ADHD has become popular over the years, and with this popularity has come both positive and negative consequences. On the positive side, its popularity has given people ideas on how to spot it. They look for distraction, impulsivity, tangential conversation, disorganization, impatience, unfiltered conversation, planning difficulties, and difficulties managing projects that require multiple steps. This growing awareness may also give individuals who are properly diagnosed access to potentially helpful resources.
On the negative side, many individuals who carry ADHD have been maligned for their attributes. There are a growing number of people who use the Term ADHD as a critical adjective or an insult. He is so ADHD. I am sorry I forgot about our plans, I am all ADHD’d up today. Of course she is having a hard time, did you know she has ADHD. I’m glad we don’t have to work with him. He is so ADHD. Or perhaps the worst of the examples of which I am aware: That guy is such a mess. Somebody get him on some ADHD drugs, stat.
In an effort to identify individuals struggling with ADHD and to depathologize ADHD as a diagnosis. Teachers have been given some education about ADHD, and are provided behavioral checklists that contain items that are part of the ADHD diagnosis criteria. These checklists are behavioral checklists though. They are not ADHD checklists. The hope in giving these checklists to teachers was that they could see how many children have behaviors that make learning challenging without having enough behaviors to meet the ADHD criteria. Simply, it was meant to normalize behavioral difficulties, and provide practitioners with more information about children to determine if they meet criteria for ADHD.
The hope was also that given this experience, teachers would be more likely to normalize these behaviors for children and parents, and be able to provide more informative and compassionate care for children struggling with behavioral challenges. Instead, it is more common for teachers to prematurely conclude that children who have behavioral difficulties have ADHD and should be prescribed medication as soon as possible to reduce the interruptions they have caused to the classroom. This result has only further stigmatized children carrying ADHD symptoms, and affected the viewpoints of professionals that work with teachers and children’s parents.
Traditional Treatment for ADHD
Traditional treatment involves symptom identification, charts that track symptoms, coping strategies designed to neutralize these problems, and medication evaluations to fix what seems to be wrong with the brain of the person who has been diagnosed with ADHD.
People accept traditional treatment because, for the most part, they come into treatment anxious about symptoms that have been socially stigmatized, and are eager to get rid of them. It only makes sense then that people diagnosed with ADHD, and their parents or partners would be amenable to a process in which they are subjected to weekly and sometimes daily comparisons to a checklist of maladaptive behaviors. The medication process is equally punishing and arduous, as the growing body of research on ADHD is not yet broad enough for doctors to know immediately what their patients need. In fact, patients are often required to test multiple medications, and deal with some distressing side effects in an attempt to find a medication that best suits their needs. The medication process looks a lot like a fight you had with your brother, when you were a kid. He punches you, and asks if it hurts. He thinks it will make you tougher, but in the process you get punched a lot. Perhaps, eventually you become more resilient via this exchange, but you also become more bruised as well.
Personally, I don’t have a problem with the checklist or prescription medication. They can both be helpful in providing someone with resources that makes life easier, and making success a little more attainable. I do, however, take issue with the process. It stigmatizes the patient, and makes them the problem. Moreover, beginning treatment by focusing primarily on difficulties often makes patients diagnosed with ADHD feel very anxious about their innate qualities. This way of managing ADHD symptoms only makes patients more anxious, which, in turn, ties up the necessary resources required to do the work, and distracts them from potentially helpful interventions. You will find it hard to help someone be successful in treatment by primarily focusing on their weaknesses, especially in a way that inhibits their ability to acknowledge and access their strengths. Instead, this likely becomes a pathway to shame and insecurity.
Current Treatment of ADHD is Problematic
If the way we currently pursue ADHD is problematic, then why do we stick with it? We stick with it because it is not normally the patient but a concerned other (parent, partner, teacher, friend) that brings them in. The issues the concerned others worry about the most are directly addressed by the checklist and medication, which puts them at ease. These concerned others are unaware that this process also heavily stigmatizes their partner, child, or worker, and inhibits access to well-being and a strength-based problem solving approach instead of encouraging it. One thing is for sure. You will never be able to convince someone to be more able by focusing primarily on how you feel they are disabled.
The greatest obstacles to providing compassionate care to people carrying an ADHD diagnosis are how frequently it is used in the media, and the people we empower to speak about ADHD related matters. The more frequently ADHD is used in the media, the more comfortable people who are not specifically skilled or learned in psychology feel that it is appropriate to use it as slang or to diagnosis someone. People who are neither directly invested in the well being of those carrying ADHD symptoms nor possess the clinical acumen to provide compassionate care to those struggling with ADHD symptoms should not have the right to discuss such matters. You wouldn’t let someone without proper training diagnose a heart arythmia or perform hernia surgery, so why do we give so many people permission to diagnose ADHD and discuss treatment alternatives.
Think about how grotesque it is that people feel that they are entitled to willy nilly diagnose people with ADHD, and then use the term ADHD to insult someone or themselves. You don’t see people googling WEBMD, and saying that someone is so cancer or so paralyzed.
The truth is that psychological challenges have long been stigmatized and used as social weaponry by laymen who only have superficial and often incorrect understanding of them. People use a range of insults from retarded, to Schizo, and more recently, Bipolar. If there is a silver lining to this deeply upsetting phenomenon, it is that most of this commentary comes from an untrained and uneducated population that is incorrect in their judgments about 99% of the time. So if you find yourself being judged by non-professionals, take heart in the fact that they probably look foolish (especially to trained professionals). You can also be fairly sure that they are compensating for something far worse than what they have accused you of.
Self-Compassion Care for ADHD
Self-Compassion Treatment for ADHD revolves around getting a sense of your challenges and resources, while maintaining a self-accepting, kind, and objective sense of who you are as a person. It covers many areas: diagnosis, strengths, personal value, organic brain development, tricks and tools, Mindfulness Training, and Self-Compassion practices.
You are not your diagnosis. I don’t care if your clothes are inside out. Your glasses are taped on one side. You have 4 pieces of colored paper stuck to your back, and you are running your fingers through your unkempt hair while you stare off into the sky. All people have strengths. All people have weaknesses. All people have goals, and all people need to engage their strengths and shore up their weaknesses to find success. You come by your difficulties naturally, and while school and work may be difficult for you in the traditional sense, you are also likely capable of coming up with solutions and ideas that would not occur to those most easily suited for work and school.
In fact, most extraordinarily successful people we know are different. It is hard to find great success with the same ideas, and capacities that everybody else has. Take a moment to think of anybody who has had extraordinary success, and is in the public light. Now ask yourself how creative their ideas had to be to set them apart. Often to be successful you need to separate yourself from the rest of the world, it is pretty hard to do that if you are the same as everyone else. I am not saying that ADHD is always a blessing, but it certainly can be.
In general, people diagnosed with ADHD have so many strengths, but these tend to be obscured by the criticism they get for their shortcomings. Sometimes, having success is more about finding a place in which your strengths are valued rather than trying to convert your weaknesses to strengths in a venue that is poorly suited for your skillset.
Although there are many exceptions, creativity, acting, art, socializing, giving speeches, motivational work, athletics, dance, work with children, IT work, graphic design, and entrepreneurial work are strengths that people diagnosed with ADHD have been said to possess. Individuals carrying ADHD diagnoses are also capable of the unique capacity of hyperfocus. Hyperfocus is the ability to become extraordinarily focused on one thing. Find the things that you are truly passionate about, and turn on that hyperfocus. Let this process scratch the surface of some of your amazing skills. Do this for yourself, since you of all people deserve to know just how special you are.
If you never changed anything, you would still be infinitely valuable and whole. Having ADHD symptoms is not a reflection on your character. As you are human and, in general, desire the well being of others, you are by your very nature lovable. There may be some things you can work on to make life easier for you, but you should never apologize for how you came into this world or that with which you came into it. People who see you in view of your difficulties should spend more time working on their own challenges. People who are confident and happy will always see your humanity before your difficulties. Choose to spend your time with happy, confident people.
Organic Brain Development
It is true that we have some research that shows that people carrying an ADHD diagnosis have less activity in their prefrontal cortices, which are involved with executive functioning. Executive functioning is most notably describes as the operations involved in planning, organizing, and focusing. Having less activity in your prefrontal cortex at baselines is not the end of the world. We have many methods to increase activity in the prefrontal cortex, which will help you live a long, successful, and very happy life.
Sometimes, it is hard to be hopeful, when you are confronted by experts or the media, who offer problem-focused narratives. To regain your sense of ease and self-agency, follow this simple advice. There are two kinds of people in the world: those looking for problems, and those looking for answers. Practice self-compassion for the people looking for problems, and develop alliances with those seeking answers. This will free you from having to carry the burden of those people seeking problems, and will give you an opportunity to have hope and perhaps a lightened load by spending time with other people seeking answers.
Tricks and Tools
There are so many tricks and tools that will help you manage ADHD symptoms. Here are a few of the good ones:
· Find classmates or fellow workers who are organized, and learn from their structure.
· Think about the end of a story you want to tell first, and then tell the story with that in mind to avoid going on tangents.
· Seek smaller groups to learn in, and sit in the front of class to avoid distraction.
· Find teams or clubs that will help you practice being part of a group and managing external organization.
· Acquire tools for external organization like a planner, date book , or date program on your computer. Keep all relevant material related to a subject in the same place and dated, so it is easier to retrieve it later
· Set time constraints on work and breaks, so you are getting enough of each to stay focused and get what you need done.
· Take care of fundamental responsibilities or the basic requirements of work/school assignments before adding any exciting extras.
· Prepare work or school materials the night before, so that you have ample time to get ready in the morning.
· Fill your day with organized activities, so that you have structure in your life that brings you well-being, and leaves you with just enough time to get your work done (this will secretly organize your time).
· Every single class and work assignment has a pattern to it. Once you discover the pattern, you will know exactly how much work to do and when to do it. Give yourself extra time and patience to discover these patterns, and celebrate the success that comes with your discoveries.
· Take time to do activities that ground your energy in your body. Having to focus, organize, and plan all the time can be very stressful for folks that carry an ADHD diagnosis. You can do this good work, but you need to reconnect to your body to unwind. Plan some fun ways to do this. Go to the gym. Go for a bike ride. Juggle, if that is your speed.
· Spend time basking in your strengths. Do things that you are naturally good at. Just because you have some challenges does not mean that you are not talented at so many other things.
· Surround yourself with others who appreciate you in all of your glory – the good, the challenging, and the amazing. Make sure they support you, and remind you of how great you are. Self-acceptance and an awareness of strengths is the best fuel for success and happiness.
· Burn this phrase into your brain. There is nothing wrong with me. In fact, there is so much right with me that I work on using resources to share more of myself with the world.
As mentioned in the organic brain section, mindfulness research has actually demonstrated growth in the size of the forebrain related to the prefrontal cortex. With this increase in forebrain comes more success with executive functions. Most people think that mindfulness means that you just sit in a boring place in a prison of silence, but it is actually quite a riveting place and filled with a cacophony of sensory activity. Examples of this include: mindful walking, mindful eating, mindful visualizations, mindful physical activity like juggling, mindful body awareness, and stress diminishing practices such as soften, soothen, and allow.
Even the traditional meditative practices require you to follow the ever-changing flow of your breath, and your body’s response to thoughts and feelings. If you sit long enough, you will actually see a host of images from your day, week, month, or even throughout your life. It is like a fast paced, flip book of your life. How amazing is that! There is even mindfulness dream work. Who doesn’t like to talk about their dreams? Best of all, it is a kind way to strengthen your executive functioning skills, and one that you can tailor to your own fit.
Self-Compassion Training is essential for ADHD treatment. As previously mentioned, based on social views and current treatment of ADHD and ADHD symptoms, there is virtually no way to escape feelings of anxiety or shame that come with these challenges. Self-Compassion training works well for these issues because it is about acceptance and kindness, which counteract anxiety and shame.
Most ADHD patients I have treated find it reassuring to know that these practices have been around for thousand of years and have been an important part of helping courageous people. The monks of Ancient India used compassion practices to face dangerous, jungle animals on their quest to reduce suffering, and the famed Shaolin Monks used self-compassion practices and mindfulness to protect sacred scrolls. When people realize that self-compassion is about courage and not cowardice, it frees up the part of them necessary to do the hard work involved in acceptance. Acceptance, in turn, gives us access to the resources we need to more deeply develop our strengths, and remediate our weaknesses.
Specific to ADHD difficulties, Self-Compassion practices can treat anxiety, impulsivity, planning issues, impatience, sensitivity, and consistency issues. By acknowledging these issues when they arise with kindness, objectivity, and no judgment, self-compassion practices allow people the opportunity to understand them, process them, and then respond to them in ways that lead to solutions and greater self-agency. This process is rewarding, and a far cry from the punishing process of working on difficulties in the service of shame or external critics. People reach continued success more easily when it is based on self-growth and self-acceptance than when it is based on escaping shame and fear of failure.
Self-Compassion practices also have hidden benefits. Self-Compassion Practices actively engage the prefrontal cortex (executive functioning center) and do so in a way that disengages the amygdala (fight, flight, or freeze). Self-Compassion practices have you acknowledge suffering as it arises, which involves locating it in your thoughts, body, or feelings, which requires the prefrontal cortex. You continue to engage this part of your brain by organizing suffering into a particular thought, feeling, or sensation. This work is continued by seeing if you can make room for it, and finally completed by developing an action plan that brings compassion to your experience. As you can see, this process involves focusing, organizing, and planning, and does so in a way that rewards the practitioner.
Self-Compassion practices also help with emotional regulation, as feelings are acknowledged, accepted, and allowed to pass. Lastly, it helps with impulsivity, giving the person using the self-compassion practice the opportunity to notice the impetus for a maladaptive behavior before it occurs or perhaps the maladaptive behavior itself when it occurs.
In the former case, that person is given the opportunity to select an adaptive behavior when an emotion, thought, or bodily sensation come up. For example, you feel anxious in conversation, which normally leads you to blurting something out (the maladaptive behavior). With self-compassion practice, you notice the anxiety, and think about what might reduce your anxiety and also be socially productive, perhaps relaxing your body, allowing your breathing to become slow and steady, or perhaps waiting for the right opportunity to say that this line of conversation is causing you stress and inquiring if it might be ok to speak about a different topic.
In the latter case, it is too late to pick an adaptive behavior when struck with impulsivity, as the self-compassion practice begins after the maladaptive behavior has taken place. It does give you an opportunity to look at that behavior and its causes and think of a more adaptive behavior to use next time you begin to feel that way. For example, you blurt something out in the middle of the conversation with another person, which they find upsetting. You then look objectively and with a keen and kind awareness at what you were feeling prior to this maladaptive behavior. You acknowledge that you came by the anxiety naturally and that the behavior did not provide you well being. You notice how anxiety feels in your body and how conversation can bring about these effects, so that you can be aware the next time you feel like blurting something out. Then, you go over more adaptive behaviors that you can choose in the place of blurting for next time. In both the former and latter cases, the impulse to act is replaced with reflection, and this reflection will eventually result in more adaptive behavioral responses.
All told, there is hope for those who carry a diagnosis of ADHD to get the kind of care that honors their person, and works to develop self-acceptance and self-agency. Whatever care you are currently providing to those with ADHD or whatever care you are receiving, may it be supportive and encouraging for all those involved. May it inspire hopefulness and vitality in you and others, and may it bring considerable ease and meaningfulness to your life. Even if you forget, you are worth it.
365 Days of Kindness. Self-Compassion. Day 48. In the Books.