Something Shiny: ADHD!

David takes us back to second grade and playing following the leader, where you do the same maneuver on the jungle gym that the ‘leader’ did. He always felt his leadership was undervalued. It was finally his shot to be the leader and he wasn’t going to waste it—he is up way high in the air and looks down and says “Follow the leader!” And he lands with both feet about 15 ft down onto the wooden beam he was aiming for. Everyone looks at me and goes “You win! We quit!” That’s a perfect example of response cost: as a child, I didn’t think that if I nail this, no one wants to play anymore, and if I fail I might end up as a quadriplegic or dead. No thought of those consequences and what they would look like two hours later. Thank goodness no one went after him, he never thought that the other kids not getting it would be bad. The impulsivity in that jump and the response cost that was forgotten. The take away is it’s not worth it to win that game by beating everyone--it's also not really a lesson learned. Bobby shares his story from the week, and is in a show and is an understudy, where he has to do all the prep on his own and doesn’t get to do the reps with the other actors. Hard to do with ADHD. Also hard to do when he already had a bunch of work on his plate and took on the extra load and found himself procrastinating on memorizing the lines. David wonders, did the task get done, though? Did Bobby memorize all his lines in a day? He didn’t, but he did do a big bulk of it and did one scene per day and it’s been a challenge but he’s been more successful doing that way. He’s listening to the scenes on loop and does it in the background while he’s doing other things. We have all been there, where there’s a reality where we don’t get to make the structure until we’re in the crisis—now I have a plan, why didn’t I make this plan before? It’s because you weren’t in your sweet spot of stimulation. And he’ll (and we’ll) do it this way again. David points out that Bobby is learning his authentic way of working and not judging it. What would have happened if all the internal freak-out judgements and questions—if someone else had asked you those? Bobby admits he would have crumbled under that pressure, it would have deeply affected his productivity. Isabelle thinks she knows where David is going with that question, and recalls podcasts she’s been listening to on anxiety that were echoing the notion that what you resist, persists—and it's the same with this. Acknowledge the anxiety and roll with it. What she’s learning is that if you think you need to beat yourself up to get something done, you can remove that part, and still get it done last minute. David learned this very late in life. He was talking to his partner, Robin, and was stating that they were going to clean bit by bit in preparation for the people coming to visit them. And she looked at him and said: “you’re not going to do it bit by bit, you’re going to wait until the last minute, and freak out, and while I’m at work, you’ll get it done.” And he was like “yeah, you’re right. Is that okay?” And she’s like “yup.” If I can talk about it without shame, a lot can change. And if you’re trying to beat yourself up so someone else can’t, you get totally distracted from the task. It becomes a perpetual motion machine of shame, and it takes so much energy. Isabelle describes how her motor (or brain) keeps running and sometimes gets locked into a space where there’s no brakes and so sometimes, the setting is on shame. She is a champion shame spiraler. David describes how we lock in on the activating state we have the most tolerance for. David has a lot of excitement in his life, like a golden retriever, he authentically labels things closer to excitement rather than anxiety. Where does shame or anxiety displace stimulation from the task? For some people, you need the shame—it’s something someone else makes you feel (like peeing your pants in public is shame, peeing your pants in private, guilt). Shame is incredibly stimulating: "If I don’t get this done, I will be socially rejected and annihilated." This gets your heart pumping, adrenaline going. We’re all adrenaline junkies. How do you turn the shame into a tool? (Pause for siren and airplane noise and acknowledgment of us recording in a landing strip right now) Isabelle pictures the scene from Star Wars (errr, Empire Strikes Back, thankyouverymuch), where Luke goes into the cave. If you can acknowledge the fear that’s happening, you can face it. David uses the example of doing a talk in a big crowd and his shame spiral goes to a very black and white extreme where if he messes up his talk he’s going to end up homeless. So the first time he gave this talk he took weeks. And then he got better at it and wasn’t starting on it so far ahead. So what if he could just plan on doing it on the 6 hour flight? The Shame Force is ready to go—but ready to go at an appointed time, not for weeks in advance. No one way I’m not going to do this thing, and so that black and white fear of failure is ready to help boost and let him finish his prep for this big talk on the plane. Bobby and Isabelle struggle to catch up with that idea, is it using guilt instead of shame? No, it’s removing the shame from HOW you do the thing, and instead letting the fear of failure and potential shame do its work at an appointed time: having a plan and honoring the plans you have. So David will get ideas for the talk and put it on the calendar for the plane ride and then during the plane ride, let that fear of not finishing the talk and failing hit, but not until the appointed time. If we fail, how can we learn something from that and not fail next time? How do we work with goals when we fail and not achieve things? It’s about effectiveness rather than our idea of what things look like: studying, effort, trying—what do those things look like (because we are little stimulation-generating machines). The trap is: if I spent more time on this, could it have been better? If we are living in “could’ve been better” we’re always trapped. So the question is: “was it good enough?” And what if the next question is: “what can we do differently?” What if we focused on the outcomes, rather than the process, and just judged what we did (and set a goal to learn how to do this all in one night, rather than the 30 years it took David to learn).

DAVID’S DEFINITIONS

Response Cost: a neurological skill that helps you know the consequences of your actions later on down the road. This is a forebrain skill that is often harder for folx with ADHD.

For lecture slides, full show notes, and more, check out our website!

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Cover Art by: Sol Vázquez

Technical Support by: Bobby Richards

Isabelle & David welcome Isabelle’s husband, Bobby, and their friends, Christina, AJ, and Gabe, to continue to listen and learn from David’s tried and tested presentation on ADHD, which he normally gives to fellow clinicians (for the 1st-9th parts of this talk, please see episode 4, All About ADHD Part I; episode 6, All About ADHD Part II; episode 9, All About ADHD Part III; episode 12, All About ADHD Part IV; episode 15, All About ADHD Part V; episode 18, All About ADHD Part VI; episode 21, All About ADHD PART VII; episode 24, All About ADHD Part VIII; episode 27, All About ADHD Part IX). David launches right into why we get into fights when we leave and we procrastinate, imagine a scalloping bar graph that shoots right near the end, and then right back down. David uses the example of how when assigned a paper, he realizes he has three weeks to work on it, so he plays video games, he does other things, and then his anxiety grows as he gets closer to the deadline, and then it shoots up very rapidly, and he goes into “oh my God, I’m going to be homeless, I’m going to fail, no one’s going to love me, I’m stuck in a van by the river.” Worst case scenarios to the extreme. Now, everything he does related to the paper brings him terror and so everything he does toward the paper gives him the immediate gratification of relieving some of the terror. Any action toward task completion is naturally reinforcing at this point. And the flow feels better and better because it’s getting you further and further away from the dragon. And then you turn the paper in, misspellings be damned, and you sleep the rest of the weekend. The anxiety level plummets down. The same graph can be used toward anger and task completion, too. We are using anxiety or anger as self-medication. David is not quick to throw medication at people but he does say that the second that anxiety and anger around the procrastination get in the way of your life and your relationships—can you see how a stimulant medication might help? A stimulant medication raises your ambient level of stimulation without you having to be anxious, angry or aroused. You need that stimulation to be able to work (like the allele cells and environment). Medication gives you a sense of urgency without a crisis. If you give ADHD medication to a neurotypical person, they will not perform better on the task but they will believe they did. They will write a five page paper and then they’ll turn it in and get an A (they would’ve gotten anyway). A person with ADHD will do significantly better on the task, believe they cheated because they used meds (and because of the knocks to their self esteem) but they also have a better evaluation of their work. The side effect is to give you a better ability to appraise their work more accurately, and it reinforces doing more work because it reinforces a sense of mastery. When someone doesn’t need ADHD medication, the medication will make transitions harder, it will make them more angry, more anxious over times and more rigid. With ADHD population, it helps with distress tolerance, transitions, and flexibility. We procrastinate when we need more medication. We procrastinate on packing for a trip, making lunches, making a list—the more boring a task, the more stimulation we need to do it. Gabe asks: where’s the balance of that? What if you accommodate yourself and never touch socks again? But you have to be an adult and do things you don’t want to sometimes. And David responds: Why not? Why not have only the same sock and not pair them at all? Or outsource that particular task. But, Gabe counters, what if he wants to learn the skill of folding laundry? How does he gain that skill? Medication is one option, but David asks more basically: how do you up your level of stimulation? Another way is to make it about time. Set a timer, don’t cheat, how many socks can you pair? Gamify it somehow, you can experience winning/losing. AJ names that this is something he did but didn’t have a name for. The reason he started folding his laundry is because his partner appreciated it, so it’s a win because it’s his partner’s love language. And once you’ve started you can always listen to one more song because there’s structure and progress. What if you say “ugh, I gotta clean my room” — what’s wrong with that statement is it’s too broad. You have to make it a smaller objective, like clearing everything off the counter. So with kids, day one, we’re going to clear the counter. Then we’re going to sift out the clothes. Now find all the cassette tapes, etc. Isabelle gets super excited about the KonMari (Marie Kondo’s organization method, see links below) because it’s literally this: taking everything of a category and putting it into piles, then deciding if each thing sparks joy. It’s simple, it’s structured, and it uses piles. David wants to make it clear that when the kid actually sweeps everything off the counter, and sees the big mess on the floor, they actually melt down, and it’s why he recommends it. That’s when you say to your child, “I know this is overwhelming and I’m here to help, I’m here with you. Now let’s get all the clothes.” Now you’re body doubling and you’re setting the tone for emotional regulation. It’s about sorting out the larger tasks and breaking them down. Another example is “tomorrow we’re going to leave”—making this broad statement when going on a trip. It doesn’t factor in the smaller tasks, all the stuff that’s packed into transitions gets left out. It seems so obvious but is so helpful to put language to. “Tonight I’m going to have dinner.” Gabe names that with their five year old, they found out they needed to draw pictures and draw it out the night before and give him predictability for the next day, but he never did it for himself. David names that he shouldn’t “should” all over himself, it’s about stretching these moments out. Do you ever take your morning routine and think about what the sequence or day will look like? Because now you have win probabilities and structure and a plan. It’s amazing how for someone with ADHD you can repeatedly have a 15 minute conversation about how someone is going to drink a cup of coffee—routines are hard to establish and we belittle ourselves for needing help with this, even though the details of the routine—when do you add the cream? When do you drink it? Do you pick your kid up first? If you pick your kid up, you’re taking care of them and will forget to have your coffee. Bobby describes it as putting his oxygen mask on first, that he needs to attend to his needs first because otherwise he’s not going to be a better person or parent. Isabelle describes how when she first got into body-based psychology, she was astounded that other people didn’t notice how it helped them remember to eat or go to the bathroom or do the basic care and maintenance of having a body. For her it was game changing to have a structure for how to check in on herself. When it comes to body based or other ways to create structure or accommodations, don’t just the accommodation, judge the accommodation’s effectiveness. For example, David worked with a kid who was going to give a big presentation and was feeling nervous, and he asked to put a marble in his sock.  Knowing when you need body soothing or stimulation is great, knowing that chewing gum is mild stimulant and some people need to chew gum to tolerate stress. Pressure, like the pressure of a weighted blanket or a cat/dog in your lap, or a shower can be nice, but it’s good for soothing, not necessarily to help attend and it depends on what your goals are in the moment. There’s no quick fix and no one answer and there’s no way to make a hard thing easy except through exposur...

David asks: what about brushing your teeth and things that don’t have immediate gratification, necessarily, but you have to do them over and over again? How do you motivate yourself to do them? It’s preventative-you don’t see what you save, you don’t know what Past You did for Future You when you’ve brushed your teeth. David’s answer is to outsource a lot of decisions that he doesn’t want to make to ritual, and the world of pain is part of everything we have to do. He just does it because it’s the routine (like getting up) even though it is so hard, so very hard, to do the things we don’t want to do. The fact that we can feel this much pain helps us want to prevent other’s pain, makes us think creatively. David might be willing to bet that a lot of technology and innovation that makes things more efficient and helps us skip the boring tedious parts is perhaps invented by folx with ADHD. For folx with ADHD, you are tested in fire all the time, and it does things—there is negative stuff (sucks experiencing rejection, sucks making mistakes, sucks not being perfect, sucks being found out)—but our ability to think outside the box because we’ve had to struggle our whole life is something he doesn’t want to surrender. Isabelle names that it feels that David saying that expressed compassion to the part of her that didn’t get that before. She thinks about how in trauma work there’s this mythology around the trauma making you stronger, but also—you could’ve been great without the trauma, thank you. Isabelle didn’t really give herself credit for the strengths, and often assigns the strengths and things that she has achieved to good fortune or luck, while taking full ownership of the blame, shame, and mistake-making parts. It has taken her a long time to not just jump straight to “I got so lucky!” And recognize that maybe she had something to do it with—and wonders if she’s the only one? David names that this is so relatable—it is so hard to acknowledge that our strengths are coming from the same place our vulnerabilities are. It’s so easy to say we got lucky or it was chance, because we don’t get to refine the skills to know we did more than get away with something. We don’t fit in the Normal Rockwell image of how things appear and so we don’t think about doing things the same way others do, either. David names how a part of him would be ashamed about getting ready for a school presentation in ten minutes—instead of practicing every night for twenty minutes, like he thought he should. Never mind that he still got an A, was able to speak with great energy, that the fact his tone of voice was a little more engaging—all of those things are ADHD. David is just thinking he got away with it, because he’s not counting all the times he thought about doing the thing and then didn’t, because they were ‘dumb anxious thoughts,’ never mind that he got it done and got a good grade, he was still a fraud because he was different. Now he can look at it in a balanced way, it’s all ingredients to who we are. In the real world, you’re not in trouble if you get it done too fast. Isabelle convinced herself people would think she cheated if she was honest about how she did something. We encounter so much pain, we don’t need any help seeing the fault of our actions, David is really good at that—but we all need someone to remind us of what we’re really good at. Folx with ADHD are used to calling out ADHD behavior when something is not going right; getting use to calling out ADHD behavior when things that are happening that are excellent, and would not be happening if not for a person’s ADHD. There’s so much pain, let’s honor the great things. Isabelle thinks about how she was at the park with her kid on a playdate and had a snack bag and thermos with tea. She proceeded to leave this tea everywhere and put the tea everywhere, on slides, wherever, forgetting she had it, circling back, and meanwhile, her kid is playing and pushing their amazing boundaries. She always thinks someone has come in and moved something, like the realization in the film A Beautiful Mind that someone’s hallucinations are so real to them they feel like reality. David calls Isabelle on calling this a delusion: somebody did move it. It was you. And you don’t remember it because you didn’t make a memory because you were busy doing ten other things. The whole thing is accurate. Isabelle laughs so hard and thinks she might need to get that tattooed on her: “Somebody did move it, and it was you,” Memento-style (see below). Isabelle notices that over time she is much more open and discloses more quickly that she has ADHD, in an attempt to normalize it and make it a safe conversation for the other person, too. And she notices that in the past she would maybe make it more of an apology or an explanation—don’t mind me not keeping track of the tea mug, my working memory is shot—but she realizes this added dimension, that while she is beating herself up inside for losing the tea mug so often, she is also really relaxed and happy and playing with her kid, and that’s an ADHD strength. David asks how often she will be upset with people for making mistakes? Isabelle names never, and may even be forgiving to a fault, it takes a lot for her to take a mistake personally. David asks: do you realize that is an existential superpower? We make more mistakes before breakfast than other people do all year; if I can make you feel better about the mistake you just made, I feel better! If I make a mistake, I’ll beat myself up, but if you do, I’ll find every way to preserve your self esteem and integrity. Isabelle wonders if existentially, this resonates with so many traditions and theories around the idea of not taking things so personally, witnessing the thing instead of personalizing the thing. And David names that it cannot be to a fault, you’d never knock someone for having such a worldview. And our ability to remove pain in the absence of more information is impressive. David names that our superpowers often connect to how ADHD works in us. For David, he can’t remember what he just said (working memory) but he retains something he saw on a screen once that was a fun fact…forever (did you know most polar bears are left handed? That coca-cola’s original color was green? That Hong Kong had the most Rolls-Royce’s per capita in 1992?). Some people can recite whole movies verbatim to the character. To not have the delay in gratification skills and response cost awareness to really recognize the consequences of someone’s failure, and instead be the healing they need by being understanding: this is a magic. We’re good at creativity, problem-solving (not good at avoiding problems, but good at solving them), adaptability. David goes down a tangent of Kierkegaard, a philosopher who wrote a lot about anxiety being complex and connected to how much you know yourself, the more you know yourself, the more you know what to do in life. But more than that, he also named that freedom means having lots of choices at all times—something that someone with ADHD can relate to—things I can do in a given moment, how can I pick what to do? Paralysis by analysis, being stuck by so many options, how the heck do you pick something? In order to pick, when you have a lot of options, is a leap of faith (he means it more religiously, but David means it more colloquially)—leap of faith based on who you are. For example, I don’t like hurting people, I like laughing, I don’t like inside all the time—I might have 30 options in front of me, but only four fit that criteria. And even more than that, how do you pick amongst the four? Take a leap of faith, because you only get to know yourself through the decisions you make, not the de...

David begins by naming that dealing with a lot of a frustration is part and parcel of ADHD—and yet, we don’t want to make everything easy, some things are supposed to be hard. Essentially, there is a certain amount of frustration and discomfort that someone with ADHD has to be ready to experience. Isabelle is hit with that and explains that frustration tolerance is how much discomfort we can handle—when we’re waiting, someone’s running late, we’ve lost an item, pick a thing—and as much as it might be nice to hit the easy button and want this all to be squeegee’d away (so satisfying), it cannot be. It’s more like an old rag that barely gets the soap off. David names that Noah and him have long conversations about it, and his friend focuses on what you can do to experience discomfort, tolerate it, and build accommodations about it. He’s the kind of person who sees a big scary book and decides to read it, and David oppositionally wonders why you would put yourself through that? He sat down and taught himself how to read—David wonders at what it takes to sit down, take time, stare at a book, and flip pages, and reread a page or paragraph over and over again.  For David, a lot of those hurdles felt unfair and unjustifiably frustrating, so watching Noah tackle a task simply for the mastery of it was a new idea. In very general terms, the grey matter around our brain gives us a little more impulse control. The more time you spend practicing something, the act of practice—a puzzle, a book, sitting and breathing, going for a daily walk, etc.—the act of continuing to do it even if you don’t want to builds grey matter, it builds your frustration tolerance for the thing you’re trying to do. Isabelle clarifies that this is a task that you can’t require your hyper focus to do, because you’re not as interested in the thing.  David describes how he was struggling with fifteen minute car rides, and then got stuck with the first to be picked up, last to be dropped off slot on the bus route for school—hour long experiences. Suddenly, after having practice taking the bus, which sucked, it happened that he gained a greater tolerance from that. Isabelle asks if the the strife and frustration got him something, that wasn’t needless suffering: short term gain v. long term gain? David names that it is important to honor that it is more painful for us to do things we don’t want to do than people understand. You want to ball up your hands and stomp your feet, the amount of restraint it took to not swear more than once in traffic—there are so many places where we don’t fit. We encounter the pain of not doing the things the first time, then the double pain of judgment—is it me, or them? What’s the best way, and how do I know? Folx with ADHD tolerance for distress is much higher for a lot of things than others understand, but not for all things (like people walking slowly, waiting in a long line with a delay, being stuck in traffic). The example of people walking slowly made Isabelle cringing at the very thought of the moment: it is actual, physiological pain. It makes Isabelle think about childbirth and the practice she underwent called mindful birthing, which meant she slowly tried to acclimate herself to discomfort and pain (such as from holding an ice cube) and then to practice different approaches to noticing it mindfully and riding it out. She describes how she noticed in the labor process, which took many days, that there was this internal, full-body sensation (beyond the contraction) in response to the discomfort she was in, not dissimilar to the response she feels when she’s stuck behind people walking slowly, and she noticed that her endurance surprised her, not being naturally athletic or very physically gifted in that way. She describes telling herself “it’s only one minute” or “it’s only ten more minutes,” like a button to counter the impatience she feels (similar to the “Unbreakable Kimmy Schmidt”). David is stunned and wants to relate to what Isabelle is saying because though he cannot fathom childbirth, he resonates with something for him. He goes back to his psychology class sophomore year and names that it’s a duration measure: something that has a beginning and an end. Everything that is crappy has a beginning, and an end. He had the kind of learning that things stink, so you avoid them, but it gets in the way as he gets older. All of a sudden, something clicked, that he learned if you get something over with, it’s over with. When we’re talking about how much pain people with ADHD experience and how much we need to experience those things, we need to remember that the time you’re doing the thing you really hate, it’s going to be over with. Maybe you’re only going to have to do it once, or twice, or six times. “I can’t do that thing, I have no more room for pain.” Which David understands, and if you have any in the tank, “let’s do this thing so you don’t have to do it again.” Isabelle describes that often feels like there are only two times: Now v. Not now, which reminds her of how little ones think, developmentally: there’s a sense of “I don’t wanna,” and how quick it is to forget that you still have to get it over with, which reminds Isabelle there’s more than now or not now. It wasn’t until David was in grad school that he recognized that not now matters. He started calling it Past Dave and Future Dave—thanking Past Dave for making things easier for Future Dave. David walked past a Brita filter and filled it up with water, and said “I got you, Future Dave.” I saw that I had cold water the next day, and he said “Thank you, Past Dave!” Any special comfortable sock is a good day sock—he plays with Future Dave. This is how we get through the little moments and things that have no immediate gratification.

Mindful Birthing questions? Here’s a link to the organization that does it, and to the book, and even an excerpt.

Behave (book briefly mentioned by David) by Robert Sapolsky

Unbreakable Kimmy Schmidt

DAVID’S DEFINITIONS

Frustration Tolerance: this is directly related to how much BS/or annoyance we can take for any given situation. The way we build it is by practicing tolerating the BS/annoyance. One of the more basic examples of this, would be getting used to being in the car for long drives by taking long drives in the car.  Yes, even the idea of building a tolerance to frustration can require building your frustration tolerance. 

Duration measure: The thing between a start and a finish, recognizing how long something takes. 

Tips for accommodations:

• Where does the behavior NOT happen?
  • Get clues about the environment. 
  • Figure out what works for you.
  •  Embrace it. Radically accept it.
  •  Throw out what doesn’t work for you.
  •  Don’t look at it as a failure.
• How to tell what to outsource: you can tell someone what to do, but you can’t tell them how to do it.
  • What do you want done in a specific way? 
  • This goes both ways: how to give instructions to someone with ADHD (see above).
• Practice asking for time or for less when someone is giving you a big list or...

Isabelle & David welcome Isabelle’s husband, Bobby, and their friends, Christina, AJ, and Gabe, to continue to listen and learn from David’s tried and tested presentation on ADHD, which he normally gives to fellow clinicians (for the 1st-8th parts of this talk, please see episode 4, All About ADHD Part I; episode 6, All About ADHD Part II; episode 9, All About ADHD Part III; episode 12, All About ADHD Part IV; episode 15, All About ADHD Part V; episode 18, All About ADHD Part VI; episode 21, All About ADHD PART VII; episode 24, All About ADHD Part VIII). David describes how with ADHD, the context matters. As part of a respite care program, he once took out this amazing kid out who loved to scream--not angrily, he just enjoyed the sensations of screaming. The behavior would get to his parents and they felt they couldn’t take him out to eat, etc. because the screaming would bother people. David took him to a football game. Is there ever a point in a football game where it’s not okay to scream? The same behavior is contextually appropriate. Gabe thinks about violence or hunting, which he is wondering about connecting to ADHD and appropriate/inappropriate behaviors—David does not see a connection between violence and ADHD. Instead he talks about danger and stimulation. He picks up an agate coaster (rock) and says if someone with ADHD was handed this, they might start tossing it around. But tell that person that this is a one of a kind, very valuable thing, and they’re not going to toss it, the added risk has raised the stimulation so you don’t have to toss it anymore to be stimulated. It’s about safely increasing the danger or risk of something, pushing the limits. Another example is the water cooler. David describes working with kids where they press the button to fill up their cups with water to the very top, to see how high they can make it, and then have the added risk of trying to carry the cup without spilling it. In those moments, they are actually attending so well to the water, really focused on it. Bobby wonders if his “That’s So Raven” (see below) moments, where he has flashes of what might come to pass, like the danger in taking one route or another. Isabelle hypothesizes that it's a way to introduce danger to a scenario that doesn’t hold any. David describes that it’s a way to safely visualize danger so you can organize your thinking, but not actually have to experience it. Everyone has a different level of tolerance to danger, and it’s not about “hugging the danger,” it’s more about introducing structure. Like at a garden party, telling a kid to make sure this guest has enough water and whatever you do, don’t step on this other person’s shoes, and suddenly, it’s not a dead person command (something a dead person can do, AKA, not what you give someone with ADHD), it’s actually structure. Isabelle wonders at how this seems to help with their toddler (setting up some ground rules to think about ahead of time before visiting a place) and at how she might do that for herself, setting up rules for a meeting, let’s say, where she knows she’s going to doubt what she said so she’s going to say something silly and get it over with first thing. Bobby likens it to an accusational audit, which is a negotiation strategy, where you make all the accusations you’re scared of hearing up front, you get them out of the way.  Bobby gives an example of asking for a raise and starting off by saying “I know I might seem ungrateful or like I don’t understand how tight the budget is…” This connects to David’s DARE technique for asking for accommodations. D=Describe the dilemma.  “I really want to ask for a raise because I think I deserve one but I don’t know how to do it.” A=Ask for accommodation. “I would really like a raise.” R=Reinforcement, no matter what they say.  “Thank you for saying no, I appreciate your honesty and being up front with me.” E=Empathize, or remember that the other person is a human and negotiate closer to what your want is. “I hear you, when’s a good time to come back to this conversation?” AJ seconds that this is a technique similar to what is taught in his sales-based organization, and David describes that he stole it from DBT (dialectical behavior therapy, see below) and it’s acronym DEARMAN, because it simplifies it for someone with ADHD (too many things to remember). Gabe asks about the romantic nature of danger, how he pushes limits, like when he was younger, see how far he could ski down a black diamond ski run without turning, which led to him being injured. David wonders about this: is there any way that him telling Gabe no wouldn’t stopped Gabe from doing this? (no). Would Gabe have just gone back another day to do it? (yes). The potential consequences on that day might’ve been worse? (yes). David says there is no way Gabe would’ve learned those limits without trying it himself. So how to set that up to do it as safely as possible, without trying to prevent what the person is going to do anyway. David describes how collaboration is one of the biggest ADHD accommodations and you don’t need another person with ADHD to do it. People with ADHD have a lower self-esteem and have a greater callous to take injury, but neurotypical folx don’t get injured as much (their self-esteem), so the person with ADHD in a group will often fall on the grenade or blame themselves. It also means you might be more organized or task oriented than usual because you don’t want the other person to fail. This is similar to body doubling. When you sit down and join somebody, think about the structure you’ve just put into free time (for example, we’re all studying! Parents sitting down to read alongside their child who is working on homework). It helps when working in groups to find people with complementary, not competing, strengths. Isabelle describes how becoming a parent served as this kind of body double and heightened danger accommodation—first of all, parenthood undid all her previous accommodations, but now she finds that during naptimes, when her kid can wake up at any moment (danger of being interrupted!) She gets so much more done because she feels that risk and pressure and she feels like she owes it to her kid to get it done.What happens when the naps doesn’t happen? David describes that he would consider the rule that the kid doesn’t have to sleep, but can’t leave the room. And earmuffs for the sound. He also shares that the next level of an accommodation is the metacognition around it, the awareness of saving those tasks for naptime. David goes on to explain that he works with clients who struggle to get to work on time, but are on time when they have to drop off their kids at school (when someone is dependent on you, you don’t want to screw it up for them). The key is to not become dependent on the other person. If there is a dependence on another built into the accommodation, it will foster aggression. The more you need something, the more dependent you are on it, and it gets taken away, the more incensed you become. The difference is like being dependent on the sun or your partner, you’re going to lose it if someone threatens them. So instead of having a partner always make the lunches because they help you get the kids to school on time, you ask “can you make the lunches?” Every day—it’s not a dependency or an expectation, it’s an assist, but you are still accountable for the thing you’re trying to do, not angry that the other person ‘screwed it up’ for you. Ask more. But as folx with ADHD, we’re often trained to ask less because we’re told NO so many times. 

Isabelle & David welcome guests to a live Q & A (previously recorded) and start by addressing the question: What is it about folx with ADHD and overexplaining? Isabelle really relates to this as she overexplains the question. David describes the intersection between mastery and guilt. When you have a lot of mastery around the topic makes it hard to structure a response. You have so much to say, and as you start talking, you realize the holes in what you’re saying, so you go back and try to respond more and try to fill in more and more, and because you have a lot of mastery you have a lot of information. There is also a sense of guilt: when people are trying to be understood, or are feeling misunderstood, people can overexplain when they’re trying to explain themselves. This is literally what structure looks like: over explanation is a structural issue, thinking about the beginning, middle, and end of what you’re going to say. With ADHD we often had a good beginning, a solid middle, and then…it’s just supposed to end. Why are people still looking at me? But I’m still talking…(awkward silence). Isabelle names there’s a look on people’s faces when she’s talking too much and often makes a joke about talking to much to end it; David notices when people start checking their watches or phone, or starts looking around the room, he just assumes that people are done. YAY for the podcast format that helps them both talk longer than might usually be socially welcomed. Isabelle describes how many a part of overexplaining is wanted to clue someone in to what’s going on in her head when she unmasks, like it’s the closest thing to seeing her thought process and the tangents and longwinded way she sometimes gets to things. She also finds herself wanting to fill in silence with jokes and facts and anecdotes and is often the one to try to break the ice. David names that this could be something else: namely, how comfortable are we with nothing? David has a low tolerance for someone asking a question, let’s say in class, that no one’s answering.  It could also be called mansplaining, in the form of David just taking up air time, but he’s noticed it often helps start off conversation. Isabelle agrees that her awkwardness often brings people together. Noah chimes in to name it as being natural pickle jar looseners. Noah names gaslighting, and if someone has been gaslit (by others or themselves) their whole life, they may walk around feeling like they need to prove that they’re not “crazy” —Noah describes that he often asks himself “is this weird? Should I say this? Are people going to think…” before he says something. Everyone on the call starts nodding vehemently. David names that folx with ADHD often are very connected to someone else’s inner state, they have lots of mirror neurons (neurons that fire when you’re witnessing or anticipating someone else doing a thing AS IF you are doing the thing yourself, which some folx think can be linked to empathy—see fuller definition and resources below). Isabelle and David open it up to even more questions. Noah starts with the challenge of working with clients who keep developing structure to get something done and it works for a week, but then they have to keep recreating or honing the structure week after week and it’s not working. David responds that there’s often an overcorrection when people are putting in structure, for example, they plan out every minute but it’s not sustainable. Also there’s novelty: novel plans can be attended to and are often stimulating, but once something is not novel, it can’t be attended to the same way. Even if you don’t really like the thing you’re doing, it may still give you a dopamine hit. Noah gives an example of the Pomodoro method, which uses timers. David names that not all interventions work well for different tasks and people. Think of the brain of someone with ADHD as a jet engine—it’s not disabled, but it might find it hard to go in the slow lane or try swimming. So now introduce an intervention that means you take a break quickly after starting (and started a jet engine can take a while)—is the person having trouble taking breaks or having trouble starting? Start a seven minute timer and have to start before it goes off. If it’s a taking a break intervention, maybe take a break when you next go to the bathroom. Breaks and ADHD is hard, people will believe they need to take more breaks, and that’s not true—people often need less breaks, to stay in rhythm longer, and take breaks when it’s effective. For example, instead of a break after school, knowing your medicine is not going to work as well later, going to punch a wall (or do some movement) and then resume homework. It’s like the intervention of needing extra time on a test, when we often need less time. Isabelle wonders what are questions you can ask to figure out what interventions you need? Figuring out what the task is, whether they accomplish the task, and whether it hurt (what are the pain points?) For example, if someone was able to write the paper, but it was hard to write, you figure out an intervention that helps with that part, like body doubling, where another person creates the illusion of structure. Another question: how does someone who may or may not have ADHD adjust to a change in their pace (say between pre and post pandemic times) and recharging their batteries? If our brains are like jet engines and we’re adjusting speeds, how do we rest? Healthy routines are often helpful. But David thinks about the Inception test, which is how you can gauge that something subtle is different—you may not get the warning that your battery is 5% and that might be a rare occurrence, so we get thrown off. David names some cues he puts into place to see if he’s fatigued, like if he’s had lunch, if he feels like cooking, do his shoes feel heavy? Concrete ways to sense if he’s fatigued to then take care and recharge his batteries. It’s connecting physical things that you notice first, like watching dumb shows, or whatever weird things you do when you’re tired (you’re going to notice them first before you notice you’re tired). The recharging of one’s battery is one of the most judged and stereotyped thing, according to David and Isabelle.  People will believe they’re recharging their batteries if it’s boring. Maybe redefine it in a way that’s more fun, like wearing those pants that have lights in the bottom. The quest is going to be figuring out what recharges your battery—learning when you’re worn down is going to be one thing, then figuring out what actually recharges you--choosing the hard button sometimes, too, which means going for the thing that actually recharges you, versus the thing you enjoy but that actually doesn't bring you a lot more energy. David also names how much stimulation you get in nature, just how much is happening when you watch a fire burn or the leaves in the wind--there is a ton of information going on all at once. Isabelle summarizes that when thinking about self care, think about what behaviors you are doing right before you realize you're tired (what are concrete signals)? Whatever you're doing to help yourself recharge: is it an easy button or a something that's really working? Are you over or understimulated? Both can make you feel drained, so be wary of the stereotypical things that are advertised as "self-care" and pay attention to what is actually true for you.

What about that study on shocks being more painful if you think you were shocked intentionally (by Bumbling Steve v. Intentional Steve)?

Isabelle & David welcome guests to a live Q & A (previously recorded) and describe the origins of the podcast, when the two were working together. David had given a presentation and had been gifted a microphone to record his presentation and turn it into an audio book. Isabelle had been welcomed by David to the tribe of folx with ADHD as she slowly realized her own ADHD diagnosis, and was hopeful she had it because it could remove so much shame, blame, guilt, and doubt and increase her understanding of herself. She was brimming with questions for David. They wanted to make a podcast to remove the barriers to this information, which you may normally pay a therapist for—not everyone can pay for a therapist, let alone reach one or feel comfortable going to one.  David recalls his brother, who’s mission was to increase understanding to reduce suffering, which is a great way to sum up what the podcast is all about: to increase understanding about ADHD to reduce even one person’s suffering. Without further ado, the two begin to answer questions asked by Q & A participants, the first being, why, when asked [a broad question like: what do you want to know about ADHD?] Their mind goes blank and they can’t think of anything? David names that it reminds him of straddling two countertops like Jean Claude Van Damme (see clip below) and could come from two angles. If someone has ADHD and they’re reading a structureless question, it’s so broad, too little to think about—structuring the question would be very helpful and sparking specific ideas. If the asker is someone without ADHD, they might not know how many parts of the world ADHD touches, how people learn differently, how people hum at different energies, what natural homeostasis looks like for different people. You might not think ADHD has something to do with someone’s sexual appetite, why textures feel strange, why someone seems selfish, why someone doesn’t take care of themselves, why someone is ruggedly independent and ask people for help (fill in the blank), etc. Isabelle notes how she’s noticing that a particular shade of pink on her screen always makes her feel nauseous when she sees it. How to narrow down a broad question, or deal with ordering food—think about categories. As an adult you can (sort of) get whatever you want, and that is a huge question. On a side note, why do buffets exist, Isabelle wonders, while David likes a buffet. What kind of food do you want, hot or cold? Hand food or silverware food? Spicy food, etc.? So one way to rephrase the question is to sprinkle in a category or detail. How important is it to see someone (as a prescriber or therapist) who has a lot of experience with ADHD? Maybe not so important. David names that he would consider what somebody’s biases around ADHD are and ask that question: what do you think of that diagnosis, do you often see people with this diagnosis, etc. We often forget that we have hired them, that psychiatrists and other prescribers work for us, we hired them, we can decide that we don’t work with it. Someone who is willing to try together to find something that works for you and be willing to experiment with you, v. When someone is naming the connection between stimulant medication and drug abuse, the question is not, is it the right thing to do, it’s: does it work? Examples include people who have been off of meds but now drink 13 cups of coffee? David makes it clear that psychiatrists work with psychiatric issues—ADHD is a medical issue. A general practitioner or doctor can prescribe you medication; you don’t have to go to a psychiatrist unless there’s a psychiatric issue. In the ADHD world you’re often working in one of two ways: do you need gas, or do you need brakes? Do you need something to speed you up or slow you down? When people look at it as a psychiatric issue, they try antidepressants or anti-anxiety meds, but when people are medicated to reduce anxiety they act out to increase stimulation. David also names neuropsych evaluations have a hard time differentiating between anxiety and ADHD—sometimes it’s less important to know what it is, than to see what works (more sleep, which meds, which interventions?) Next question: What about people who’s partner has ADHD and gets irritated by their behaviors that may connect to ADHD? David names how important psychoeducation to understand what’s going on. Is it the person’s ADHD or their middle finger? Is it their inattentive type behaviors or do they really want to hurt you? David names the study (cited below) that shows that when someone feels like someone is intentionally shocking them, it hurts more, and when it’s not intentional, we feel the pain less. “He did it again, didn’t mean to,” and when you were in a fight and realizing what someone is not intentionally doing to you. Knowing where you can expect things to change and where you need to expect acceptance are important things. It’s not that you’re helpless and someone with ADHD is going to destroy your life, let them go, etc. just to know where the struggle busses are (for example, being on time v. Quality time), you create an accommodation around the idea that misses will happen, but don’t set it up so that the person who’s in the hot seat is always having to defend themselves. David gives the example of how his behavior might change if his partner shamed or blamed him for showing up later than expected. He would still show up late, he just might not text—because he would change the behavior around the shaming and blaming. That’s why getting diagnosed can be important. What if someone doesn't want to get diagnosed or get support? When someone doesn’t want to change, it’s an important piece of data, too. You don’t have to listen to this podcast, you don’t have to get more information, but these behaviors have to change and you they have to be more understood, so how are we going to do that? People often dismiss their ADHD diagnosis because of the stereotypes and myths. Noah jumps in and interjects that it helps in friendship to not take it personally, like in his friendship to David, he needs to not take his lateness personally, and David has to not take his ready-to-go-ness personally, either. 

Jean Claude Van Damme counter split straddle clip (from "Time Cop" (1994)-- please note this is the scene that leads up to the famous counter splits and also note there is some adult language, violence, and action film cliches involved). Side note, there are compilations of his famous split scenes available if you google them. 

What about that study on shocks being more painful if you think you were shocked intentionally? Check it out here.

For more, check out our website!

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Cover Art by: Sol Vázquez

Technical Support by: Bobby Richards

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Isabelle & David welcome Isabelle’s husband, Bobby, and their friends, Christina, AJ, and Gabe, to continue to listen and learn from David’s tried and tested presentation on ADHD, which he normally gives to fellow clinicians (for the 1st-6th parts of this talk, please see episode 4, All About ADHD Part I; episode 6, All About ADHD Part II; episode 9, All About ADHD Part III; episode 12, All About ADHD Part IV; episode 15, All About ADHD Part V; episode 18, All About ADHD Part VI; episode 21, All About ADHD PART VII). Bobby starts by naming that a lot of self-help and business books focus on you giving one specific thing your all and focusing on that, continuing David’s idea that folx with ADHD are like relief pitchers, so don’t try to make them all around baseball players (play to your strengths rather than trying to change your vulnerabilities). David names that it can be distracting trying to be perfect. Bobby also names that being a freelancer means you are wearing so many hats and getting caught up in so much minutia. But it also is scary to say you’re going to say no to 98% of what you would normally do and only focus on the 2% that’s your focus—also, what about the fact that Bobby (and many of us) want to wear many hats and do so many different things? Isabelle relates to this in how she checks out a number of ebooks from the library and reads them all, but in patches and based on what her mood is. David names that what they’re both talking about is the structure. You are focusing on one thing, but you’re using a structure to determine what that one thing is, and how it’s more of a pattern and a rhythm than you might realize. Bobby names that he thinks it’s true because of Isabelle’s 5 year journal, that reveals they are way more into repeating patterns throughout the year than you would think. Focusing on the things you’re really good at allows you to notice what else you should pick up and add to your repetoire. People with ADHD often overcommit because they want to make people happy. So saying you can focus on what you’re good at doesn’t mean you have to do it one way, it’s more that finding what you want to do helps you feel less overwhelmed. Find what you’re good at and invest energy into it. David is good at talking and listening so that’s what he does for a living. It’s about accepting your vulnerabilities and knowing who you are, it’s about embracing, not curing. ADHD requires a variability of stimulation. In the absence of stimulation, we can’t do tasks. Example: one explorer goes ‘there’s a cliff!” While the person with ADHD goes “there’s a cliff!” and almost runs up to the very edge and sees an orchard that was hiding there. The need for stimulation is why you might get closer to the edge of the cliff, it might mean why you wait until the last minute to do something. This connects to procrastination and self-stimulation. (For MORE on procrastination, check out episode 08: Are We Designed to Procrastinate?) Which emotions help your heart beat faster, that help you self-stimulate? The ones you’ve practiced the most, usually, including: anxious, angry, or excitement (or arousal). Bobby and Isabelle both relate to the anxious/angry during transitions part. You can always expect those things around a transition. It can make you feel like less of a monster, if you can expect it. Instead of saying “why are you always so mean to me when we leave?” You say “oh my gosh, we need to leave, I’ll meet you there.” David mentions that it’s a DRO technique, which means a Differential Reinforcement of the Other (DRO), a type of behavioral technique that makes the behavior you’re trying to avoid not an option. Bobby uses accommodations to make sure he’s on schedule, so he gets anxious and needs to be on schedule and tries to be early. Isabelle, on the other hand, has her own rhythm and path and gets overwhelmed when she hears too many voices coming at her, and then gets really mad at herself. David names that it may be less about being mad at getting micromanaged and more about getting distracted. Isabelle agrees, that it feels like six competing voices sometimes, and it’s very overwhelming, she gets that way about music and sounds in general. David talks over Isabelle to demonstrate what it’s like when she’s trying to go through her list and giving her instructions, and she gets so mad at him (and it’s okay, it’s part of the example) and he points out her way of creating a sound screen is to hate somebody. So with structure and independence, you don’t need to get angry because you don’t need to self-stim (see below) to stay focused. In essence, there's no way she can take on another competing stimulus (like someone telling her what to do as she has her own thoughts about what to do) without self-stimulating unless she is on a medication. AJ posits that maybe this means don’t give competing instructions to someone with ADHD to limit this phenomena; David revises this as the person with ADHD saying “One, I need one”—it’s about a need to self-regulate the process. Or if you give someone with ADHD a task to do and they say ‘sure,’ it may get done in the next two days. So the call and response around this type of request might be “sure” and then let them do it right then, or alternately the person with ADHD saying “I can’t” and you believing them. Gabe wonders how can you do this with kids, where you have so many different variables, and how the task of getting the kids to school on time, for example, becomes lost because there’s so many moving parts. He names that if he has to get the kids somewhere and his wife has prepared a bag with all the needed things, he’s able to do it. David asks what the accommodation there is: all the stuff being ready. He asks Gabe what he would need to get to school early? Gabe answers: all the stuff being ready. You can see exactly what you need but it can be hard to put it into a different context. One tip for talking to a child or someone with ADHD is to never ask them to do something a dead person could do. Examples include: “stand there,” "sit there,” “don’t move,” “don’t touch,” “wait for five minutes,” etc. You instead say what you want them to do, and be specific. “Play quietly” doesn’t tell them what to do, it opens the door to everything. So instead, try “run around the block” or “run back and forth to the tree over there.” When it comes to asking kids to be quiet, making it a game, like a whisper game, instead of just saying “don’t be loud,” which doesn’t work. Knowing this is supposed to happen is really important, with kids, helping them recognize that the angry, frustration, arousal, stimulation needs are supposed to happen. We want to avoid saying the words “just” and “should” with kids, at all times. Don’t “should” all over yourself. Bobby acknowledges doing this too often. Avoid saying “this is easy…” and try “I know this is hard and you only have two things left.” Because when someone’s self-esteem is damaged, they’ll throw everything away, and when they’re self-esteem is intact, they’ll do everything to save the crystal ball. Gabe gives an example with his kid finishing most of the broccoli in order to earn his cookie, but then he entered scorched earth level moments because there was one more bite—Gabe noticed himself wanting to say "it's just one more bite…” and instead thought of saying “I know this is hard, you did good” and actually told his son he had done enough and gave him the cookie. David names that this was smart, you want to avoid power struggles with someone with ADHD because the whol...

David mentions that he is sitting on the floor, because he still hasn’t gotten a desk. Isabelle supports the floor sitting and prefers it herself for her sessions, or standing. The two agree on swivel chairs and some of the squeaky and smooth qualities of swinging or rocking, and Isabelle mentions that 5 S’s, or the hacks that are supposed to help lull an infant to sleep (5 S’s) —what is it about water that Isabelle finds so soothing on a sensory level? Isabelle’s theory is that it provides a deep consistent pressure, and a lot of sensation and stimulation, the almost-weightless feeling— a set of physical sensations. David validates this: cold water is a neurological stimulant, and the sense of buoyancy may not be comforting for everyone, but soothing for you. David mentions Wim Hof and his method that uses very cold water/showers and breathing methods to give a bit of a reset. David points out that water may also be helpful because it provides bilateral stimulation and an element of risk taking (you have to keep swimming or moving or you’ll drown), and Isabelle confirms that for her that pressure and buoyancy and the sensation of being pulled down (like Twilight Zone Tower of Terror). Bilateral stimulation is when you stimulate first one side of the brain, then the other. It has been known to help with trauma processing (for example, what’s used in a method called EMDR, or Eye Movement Desensitization and Reprocessing), and added stimulation can be comforting alongside cognitive processing. Owning the idea that it might be comforting for you, not for everyone. There is a spectrum, for example, some people love a weighted blanket, some people cannot tolerate it. Make sure it’s a weighted blanket that is right for your age and weight range (because there are limits)—David almost threw his arm out throwing a weighted blanket. David tried it for three nights and then got too hot. Isabelle and Bobby’s blanket doubles up when one of them tosses their large blanket onto the other during the night. Isabelle talks about all the sensory rooms she wishes existed, and how awesome certain sensory toys are, and they agree about ball pits and how it feels. She mentions the City Museum of St. Louis (see below) which is filled with incredible sensory experiences—Isabelle had an experience where (as a six foot tall person) in a ball pit, she thought there might not be a bottom. David helped prompt Isabelle to remember what she was talking about by repeating back what her tangents were. Isabelle names that she has not idea where she learned something but can also picture it—David names that there are anchor memories. Isabelle notes that conversations with neurotypical friends—she slows down, tries to stay on topic, tries not to interrupt, which she notices she does not do with her neurodivergent friends. David never understood what masking was until he met David Flink and became involved with Project Eye to Eye. David learned through the trainings and collaborations with that organization that masking (pretending to be neurotypical) was chipping away at his authenticity. His usual rate of talking is 1.5x—and it takes energy to slow down, both Isabelle and David agree it’s exhausting to slow down. David describes how when everyone was talking, this awesome guy named Grady was throwing a ball against the wall, and then he shared this racquetball experience with each other. No one in that room dared to challenge someone to say they weren’t paying attention, regardless of what they were doing—it was such an empowering and incredible space. Isabelle remarks on how amazing this sounds and names that throughout this whole conversation, she has been fidgeting with a My Little Pony plastic tail—and how it would feel to hold up that fidget toy with pride. The importance of explaining to people why we need our sensory toys and fidgets and just how much it matters to unmask and set new models for people.

5 S’s (for soothing babies, developed by Dr. Harvey Karp who wrote the book The Happiest Baby on the Block) but as David and Isabelle name, these can be great sensory ideas for folx in any age or stage)

-swaddle (think of a weighted vest/tight shirt/weighted blanket/body sack/body sock)

-holding baby on their side or stomach (lying down in that position)

-shush (imitating white noise) (noise machine or ambient music)

-swing (or rock)

-suck (pacifier or thumb)

Twilight Zone Tower of Terror

City Museum in St. Louis

Project Eye to Eye 

Wim Hof: Also known as the Ice Man, developed a breathing method to endure cold temperatures and holding his breath a long time. It’s a breathing method that can help you stimulate yourself and ground yourself using a cold shower, for example. 

DAVID’S DEFINITIONS

Bilateral stimulation: Any rhythmic stimulation of first one side of the brain/body (eg. left), then the other side (eg. The right). Essentially it’s going back and forth, back and forth, almost like a metronome, but with a tone, a tap, a light, or a movement. Examples that we naturally do are: walking, climbing (first one foot, then another), or butterfly hugs (see here).

EMDR (or Eye Movement Desensitization and Reprocessing): a therapy used to help clients process traumatic events that involves rhythmic bilateral stimulation (in the form of tones, taps, or even flashing lights, that first stimulate one side of your brain/body, then the other, back and forth.  For more, check out the American Psychological Association description of this type of therapy.

Learning Difference (LD): Because learning disability is a crummy, inaccurate term. For example, David does not have a learning disability, he has a sitting still disability. 

Masking: Often used in referenced to folx with Autism Spectrum Disorder (ASD), it also applies to folx with ADHD (or both!), it’s the idea that you have to wear a neurotypical mask to be accepted or to engage in a world made for those that are neurotypical. It can be (and feel like) a matter of survival. 

From a great article on the topic:

“For many neurodivergent people, masking is a survival tool for engaging in neurotypical societies and organizations. Masking (also called camouflaging) is the artificial performance of social behaviors deemed more “socially acceptable” in a neurotypical culture.”

Sensory Tools Galore!

First of all, there is no one size fits all! This list is not exhaustive, but it's a start.

Balance boards

Bean bags (some lighter/heavier, hand held, chairs)

Bilateral stimulation (see above definition)

Body sock/body sack

Are folx with ADHD made to be night owls? Or early birds? Or does your early bird/night owl setting, which feels so engrained in your personality, actually have more to do with giving yourself distraction-less time? David and Isabelle explore myths, misperceptions, and truth bombs about the nature of sleep and ADHD, including tips on setting up your morning or evening (or all day) routines, dropping the shame, and embracing what you may be doing right in staying up late (or waking up early). 
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Isabelle is super tired and is tired of her own choosing. She has been waking up earlier than usual in an attempt for her and Bobby to each get some alone time in the morning to get situated and start their routines and transitions differently. She does yoga, exercises, meditates, and can see that it gives her more energy. She wonders if folx with ADHD are actually night owls by nature, having spent years waking really early, then sleeping in—but is it ADHD? Delayed sleep phase is one idea, but David mentions that folx with ADHD seek out a distraction-free environment, and where you get that time (whether in the morning or in the night time) is the kind of person you become (early bird or night owl). So you adapt to achieve the distraction less time in the morning or at night. We carry so much of a load for all the things we’re not doing (I still need to call this person, I still need to do all these chores, etc). the escape of things being too late or too early to do also gives us distraction-less time. Being up early or staying up late gets really simple, it takes away choices. What happens when you are hyper vigilant all the time that you’ve made a mistake and someone is going to call you on making a mistake before you realize you’ve made a mistake? Or that you’ll later be embarrassed for doing something impulsively? This connects to how often is anxiety used by us to drive things, the anxiety of being an imposter, being seen as incompetent—there are lots of these themes for people. Certain environments shut off the anxiety or the drives. How much shame we have determines the intensity of the anxiety, hyperfocus, hyper vigilance. One of the reasons we are doing this podcast is to reduce that shame: there’s no shame in your night game! If you are still getting up and doing the things you need to do in the morning, go for it. If you like to wake up super early and run for hours—we can self-authorize to do the things we like and need. And shoutout to new parents, from David, that in between all of the unsolicited parenting advice, you need to believe in yourself and your needs, and not have shame for your needs. There can be so much anxiety for the ongoing assault of judgment about how you should be doing it; or how you should be spending your evenings. Or how you should be spending our mornings. Or how neurotypical you should look, how you should ‘do’ ADHD. There is no right way. If the task gets done, drop the how. Isabelle points out that early birds are often praised while night owls get the shame. David names that it’s more about finding mastery over your behavior. The answer is yes, there is no better, the real question is: are you getting up for the things you need to get up for? It’s the metacognition (see definition below), that gives you awareness that you have some mastery over your behavior (eg. Like waking up early easing your morning transitions. Isabelle is so tired she realizes her tangents are in slow motion and David names that he sees her turning on her blinker to make her tangent. Isabelle remembers reading a book about sleep that mentioned a method used by the military to fall asleep in two minutes (see article below), that includes relaxing your jaw. David names that sleep training often relies upon fatigue, and fatiguing your body. Weighted blankets can help (but with a word of caution, they are quite heavy, so if you try to throw it across your bed like a regular blanket, you will throw your shoulder out). It’s tough to plan what time to go to bed without factoring in what time you want to wake up, nor that you need to wake up earlier the day before so that you’re actually tired and fatigued when you try to go to bed early. Isabelle experiences this every time she tried to go to bed early before a trip. David is trying to actively do this now by waking up earlier the day before and drinking lots of chamomile tea. David names: we often do the right things but we don’t know why. When you’re staying up later, you’re getting the alone time that you need, but you’re not allowed to have it. Or if you’re listening to music all the time it’s helping you tune the distractions or scary noises out. Sleep hygiene is a place where we should all over ourselves (stop ‘shoulding’ on yourself). Sleep hygiene is creating routines: does it help? Does it help you get sleep? It’s also effective to chunk time together, going to sleep could connect to when you wake up, what you do in the mornings. David names that he needs to lay on the sofa breathing and thinking before he goes to bed. Sometimes he doesn’t make it to bed, but it’s not because he wants to avoid his partner (it’s the opposite of sitcom plots). Isabelle can feel that she’s getting too tired, her face feels dead. Isabelle goes on a tangent where sleep is a reflex or a drive that happens, and you have to get out of the way or essentially distract yourself. One way to distract yourself is to play categories, where you pick a category and then try to name something that starts with the letter A in that category, then the letter B, and so on—essentially bore yourself to sleep. Another trick that David and Isabelle both reveal is that you can scratch your pillow to be your own DJ or hear your own heartbeat like it’s a train—and in a final twist, that a chip crunching in your mouth is actually a miniature sonic boom (source below)! 

Falling asleep in 2 minutes military (navy pilot) hack

More on sleep and how it’s a drive/reflex rather than something you do (Source: Johns Hopkins Medicine):

“Your body can’t force you to eat when you’re hungry, but when you’re tired, it can put you to sleep, even if you’re in a meeting or behind the wheel of a car. When you’re exhausted, your body is even able to engage in microsleep episodes of one or two seconds while your eyes are open.” 

Chip crunches are tiny sonic booms — check out the book “Gulp” by Mary Roach, or her shorter NY Times article in 2013, “The Marvels In Your Mouth” 

DAVID’S DEFINITIONS

Delayed sleep phase: Specific to some people whose bodies don’t produce melatonin at the same level, it's very difficult to go to sleep and notice tired signals (not necessarily ADHD). 

Metacognition: Thinking about thinking. Understanding and awareness of why you do the things you do. When you reach this point with any behavior, you’re more than halfway there. 

Sleep Drive: Your body craves sleep like it craves food, except your body can put you to sleep if it needs to, whenever it finally needs to, which is why driving or operating heavy machinery or making big decisions while very tired are usually not the best idea.