ADHD Support
Strategies
With ADHD there are so many ways to approach therapy, depending on what type of therapy your counsellor uses, as well as their own individual style. In my experience, a lot of people who look for ADHD support start out looking for tools to manage their symptoms. Knowing that ADHD people often struggle with delaying reward (impulse control and task initiation), there are general strategies that can be helpful to work around/with ADHD brains. Such as:
Breaking tasks down into smaller pieces, even if it seems meaningless compared to the full outcome you’re looking to achieve. The point, to get an immediate task reward by savouring something as completed to help motivate ongoing action. The important thing is to savour and acknowledge the little things along the way so we have something snack on as achievement while we run the marathon towards larger outcomes. ADHD brains struggle with “out of sight, out of mind” more, while non-ADHD brains can better perceive reward beyond immediate outcomes and may require less mindful approaches.
Creating alerts to check-in with how the day is unfolding to get a better sense for how long things take to do, or better understand patterns of distraction. Expanding our scope of awareness helps with better understanding our difficulties and develop more specific strategies. ADHD folks tend to get hyper focused on external things, struggling to also notice internal experiences. This difficulty, for example, can impact awareness for when we last ate or drank water, which can in turn impact our energy levels and ability to regulate concentration. With less internal awareness for feelings and sensations, it can also impact our sense of time. Being in an ADHD body can feel like living in a casino sometimes, we’re taking in a lot of information and there are no clocks around to signal the passage of time.
Pairing new desired habits with whatever things you already have regularly in your life can make the addition of a new behaviour easier. Whenever working on therapy practice with a client, I always ask them when in their day would work best to try it out, and what they can pair it with as a way to remember to do it. Think of it like using one established neural highway as an opportunity to build out another road for new pathways —using already existing infrastructure to build out more. If there isn’t any routine or consistency, then building out habits from things that all people do, such as waking up and going to bed, may be a helpful starting point.
Mental Health Therapy
There a LOTS of general tips and tricks that can be helpful for ADHD annnnnnnnd not uncommonly people have come to me saying “I’ve tried x, y, z and nothing works for me!” Or, “that’s a great tool and all, but here are all the barriers to even trying it in the first place!” Tools are great, and sometimes the other missing piece is unpacking psychological barriers. If someone has gone years with ADHD and has struggled to access medication or find helpful resources, what can happen is reinforced reactions from living with ADHD builds up and becomes the barrier towards movement. An example is trying becomes associated with failing, which may bring on feelings of dread, which can cause a shut down freeze response, or avoid and run away (flight response), from the thing that we’ve tried doing so many times and feel hopeless to overcome as a result reinforced feelings of failure. There are as many unique reasons for why someone may struggle with implementing strategies as there are people struggling because we each have our own unique life experience that informs where we are at today.
Other times, traumas and mental health difficulties interact with ADHD brains to make the symptoms of inattention or hyperactivity even more exaggerated. Such as, dissociation. Human bodies have the capacity to separate themselves from feeling distress when overwhelmed. If we don’t feel like we can fight against a threat or run away from it, we may freeze, and shut down from feeling. Dissociation is an adaptation, and like all adaptations they can vary in intensity and become maladaptive (aka, decrease someone’s quality of life). The experience of dissociation can vary from every day zoning out to dissociative disorders. If inattention is already something an ADHD person deals with, add in life experiences that reinforces dissociation as a coping strategy, and that can impact attention regulation that much more. Dissociation can become more of a default response to stressors. To read more about ADHD and dissociation, there is this article, “What is Dissociation in People with ADHD?”
Emotions Regulate Attention
Whatever the difficulties someone is having, the common theme is emotions. Emotions help us regulate our attention. A researcher by the name of Domasio was studying the impact brain damage to the ventromedial prefrontal cortex —it is basically an important part of our brain that helps us make decisions with consideration for our own and other’s well being, communicating with the emotion centres of our mind. He found that people with brain damage in this area could take in information and recall, but their ability to make decisions was impaired (trying to figure out where to put an appointment in the calendar became an overwhelming task). Continued research led him to put forward the argument that when we learn information, feelings are paired with it to help us determine its importance and how to respond to it.
Emotions are Communicators
Emotions are communicators and important information for us to determine priorities for our survival and well being. If we never got sad, a cue that something that matters to us is gone, then if someone went missing our motivation to look for them may be impaired. Anger can communicate that something important to us has been violated or is threatened. Fear is cuing potential danger. Shame can be about not living up to a value system and fear of judgment in the eyes of others. However, we often don’t have control over what emotions we have because they can be triggered by our autonomic nervous system. But, we do have control to how we handle what comes up, which can then inform what other feelings arise.
If, for example, we were a hyperactive child and told “you’re too much.” From feeling sad and rejected during these times, we may feel ashamed as an adult when we get excited about a topic and speak at length about it, anticipating we’ll be told “you’re too much.” In this example, shame may be functioning as a way to get us to “fit in,” but its a secondary reaction to the core feelings of sadness and fear, and may not be serving us because its feeding social anxiety —now when we think of sharing something we’re excited about, we may feel uncomfortable, anticipating others won’t be interested, and in anticipation of rejection and shame, retreat.
Therapeutic Interventions
If taking an emotion focused therapy approach we may try to evoke what it felt like to feel ashamed during these times and see if we can facilitate you having a new response, or access those primary feelings, to shift how our body pairs social excitement with the feeling of shame.
If taking an Acceptance and Commitment Therapy (ACT) approach, we may start to notice that reaction, “I’m too much,” and use mindfulness to defuse from that thought, working on strengthening our ability to observe that thought or feeling, and reconnect with doing what matters to us.
Or, if using EMDR, we may reprocess experiences that reinforced core negative beliefs that burden present day attempts to improve yourself. Each therapy approach comes with its own strengths and approaches.
Overall, if you find what you’ve tried so far not enough to create the change you want to see, individual therapy can be a helpful way to figure out your unique difficulties and how it interacts with your life experience on the whole. Addressing ADHD does require intentional strategies and often benefits from therapy on all the behavioural and emotional experienced reinforced over time while struggling with ADHD.
