“I mess up all the time.”
“My train of thoughts goes a hundred miles an hour.”
“I rarely ever feel a sense of belonging.”
“I couldn’t focus at all during the meeting today. My ADHD didn’t allow me.”
“I am so sorry I didn’t understand that. I am afraid, I was tuning out again.”
It’s noticeable that among an entire catalogue of different diagnoses found in the latest version of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) by the APA (American Psychiatric Association), ADHD (Attention-Deficit/Hyperactivity Disorder) seems to be diagnosed more than anything else these days.
According to the chief executive of the ADHD foundation, Dr Tony Lloyd, ADHD services are swamped. You might wonder ‘What is this wave of ADHD in our society about?’ Well, this is a big question, and I will narrow it down to one particular reason: ADHD is no longer exclusively diagnosed in children. According to the ADHD foundation there is a 400% increase in adults seeking a diagnosis since 2020 alone in the UK. Based on own observations in the therapy room with my clients, I can confidently state that more and more clients self-diagnose or seek diagnosis for ADHD.
Now, what does ADHD in adults look like and what causes it?
Adults that identify with ADHD (or ADD, as it used to be called) often share the difficulty to focus and prioritize. Other qualities that are often shared among adults associated with ADHD are restlessness, inattentiveness, disorganization, being easily bored, a regular sensation of ‘tuning out’, a strong inner critic that makes the individual feel insufficient and ‘abnormal’, low self-esteem, relationship concerns, social alienation and lack of belonging.
While the exact cause of ADHD is not fully understood, a combination of factors is thought to be responsible according to the official NHS website. These factors are genetics, brain function, brain structure and brain injuries. The website also mentions studies that suggest that people with ADHD may have an imbalance in the level of neurotransmitters in the brain, or that these chemicals may not work properly.
Now, as a person-centred practitioner, I am deeply curious about the development of personal experiencing in people, thus to understand ADHD solely as a genetic or bio-chemical phenomena does not satisfy my curiosity to understand its development. This doesn’t mean that I lack appreciation for neurodiversity. In fact, the opposite is the case. However, I strongly believe that to understand all facets of a so-called ‘medical disorder’ (this includes Depression, BPD, Anxiety, ADHD etc) a deep dive into the psychological development of an individual within their cultural, socio-economic environment cannot be ignored.
When I sit with a client who associates with ADHD related qualities, a peek back into their childhood is often quite revealing. Often, it becomes quite quickly quite clear where their qualities to ‘tune out’, the struggle to focus, their self-blame and sense of alienation from the rest of the world come from.
I know, you probably now think: ‘Aw, not again! Doesn’t all get messed up in childhood?’
I hear you and you know what, you might be quite right. Many of the perceived “pathologies” that we experience as adults are often originating in our childhood. Yet, it is important to understand that the things that we beat ourselves up for as adults have not always been a disservice to us.
Let’s take a look at the following statements: ‘I messed up again’, ‘Once again, I got up too late, I am such an idiot’, ‘I just tuned out again and have no idea when we meet up tonight, how damn hard can it be to listen?’ All those statements of self-blame are brutal and people who identify with ADHD often do exactly that to themselves – they beat themselves up for being different, for not quite getting it right. Yet, this self-blame, harsh inner critic, the regular tuning out and lack of focus have not just happened to you. You have created it yourself. For good reasons.
You might remember from previous column entries, that I keep asking you about your personal understanding of human nature. Well, this is the moment to ask yourself this question again. What is your understanding of human nature? Do you believe that the body works against or for you and your survival? I assume the majority of you agree with me in assuming that our body is naturally inclined to work for us. Consequently, there will be a good reason why self-blame and tuning out were helpful to us at some point in our past.
Imagine the following: Liz is 5 years old. Her mother struggles to attend to Liz’s emotional needs as much as she struggles to attend to her own. Her mother and father fight a lot and the underlaying energy in the house is one of stress and disorganization. Now, what do you think how does Liz feel? Does she feel safe, relaxed and loved or does she feel rather anxious, confused and lonely?
When we are young, we don’t have the capacities to analyse, assess and rationally conclude the happenings around us. This means that Liz, aged 5, does not look at her mum who is disregarding her needs thinking: “I can sense my mother’s overwhelm with this situation and I can see that she is projecting her own issues onto me.” No, that’s not what is happening. In fact, that would be incredibly scary to conclude at that age. Imagine little Liz realised at that age that her mother is not ready to meet her needs and cannot look after her the way she truly needs her to. This would be catastrophic as Liz could not do anything about it to change her social external environment.
Given that Liz cannot control or change her external environment she will learn to control and change herself accordingly. She will take responsibility for the difficulties in her environment and feel responsibility for mum’s upset, the fights between her parents and the absence of love and closeness. She will also take responsibility to improve the given situation. She will do so by trying to make mummy happy, to not burden her parents, to adjust and please the external environment and to blame herself if she does not manage to keep the peace. Sometimes things would get really loud and overwhelming and to endure the situation Liz would tune out. She would learn to swallow down her emotions because there is nobody there to hold her. Growing up she wouldn’t be greatly connected to her emotions. She would possibly hold some underlying anger that she could never release towards her parents. As an adult she would be a master at adjusting to her external environment and be great at pleasing others – because that is what she learnt from Day 1 on planet Earth.
I wonder whether this example resonates with you. If so, then I encourage you to stop beating yourself up for tuning out from time to time. I encourage you to stop beating yourself up for apologizing all the time, for struggling to connect with your own feelings and for formulating your own opinions. It’s understandable. It’s not your choice whether or not you tune out, forget something or cannot access your feelings. It just happens. It’s learnt behaviour. It’s coping strategies that you acquired over many years. Again, for good reasons. What you can change though is how you relate to your coping strategies when they emerge uncontrollably in your adult life now.
The next time your thoughts drift off when your partner is talking to you; you forget about an important meeting in your calendar; you cannot focus on the book page in front of you; or you get scared to express your emotions – don’t beat yourself up over it but be compassionate. Empathise with your younger self who tried so hard to survive and keep the peace. Empathise with you in that moment right there and respond to you the way you wished your parents would have responded to you when you were younger. Hold yourself, be kind and understanding toward yourself. And then – simply see what happens.
My good old pal, psychologist Carl Rogers (1961), once said that “The curious paradox is that when I accept myself just as I am, then I can change.” It’s this change that you too can experience now by starting to radically accept the things you do and not do, say or not say, feel or not feel.
I get it, it’s not easy to break old patterns and suddenly embrace yourself for who you are. Yet, remember, whatever you learn, you can unlearn. Hence, the power and control are yours to free yourself from self-blame and self-destruction. Ultimately, you are one big step closer to coming home to your true self today, simply by curiously enquiring about your way of being and learning more about how to authentically live with ‘Adult ADHD’.
...AND WHAT IS YOUR EXPERIENCE?
Does this all sound too familiar to you? Do you also regularly struggle to connect with your social environment? Do you then beat yourself up for being weird or simply not getting it? Well, I welcome you to share your own experiences with us in the comment section below. I look forward to hearing about your personal, yet shared, experiences in the world.
Reference:
Gabor Maté, Training on Compassionate Inquiry Master Class: A powerful approach for healing anxiety, addiction, ADHD, and more.
Rogers, C.R. (1961/1995). On Becoming a Person. New York, USA: Houghton Mifflin.
The Guardian, 13/01/2023
Healthline, 27/09/2022