Why Making Phone Calls Is So Hard in ADHD

There is an item on my list that has been sitting there for three weeks: calling a number. The call will take two minutes. It has been three weeks.

Even as I write this line I feel a little ashamed, because to someone looking from outside there is nothing to understand here. Pick up the phone, dial, talk. But I know those three weeks very well, and I think you do too.

In the glossary this is called phone avoidance. In this article I will describe why it is such an expensive job and what really brought it down to two minutes for me.

What is different about the phone

For a long time I took this to be a character trait of mine. Then I noticed that making a phone call, compared with writing a message, is a completely different job:

• Real time. You cannot pause to think. Stopping for five seconds while writing is not visible; a five-second silence while speaking just sits there.
• Irreversible. The sentence you write you can delete and write again. The sentence you say has been said.
• Dual task. While listening to the other person you have to build your answer at the same time. This leans directly on working memory, and it has been shown that this area works in a more limited way in ADHD (Kofler et al., 2010).
• No note-taking. Appointment time, name, address, reference number. All of it comes by voice and you are expected to hold all of it.

On top of this comes the past. If you have failed to find a word before, drifted off in the middle of the subject or interrupted the person you were talking to, the next call lands on top of those memories. What works in me most is this: before the call, the sound of a call that went badly in the past plays in my head.

Making a phone call looks like a small job. Inside it are four separate jobs run at the same time, and all four draw from the same narrow space.

How avoidance grows

The framework of Sirois and Pychyl (2013) fits very well here: putting something off removes the discomfort of that moment instantly. The relief comes immediately, the cost comes later, and this order reinforces procrastination.

Then a second layer is added: the delay itself. The knowledge "I haven't called for three weeks" makes the call even harder, because now an explanation owed is added alongside the call. In my head I build the sentence: "Hello, I actually meant to call you much earlier..." Even that sentence feels tiring, and so another day passes.

At this point the matter moves beyond procrastination and turns into avoidance. I covered the difference in detail in the article on procrastination or avoidance; in short, in procrastination the task stays in your mind, in avoidance your mind begins to erase the existence of the task.

Preparations that work for me

What made calling easier was not courage but preparation. All of it is done before the conversation and finished on paper.

Write the first sentence. Only the first sentence. "Hello, I'm calling to make an appointment." The hardest part of the conversation is the opening; once I read that part, the rest flows. I have been doing this for a year and I still have not stopped.

List what you will ask. Three items are enough. Looking at the list while talking removes both forgetting and the "I was going to ask something" regret that comes after hanging up.

Have pen and paper ready beforehand. If the place for taking notes is not ready, you start looking for a pen in the middle of the conversation and miss what is said in those seconds. Before I open the phone I put the paper in front of me and write the date on it.

Talk standing up and walking. This makes a visible difference for me. When I sit, searching for words gets harder; when I stand and walk around the room, sentences come more easily.

Set the time. "I'll call today" is a weak sentence. "I'll call at 11:00" is a strong one. A vague intention lets the call slide to the evening, and when evening comes you say "they'll be closed."

Prepare for the voicemail too. Writing what you will say if the call is not answered prevents being caught unprepared. A bad voicemail left unprepared becomes one of the memories that make later calls harder.

Write right after hanging up. What is said in the conversation evaporates in me within five minutes. Writing three lines as soon as I hang up saves me from having to make the call a second time.

Make calls in batches. Gather all the calls into a certain hour of the week. Crossing that threshold once is much cheaper than approaching it and turning back five separate times in a day. I described why switching is so costly in the article on difficulty with transitions.

The most expensive calls: institutions and healthcare

Not all calls weigh the same. The ones that wait longest for me are always the same two groups: official institutions and health appointments.

The reason is this: in these calls the other side runs you through a voice menu, puts you on hold, then asks you a question with a term you do not know. So there is both waiting time and a high chance of being caught unprepared. These two groups have their own articles: health appointments and paperwork and bureaucracy.

There is one more thing that helps with these: accepting the time you will be on hold from the start. Putting the speaker on and taking a small, boring job next to you makes the wait bearable. As long as I thought I had to spend the waiting time doing nothing, I could never even start the call.

A common mistake: trying to settle the call in one go

For a long time I thought like this: since I'm going to call anyway, let me settle everything in one go. Let me make the appointment, ask this too, close this matter as well.

This thought makes the call bigger. A five-minute job becomes, in my head, a twenty-minute matter, and twenty-minute matters are put off more easily.

Now I do the opposite: one call, one purpose. I make the appointment, I hang up. The other question goes to another item. Most of the time that second call is not needed at all, because I learn the answer in the first.

One more thing: not every call has to be a phone call. If an institution has an online appointment system, using it does not count as avoidance, it counts as choosing the way that gets the job done. Changing the channel is a much more reliable solution than straining your willpower.

When avoidance points to something else

Avoiding the phone is not specific to ADHD on its own. Social anxiety leads to a very similar picture and the two often occur together (Kooij et al., 2019).

A rough distinction goes like this: in avoidance linked to ADHD, the main struggle is in starting and holding things in mind. In social anxiety, the center is the other side's evaluation: I'll look stupid, I'll stammer, my voice will shake.

The two can also be present together, and when they are, the picture gets heavier. If avoiding calls keeps you from your appointments, your work or claiming your rights, it is appropriate to talk to a specialist about it.

The real size of a small job

While writing this article I still had not made that three-week call. After writing it I made the call; it took three minutes, and the other side never asked about the delay.

The lesson I draw from this is not "it was actually easy." Because if it were easy I would not have waited three weeks. The lesson I draw is this: the difficulty is not inside the conversation, it is before the conversation. When you move most of the load onto paper, what remains really is a two-minute job.

The written channel has its own traps; I described them in the article on e-mail and message paralysis.