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Adult-ADHD

A person-centred approach to psychotherapy or counselling can be of tremendous benefit to ADHD adults.

Firstly it is important to note that ADHD feels ‘normal’ because it is just the way you are. It is not an injury or an illness, with a sense of separateness to it. It is a heritable disability, not really a disorder – it can’t be cured.

ADHD seems to impair many of the elements of our executive functions that support our conscious sense of self, such as working memory / fluid intelligence, delayed gratification, emotional regulation, sense of time and the capacity to sense of what is important within the experience of any moment. This can often give the impression of psychosis because things that are obvious to others are just not noticed or retained in memory: ‘figure’ does not emerge from ‘ground’ as it would for others. All these factors greatly impact upon the individual’s ability to form and maintain a personal frame of reference that is suitably realistic, differentiated and value-laden. You just know in your bones that you are not like all the others. I have ADHD, and I liken it to having a hole in your head.

The impairments of ADHD make it a ‘force multiplier’ for life’s interpersonal and socio-cultural pressures. By the time you’re an adult you are likely to feel constantly stressed, anxious, depressed and self-doubting / self-hating. This is hard to manage because the pressures from others just keep coming, but also because the disability makes it harder to deal with the accompanying psychopathology. ADHD is a double whammy of high vulnerability and low resilience. ADHD people can end up feeling extremely alienated from early in childhood, when they are likely to be rejected by peers. It becomes hard to know what you want (although you can say exactly what others want of you). It has been said that those with ADHD seem to have a mental age 30% lower than their real age: they are often ‘lost’ in their social surroundings. This cruel indifference of others can lead to an unreliable, fuzzy self-concept, the adoption of rigid personas, and to an antisocial outlook. In a world where we are increasingly expected to behave conscientiously, calmly and agreeably, such pressures hit those with ADHD very hard, particularly males. Self-motivation can be low or zero, because life has been so discouraging. There is a temptation to escape into high-risk behaviours, and ADHD carries a very high suicide rate.

Medication can really help, but ultimately it would be better for society to make space those who are (not ‘have’) ADHD. They are as normal as anyone else, biologically speaking, but are increasingly marginalised by the creeping intolerance of our ‘sit down and shut up’ culture.

Most psychotherapy for ADHD is barking up the wrong tree, in my opinion. It would offer you training on how to manage your time and better organise your life. This is very shallow and misses the point: adults with ADHD have often read all there is to know about time management etc. They can write a book about it, but just can’t do it. What is desperately needed is something deeper – ADHD people need to feel understood, and for this they need to feel understandable. They gave up on themselves in childhood, and they don’t need yet more people making them feel inadequate. More checklists mean more things to be forgotten. By comparison, the non-directivity and empathic understanding of a genuinely person-centred / client-centred approach to psychotherapy offers something really unique and valuable to adults with ADHD.

To learn more about the reality of ADHD, you might start with the excellent book ‘Driven to Distraction’ by Dr Edward Hallowell and Dr John Ratey.

You could also take a look at Dr Russell Barkley’s excellent ‘30 things you should know about ADHD.

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