Something Shiny: ADHD!

Transitions and choices are hard. Isabelle and David are joined by Isabelle’s husband, Bobby, and David’s friend and fellow clinician, Noah, both of whom also have ADHD to talk about different types of ADHD. We don’t remember all the stuff we have to do to leave the house. Isabelle describes a detailed whiteboard and just how long it took to get into the habit of not forgetting things like lip balm. David puts everything into his bag at night. Isabelle has to do a one-touch rule. Noah’s and Bobby’s work bag are empty. Bobby’s really into minimizing things, which David points out is a wonderful intervention, especially for inattentive type— decision fatigue. Noah does this for going out, always ordering a blackened chicken sandwich. How exhausting it is to make decisions all the time. Noah’s experience in a blind restaurant. Bobby’s picky eating is connected to something ADHD-related—hypersensitivity around texture. David’s experience of this is big after decades of vegetarianism, experiencing the texture of meat for the first time (bacon and hot dogs are great. Other meat for him? Not so much). Isabelle references the Paradox of Choice book (TLDR) and describes the phenomena of randomly remembering facts she’s read, but struggling to remember what she read on command. Recognizing that when there is an overabundance of choice, we think we made the wrong one (or are left more disatisfied) because we always think we could’ve picked better. This relates to Isabelle’s reaction to Tinder as something that makes her nauseous thinking about it: too many choices. Same with old school diner menus. Or Cheesecake Factory menus. David agrees. Isabelle describes novelty seeking with food, whereas Bobby wants the same thing. David went to Superdawg and got everything on the menu he wanted because he couldn’t make a decision. Noah would go there, deliberate what to get for 20 minutes, and leave with nothing. Why do we all sound so different and yet similar? We’re talking about the distinctions between inattentive and impulsive ADHD types. What about combined type? Depends on the mastery of the environment: the more mastery, the more impulsive we can be, the less mastery, the more inattentive.

What is Superdawg? If you’re in and around Chicago, you’re welcome to check it out. If you’re not, it’s still a fun place to look into.  From the bottom of our pure beefy hearts. 

Paradox of Choice - book by Barry Schwartz (TLDR for Isabelle but an interesting summary appears on wikipedia). 

DEFINITIONS

ADHD types explained through how we order at a restaurant:

• inattentive type: struggles to figure out what to order, stares at menu (accommodations: always orders the same thing or same type of thing, asking the server for their choice/having the chef or someone else choose for you)
• impulsive type: orders three different entrees (to try them all), or the novel/strange seeming thing on the menu (accommodations: finding new places to eat or food bars where you can throw on whatever you want in that moment)
• combination type: see above and experience BOTH, often depending on your level of mastery/comfort (more mastery in the environment, the more your impulsivity shows up). 

Decision fatigue: the more decisions we make, the more our quality of decisions (or ability to do so well) deteriorates. Too many decisions can lead to an overwhelming feeling, burnout and poor decisions. Avoiding the complexity of decisions, can be an adaptive tool for individuals to preserve brain power for more important decisions, especially when the inattentive-type ADHD experience is loud. Here's an article on how to notice when it's happening to you.

Hypersensitivity around texture: some textures are going to make people feel more yucky inside than you would think they could. Often times it can be really helpful to honor these sensitivities, and not try to push through them unless there's serious impact on food and nutrition.

Here's a quick article on how to cope with hypersensitivities to sound, texture, taste, smell, etc. 

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Cover Art by: Sol Vázquez

Technical Support by: Bobby Richards

For our younger ears: there is a swear in the last minute of the episode. Be warned. 

Ever wonder if it’d be easier to be partnered with someone who also has ADHD (or, someone who is neurotypical)? How can you coexist no matter what the combo platter of neurodivergence? Robin, David’s neurotypical partner, and Bobby, Isabelle’s neurodivergent partner, join a relationship round table filled with practical tips on how neurotypical and neurodivergent partners can better support, communicate, and respond in key moments with one another. 
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ADHD is often scapegoated within relationships. David & Isabelle are joined by David’s partner, Robin, who is neurotypical, and Isabelle’s husband, Bobby, who also has ADHD. David describes his friendship with Noah, who also has ADHD, and how the two of them have different and complementary needs and accommodation styles (for example, Noah likes structure and being on time, David is more accommodated by not wanting to let Noah down). How relationships could look when people are aware of what they are good at, not so good at, and that they need to work differently. This is similar to how when Bobby and Isabelle were first diagnosed, they had very different ways of experiencing ADHD and their sample size (“but wait, Isabelle’s more organized, she can’t have ADHD!”) impacted their understanding of it. David and Robin describe how Robin gives David a part of a shelf—a place where he could freely be messy and do his thing. Like spots that she, as his neurotypical partner, does not try to manage. The group goes on a tangent about cockroaches running up legs and spiders in your mouth while you sleep (see below). David also observes that Robin does not ask him to do a lot of things so when she does ask him, it feels novel and he received instant gratification for doing the task, so he’s more likely to do it (and eager to please the person he loves). This also connects to how Robin asks him to sweep or clean up crumbs (more thoroughly). Isabelle notes Robin’s warmth—and recognizes that Isabelle and Bobby both aren’t as warm to each other around this feedback. Robin points out that Isabelle (having ADHD) may not see the feedback as it goes, and instead notices the feedback when she’s already overwhelmed. Isabelle and Bobby note what they call a Great America moment (see below) and notes how she was able to observe Bobby circling around distracted, like a shark, and that she was able to see he needed a different environment to complete his tasks and was able to choose to go to Great America anyway (for herself): in short, she didn’t have to jump into the shark circling herself. David points out that children (which he does not have) are like the loveliest hedonist parrots (which Isabelle and Bobby add: are also the best thing ever). David also talks about mirror neurons and how people with ADHD can have much more active empathic responses, where they can really sync up to the moods/emotions of the people around them. As Bobby is circling like a shark, Isabelle’s mirror neurons are activated and she is syncing up, but Isabelle does not need the same level of intensity. How to know when you don’t need that level of intensity, knowing when you can’t think your way out of that circle (AKA Great American moment). Also important and hard to notice when you’ve self-stimulated yourself into some intense emotion but then your next task doesn’t need it. Hard to see yourself clearly in these escalated moments and how a partner can see you more clearly sometimes and help reflect back boundaries or what you need. And so when Isabelle syncs up to Bobby, she’s trying to soothe them both, instead of paying attention to taking a break and NOT syncing up, which will help them both. Bobby notes that podcast recording sessions helps everyone. Robin also names times when she and David need to ask for what they need to sync up (or not sync up). David will call and give her a heads up telling her he’s ‘coming in hot’ from his commute/work time, when she’s on the couch horizontal watching the Office or Park and Rec—how they try to meet them halfway. How both David and Isabelle forget their age all the time. 

For more show notes, go to somethingshinypodcast.com

Why is the cockroach named Rick? For no reason, except David and Robin like alliteration. 

Isabelle mentions a sacred pact between humans and bugs? Well, it’s an ancient truce predicated on the idea that if a bug is around, that’s fine, we’re on their turf, really, but if a bug is on your body without you electing to have said bug on your body, or the bug is on your bed or perhaps in the bath/shower with you, you will use whatever means necessary to remove said bug from said body/bath/shower/bed. 

What is the Great America moment? Let’s say a group of people all want to go to an amazing thrill-ride packed amusement park (like Great America, a Six Flags park in scenic Gurnee, IL), but they’re waiting on one person to finish their work before they go. Instead of making the whole group miss out if that person doesn’t get their work done, you can honor both sets of needs: let the person finish their work and then also let the rest of the group go to Great America. Then circle back and plan another time to go together. The idea is that the person struggling shouldn’t feel the pressure/responsibility of everyone else’s ‘good time’ and that everyone can hold boundaries make autonomous choices that are also understanding and inclusive. 

DEFINITIONS

Self esteem:  is a global term that has to do with how you feel about yourself, your own sense of self-worth. One thing to consider is that with ADHD, self-esteem can be believing you're going to survive an experience: that the moment of discomfort you're experiencing will be worth it it in the future. This is hard to do when your sense of time can be two modes (now or not now). When everything feels like NOW, it's hard to believe in a later or a change or in growth. And when you believe you can do something, it dramatically increases the odds that you will actually do that thing. Self-esteem is believing that you can survive, you can do the thing, and you don't have to convince yourself of that all over again every time.

Mirror neurons: this is a very complex neurological phenomenon, that is a particular favorite of ours. When you are doing a thing, your brain fires motor neurons (eg. if you know how to ski, your brain will fire the motor fires that help you move on your skis). Mirror neurons fire when you are witnessing (or anticipating) someone else do a thing that your motor neurons do (eg. your mirror neurons fire AS IF YOU ARE SKIING, when you are watching skiing on tv). Put another way, your brain is inhibiting you from acting out what you're witnessing/anticipating, but other than that, you're copying the things you see/anticipate seeing. Think about how much we learn vicariously, through observation and then trying something you've only seen before (like a baby learning how to walk! or draw! or pretty much anything!) The more they're understood, the more we recognize that mirror neurons are also involved in recognizing emotional states and sharing your emotions with others (firing the pathways of movements we do when sad/happy/angry, etc.).  Welcome to the rabbit hole, in some assorted articles below: <...

Everything you ever wanted to know about ADHD...continues! WOOHOO! Go back and check out Parts I & III, or start here to learn more about dopamine, how to differentiate someone with ADHD v. someone who is neurotypical, why folx with ADHD run late, and what the impacts are on school (sadly, so far, not great) when someone is labeled with ADHD and receives accommodations. The things that are easy, hard, and all the myths and misperceptions that exist about what is really not a deficit, but rather an abundance and variety of, attention. The third part of a series from David, who has lectured as an expert and advocate on this subject nationally, and assisted by Isabelle, who is eagerly sponging up the information. A neurodivergent and neurotypical blend of friends Christina, AJ, Gabe, and Isabelle's husband, Bobby, sit in to ask questions. (Part III of David’s Lecture Series)
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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 first and second parts of this talk, please see episode 4, All About ADHD Part I and episode 6, All About ADHD Part II). David talks about procrastination, and why it raises the stakes, thus generating more dopamine (the chemical in our brain that gives us a feeling of reward or satisfaction), which folx with ADHD are deficient in. He relates this to the idea that winning, or a win/lose condition, as something that generates dopamine: if we leave for somewhere that is 10 minutes away with 9 minutes to go, if we get there in time, we feel like we beat the clock (won). Also, as we run late to something, for example, we raise the stakes and leave so that we will run late—thus, giving us dopamine—but we’re often miserable and blaming ourselves the whole time. Miserable, and loaded with dopamine: reinforcing the behavior that we are also blaming/shaming ourselves for. How struggles with time management (guessing how long something will take or how all the pieces will fit together) make transitions and running late even harder, and how it is important for neurotypical partners and folx to know it is not done on purpose. How to differentiate (or diagnose) someone with ADHD when a lot of symptoms of ADHD also occur in neurotypical folx (like procrastination? Enjoying sex?). Most psychological diagnoses are connected to things many people experience (such as anxiety); and most humans will struggle with executive functioning skills, but all folx with ADHD will struggle with these skills (see below for a list of skills!). Furthermore, when we get into how people recognize and learn from mistakes, that’s when you see ADHD: a person with ADHD will make these mistakes a lot more often and also carry a lot more shame and self-blame for doing them because of just how often they make them. Neuropsych (short for neuropsychological testing) can help find an ADHD diagnosis but can also miss it. For example, audience member AJ names going to go to the store and seeing the coupons, but skipping the step of putting them in your pocket (ADHD)—and a pattern of this experience, over and over again (plus the “Why did I do this AGAIN!” feeling). David’s use of the Yoda voice “There is no later, only now!” Talking about the shame spiral of the pattern of this happening over and over again. Major consequences of growing up with ADHD - social and school. Folx with ADHD, if they are diagnosed as having it impact their learning (remember: ADHD is not necessarily a learning disability, it must be shown to be impacting learning), they are often tracked with lower level classes and are given accommodations to suit lower IQ students (make things easier). Dilemma there is most people with ADHD have above average IQ: with this setup, they are under stimulated in school, and also isolated and marginalized, systemically. Sharing different school experiences, from being in gifted programs to transitional programs, to having LD labels: and the validation of folx with ADHD often disliking school (especially when they receive accommodations). Seen as if you’re doing it on purpose. Especially kicks in around ages 9-10, when peers start normalizing your world v. Your family. Talking about kids will naturally accommodate themselves in school (figure out bare minimum grade, skip homework but do well on a test, for example)—but when they do this, for example, not doing homework, can be read as personal (by the teacher) or avoid the consequences.

Dopamine deficiency? ADHD is often understood as neurobiological (brain) difference, that includes lower levels of dopamine, the neurotransmitter (messenger chemical) in our brain that gives us feelings of satisfaction and reward—the feeling of YOU DID IT…ahhhhhhh. Another way of viewing it is a neurotypical person has a shot-glass-sized need for dopamine and so little bits of dopamine fill it up enough to feel that satiation, whereas a person with ADHD has a pint-glass-sized need for dopamine. At times, you need a lot more dopamine and are starving for it, but at other times, you have so much dopamine it is so rewarding (and perhaps the reward feeling while eating that doughnut is actually that much greater), but it also makes it even harder to pull away or transition from getting that dopamine to not (imagine how hard it is to not keep watching a show you love or how it would feel if someone suddenly unplugged the tv). Keep in mind that dopamine is just one of the neurotransmitters doing some fun other stuff where ADHD is concerned.

DAVID’S DEFINITIONS:

ADD or Attention Deficit Disorder: is an outdated diagnostic label that also used to a serve as a marker (often perpetuating some shame and stigma) differentiating a person from someone who had ADHD or the hyperactive part of ADHD. Currently, everything is called ADHD, with the following subtypes: inattentive type (too much brakes), impulsive type (too much gas), or combined type (too much of one or the other depending on the environment someone is in). Folx diagnosed with ADD will often present as ADHD inattentive or combined subtype.

Neuropsych(ological) Testing: can be very expensive, and is one way to get an official diagnosis for ADHD (another is meeting with a licensed clinician who does a thorough social/school/work/life history combined with self-diagnosis). Neuropsych tests assess your reactions and responses to different challenges, and can be helpful in either the validation of a diagnosis or awareness in what kinds of supports/accommodation and modifications might be helpful. It should be noted that these tests are largely dependent on the examiner's evaluation, and aren't perfect and can be wrong.

From the Cleveland Clinic: "A neuropsychological evaluation is a test to measure how well a person's brain is working. The abilities tested include reading, language usage, attention, learning, processing speed, reasoning, remembering, problem-solving, mood and personality and more"

Procrastination: (For more, see also Episode 008-Are we designed to procrastinate?)

• this is the behavior that occurs in between the assignment of a task, and working on the task. This is waiting to the last minute, or wh...

How do we separate a task from our emotions about it?  Especially when it comes to our own battles with procrastination? Isabelle is struggling with this and Bobby, her husband, is curious to hear more. David breaks it down like this: let’s say the task is running 5 miles in 60 minutes, which sounds very hard to Bobby. Does it matter what you’re wearing? What time of day you go? If it’s raining or not? There’s lots of things we can get caught up in the ‘emotionality’: I don’t have the right clothes, I don’t like the weather, etc. The emotionality is the stuff that we get caught up in that doesn’t matter. Our view of how it needs to be done that gets in the way. Can you walk while watching a video, for example. Isabelle tries to break a sweat once a day. But it only counts if she goes to the exercise class she signed up for. Bobby asks: why does a brain with ADHD is likely to procrastinate in the first place and then why do we discount doing it differently? ADHD individual needs a specific amount of stimulation to do a task; not enough or too much, they need to self-medicate. The emotions we use to self-medicate include anger, anxiety or excitement, etc. Medication can give you the stimulation without the anger, anxiety, or excitement. We procrastinate because it boosts the stakes, gives us a threat, so every moment of working on the task is alleviating the stress so there’s no delay in gratification, we’re instantly rewarded (yay dopamine!) for working on it. If you had worked on it two weeks earlier, you wouldn’t feel any different because there was no stress/threat you were relieving, you wouldn’t get that feeling of reward. So let’s teach people how to procrastinate better, rather than trying to undo it. What if you knew you weren’t going to work on the report until Saturday—what could you prep for Saturday, instead of beating yourself up for not working on it until then, if that’s the sweet spot of stress/crunch time for you? Your brain needs to experience that threat to feel that relief. A person with ADHD can be an angry, anxious, etc. — I’m going to be a monster when I’m focusing on this, so what can we do to ask for what we need? Is it easier to find a quiet place to be a monster or not become a monster (let’s say you get angry when you work yourself up to focus on something)? Bobby and Isabelle share that they would set each other off and both need accommodations in their relationships, but realizing that the meta-awareness of knowing it connects to ADHD and what they need has helped them navigate situations and help get out of each other’s way rather than asking that person to magically change. David points out that we’re normalizing that folx with ADHD can all become monsters in this sense and that not all monsters are bad—you could be angry/anxious to the max and find ways to create room for that that minimize the hurt and ill effects on those around you. There’s lots of relational trauma for people with ADHD and other forms of learning differences. You see everyone sit down and do something one way and you do it differently, your brain tells you it’s because you’re stupid/not following the rules/not doing it right, etc. Right around between ages 7-11, kids' peers normalize their world rather than their parents. For example, how are relaxation and self care portrayed? As wine and spa time—what if you don’t like wine and baths/spas (for example, like Isabelle). David makes the point that everyone else is doing it right, we’re just not taking in the input right. Maybe no more boring baths. Something needs to move. What we can do with the optical illusion of snow falling or a shower rain falling. The ADHD brain is meant and designed to procrastinate, but people with ADHD are made to believe their thoughts are naturally wrong. Healing comes from acknowledging this. 

Does cranberry juice prevent UTI’s? Yes (and no). 

• Side note, one thing Isabelle learned on this internet rabbit hole about cranberry juice and UTI’s was this: “Cranberry is a term derived from the contraction of “crane berry.” This name is derived from the nickname of the bilberry flower, which, when it withers, is similar in appearance to the head and neck of the sand crane, a bird that often feeds on the berries of this plant.” Who knew? For the full fascinating scientific article about cranberries and UTIs, click here.

DAVID’S DEFINITIONS

• Task: what you’re trying to do - the ‘work’ of a group or a person. 
  • for example: I am finishing my project this weekend.
• Emotionality: what you do to prepare to do a task - beliefs/fears/assumptions about what you’re doing
   
  • for example: I’m doing it wrong/right, I always procrastinate, big fear you’ll never get it done, dream that someone will come and save you from having to do it, etc. 
• 
  
• PROCRASTINATION: this is the behavior that occurs in between the assignment of a task, and working on the task. This is waiting to the last minute, or what we do when we don't want to start work. 

Why do folx with ADHD procrastinate? Waiting for the last minute, or delaying starting can be self medication for someone with ADHD. Excitement, Anxiety, Anger are all feelings that trigger stimulate us (our heart rate increases). Once this happens we remove any delay in reinforcement, as all acts towards work completion reduce that feeling/stimulation. It can also really increase the feeling of winning, if deadlines are met. 

What do you mean by 'monster'? 

We all have a monster part. Our monster is the part of us that comes out when something changes in a way we don’t like or we don’t get our way; in other words, it is our extinction burst (see below). The trick is to not pretend it doesn’t happen or somehow shame it away, but instead make space for it—even plan on it showing up—and reduce the impact on innocent others. 

 Example: You really don’t want to write a paper, but you have to. As you work through the heightened stimulation you need to switch from prep work to actually working on it, your behavior is changing and you don’t like it (it’s so hard when you’re not getting the thrill of something novel, or that you enjoy, and really with procrastination you’re just getting the relief of a stressor being reduced). SO, you may turn into a ‘monster,’ — get irritated, annoyed, angry at anyone near you for getting in the way as you settle in to sit down to write it—which is ALSO giving you dopamine because emotions like anger, anxiety and excitement stimulate us (by way of building adrenaline, which ends up leading to more dopamine, among other things). Suddenly you have what you need to switch from prep to work, but—if you know this is how you work sometimes, you could let the people around you know/get out of dodge/have them be in other rooms, for example, so you’re not inadvertently getting angry/anxious AT them (it’ll happen regardless)—and that way you won’t get the double reinforcement that you’re some monster all the time ;). 

Extinction burst: Connected to behavioral theory, when you’re no longer getting the reinforcement you want, your behavior dramatically increases in frequency, duration, and intensity as you seek to get that...

What if there is no one right way to do something? Isabelle and David are joined by Isabelle’s husband, Bobby, who also has ADHD, in this discussion on why we care how we do a thing. The idea there isn’t a right way is a hard for Isabelle to take in, especially as David describes that how we feel when we feel like we have to be perfect on the outside to hide the fact that we feel so different/deficient on the inside (AKA Imposter Syndrome). For folx with ADHD, this can look like our habits and the way we approach tasks ‘appearing’ neurotypical. 1 in 8 or 2 out of 10 people have a learning disability or ADHD in the U.S. right now (Updated stat: One out of every five people in the United States is identified as having a learning or attention issue. “The State of Learning Disabilities” 2017. National Center for Learning Disabilities). Is the task of a test to take the test in one go, or to do it in 20 minutes? Are we being tested on information or on the speed (for example, accommodations for more time on tests, for example). David would write a 3 hour talk on a plane ride in less than 2 hours and would never share this because, even if the talk was great, he would be judged for how he got the talk done—he thought he didn’t work on it “long enough.” Isabelle resonates with this, an accommodation for her working memory is to do a task right away, but then sends it much later so it appears like she spent more time on it. Doing work how everyone else does it to not seem different, deficient, or to appear as if it was too easy or you cheated somehow.  If it’s easy for the ADHD person, they think it’s easy for everyone; if it’s hard for the ADHD person, they believe it’s easy for everyone. What if you did something for a job that was easy? Would you rather do something you enjoy or do something that’s hard? Bobby reclaims that reading a book includes listening to a book. He’s listening to a self-help type book—you think it’s the procrastination that’s the problem, but the problem is you judging yourself for not doing it. David talks about Wilfred Bion (see below) and whether a group was working on a task or catering to the group’s emotionality—what’s the task of every group? David and Isabelle go down a rabbit hole about group dynamics and where some of the theory comes from around the idea of focusing on task v. emotionality. What matters for ADHD is that we can do the task v. our emotional baggage around proving how we did the thing. Embracing how you work instead of judging it. For example, David knows his body doesn’t respond to meditation by breathing and sitting; he goes on endless walks instead. But if he were to let his beliefs/fears about how he’s supposed to do it impact him, he wouldn’t get the benefit of it. It’s about letting people do things their way instead of the ‘one way.’

Here’s a link to how common ADHD and LD’s are in the U.S. as well as the racial differences (racism loud and clear)

Bobby’s book he was reading on business - Bobby thinks it was Cal Newport’s book, Digital Minimalism.

DAVID'S DEFINITIONS

IMPOSTER SYNDROME: is the belief you don't belong/are bad, or that you have to be perfect on the outside along with the fear you will be found out/exposed and people will know you're a mess on the inside.

TASK V. EMOTIONALITY

• Task: what you’re trying to do - the ‘work’ of a group or a person. 
  • for example: I am finishing my project this weekend.
• Emotionality: what you do to prepare to do a task - beliefs/fears/assumptions about what you’re doing
   
  • for example: I’m doing it wrong/right, I always procrastinate, big fear you’ll never get it done, dream that someone will come and save you from having to do it, etc. 
     

OTHER FUN STUFF

Wilfred Bion (1897-1979) was a British psychoanalyst who ran group therapy during World War II out of a military hospital (so folx with trauma). He was among the pioneers of ways of running a therapy group, writing about it, and co-creating the Tavistock Institute for studying group relations with other wartime psychologists. The term “Tavistock" later became synonymous with a form of studying group dynamics experientially also known as group relations work. It was basically a way to try to understand how people function in a group. For more, check out this wiki and this article. 

Want to go down a bigger rabbit hole about group relations (a theory of group dynamics)? Check out the following (or read Bion’s work, Experiences in Groups, London: Tavistock, 1961; or an updated compilation from 1968).

Basic assumption groups: Bion observed that there are recurring emotional states in groups (so among a group of people, certain patterns of emotional experiences happen again and again and interfere with whatever task the group has come together to accomplish)—the idea being that the emotional experience is called a ‘basic assumption’ group. “Bion argues that in every group, two groups are actually present: the work group, and the basic assumption group. The work group is that aspect of group functioning which has to do with the primary task of the group—what the group has formed to accomplish; will 'keep the group anchored to a sophisticated and rational level of behaviour'.[31] The basic assumption group describes the tacit underlying assumptions on which the behaviour of the group is based. Bion specifically identified three basic assumptions: dependency, fight-flight, and pairing. [32] When a group adopts any one of these basic assumptions, it interferes with the task the group is attempting to accomplish. Bion believed that interpretation by the therapist of this aspect of group dynamics would, whilst being resisted, also result in potential insight regarding effective, co-operative group work." (https://en.m.wikipedia.org/wiki/Wilfred_Bion)

Everything you ever wanted to know about ADHD...continues! WOOHOO! Go back and check out Part I, or start here to learn more about what's happening in the brain, how to use environments to cue ourselves, how debate and manufactured fights can be ways to help you focus, and more! The things that are easy, hard, and all the myths and misperceptions that exist about what is really not a deficit, but rather an abundance and variety of, attention. The second part in a series from David, who has lectured as an expert and advocate on this subject nationally, and assisted by Isabelle, who is eagerly sponging up the information. A neurodivergent and neurotypical blend of friends Christina, AJ, Gabe, and Isabelle's husband, Bobby, sit in to ask questions. (Part II of David’s Lecture Series)
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(Part II of David’s Lecture Series) 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 first part of this talk, please see episode 4, David’s Lecture: All About ADHD!).  We talk about Auditory Processing Disorder (APD) which often also exists alongside ADHD; however, they are two different things. ADHD can make you more prone to distraction when you hear sounds, no APD (see definition below).  ADHD can also coexist with Autism Spectrum Disorder (ASD). David gets nerdy about how blood flow to certain parts of our brain connects to distraction, and how our environment can also cue us to shift blood flow to the forebrain (prefrontal cortex). Gabe notes that sports served as an important accommodation. David makes the comparison that it’s like having an energy bar in a video game, and if you don’t use it during your day, it will become anxious rumination at night. David and Bobby get distracted by Bobby’s audio equipment (or Bobby tweaking his audio settings) and David points out that being oppositional rewards us with dopamine. Debate as a dopamine booster. As a parent, how do you get out of power struggles. Talking about ADHD as too much gas (hyperactive) and too much brakes (inattentive); combined type is both, and environmentally cued (the more comfortable you are, the more gas; the less comfortable you are, the more brakes).  What about ADHD on vacation? We can get more irritable or more chill, and it can be because we have uprooted our accommodations: the structure we have in place at home that helps us get along. So we can start to manufacture structure (including undertaking vacation-only projects, getting into a predictable arguments, reading a book in a day, etc.). When we understand how ADHD impacts us (for example, starting to write a book on vacation to cleverly avoid interactions we don’t want to have, plus building in structure…but not finishing because we didn’t factor in the response cost of it) we can work with it.

Click here for slides from David’s lecture.

How genetically loaded is ADHD?

Pretty loaded. For more on this, check out this article in Nature (prepare for science!)

• On a related note, this article also points to ADHD being more of a spectrum than previously thought; as the article mentions:

In other words, ADHD is part of a set of traits that live along a spectrum, and since we tend to diagnose ADHD when those traits/behaviors/experiences are read as a problem, we lump it into it’s own bag, when really it might turn out to be a neurodivergent branch of the same tree. And so those with ADHD can exist all along a spectrum, too! Hence: calling it attentional variability rather than a deficit.

DAVID’S DEFINITIONS:

Auditory Processing Disorder (APD): a hearing disorder and has to do with how the brain processes auditory information. APD can impact attention as well, but it’s not ADHD. Note: ADHD can make it harder to hear certain sounds, for example a person’s voice in a noisy setting, but the mechanism behind why it’s hard is different than APD. 

Autism Spectrum Disorders (ASDs): a group of developmental differences (AKA neurodiversity or differences in the brain) that can cause increased sensitivity to stimulation, social, communication and behavioral challenges.  

Prefrontal Cortex (PFC): also known as the forebrain, is a part of the brain that, through dopamine, is linked to executive functioning, or the skills (check out the list below) that help you pay attention, curb your impulses, take in memories (working memory), and play with different scenarios and outcomes (cognitive flexibility), for starters. For further reading, check out this super science-y article. 

Forebrain skills that are harder for folks with ADHD (no matter the type): 

Response Cost - neurological skill that helps you know the consequences of your actions later on down the road 

Delay of Gratification - receiving the reward or win, well after the behavior occurs.

Black and White Thinking - believing or acting as if there are only two ways of thinking right or wrong. Black and white thinking makes it harder to see middle paths during an argument

Time and Organization Skills - knowing how long tasks will take, planning transition times into tasks, appropriately guessing how long something will take, or all parts of time and organizational skills.

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cover art by: Sol Vázquez

• Please note, for our younger listeners: there are some swears in this. Brace yourselves.

Isabelle & David welcome Isabelle’s husband, Bobby, and David’s childhood friend, Ashley, who both also have ADHD. Isabelle describes how feeling singled out due to her academic strengths led to her being bullied. She recognizes now that a lot of the things that were what she was picked on relate to her ADHD, like talking impulsively (and a lot), not picking up on certain social cues, feeling a few steps behind people socially. Ashley relates to this and names that girls 12-20 can be especially cruel. David felt that Isabelle presented as a super cool person. Also, David is a super cool person: he has tattoos, facial hair, and knows about psychology. Bobby just checks one of these boxes. The four take turns offering advice to their younger selves (following Back to the Future time travel rules). Ashley recommends learning math (sarcastically). Isabelle names that the things that make you shine are often the things people get picked on and kids aren’t ready for. David says it’s going to be hard and you have to practice tolerating frustration (he wouldn’t want to be told it’ll work out because then he’d stop trying). Bobby shares he would say to care less what people think and know what you’re worrying about now won’t matter. And David names that when it’s hard that is not the place to stop, it’s the place to keep going.

How Time Travel in Fiction Works: Not the spider article (someday...I will find it!) but a link to a Mental Floss article that also shows the Minute Physics video — it has a lot of cool diagrams explaining how time travel works in various fictional books and movies. You’re welcome for your new internet rabbit hole.

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.

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cover art by: Sol Vázquez

Everything you ever wanted to know about ADHD. Seriously. From what's happening in the brain, to how it's experienced day to day--the things that are easy, hard, and all the myths and misperceptions that exist about what is really not a deficit, but rather an abundance and variety of, attention. The first part in a series from David, who has lectured as an expert and advocate on this subject nationally, and assisted by Isabelle, who is eagerly sponging up the information. A neurodivergent and neurotypical blend of friends Christina, AJ, Gabe, and Isabelle's husband, Bobby, sit in to ask questions.
(Part I of David's All About ADHD Lecture Series)
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Isabelle & David welcome Isabelle’s husband, Bobby, and their friends, Christina, AJ, and Gabe, to listen and learn from David’s tried and tested presentation on ADHD, which he normally gives to fellow clinicians. ADD and ADHD are the same thing. ADHD is not a learning disability, it’s a brain difference. People with ADHD don’t automatically qualify for accommodations in schools, need to prove they are struggling hard enough. ADHD is all about the forebrain—the roses of our brain—everything that makes you, you, and makes you unique. Blood tends to flow into the forebrain when you are making decisions. For people with ADHD (see below!), being directed to do something is not doing it. You can look at a red dot, for example, just under different environmental contexts. It’s not a deficit of attention, it’s variability of attention. As you’re demanding more focus, you lose the ability to focus, unless there’s a crisis. The root word for patience is suffering. But someone with ADHD experiences much more distress (physiologically) when they are understimulated. Boredom/waiting without structure is the worst. Response cost (see definition below) makes it hard for us to know when we’re doing something that has a consequence further on down the road. The act of debating gives you dopamine. Dopamine deficiency? See more about dopamine deficiency below. Do you ever hear someone get angry when they look away from the screen (WHAT?!) It’s because they’re being starved from dopamine when you’re already starving. What elicits hyperfocus instead of distraction? The environment: safety, comfort, consistency, the person’s experience/mastery. With ADHD, they need greater levels of stimulation (hyperactive type) or structure (inattentive type) to attend? Again, ADHD is best not thought about as a deficit of attention: attention variability. We have an overabundance of attention. A neurotypical person can attend to whatever in whatever environment, and if they can’t, much easier for them to identify and advocate for what’s interfering with that (for example, “I can’t hear you, the fridge is making a weird noise!”) Whereas for someone with ADHD, it connects to self-esteem, much more difficult to ask for what you need because it makes you think you’re different or deficient or you missed the thing that’s interfering to begin with. It’s the ability to have self-esteem to advocate for the learning environment. We start to touch on ADHD and its link to Auditory Processing Disorder.

To see some of David's slides from this presentation, click here (or visit somethingshinypodcast.com)

ADHD types explained through how we buy a printer we need:

• inattentive type: struggles to buy the printer, doesn’t take into account the cost of a lack of a printer, buys one six months later
• impulsive type: buys two printers, means to put the other one up for sale, forgets to, sits in a corner for six months
• combination type: see above and experience BOTH, often depending on your level of mastery/comfort (more impulsive). Oh, it’s fun.

Forebrain skills that are harder for folks with ADHD (no matter the type): 

Response Cost: neurological skill that helps you know the consequences of your actions later on down the road 

Delay of Gratification - receiving the reward or win, well after the behavior occurs.

Black and White Thinking - believing or acting as if there are only two ways of thinking right or wrong. Black and white thinking makes it harder to see middle paths during an argument

Time and Organization Skills - knowing how long tasks will take, planning transition times into tasks, appropriately guessing how long something will take, or all parts of time and organizational skills.

Dopamine deficiency? ADHD is often understood as neurobiological (brain) difference, that includes lower levels of dopamine, the neurotransmitter (messenger chemical) in our brain that gives us feelings of satisfaction and reward—the feeling of YOU DID IT…ahhhhhhh.  Keep in mind that dopamine is just one of the neurotransmitters doing some fun other stuff where ADHD is concerned.

The Red Dot Study… came from a book David was reading off his colleague's bookshelf, pre-pandemic. Pandemic happened. Office closed (permanently). No memory of the author. We will keep looking for it, but in the meantime, our apologies and here is a study with similar findings: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763932/

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Cover art by: Sol Vázquez
Technical support by: Bobby Richards
Thank you to Christina, Gabe, and AJ for being our audience

Does feedback sting extra hard? David introduces the concept of rejection sensitive dysphoria (RSD), where you interpret feedback or questions or redirections as being very harsh and personal, and then really take it to heart—even if that’s not really what is being communicated to you--and how this plays into relationships. This episode, David and Isabelle are joined by fellow ADHD clinician, Noah, and Isabelle's husband, Bobby, who both also have ADHD.
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Isabelle & David welcome Isabelle’s husband, Bobby, and David’s friend and fellow clinician, Noah, who both also have ADHD. David introduces the concept of rejection sensitive dysphoria (RSD), where you interpret feedback or questions or redirections as being very harsh and personal, and then really take it to heart—even if that’s not really what is being communicated to you (example: Did you empty the dishwasher? Someone with RSD: WHY DO YOU THINK I’M LAZY?!) What do you do if you and your partner BOTH have RSD and ADHD? Awareness is gamechanging. How you give people the feedback that maybe they’re taking your feedback too personally/harshly? There is a comedic setup in giving people the feedback that they may not take feedback well. What if your partner is neurotypical and feels like your ADHD hyper focus forgetfulness feels like you’re doing things on purpose, then you go down a shame spiral of forgetting (for example)? The neurotypical partner may have resentment towards the behaviors and also, how can it get better? It will happen again, we will fail. Not trying to be something you’re not, but also always working to improve and putting in effort, as well as paying attention to repairs and actually doing the work to prioritize what your partner’s needs are-speaking their love language (see Gary Chapman’s Love Languages below). How RSD connects to years of feeling like you’re failing and getting social feedback there’s something wrong with you. The importance of finding a partner who accepts you and gets that ADHD is not going away.

WHO IS GOTTMAN? Basically John & Julie Gottman are relationship gurus who found an institute years ago where they research how people in relationships interact scientifically. With their experience they define the individual ways we crave, express and accept love from others. For more information, check out: https://www.gottman.com/

DAVID’S DEFINITIONS of Gary Chapman’s Love Languages (https://www.5lovelanguages.com):

1. words of affirmation - talking about your feelings of intimacy, appreciation or praise to another person 

2. quality time - making time to be in close proximity with another person doing a preferable task

3. physical touch - acts of touching, kissing, hugging, physical acts of closeness

4. acts of service - being able to take care of things or fix problems for other people

5. receiving gifts - feeling appreciation from the things that are given to you by another person

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cover art by: Sol Vázquez

Ever find reading (uninteresting stuff) hard? Does music help you focus or distract you or every version in between? More neurodivergent friends (Ashley) and family (Bobby) join Isabelle and David in discussing being diagnosed with ADHD in the 90's, what it's like to read (and what accommodations help), and what hyperfocus looks like. Also, stuff about Richard Dreyfuss.
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Isabelle & David welcome Isabelle’s husband, Bobby, and David’s childhood friend, Ashley, who both also have ADHD. Ashley shares that she was diagnosed with ADHD back in ’94 when understanding of ADHD was still in its early days and accommodations like audio books and extended time for test taking were new(er). The group describes what reading looks like, including eye tracking issues connected to ADHD—and the levels of accommodations they each use, including highlighters, white noise, audiobooks, etc. One way of handling a breakup is to mouth the words to the song that's playing while you're being dumped. Other accommodations to encourage hyperfocus on reading also include listening to older instrumental music, and matching beats per minute to the task you're doing. The advantages of continuous play on music platforms (like Spotify, not a sponsor) and the rabbit holes you can get lost in. Bobby’s tangent on a gem of a comedy album (see below). The group also discusses other labels that you can gather along the way with ADHD; David was labelled as having behavior problems, skipping class, acting out. Bobby experienced the world as Ferris Buehler and his response to being bullied was to work the system to get the bullies to leave you alone. How impulsivity can help you work the system or leave you hanging. The idea of either not trying to make waves or making waves when none are around. The message David got was that there was something wrong with him. The white privilege of an ADHD diagnosis, as opposed to being labeled oppositional defiant. 

Name of Bobby’s find (click for a link to a youtube video): I Wanna Meet Richard Dreyfuss by Gabriel Gundacker

Eye tracking issues (related to ADHD): Typical issues that can impair reading are related to either impulsively (jumping to a wrong line) or attention issues related to thinking about off topic things while reading. Click here for more.

DAVID’S DEFINITIONS:

IMPOSTER SYNDROME is the belief you don't belong/are bad, or that you have to be perfect on the outside along with the fear you will be found out/exposed and people will know you're a mess on the inside. 

OPPOSITIONAL DEFIANT (Disorder, AKA ODD) is a clinical diagnosis that is applied to children marked by intentional acts of disobedience, and conflicts with authority. This diagnosis is much different than a diagnosis of ADHD, although some parts of ADHD can be oppositional in nature, they are not truly rooted in fighting Authority, as much as the rooted in finding agency. For example, a person with ADHD may find themselves fighting an authority figure because they took a candy bar they were eating and want the candy bar back. A person with ODD would fighting the authority figure because they were an authority figure, forgetting about the candy bar.

RESPONSE COST is understanding the consequences of our actions, later down the road.

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cover art by: Sol Vázquez