What is ADHD?
From time to time, a mental health condition seems to come to the forfront of our attention, and in recent years it’s Attention Deficit Hyperactivity Disprder – or ADHD. I don’t mean to sound like I am trivialising diagnoses, but what we have seen is a condition normally associated with restless, impulsive, children extrapolating itself into adults. Have adults changed in recent years? I don’t believe so. What has happened is that there is more awareness of the presenting conditions of ADHD and more and more we recogise these traits in ourselves. So what do we mean by ADHD? This is the NHS’s definition:
Adults with ADHD may find they have problems with:
- organisation and time management
- following instructions
- focusing and completing tasks
- coping with stress
- feeling restless or impatient
- impulsiveness and risk taking
Some adults may also have issues with relationships or social interaction.
Does any or all of that sound familiar? We probably all know those symptoms at least to some extent. It’s important to remember that when the medical profession identifies a mental health condition, it’s with the aim of identifying a treatment, which usually means medication. Although to be fair, the NHS also states that therapy – specifically CBT, which is what it offers – is another “treatment”.
Mental health charity, MIND, also remarks that adults with ADHD might be misdiagnosed:
Lots of the main symptoms of ADHD are things that impact your behaviour, mood, and thinking. So you might be misdiagnosed with a mental health problem like depression, anxiety, obsessive-compulsive disorder, or a personality disorder.
None of this really explains what ADHD is. But it does inform us that it results in a cluster of behavuours which can be treated medically, or taken to therapy.
ADHD in therapy
There are many ways therapists approach ADHD. For example Life Coaching is a relative newcomer to this area, and it offers ways of collaboratively setting goals and essentially helping clients make changes they need in order to manage their lives in a more helpful way.
Meditation is often recommended as a way of reducing the effects of ADHD. In the yoga tradition, mental suffering is generally viewed as the intellect turning in on the person (the person’s sense of self, or identity, anyway) rather than being used to drive ourselves forward in the world. The belief is that meditation helps us put some distance between our intellect and our identity thereby giving us more control over our decisions and actions. The yogi, Sadhguru, takes a more positive perspective, encouraging us to celebrate difference rather than celebrating conformity.
In many talking therapies, ADHD wouldn’t be something that leads to any particular interventions on the part of the therapist. The person centred approach emphasises potential rather than problems. Such a counsellor will have a goal of self-actualisation for their clients, a position not too far from Sadhguru’s. Psycodynamic counsellors are more likely to think what must have happened in early childhood that caused their client to be the person they are. The child might have felt a failure, for example, and the adult still feels a failure.
My approach
Consistent with the psychodynamic approach, I would be looking at what might stand between the person now and the person they want to be. Take one of the conditions listed above – coping with stress. This is a common presentation with or without the other symptoms in the list. But what is stress? It’s the body’s fight-flight response. It’s our reaction to a perceived threat which leads to cortisol being released, effectively gearing us for a fight or a quick exit. But most stress isn’t brought on by an advancing tiger or an erupting volcano. It’s our interaction with day to day events at work, in our relationships or even when we’re on our own. That threat is emotional. We are doing all we can to fend off an overwhelming emotion because we haven’t learned how to tolerate the emotion in question, shich might be shame, hurt or guilt, for example. Indeed it is the presentation of these raw emotions from our unconscious, and our defences against them, which psychodynamic therapy seeks to make conscious.
Indeed I would understand all the listed symptoms in similar ways. And the therapy isn’t about some kind of inellectual interpretation of what might have happened in our early lives that brought about that behaviour. It’s all about the therapist getting into the emotional overwhelm with the client and containing and processing the emoutions that both feel.
Adrian Tupper is a counsellor practising privately at Space for Therapy and at Eyre Place Osteopathic Practice.