payments. I efile my taxes even though it costs more than mailing. I make my poor roommate get the mail and deliver the rent payment. I don't visit friends much. I don't travel unless it's required for my job.

I don't have kids even though I want kids. I don't have pets even though I want pets. I'm optimistic that I might be able to handle pets some day.

Cueing

This page about TBI suggests it can be helpful to have someone or something tell you to start. I'm actually not sure the cuing would be too helpful for me, but either way, it is definitely important to avoid "nagging," like it says. Nagging triggers counterwill, which will be yet another emotional obstacle in the way of doing a task.

Did I mention this sucks?

Hopefully those of you with initiation impairment got some benefit out of this post, if only to put a name on the problem and know you're not alone.

Feel free to leave any links or book names to anything else that has any help regarding this problem. Honestly, I'd be relieved to see more mental health professionals even acknowledge this problem existing.

About what's wrong with me!

I decided I wanted to write a thorough document on all my issues, for a few different reasons. One reason is so that, the next time I go to a psychologist or something, I can have everything I want to discuss already planned out. Another reason is so that I can see how my perceptions of my problems change over time. My main reason for actually posting this publicly is the hope that folks with similar problems will see this and provide advice on what has worked for them, or at least get some commiseration out of the fact that we're not alone!

The divisions are kind of arbitrary.

Executive Functioning Problems

Life is too complicated! I believe I've had these traits since I was a kid, but it wasn't a big problem at the time because of the different circumstances.

Inertia and Pathological Avoidance of Demands

I have particular problems with transitioning between activities or doing out-of-routine tasks, like my brain can't "shift gears" properly. (This is related to the "reticulating splines" concept.) I have particular trouble going to work each morning; sometimes I have trouble leaving work. Sometimes I avoid fun activities because it's too much trouble to get started.

However, the problem isn't all about transitions. I feel frustrated, stressed, or anxious regarding almost any task or obligation. The emotion is extremely disproportionate to the unpleasantness of the task. I have to force myself to do tasks that are fairly easy. Difficult tasks may not get done. Sometimes this trait a problem at work, depending on my assignments.

It's like being really lazy, except laziness normally comes with the expectation of some kind of benefit and this doesn't. I feel like I should be able to overcome this problem by force of will, but even if I'm able to do the stuff I need to do, I'm still going to be pretty miserable about it.

I am interested in a lot of things. There are too many things and not enough time or energy to engage in them all, so I try to ignore less productive or less fulfilling interests, but I feel like I sometimes get "stuck" on things that are easier to engage in. 

This is probably my biggest problem.

Horribly Disorganized

Daily adult life is too complicated. I forget to do important things. I can't cook for myself regularly, clean, or otherwise handle more than two weekly chores. I have a poor working memory, like I don't have enough RAM in my mental computer. I often fail to refill my prescriptions on time. 

I can do computer programming, but so far, it has been impossible to do complex programs.

Sometimes I stick to routines because doing something over and over means I don't have to redo all the planning each time. It's a good thing I like eating the same thing for lunch every day for months at a time, because I'd probably have to do it regardless.

I can't routinely show up on time to places. I can usually manage every now and then by putting 110% effort into it! But you can't put 110% effort in every day, so it's pretty much impossible for me to hold a job where the boss cares a lot about punctuality.

Attention difficulties

I am easily distracted, and I have a tendency to "zone out." It's worse when I'm tired; I am almost always tired. I am being treated for ADHD with 10 mg of Adderall per day (plus around 200-400 mg of caffeine), which is inadequate but better than nothing. 

Communication/Human Relations

My social skills aren't horrible, but considering how much studying, self-training, and research I've done on the topic, you think I'd rule the world by now, or at least be pretty rich. Alas, it's not so. The fact that I'm not better off should indicate how untalented I naturally am in this department!

Social Skills

When I was a child, I was horrible at interacting with others. I accidentally bullied people or was a pest. Nowadays, I have a lot of "book smarts" about social skills but often don't know what to do in the middle of an interaction. I am very unassertive. It seems I make bad first impressions but people later end up liking me. 

Difficulties with Verbal Communication

I have trouble retaining information from discussions. (I seem to learn well enough from school lectures, so I don't think this is entirely an auditory processing problem? It seems to have something to do without how the information is presented or organized.) I have trouble remembering spoken instructions, sometimes trouble understanding them at all.

I have difficulty thinking of what to say. When possible, I try to plan or rehearse conversations in advance. I'm very anxious when I'm unable to plan, e.g. a meeting is scheduled with an unknown topic. When I'm emotional, it becomes even more difficult to talk. A few times when I was a kid, I was completely unable to talk when I became emotional.

Lately, I've started to notice that other people seem to have trouble understanding what I say, but they don't realize that they don't understand. (Alternatively, they are pretending to understand because they are getting impatient with me!) Although I only recognized it recently, in retrospect, I realize I've had this problem for a long time. It causes problems when discussing work-related info with colleagues, explaining my symptoms to a doctor, or communicating with almost any other business I need to use.

I can't talk while there is other speech happening, e.g. TV is on in the same room. If someone starts talking over me, I can't raise my voice. I just lose the ability to talk until they stop. It's like my ears and my mouth just can't go at the same time. If I'm trying to participate in a group discussion, I have to hope everyone else acknowledges my "raised hand" gesture, because I cannot butt into the conversation.

Sometimes I have trouble talking correctly, such as inverting words in sentences or stumbling over pronunciation. I had speech therapy for a short time in fifth grade because I had a slight lisp. Sometimes I feel like I still have a lisp, but that counselor I saw once insisted that I do not. Some businesses are using voice-recognition systems in their phone menus instead of the usual "press 1 to..." system. I hate those with a passion. They never understand what I say.

Sometimes speech vibrations in my mouth are painful are startling, due to my tactile hypersensitivity.

Social Anxiety

I'm nervous around new people. I also have a lot of anxiety about phone calls. This is especially true of incoming phone calls from an unknown person, because at least with outgoing phone calls, I can plan the conversation first. Although, if I do have to make a phone call, I have to psyche myself up first, in addition to planning the conversation.

This used to be a big problem at my job because they had me in a position that makes and receives a lot of phone calls from people outside of our company. I noticed at one point, outgoing phone calls started to be a lot less stressful. If I realized I needed to make a phone call, I could just pick up the phone and start dialing! I guess this was essentially exposure therapy, but part of it was that I became an expert on the topic of those phone calls. Making calls in my personal life was still difficult.

Sensory Problems

Hypersensitivity

Many sensations that are insignificant to others are painful to me. The biggest problem is sound, but all the senses are troublesome. I hate most vegetables. I like bland food. If I experience a lot of sensory input throughout the day, even if it's not unpleasant sensations, I will progressively become jittery, then anxious, then fatigued, then angry. I have learned to actively monitor and manage my sensory input (e.g. How close am I to overload? How much will a certain activity affect me? Can I afford the cost of that activity?), which has helped a lot. Before I understood this problem, I thought I had anger issues, because I would sometimes lose my temper and scream or attack people. Nowadays I may still lose my temper but it happens less often and I have only attacked inanimate objects. When I was a child, brushing my teeth was painful because the minty toothpaste burned my mouth. 

Sensory Stimulation

I usually wiggle my leg when sitting. Sometimes I do other repetitive actions such as bouncing, rocking, or humming. Sometimes other people seem bothered by these actions or misinterpret them. There are also some non-repetitive actions such as pressing my hands together in front of my chest (proprioception exercise). In bad situations, harmless stimming is not "enough," so I scratch or bite myself. I haven't had to cut myself yet, but I have applied rubbing alcohol to existing injuries just to cause pain. 

When I was a kid, I often spent as much time as possible sitting next to flower bushes and staring at bees. Related?

Poor motor skills

I'm clumsy. I often knock things of the counter, drop things, or lose my balance when turning around. When I was a kid, it was hard for me to learn physical tasks like riding a bike or tying shoe laces.

Trouble recognizing faces (prosopagnosia)

For the most part, this isn't too bad. It's mostly only a problem regarding people I haven't known very long or don't see often. It causes minor trouble at work (e.g. when I'm tasked with watching the front door and unlocking it only for fellow employees who have forgotten their badge). Sometimes I have trouble distinguishing characters in movies.

Auditory Processing

I have some trouble understanding speech in non-ideal situations such as a teleconference. I don't like to watch TV/movies without captions or subtitles. It's only a minor problem most of the time... at least I think so. It might be related to my difficulties retaining information from discussions.

Emotional Problems

Unhealthy Lifestyle

I mostly eat unhealthy food. Most healthy food is difficult to tolerate (sensory issues) or difficult to prepare (executive dysfunction), or both. I am more sedentary than I want to be due to a foot injury. I have a variety of health problems. I have gastrointestinal problems; I'm obese and pre-diabetic. 

My appetite is completely disconnected from whether I should eat. Sometimes I get hunger pains but still don't want to eat; sometimes I want to eat way too much.

Recently (October-ish 2015), I've tried reducing the amount of sweets I eat. I still limit dairy and grain, and I avoid legumes almost entirely, and I don't get enough veggies. My consumption of aspartame has skyrocketed, and probably for that reason, my appetite is very reduced compared to before.

Depression

For the most part, I feel like my depression is being adequately treated. (I take sertraline, 50mg daily.) However, it kind of fluctuates in severity, and during the bad episodes, I still feel like crap in spite of the medication.

I've noticed a recurring pattern among my friends, family, and mental health professionals: everyone acts like depression is Problem #1. Like, I'm not even allowed to be a competent adult until I become happy, completely eradicate depression from myself, and become incapable of feeling any negative emotion ever again. 

Screw that.

I could understand this sentiment if I was constantly wallowing in despair, but I think, given the circumstances, I'm actually in a pretty darn good mood most of the time. My colleagues at work even call me "cheerful." When I'm not having a bad episode, it feels like I don't even have depression, except for the fact that I'm still taking antidepressants. I often go months at a time without having a bad episode. Even in the bad episodes, as long as I'm still on the meds, it's not all that bad. (I have to take it easy, but it's not like I'm suicidal or anything.)

It's time to start actually making life better instead of trying to make myself feel better about how badly life sucks.

Compulsive Self-Injury

I have bad habits like chewing my fingers or the inside of my mouth or scratching at pimples or bug bites. The urge to do these things feels different from stimming. Sometimes it's painful, but I can't resist doing it. 

Miscellaneous

I have a phobia of most arthropods. I'm easily started by shapes at the corners of my vision because bugs could be lurking anywhere.

I have trouble sleeping, and I have trouble staying awake.

I like to walk a lot. Normally this would be a good thing, but it used to get in the way of me doing other things, e.g. I'd end up walking around talking to myself when I'm trying to get work done at my desk. Nowadays, my foot injury means that I end up in pain if I walk too much, so the impulse to walk makes me restless or sad.

Sometimes I feel random pains for no apparent reason. 

I'm not sure what the exact trigger is, but sometimes hearing discussion of blood-related medical problems can cause me to have some kind of vasovagal response, and if I don't lie down shortly after symptoms start, I can pass out. The main situation where I have to worry about this is the interview they give you before you can donate blood, but it sometimes comes up when dealing with medical treatment. Also I once had a response from standing too long during an event at school.

Speaking of standing, I can only stand in one place for about four minutes before I start getting a stomach ache. I've had that problem since I was a kid (which meant my evil step-father was always using corporal punishment, even when he was just making me stand in the corner). I don't have this problem from walking.

Potentially relevant non-problems

I have trouble with strict routines, but I like things to be consistent and predictable most of the time. If my friends are going to invite me somewhere, I want a warning a few days in advance. I don't like surprises. I don't like spontaneity when it's caused by other people. I eat lunch at the same fast-food restaurant every day, and I always order the same thing.

I like to touch soft things (clothing, etc) in stores. My mom used to yell at me for it. Finally I'm a grown-up and can manhandle clothing as much as I want.

Strengths and Advantages

I'm not 100% loser.

I'm highly introverted, and not very talkative, so I'm almost completely immune to loneliness. I don't need a lot of friends, and I don't have the disadvantages that come with really needing a lot of face-to-face friend time. I can devote a lot of time to my hobbies.

I am aromantic asexual.

I'm a fast learner and I know the basics about a lot of things. I'm kind of a jack of all trades and a master of none. I can do simple computer programming, I have some art skills, and I have good written communication skills. Lots of people like the pictures I draw.

My social skills knowledge and my policy of being optimistic about people make it fairly easy for me to be a nice person.

My IQ is 117.

Social Skills

I think social psychology and human relations are super-interesting, so I have picked up a variety of techniques. Most of these tips are probably obvious to most people; they just do it by accident without even thinking about it! But some of us missed the memo. People with certain disorders or autism tend to be particularly untalented at figuring this stuff out without instruction, but with the way neurotypical folks seem to absorb social conventions by accident while growing up, they can easily end up with problems if they grew up around people with unsuitable social habits.

Assertiveness tips:

Seeing as how I'm debilitatingly unassertive, it might seem like a terrible idea to get advice on the matter from me, but I've noticed that there are actually people out there that are worse about this than me, so here are the tips I've found.

This is a topic a lot of people realize they need help on, so you can also search for "assertiveness tips" or "how to be assertive" to get some more information.

Respect yourself!

What is assertiveness? It's being confident and direct in claiming your rights or putting forth your views.

The main prerequisite to assertiveness is the belief that it's okay to be nice to yourself. Sure, you want to be nice to people, but you're also a person. You don't have to do EVERYTHING other people request of you, even if their requests are reasonable.

It may help to consider reciprocity, i.e. how often other people help you. I mean, I think an ideal community is one where everyone is always helping each other out, but consider whether you actually live in that kind of community. (You may have that kind of relationship with a few people but not others.) I know someone who acts like she lives in an omni-helpful world when she totally doesn't. She's always asking other people for favors, but they never pan out. Meanwhile, she runs herself ragged doing everything for everybody. It might be okay to act like that if you have people who are going to help you out, but if you live in an "every man for himself" setting, you need to help yourself first, then help others after your own needs are met.  I'm not saying you should only help people who help you, just that the help you give out shouldn't too far exceed the help you receive.

Don't be hostile

Assertiveness is not aggressiveness.

When someone makes a request of you, your options are not limited to (1) do whatever they ask even when it makes you feel all bitter and martyred (2) disparage their character for having the nerve to make that request. Try to say no without turning it into a fight. If you're mean about it, the requester is guaranteed to feel defenses or resentful. They might have argued anyway (even though that would be terribly rude of them), but they're a lot more likely to argue now that they want to convince you that you weren't justified in treating them that way.

Even if you give in and do what they want after all, they're not going to feel very grateful if you were a jerk about it.

Say No and Shut Up

If you decline someone's request or unsolicited advice, resist the urge to give a long-winded justification for your choice. That just invites argument. The following two tips give you advice on what to say instead.

"Pass the Bean Dip" technique

This tip applies mostly to unsolicited advice. I'm pretty sure it originally came from a parenting blog, or maybe a homeschooling blog. The name was probably inspired by family gatherings, which are an unholy chaotic pit of unsolicited advice, but such gatherings are likely to contain food and condiments that can be cleverly used to distract your enemies! The idea is that you respond briefly to whatever someone said to you, then immediately change the subject. Don't actually say bean dip if there's no bean dip for them to pass to you.

For example:

"You should just feed the baby formula. She would sleep better that way."

"Thanks for your concern. Can you pass the bean dip?"

Broken Record technique

This is a technique where another person is arguing with you and you need to stand your ground. You keep saying essentially the same thing until the take the hint and give up.

Fogging

Fogging is an assertiveness technique for dealing with obnoxious criticism. You express agreement with the true parts of what the person is saying, e.g. if they say, "I see you're dressed the same trashy way you always are," you can say, "Yes, I'm dressed the way I normally dress."

I don't have any practice on this technique, because most people where I live are more subtle with their hostility, but I wanted to mention it just in case you need it.

What situations trip you up?

If there are certain situations where you have trouble being assertive, try to avoid having that situation overlap with situations where you need to be particularly assertive. 

For example, I have a hard time with verbal communication, especially face-to-face, especially if I didn't get any advanced warning to prepare for the  conversation... so I'll agree to all kinds of ridiculous things if I'm not careful. My "escape plan" is to say something wishy-washy about how I'll have to give them an answer later.

Amiability tips:

Here are tips on how to avoid appearing argumentative, hostile, or conceited. This list assumes you aren't the kind of person who likes creating drama.

Non-Accusatory Complaint

If you need to lodge a complaint so that a problem will be corrected, you can do it in a way that avoids criticizing the receiver of the complaint. Putting forth an accusatory complaint will make the receiver defensive, and if it turns out that the problem wasn't the receiver's fault, it will make you look silly and make the receiver feel a false sense of "problem solved."

For example, suppose you're taking a class and your teacher graded your test incorrectly:
Bad: "Hey, you graded my test wrong."
Good: "Hey, there's an error with how my test was graded."

About Opinions

"Opinions are like assholes: everybody has one, and nobody thinks theirs stinks." -- popular saying

Just because someone says something about a topic on which you have an opinion doesn't necessarily mean you have to give your opinion. If it's just small talk or otherwise non-important, you might consider keeping it to yourself, especially if your opinion is contradictory or negative to what was already said.

However, if someone someone asked for your opinion or you want to have a polite debate or discussion, try to state a fact about yourself instead of giving your opinion. For example, you can say, "I didn't like that movie," instead of, "That was a bad movie."

Use "I Language"

"I Language" is relationship-counselor-speak for "talking like someone who's not an overly hostile asshole." Basically, when you have a disagreement with someone, you talk about yourself or the concrete facts of the situation, instead of blaming or criticizing the other person.

Besides the fact that blaming and criticism rarely get you what you want (more on that later), talking about yourself and the situation is just going to be clearer and more accurate. Things like "You're so selfish" or "You never help out around the house" or "You hurt my feelings" don't really communicate anything useful.

There's already been a ton written on this topic by more intelligent people than me, so I'm just going to leave you with two informative websites I found:

• The technique explained in detail at Austin CC.
• Lots of good and bad examples are provided at Families.com

If those links ever die or you want more info, you can find similar pages by searching for phrases like "I language in communication."

Humility (using "I think...")

You probably had at least one English teacher who insisted that you should never start statements with things like "I think" or "I believe." Well, you shouldn't take etiquette advice from your English teachers, even when they aren't the types everybody hates. That's not their specialty.

Dale Carnegie's How to Win Friends and Influence People tipped me off to this wisdom from Benjamin Franklin:

I made it a rule to forbear all direct contradictions to the sentiments of others, and all positive assertion of my own. I even forbade myself the use of every word or expression in the language that imported a fixed opinion, such as "certainly", "undoubtedly", etc. I adopted instead of them "I conceive", "I apprehend", or "I imagine" a thing to be so or so; or "so it appears to me at present". 

When another asserted something that I thought an error, I denied myself the pleasure of contradicting him abruptly, and of showing him immediately some absurdity in his proposition. In answering I began by observing that in certain cases or circumstances his opinion would be right, but in the present case there appeared or seemed to me some difference, etc. I soon found the advantage of this change in my manner; the conversations I engaged in went on more pleasantly. The modest way in which I proposed my opinions procured them a readier reception and less contradiction. I had less mortification when I was found to be in the wrong, and I more easily prevailed with others to give up their mistakes and join with me when I happened to be in the right. 

-- Autobiography of Benjamin Franklin

(Try to use a reasonably confident tone though, at least in professional settings, or you'll give some people the impression that you're guessing wildly.)

So scratch out all the "I think" from your English class homework assignments, but use it as much as you want (maybe more?) in every other context.

Can you get the same result by agreeing?

For an example, I'm going to totally plagiarize something I once saw on a parenting message board (I don't remember who told this example; please claim it if it's yours).

The Mom posting this advice was talking about dealing with her own mother (the Grandma). Grandma would call her and suggest that she bring the family over to visit. The Mom found that if she responded, "Ugh, I am SO busy, there's no way I can make it over there until at least Wednesday!" then the Grandma would be upset and argumentative and start complaining about how she never sees the grand kids, et cetera. But if the Mom responded with something like, "Sure! How about Wednesday?" then Grandma would be happy ("Great, I'll make pancakes!").

Either way, the Mom was agreeing to bring the family over on Wednesday, but the Grandma's feelings and response were different based on her attitude.

On one hand, maybe it seems silly of the Grandma to care so much about the presentation of the response, since she's getting what she wants either way, but I think it actually makes sense. The grouchy response has some underlying implications of "your request is unreasonable" and "bringing the family to see you is a big hassle for me," and it's those implications that Grandma was actually arguing with.

Good Intentions tips:

Trying to do something does not automatically mean you actually are doing it. That applies just as much to "being nice" as it does to anything else.

Everyone hates unsolicited advice

I gave this one its own post. Read it here.

Don't overdo favors

When someone does something nice for someone else, the beneficiary often feels obligated to repay the favor in some way. If the benefactor insists that the favor does not need to be repaid, that does pretty much nothing to reduce the sense of obligation! You don't really have to worry about this with family members and close friends, because you'll be helping each other out all the time, and there's no need to keep score when you feel like it'll even out in the long run. Therefore, this advice applies mostly to casual friends and acquaintances.

From my observations, it seems like the "amount" that someone feels compelled to repay is based on either (a) the beneficiary's perception of how much trouble the favor caused for the benefactor (b) how much trouble it would have caused the beneficiary to do that favor for someone (c) a midpoint between the two. The amount of benefit that the person actually receives isn't necessarily a huge factor.

That means, it's entirely possible for the beneficiary's sense of obligation to exceed the actual benefit of the favor! In that case, the beneficiary dislikes receiving the favor.

Thus, if you try too hard to be nice, you could actually end up annoying someone. They'll have trouble holding it against you, but it could still cause them to dislike you if it's an ongoing problem.

By the way, all this talk of favors applies to both acts of service and material gifts.

Non-Annoying tips:

These are some things to keep in mind so that you can avoid accidentally being a pest.

Personal space

People will usually get annoyed if you get too close to them. This varies a lot by culture and personal life experiences, but in the USA, and good rule of thumb is that people want at least three or four feet of space when they're facing each other and having a conversation. However, when they're standing side by side or something, a smaller amount of space is okay, probably about two feet.

In crowded places, such as a busy subway, it's not always practical for everyone to keep as much space as they want. Most people understand this and are reasonable, but one tactic for dealing with the discomfort is pretending the people encroaching on their space are not there or are some kind of inanimate objects. Therefore, people may get annoyed when you talk to them in these situations.

Buffer Seat

In places like theaters or buses, the seats are usually so close together that people will be in each other's space. It's especially bad if either of you are too fat for the seat! Therefore, it's appropriate for strangers to leave an empty seat between each other.

However, sometimes there's too high of a person-to-seat ratio, and it's not possible for everyone to have a buffer seat. In that case, it's not reasonable to insist on a buffer seat. Even in situations wherein people can stand, it's not always easy to stand that long so some people are going to sit in the empty seats. If you're the person who fills the buffer seat, don't be offended if a stranger stands up and moves away. It's nothing personal; they just want more space.

Phone conversations

Seriously, don't have extended phone calls in public places where the people around you can't move away without inconveniencing themselves.

Note, this only applies to verbal conversations on the phone. Some people act like there's something horribly morally wrong with you for doing things like texting, gaming, or reading email, but there's no reason people should be legitimately annoyed by those things, unless you're doing them in some needlessly annoying fashion.

Here are some reasons why verbal phone conversations are actually totally rude:

• It's really irritating and distracting to overhear half of a conversation. It's a lot worse than just overhearing two people talk. Here's an article about a study that found out this information, just in case you were wondering whether I'm the only one that's annoyed. People don't have to be trying to eavesdrop to be affected; even if your phone call is the most boring thing ever and they'd really rather think about their grocery list, their brain is going to stick to your phone call. It's distracting enough to interfere with the cognitive abilities needed for many daily tasks, so in some situations, it can even be dangerous.

• The person having the phone call is also distracted and therefore has a reduced ability to be considerate of other people who are present. If you were talking to someone in person, the other person would be there to notice things that you miss.

• It's harder to hear each other over the phone, so you probably talk louder than normal and frequently repeat yourself.

You can cut yourself some slack if the call is highly important. It's still rude, but some rudeness is forgivable in extenuating circumstances.

Pleasantness Tips:

Doing these things will make people more likely to consider you pleasant and friendly.

Greet people (usually)

This seems to vary a lot by region and setting. I've heard that in some places, you're expected to greet every stranger you pass on the street, which seems weird to me.

However, even in places where it's normal to keep your head down and avoid eye contact with strangers, it's usually a good idea to greet people you know, like when you pass a coworker in the office hallway.

These greetings have two parts:

• First, give an indication of who you're greeting. The normal way is to make eye contact, but it usually also works to say their name in the greeting or look in their general direction.
• Second, communicate the greeting with words, a hand gesture, or both.

It can be a good idea to consider what a person is currently doing before you greet them, to avoid interrupting something.

"How are you?"

Half the people who ask this are using it as some polite figure of speech and don't care how you are, and the other half are just trying to give you a chance to report some kind of news, like a more formal version of, "What's up?" Generally, you should respond to this with, "Good. How are you?" but it's also a chance to say something like, "Oh God, call an ambulance," or, "Just so you know, the copy machine is broken again," in applicable circumstances. 

If you feel like crap, don't say so as a response to this question unless you're expecting the asker to do something about it. You also won't get any good results from faux-positive responses like, "eh, I'm alive."

I feel like it's a bad idea to ask this when you're not in a good situation to have a conversation, e.g. a fast food cashier greeting the first customer and other customers are waiting. However, it seems that many people disagree with me.

About Conversation

A lot of people like to talk about themselves. Certainly, I think most people prefer to talk about themselves or other things they're interested in over other topics. So if you're trying to get on someone's good side, make it easy for them to talk about themselves or their interests by asking about them. If someone tries to talk about something that happened to them, they will often be annoyed if you talk about your own similiar experiences before they're done with what they want to say. If you don't like to talk about yourself (or at all) but someone keeps asking you about yourself in the course of some awkward attempt at small talk, don't worry, they're probably not a stalker. They're just trying to give you a chance to talk about yourself because they think you'll like that.

Empathy* tips:

*By "empathy," I mean putting yourself in someone else's metaphorical shoes--not necessarily feeling the emotion they're feeling, but having an idea of their point of view.

The world is filled with all sorts of people, and you will never understand them the way you understand yourself. Never assume you know someone as well as or better than they know themselves. Still, some understanding is better than no understanding, so here are some tips for considering other people's point of view.

Everybody thinks they're good

Seriously, all sorts of mass-murdering sociopaths have been convinced that they are wonderful people that the law unfairly punished. It's not even that they didn't know (somehow forgot) that they killed those people, but rather the murders didn't take away their self-identified "good person" points.

This has implications for when you want someone to change their behavior.

Mainly, if you give someone unsolicited criticism, it's quite possible won't believe you. (If your criticism describes an objective fact that they agree with, they won't agree that there's anything wrong with that fact.) Instead they'll be offended and defensive and consider YOU to be the bad guy. So, you might as well try to avoid criticizing people when possible.

When you want people to change their behavior, try to be precise. Tell them what you want them to do or stop doing. Don't just tell them to "please be respectful." I mean, it's not like they're going to respond with, "OHHHH, I didn't realize I was supposed to be respectful! Silly me! I'll fix that."

Forgive other people's nonverbal behavior

If someone is annoyed by a situation, it's true that they shouldn't take it out on you. However, if you insist that they effectively pretend they are not annoyed, you're requiring them to have excellent acting skills. Is it a moral flaw to not have excellent acting skills?

Besides, even if you're absolutely sure you interpreted their facial expression, pose, tone of voice, or sigh correctly... maybe you didn't. Even if you're normally good at reading that sort of thing, if someone is from a different region or has neurological differences, they might have different body language than you're used to.

So, if someone does what you want but acts upset about it in the process, let it go.

Everyone wants to be treated with respect

This includes people who have a lower social status than you, such as your children. Basically, don't throw all these techniques out the window just because you're talking to your kid.

Acknowledge personality differences

The Golden Rule has its limitations. Everyone wants to be treated with respect, the details vary from person to person. It's still a good idea to keep the old "do unto others as you would have them do unto you" maxim in mind, but it's a guideline, not a hard and fast rule.

I hope to eventually give many of these differences their own post, but here's an example for now:

Some people like to talk more than others. They just find conversation to be a relaxing activity that helps them bond with people. Not everyone is like that. Lots of folks can talk okay, but it's terribly unfun. There are even some people who aren't very good at talking, so they have to put a lot of effort into it, and long conversations can be mentally exhausting for them.

Likewise, different people like to spend different amounts of time in the presence of others. A good half of the population is more introverted than extroverted, which means they really need a certain amount of time alone to relax, and how much time will vary.

So if someone wants to spend time with you sometimes, but they don't want to spend as much time as you want to spend, or they don't want to converse as much as you want to converse, don't take it personally. It doesn't mean that they don't care about you as much as you care about them.

I've found that it pays to be optimistic about people. When someone does something, you have no way of telling what their motivations and intentions are, and there's usually multiple possible explanations from your point of view. So why not give them the benefit of the doubt?

More info

Feel free to add additional techniques in the comments or to expound on how these techniques have worked for you. It would be great to get info on how all this stuff works in different regions.