Something Shiny: ADHD!

David and Isabelle go into greater depth about neuropsychological assessments--both back in the day and now-for kids, and for adults--and Isabelle's AHA moment about self-disclosing her AuDHD self. From the odd history of the intersection of Autism Spectrum Disorder (ASD) and ADHD (did you know you couldn't be diagnosed with both for a long long time?) to realizing how literally she takes the world and how much it helps to finally have a turn signal on the car that is her, David and Isabelle dive deep into unmasking and the mistrust we have for the world when we are so misunderstood.

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Isabelle likes having her new neuropsychological results because someone who is not her got to tell her that she has autism, and David has a different experience. His story was like three different hours of testing done at school, and it spit out that he was Oppositional Defiant, and then only in college did it notice he had differences in spelling and then ADHD. His experience is watching clients have their kids be flagged by a pediatrician or teacher to be tested and then they want to retest themselves. But David is so scared he’d go in now and learn…he doesn’t have ADHD? And that Isabelle actually understands this, because there was a big gap (of several months) between the interview and the tests. Isabelle goes into further details around how she took her test in a little cubicle. And how for kids, it looks more like play, it involves an IQ test and way more details about processing speed, working memory, visual spatial reasoning, reading, symbols, numbers, etc. to help with understanding learning differences and accommodations. So Isabelle had to sit in a cubicle and stare at a computer and click on a mouse for fifteen minutes and it was awful. When he was a kid, David was pulled from class, he had no idea how long it was going to take, there was a person sitting there who was reading from a book and asking him questions. For kids, a level of buy-in becomes very important, it’s hard to get data when you’re a willing participant. For David, his first neuropsych showed how unwilling he was to participate, because it was something he was forced to do because there was “something wrong” and they were looking for what was wrong. This is not don’t like this anymore. It’s important to talk to someone who has been assessed to see how they liked their assessment. You can get a second opinion. There are people who specialize in different areas of neuropsychological testing. And someone who is great at diagnosing ADHD may not be great at diagnosing autism or vice versa. And up until 7 years ago or so, it was impossible to have both autism and ADHD be a primary diagnosis; which connected to insurance company lobbying when the DSM was being updated, ensuring that the rates of certain conditions wouldn’t skyrocket because that would impact insurance coverage and ability to cover/deny and all kinds of political and social isms. The history of diagnoses and what makes the cutoffs incorporates layers of ableism, racism, sexism, homophobia…all kinds of oppression. David names how important it was an opening when you could have a combined AuDHD diagnosis because it started to mean that these diagnoses of deficiency, and all the stereotypes around all autistics being nonspeakers or having high support needs, started to get busted and it became more encompassing, maybe even of strengths? It’s possible for us to be complex beings, being perceived as having ADHD or autism in another context. We are the keepers of the stigma, it was the ‘last thing we wanted to be.’ The other day, Isabelle’s kid went to the doctor, and she always felt the doctor was annoyed with her for being so literal and asking so many detail-oriented questions. Her kid answered the doctor’s question of “does your throat hurt?” By checking in and saying “No.” And she had a lightbulb flash and realized he was taking the doctor literally. So she tells her kid “You and me, we both take things really literally and answer questions extremely honestly. I think the doctor means when she asks if your throat hurts, she means across the last week or so and not necessarily all the time or right now.” And he answers, “YES!” And she saw the doctor warm up to her kid and to her and she felt the difference, and maybe it was the vulnerability or the disclosure. For David's friend, there was a significant amount of distrust in the world, there was a pattern of miscommunication and people asking you things that they don’t mean, when they learned they were autistic, their last instinct was to tell someone. But when they came back from the dentist, they talked about how much the light was bothering them, they gave me some glasses and made it so much better. David can't make us all believe we are safe, we can feel cared for when we tell people what we need and they respond. Statistically, some of the time, your need won't be missed and until recently, Isabelle didn't know she really needed, she would’ve said words like “anxious” and “please give me more time" 

Isabelle shares the results of her neuropsych with David: she is AuDHD! As a grown human learning she has AuDHD (ADHD + Autism Spectrum Disorder), what does it mean to 'get a neuropsych?' What even IS a neuropsych? Who gets one and why? How does high-masking autism look like for Isabelle? Busting myths, calling out fun factoids, and celebrating this news and the decrease of suffering it has brought to gain self-understanding and acceptance.
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Isabelle is SO EXCITED to see David's face. Because for the last few recording sessions she hasn’t been able to see his face. And now she can see his face. She doesn’t know she misses it, and David is wagging his tail and doesn’t know if she’s making any sense. The checking for understanding is missing. Isabelle got back her neuropsychological assessment results back. She has “severe” ADHD and also, is high-masking autistic. A fairly common question is: do I need to get a neuropsych? What does it do? David names we can all know something but this is different from the actual experience of it. Are there electrodes to your head? (no) How many magnets are you exposed to? (none) Is there a flowchart?  Isabelle doesn’t know a ton about assessments but she knows a little more now. So, for each job title or profession, you can administer different types of assessments, which involve data from interviews, and written/verbal tests—and a “neuropsychiatric assessment” is conducted by a neuropsychologist, someone who is skilled at administering and interpreting test results as well as being super savvy about neuroscience and the brain. It’s a battery of tests that is designed to help someone determine a psychological diagnosis (and how a diagnosis impacts your thinking, behavior, feelings, functioning, etc.). Isabelle’s experience was, she had used up her deductible and one of her kids as well as her and Bobby decided they wanted to learn more about themselves and get a neuropsych. And she wanted to test it out because she always had a little more mustard on the hot dog of ADHD, more auditory sensory stuff. So Isabelle went in for about an hour long interview and asked me a lot of directive, specific questions. No electrodes, sitting in a cozy office. She was asking questions about friendship, life history type questions about her childhood. With ADHD and Autism, you’re talking about neurodevelopmental conditions, meaning it’s baked in and showing up throughout your life. She was asking a lot of questions about what it was like for Isabelle socially, the years of bullying and taking things very literally, social faux pas, being late to catch on to social subtext or data. And stimming? Which applies to all neurospicy folk. David likens it to a car exhaust—it’s not anxiety, it’s repetitive movements that let out extra steam and overstimulation, when your senses have taking in too much it helps you release. Isabelle thought it was anxiety! But she…actually isn't very anxious. She likes wearing tight clothes and textures, she flaps her hands and holds her hands like a t-rex. She’s realizing how much she would be overloaded after a day, and she would pace, and wiggle her hands, she needs detailed handwriting, and she just wants to be left alone under her weighted blanket. And be crying. She’d say “and I'm overhwlemed because I had a hard day at work!” When for her, she was missing a crucial piece of information. Which is she went to Target, and was under fluorescent lights, and some random stranger talked to her and she didn’t understand it, and then when she said “what?” He looked at her funny, and THAT connected more to the state she found herself in than having a bad day at work. Sitting with uncomfortable feelings and anxiety is different—David names that with anxiety, people can be thought of as fragile, and that can be helpful—but when it’s applied to someone who is neurodiverse, who isn’t fragile, it can be pretty frustrating. David describes how he sits and bounces his leg pretty fast and his whole body will be shaking (best kind!) And David is sitting there stimming, and people turn to him "it's okay, it’s just a doctor's office” and they assume he's anxious, but he’as actually in an ADHD stupor and he’s bored and waiting and feeling good. So much of how people are perceived has a significant element of judgment. Over and over again because she's sitting still or pacing or rocking on her feet—they read Isabelle as impatient or angry, blew her mind. When you see her rocking back and forth and expressionless she's super happy and chill, but you take it as a signal she needs to mask and explain and do things to signal she’s happy and sometimes she doesn’t understand it herself so she just says “yes, I am angry.” And she thought she was a liar—because she’d be dishonest, she’d agree with someone else and say “yeah, I’m antsy.” Even if she wasn’t. David points out that that’s not lying, that’s masking. David speaks to how complicated lying is in neurodiversity, because friends will say “I’ll see you tomorrow night" but then there’s an Impulsive moment and it doesn't happen. How integrity can be perceived, and what you want to own about ourselves. Going back to the assessment process, she had a student in a room and Isabelle likes this because (she’s realizing) it helps her play the eye contact game. David describes the hack of looking at people between their eyebrows instead of in their eyes. Isabelle owns that for her, not for every neurons-icy or otherwise human, she feels like she's gazing into a person’s soul when she makes direct eye contact. It feels rude to her to look at her eyes without a closer emotional bond and without consent, and she looks a bit higher and eyebrows give her data and when she's looking at someone's eyes its too much. David shares: it’s ten times more stimulating to look someone in the eye (10 times more neurons fire). WHAT?! yes. Isabelle is sobbing and confused saying “am I crazy? Am I making up that I am on the spectrum for some weird reason?” She was also listening to see if getting a neuropsych is worthwhile for her (for school or work accommodations)? ADHD was so obvious to Isabelle, but this was causing her distress: the idea and theme in her life of being the last to know something obvious. Increased understanding reduces suffering—what are choices? What are your needs? So much about what shouldn’t or should? What parts of things can you embrace v. ‘Toughing it out.’ Isabelle was in there after an hour and some change. Bobby also went in for a half hour and came out and got resources on ADHD and doesn't seem like he'd get a lot out of a neuropsych and if so, it’s not causing any pain, and maybe you already know what you know and you don’t go through this? Side note, this is not a prerequisite for self-diagnosis. This is a systemic hurtle, it can help you understand the world around you or help you get accommodations around specific areas of work, v. Being in school. But bear in mind, it’s not just for kids.

Eye contact being more stimulating than not in general --in short, it connects to nervous system arousal (even brings in the fight/flight system) as well as dopamine loads and social conventions (like reciprocal communication) but in short, this study sums up a bunch of studies across time that show how eye contact is perceived and impacts nervous systems. (Source: Frontiers in Psychology)

Why eye contact may be EXTRA overstimulating for autistic individuals (Source: Scientific Reports, 2017): hint, ...

Isabelle and David welcome back Marcus Soutra, co-founder of Eye to Eye and founder of For the Good Consulting, and explore the nature of authenticity, "coolness" and the meaning of masking with nation-wide advocacy expert and fellow ADHD and LD-er. How did being "cool" go from being rich and unaffected to being authentic and open about ND/LD identities? From the loneliness and high masking rates of ADHDers, to Abercrombie & Fitch t-shirts and social media, the ways ND culture has approached masking and unmasking.

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Isabelle talks about how being wealthy and affording the performance/clothes of ‘coolness’ growing up was Abercrombie & Fitch back in her high school days--these were expensive clothes that you had to get at the mall and were part of the performance of being 'cool.' And what about how much of coolness, at least for a time, was defined by money, or access to certain expensive clothing brands (like Abercrombie and Fitch) What it means to perform and be high masking, for her. There is a coolness factor, the kid who can pick up what’s cool has an advantage over the kid who doesn’t. Marcus sums it up: are you able to fit in and be embraced by the neurotypical world? And if you can’t, there’s the loner path, the bully path? The empathy he has for the bully path—they were, in his past, the LD/ND kids who were dealing with loneliness and not masking well and it was their way of finding their way to a role in the school community. 60% of people with ADHD say they mask on regular basis and 33% say there is a loneliness to the experience of having ADHD. Then there’s also the pain of being high-masking or being accepted by the neurotypical world, how little practice you have at sitting with who you really are, and finding a stable sense of self. There is a way to be a self to fit in that is not the same as an authentic, self-confident knowing-who-you-are self. The difference between doing it in a healthy way v. doing it in a way to survive. Hard to know what parts of you are okay, and when you’re blending into a neurotypical world, there’s a significant advantage of being able to read the rooms around social cues. Marginalized senses of self are real, having to exist believing you’re less than. Or believing if the mask ever falls, it’s terrifying. Isabelle names that there’s a management around masking and the layers, like she can unmask and say “I have ADHD!” but she doesn’t say, “I have ADHD and I screwed up the finances again so I can’t afford the school bill.” Something for her connects coolness to unaffectedness, not being vulnerable, or not caring what others think. Beyond the unique person who owns where they are, where does coolness come from in our culture? Marcus responds that it's often the people at the top of the social hierarchy, it’s the celebrities, the role models.  Growing up for Marcus, there were the most attractive movie stars who were dyslexia, like Tom Cruise, Orlando Bloom, not Paul Giamatti. When it came to Aspergers (previous name for low support need Autism, check out more in depth on this history below) or Autism (before it was known as Autism Spectrum Disorder or ASD) were superheroes, like RainMan, Temple Grandin, and that was our introduction to the autism community. If you’re dyslexic, the way to make it out is to have hotness or have superhero qualities, and if you don’t fit into either one of those, good luck. This brings up how celebrities are not so far removed anymore, from the days that you got these bland PR stories or tabloids, now you have people sharing their stories and unmasking on social media. Marcus names that authenticity is now a part of social media, and it’s important for celebrities to have a cause, to be speaking to some aspect of this. If we'recynical, it could be a branding strategy, or it could be a shift in culture, because this emphasis on authenticity rather than hiding has been a big change in the last five years. 

What is Abercrombie & Fitch? The following documentary covers it pretty much:

"White Hot: The Rise and Fall of Abercrombie and Fitch" (Netflix documentary)

DEFINITIONS:
Masking: Often used in referenced to autistic folx (Autism Spectrum Disorder (ASD)), it also applies to folx with ADHD, OCD, and all kinds of neurodivergence (ND) and learning differences (LD), like dyslexia, dycalculia, dyspraxia, dysgraphia, etc. 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. You 'pretend' as if you brain and nervous system work in ways they don't. 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.”

For more on Marcus Soutra:

www.For the Good Consulting.com

Soutra is a dynamic, award-winning advocate, leader, and trailblazer in the field of neurodiversity (ND). An ND individual himself and former classroom teacher turned social entrepreneur, he co-founded and led Eye to Eye, scaling the organization’s impact on thousands of schools and individuals across the United States. A sought-after speaker, Soutra has delivered compelling talks on stages worldwide, from Harvard to Tokyo, has appeared in dozens of television broadcasts and podcasts,  and has been featured in leading publications including Forbes, The Hill, and Philanthropy Digest. In recognition of his transformative work, he received an honorary doctorate from his alma mater in the spring of 2024.

As the founder of For The Good Consulting, Soutra now supports organizations dedicated to driving systemic change for individuals furthest from opportunity. He resides in Brooklyn, NY, with his wife, an educator and learning specialist, where together they continue to advocate for a more equitable world for all students.

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Cover Art by: Sol Vázquez

Technical Support by: Bobby Richards

Isabelle and David welcome back Marcus Soutra, co-founder of Eye to Eye and founder of For the Good Consulting, and ask an interesting question of this nation-wide advocacy expert and fellow ADHD and LD-er: how has life in schools changed for neurodivergent kids, especially now that some of us are parents/educators/in charge? Are kids still afraid, as David was, of having to go to the nurses' office? And how has what's "cool" been redefined in the past decades? From trauma modes to collared shirts, from shifting ADHD from a diagnosis to an identity, the three explore perspectives on masking (AKA using energy to appear as neurotypical), which can be both a poison and a salve.

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David wonders, given that Marcus travels across the continental United States…what is he seeing as patterns in neurodivergent culture? Marcus describes that he sees the elder millennials having kids who are now being identified as being neurodivergent, and naming, “The trauma ends with me,” and they’re refusing to hand this off to the next generation, and because a generation that grew up with these labels are now turning into parents, school leaders, caregivers, people in charge. David likens this to growing up in an earlier generation where he was taught to toughen up, to take the knocks and handle it. Isabelle relates this to how when you’re living in survival mode, you can’t also be processing the trauma and making meaning of it, you first have to survive—and part of survival mode is to have tunnel vision, to stay tough, to not pause to feel. So it would make sense for a generation that maybe always was in survival mode to try to pass that on to their kids in the form of “toughen up.” She relates to wanting to break this cycle, though, so hard, as a parent. And also—what does David mean by the “boy named Sue” generation? (Answer: it’s a reference to a Johnny Cash song, see below). Marcus describes how this compares to other movements, where something that used to be a diagnosis or label is then taken back as an identity. As he has ADHD, he was hoping this change would happen so much faster, in his small, privileged ND community this change happened so rapidly. It does take these generational shifts and changes to make these things stick. David names that individually, we all have individual struggles that rub up against the system. It felt like school was meant to take parts of us away, it was like an eraser trying to shave parts off. But we are be keepers of that. In school there was no concept of advocating for an accommodation, it was just: do you want to look weird? Leaving class early to go get his meds. How has this changed for kids and adults? It’s hard to generalize because “you know one neurodivergent person, you know one neurodivergent person.” But having an open conversation about something and talk about it and acknowledge and not other it—it does set it up for students to have a teacher they can talk to and ask for what they need (even one adult in that building). The needle has moved from the average high schooler even knowing what dyslexia/ADHD/any ND or LD is. Marcus wasn’t bummed out about dyslexic, but back in high school, it was other people were going to see him being different. He refused to get accommodations for the third time, because if he got accommodations for it, he wouldn’t take the SAT at the same time. Isabelle remembers that as a full body memory, taking the SAT being a production back in the day and even in her own experience being bussed on the short bus into a different school for a Gifted program and how it signaled you were different but also you didn’t want to belong to this select tribe, either.  David names: different is dangerous in some ways, not just for kids but for adults, too. You walk into a room and everyone is wearing a blue “I’m here for a reason” shirt and you might slowly back out of the room and go “I don’t belong.” Trying to be like everyone else is both the salve and the poison—it helps keep us save when we’re masking—what does everyone else is doing? It helps us mask, but David’s first time being a room where people admitted they were neurodivergent, Grady was bouncing a racket ball, the relief and joy you feel when you can join in being more authentically yourself. Isabelle is thinking of the “Cool Bean” book (see below) and how in that story, the beans are ‘cool’ not just because they are performing as cool and have style and whatnot, but also because they are willing to take risks and help those who are being bullied or laughed at, that are able to stand up for others and themselves in a way. This is so different than ‘coolness’ as Isabelle experienced it in her little bubble growing up in suburban Chicago, where coolness felt way more about avoiding being targeting and felt meaner and scarier and more about social power and wielding it (with meanness). Marcus names how his masking helped him in a way; he didn’t know if he could get away with getting into trouble so he would know how to appear wearing a collared shirt and combed hair and befriend his teachers so that he would get on their good side. David describes how with ‘coolness,’ it could be more about performing as if, rather than actually being it—like Marcus wasn’t actually friends with his teachers but he had the appearance of it, and how often we take those appearances of coolness and roll with it. Isabelle wonders—what about the privilege of masking? Like the way people who mask more easily and slot into neurotypical expectations have privileges and also—‘detecting’ what’s cool? And what about how much of coolness, at least for a time, was defined by money, or access to certain expensive clothing brands (like Abercrombie and Fitch) What it means to perform as if you are confident in who you are, 

Johnny Cash’s “Boy Named Sue” (live at San Quentin, 1969)

Cool Beans book (by Jory John) read aloud (by Harper Kids)

Smart Cookie (also by Jory John) read aloud (by Magical Little Minds) about learning differences/neurospicyness according to Isabelle

More on Marcus Soutra:
www.For the Good Consulting.com

Soutra is a dynamic, award-winning advocate, leader, and trailblazer in the field of neurodiversity (ND). An ND individual himself and former classroom teacher turned social entrepreneur, he co-founded and led Eye to Eye, scaling the organization’s impact on thousands of schools and individuals across the United States. A sought-after speaker, Soutra has delivered compelling talks on stages worldwide, from Harvard to Tokyo, has appeared in dozens of television broadcasts and podcasts,  and has been featured in leading publications including Forbes, The Hill, and Philanthropy Digest. In recognition of his transformative work, he received an honorary doctorate from his alma mater in the spring of 2024.

As the founder of For The Good Consulting, Soutra now supports organizations dedicated to driving systemic change for individuals furthest from opportunity. He resides in Brooklyn, NY, with his wife, an educator and learning specialist, where together they continue to advocate for a more equitable world for all students.

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Cover Art by: Sol Vázquez

Technical Support by: Bobby Richards

Isabelle and David continue to talk with David’s brother’s friend, Aaron, and dig deep into why winding down and going to sleep is the hardest transition of all: because you're staring into a black hole of no dopamine for hours! And also, a lot of traditional sleep hygiene tricks may not work. Folks with ADHD have higher rates of sleep apnea, among other sleep disorders, and also, can do with staying away from preferred activities before bed. This, sleep tips and tricks, and recognizing the value of being open about your neurodivergence...as well as some really good callbacks to the previous two episodes (096 and 097) regarding "St. Elmo's Fire's" amazing theme song.

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Isabelle and Aaron wonder: what’s with this PDA business (persistent drive for autonomy/persistent demand avoidance)? David explains: It’s hard for us to connect a learned moment with an experience, it’s hard for us to take a moment we're learning now and take it into the future, and we're distractable. If we're in a place with any shame, guilt, or anxiety, distraction becomes highly reinforcing. We are highly reinforced by not paying attention to what we want to pay attention to it. We're not seeing the long term consequence, we don’t understand what we're doing to our future by not doing it in this moment--delay of gratification and response cost. Like, what did you do today? “I watched three seasons of Scrubs and ate a buffet of Indian food.” We can't claim any wins at the end of the day, but in the moment it felt so nice, it was a distraction. Neurologically we don't get a success, norepinephrine —you feel anxious, and it leads into their evening, and for kids and adults, if you're really anxious about the next day, you don't want to go to sleep. “The longer I'm up today, the longer today is! I don't have to face tomorrow if I haven't gone to bed yet.” David has been thinking about this with his friend and colleague Noah, based on this book, Dopamine Nation. If we’re not accommodated or assisted by something during a transition, and then you have nothing else to do, you are looking down a long dark hole of no dopamine—that’s why the evening can look so hard. The road to sleep to extra awful, you have to sit still, you have to tolerate frustration and still yourself enough to go to sleep. David names: we are considered overtired if it takes less than 15 minutes to fall alseep—most ADHD folks, as an accommodation to not sit in the discomfort of staying still with no dopamine, don’t hit the bed until they are beyond exhausted and just crash. Isabelle and Aaron disbelieve this. Isabelle does not compute that this is how people live, that people just lay there for 8, 10, 15 minutes and slowly go to sleep, this has never happened to her. Aaron gets anxious that he won't fall asleep in 5 minutes and then can't stand the guided meditation.  David will be snoring watching tv on the couch with his partner but doesn’t confirm he is “tired." with Delayed sleep phase onset, this is a thing we struggle with. Accommodations for sleep? Did you use enough physical energy during the day? You can't go into a preferred activity before bed—you have to find weird shows or things that are interesting but not so interesting it will keep you awake. What is a preferred activity? If you're super into a video game, for example—if you can't sleep, don't play the video game. The things that you prefer and wake you up, engage your hyperfocus. What's the boring video game that’s like paint by numbers? Isabelle will read nonfiction when she’s not feeling very tired, but if she reads compelling fiction she will stay awake. Because, who wants to sit in boredom? These are tips that are not sleep hygiene or what you’d expect. So many tactics to help a kid fall asleep are there to help them get bored enough to stay still and not reach for a preferred activity. The most important task in the brain's development is boredom: One of the most important things is to experience boredom. It's really important and yet we run from it all the time. A neurotypicaly person needs to encounter a certain amount of boredom to get creative. But with ADHD, we are bored a 1000's of times more often in a day than a neurotypical does in a day, and the feeling of being bored is so caustic and our brain is so creative and thinking of fun things all the time. But because we encounter so many micromoments of boredom, it makes it really hard to tolerate the 10 or 15 minutes to fall asleep. Or try something on in the store. The moment of a transition that's boredom and hurts. When do we want to sit with it, when do you want to avoid it? David tries to stop listening to a D&D podcast he wants to, he's trying to train himself to be awake still and do it at a time and then fall asleep, instead of falling asleep when he crashes. AND there are literal sleep disturbances. People with ADHD have a much higher likelihood of getting a CPAP machine and sleep apnea, cause our physical necks are bigger (what?!). We have to think of social conventions made to busy people as problematic: are you folding your underwear because you're worried about them wrinkling? So many clothes are not wrinkling! Clean your clothes, but don't think you're failing at life if you're not folding laundry. Aaron requests more on sleep, and refers to an older episode by name "I'm not tired, you're tired!” David wonders: what would a Aaron tell his younger self if he had a 20 second time machine. He’d like to tell himself: “be brave, it's hard, it gets better. And look into ADHD earlier." The whole sequence of anxiety he’s had to deal with has been altered by knowing about ADHD and being medicated. It's not just the medicine, it's finally having a reason for how his interior life is the way he is. If there’s no reason, it's just your fault—why is Aaron a slob in his private places? It's not a character defect. But some people with ADHD are clean and tidy! Isabelle is one of these people—she just got a label maker and has been labeling her cabinets and pantry with things but then putting exclamation points at the end, so it says things like “BEANS!” “PASTA!” Referring back to Ep097, David names that Isabelle is a promoter: of pantry staples. But for Isabelle, she doesn't mind if others are making messes, she just needs things to be in order because otherwise they will move on her, it's a way to accommodate her working memory and find things again later. There isn't a right way to fit into this culture,. There's parts of ADHD culture—and theory of group dynamics, that says that people within a group have more things different between each other than they do with those outside of the group: ADHD is no different. Like medically: with depression, you can sleep not at all, or sleep a lot: these are opposite things and yet they all fall under the same diagnosis. Some things we can all relate to, like the way that we are hurt by our own integrity (not doing what we wanted or said we would do), our celebration and glee at remembering to do or finally doing the boring thing! Recognizing you have ADHD is a bit like parts of you being seen before, and suddenly all these associated pains --you don't know why you can't do what you want to do, and it has be to you. Aaron ties that back to his calvinist upbringing: “I wanted to do this, why did I forget?" It's the internal monologue we have to chance. There are parts of us that in a wheelchair and we keep coming at stairs. Isabelle references “I wanna to be a man in motion? All I need is this pair of wheels. Take me where the eagle's fly: St. Elmo's Fire."  ...

Isabelle and David continue to talk with David’s brother’s friend, Aaron, and contemplate why folks with ADHD can be so enthusiastic and excited about interests, people, etc. Is it because we are like puppies who are starved for reinforcement (dopamine)? Or does it come from living a life on the outside and the joy of connection when it has been missed for so long. With callbacks to Greatest American Hero (See Ep095) as well as the real story behind the theme song to St. Elmo's Fire.

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David describes how borrowing from LeDerick Horne and his brilliant theory around leadership, that folks in leadership can have a number of qualities, including being promoters. Folks with ADHD can be natural promoters, and being a promoter is actually a form of leading others. With the caveat that we must be into what we promote. And how excited we are about people and how we talk people up. David names that perhaps this has something to do with how we are starving (for dopamine) and intimacy and connection and relatedness can help us fill that void, we reach for the connection and get excited. Isabelle wonders if this relates to an autism(ASD)-style special interest, how she perpetually is excited and has a working principle that everyone could find common ground if we just found a shared hobby or special interest. David likes to tell people on airplanes that he's a car salesman so he can talk and listen to his heart’s content but he doesn’t have to focus on what he does. Isabelle names that even though David is not very savvy about cars, he could sell a car because he's such a natural salesperson. Isabelle names that anxiety around overselling things, she might encourage people to try new things, take new risks, explore and play—but her working memory is so poor that she doesn't know if she oversold, she has to refer to notes or something as reference. David loved serving as fun because there was a high degree of risk and failing so it helped me remember things. David names that we are not starving puppies with watery eyes, but we are highly susceptible to be reinforced, so when we see someone else’s tail wagging, it shoots up our levels of dopamine, we are highly reinforced. The establishing operation—social connection and social mastery is water for us, like the water-deprived rats being reinforced in Skinner boxes. The environment makes Isabelle’s puppy quality feel safe or good or not; and can lead to her feeling starved of that connection and reinforcement. The feeling when you have no one wagging their tail back at you—how many mistakes we do make, how many social gaffs and miscues, and big ones. It's almost like we find ourselves so marginalized, its like finding a prison gang when we find people who get us. What does it do to your sense of self when you can't do what you want with your morning—how that deflates your sense of self. Isabelle feels like she shares a bond with the other parents and caregivers that are always running late—it flares up imposter syndrome and “if you only saw me five minutes ago." David reframes this as "if only you saw what it took me to get here and I made it!" Aaron is a master of social engineering, even though he's almost always good at it and social interaction, he remains scared the whole time. The anxiety hits because if it doesn't work out, he takes the hits hard: he can take a lot of them, but they hit hard. David shares one of his hits—he was spending a lot of money for grad school, wanting to read all the books for all his classes, he was going to learn it all...but he didn't do any of the readings for one of his classes. The class was talking about this person out loud, “Ed Nafoah” — he was like "what is this Nafoah guy talking about ?” and everyone in class is like “Edna? Her name is Edna Foa.” It took five to ten minutes for David to feel the cabin pressure returning and the lights to come up and to return to his body. Aaron points out that his impulsivity could carry him through it—David had a ballast and in grad school and they were talking about different psychosocial backgrounds, step or two based on privilege. The professor holds up a dollar and says "the first person to…can have this dollar?” He’s never seen someone authorized like that. Aaron sings the theme song from “The Greatest American Hero” which we all know, and the superhero suit is David’s impulsivity. 

Who is Edna Foa?

Greatest American Hero trailer (he is LITERALLY "walking on air")

Story behind St. Elmo’s Fire theme song, "Man in Motion" 

• here's the music video and the song 
• A quick synopsis of the backstory behind the song (Source: Wikipedia)
• And an interview with the songwriter/singer, John Parr, discussing how he came up with the idea and how he snuck it in to be the theme song for this 1980’s Brat Pack Extravaganza. 

For more about our guest:
Aaron Michael Ullrey (he/him)
Writing and Editing Specialist, Editor in Chief
Research Associate, Transcendence and Transformation
Center for the Study of World Religion (CSWR) at Harvard Divinity School

Instructor of Religious Studies

The University of Houston

Instructor of Sanskrit Language

University of Naropa 

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Cover Art by: Sol Vázquez

Technical Support by: Bobby Richards

Isabelle and David welcome David’s brother’s friend, Aaron, who, as a recently diagnosed ADHDer, brings up the idea of if ADHD is a superpower, it's like the super suit in “Greatest American Hero:” a suit given with a manual that got lost on the first day of use. What happens when you find your ‘ingredient’ for doing the things you previously struggled with and now can do? How does your self esteem and sense of self efficacy impact how you handle days when that ingredient is missing? This plus being puppy dogs together, tackling Mt. Laundry, and why intimacy beats contempt.

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David and Isabelle welcome Aaron, a longtime friend of David’s brother, who was recently diagnosed with ADHD as an adult. In thinking about ADHD, he thinks about this show from the 1970’s, “Greatest American Hero,” where this teacher is given a superpower suit by some aliens, who also give him a manual for the suit, and he loses it on the first day, so he goes around saving people but also is seeking this manual and he always gives it up to save someone. He resonated with this character so much, and for Aaron, medication made a huge difference—he is able to wake up and do the thing and then he is able to do. He’s been medicated for anxiety and depression his whole life and taking medication for ADHD doesn’t make those go away, but it helps him be the person he always wanted to be. Isabelle so resonates with the suit metaphor and how she and Bobby attempted to make their home more ADHD friendly (see “Keeping House While Drowning” and all the ADHD friendly home tips below!) And she forgot her medication and instead of spiraling into anxiety, when she realized why she stalled out all day, she was able to recognize it was “oh, I was missing my ingredient.”  David points out that it’s not just medication, because medication is not for everyone, it can be so many things, once we find out what the ingredient is—working out in the morning, the coffee routine, whatever it might be--when you all of a sudden miss it, you can pinpoint it and recover. Even more so, Aaron describes how it is a conscious habit, as a child of the 80’s, he is not about the idea of 'working on his self-esteem,’ but realizes through therapy and his conversations with David that it keeps coming up for a reason, there are wounds there that do shift when you are able to do some of the things you previously struggled with. David can recognize those nasty voices in our heads, the angry voice as a teenager to get himself to do things. Based on his arbitrary math, while it takes 6 weeks to build a neurological bridge, it takes 6 years to build a habit. He chose to make excitement that it will be over the habit over the anger over having to do it. Whether it’s medication or nervousness or anxiety, David recognizes that something has to stimulate him so he has to choose his path and practice it. Aaron remembers his psychologist friend Dave 20 years ago sharing the 3 paths to happiness (he was studying at the time)—the first is excitement, the second is contempt (at least temporarily), and the third is intimacy. Aaron is excitable and comes from a contemptuous family and wants to focus on intimacy. This makes Isabelle make awkward spiders with her hands, the idea of gossiping and spreading shame makes you feel reassured and safe but also brings with it a threat and temporary condition; for Isabelle, intimacy means playfulness, curiosity, a willingness to see what happens next, and as David defines it: a shared vulnerability. Aaron ordered up BRAIN STUFF, and sadly David has no links, so Isabelle tries to fill it by talking about studies that connect to how we associate the negative talk about someone with the gossiper, not the subject of the gossip. David names that he does think ADHD is a superpower with a missing manual, and the tricky part is let’s say we’re talking unbridled enthusiasm: it’s a superpower and contagious and also has an effect on the recipient. David names being okay with someone not wanting to be the recipient at this current moment. 

THE THINGS WE MENTIONED:

• Greatest American Hero Opening Credits (Worth it to finally see where this song comes from and for the flying haphazardly imagery)
• How to Keep House While Drowning by KC Davis
• So You’ve Been Publicly Shamed by Jon Ronson
• "Punishing or praising gossipers: How people interpret the motives behind negative gossip shapes its consequences" (source: Social and Personality Psychology Compass)

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Cover Art by: Sol Vázquez

Technical Support by: Bobby Richards

Does ADHD make you an overly optimistic puppy dog? Or the sprinkle of trickster magic in someone else's day? And is there really a "better" way to be, optimistic or pessimistic? From David being a prophetic hot dog vendor at Wrigley Field, to trickster archetypes, to the differences between vulnerable in the process of something or being vulnerable at the end, Isabelle and David dig into a totally unique way to consider optimism and pessimism as adaptive. 

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Once upon a time, David sold hot dogs at Wrigley Field, yelling out “here’s your hot dogs!” To do that, he talked differently, throwing the accent in so thick. This was during the McGuire/Sosa run streak, and he would say “Sammy’s going to hit a home run to you in the 7th” and he had a 50% chance of being right and he made it a great time for those kids. This makes Isabelle think of Tricia Hersey, the Nap Minister, who has done all this work on systemic racism and the Black American experience, and rest as resistance or a form of activism. She also is talking about lot about trickster energy. Isabelle thinks about this in the form of ableism, how she talks and writes about trickster energy, and making magic in something that feels subversive and is part of the time as well as not a part of the time. Like David is performing the role of the hot dog vendor, but then because he predicts the ‘future’ to the kid, he adds a twist to it and he becomes a full human, like more than a role. Isabelle’s shortcuts often fall around domestic labor. David likes how it elevates the hot dog vendor to more than an NPC—after the game, if he predicted it was right, reclaims that he was actually a main character. But also it was greater than what David was doing. Isabelle notices that this lines up with a neurodivergent strength with ADHD, the going on tangents, the divergent tangents. Isabelle names that recently things have been really tough personally and professionally, and yet she has this relentless optimism; Isabelle can’t help but bring in the playful energy. Is her optimism really about ADHD? David names that optimism is not about accuracy, it has to do with process. Optimism is: ‘it’s not a loss until it is,” and you can be miserable for 3 weeks leading up to something or miserable for the one moment you feel the loss. But also, David warns, optimism can be dangerous when it comes to expectations. If you expect a piece of (astronaut) ice cream when you get home every day, it is a set up when you get upset you didn’t get the astronaut ice cream. Optimism is radically accepting that we haven’t lost until we have. In one hour we can feel sad, but right now, we can still win. For David it’s how he can sit with his nervous system, it’s changing the meaning of “in process.” Isabelle really likes this, as she is relentlessly optimistic. If she is more willing to take risks, if she doesn’t have a big response cost, she doesn’t have a great estimation of how hard or long something is going to be, a poor working memory, and it would track that overall she would get smacked in the face by a 2 x 4 and then wake up the next day and forget it ever happened. She doesn’t remember the fails until she's failing again, and anything is possible until it isn’t, or she remembers the fails but this time, it could be different. And, is part of that really a choice she’s making or is it just a shortcut, a mental shortcut—you could call it optimism that she always leaves the house not accounting for traffic because she believes in parking magic. It would be way harder for her to keep all the possibilities in mind. David asks: are you forgetting to account for traffic? That’s executive functioning stuff. Or are you optimistic about there being no traffic? If you’re leaving late thinking you’re going to get a good parking spot, the memory deficit reinforces this perspective. But isn’t it easier to live with miracles and magic and not borrowing trouble? You’re not ruining your present moment by fretting about something that hasn’t happened yet. But if Isabelle could have accounted for her executive functioning maybe she could’ve avoided some thing. When we are struggling to pull out optimism in an area, we’re looking at areas of self-esteem. It’s really hard to be optimistic if you don’t have a sense of mastery in who you are and what you’re doing. You have to have a sense that you are enough or that you matter, you have to have some power or some say in a world. Survival mode, by necessity removes optimism, makes you pessimistic. When you’ve survived trauma, which is anything that overwhelms your sense of hope, what devalued or dehumanized you or left you feeling out of control, and it was something that Isabelle was internalizing something was the worst. Back in the day, in older versions of the DSM, included in PTSD was the idea of a ‘foreshortened future,” there’s not way she could survive or make it through another developmental state. When you’re in survival mode, you think you’re getting all the important data, black and white, like an old news reel, you think you’re getting all the information, but you’re getting very little data, which can be both helpful and hurtful. Does optimism indicate the opposite of the trauma response? Is it an indicator you're not in the survival mode? But David names: optimism is not a better, pessimism is not a worse—both are accommodations and have their uses. Maybe you’re more vulnerable in process, and less vulnerable at the end, so being optimistic is an adaptation for you. For someone else who is more vulnerable at the end and less vulnerable in process, being pessimistic would be an adaptation. We surrender parts of ourselves when we try to be somebody else, and David is a proponent of humanism, that humans as a whole make sense, and we’re doing our best. He’s not interested in optimism being used to invalidate pessimism or pessimism being used to invalidate optimism. 

NPC - Non-Playable or Non-Player Character: a term from gaming that refers to characters that cannot be played by the person playing the game. (Source: wikipedia).

Nap Minister, Tricia Hersey and her book, Rest is Resistance

Trickster Archetype: (from Wikipedia): "a character in a story who exhibits a great degree of intellect or secret knowledge and uses it to play tricks or otherwise disobey normal rules and defy conventional behavior." Examples Isabelle mentioned include: Loki (norse mythology and the Marvel Universe), Anansi (Ashanti folklore)

ADHD's links to optimism:

• The Positive Aspects of Attention Deficit Hyperactivity Disorder: A Qualitative Investigation of Successful Adults with ADHD (Source: ADHD Springer Journal)
• Incautiously Optimistic: Positively Valenced Cognitive Avoidance in Adult ADHD (Source: NIH/Cogn. Beh. Pract.)
• Positive Illusory Bias (PIB) related to ADHD in kids and parents (source: University of British Columbia)

How do you make your time off the most efficiently relaxing? Or unlock a peak game night or other family time experience? And why are we so hell bent on intensity of experience, versus frequency? David and Isabelle straddle talk of perfectionism, their own relationships to building time-off experiences, and how frequency is our friend, as well as the idea that perfectionism is not a dirty word, but perhaps relates to masking, needs for structure and predictability in neurodivergence.

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Isabelle describes how her and Bobby would take time away just the two of them, and realized how time would move so differently, especially if they just let themselves hang out and not put extra pressure on the time off. David names that we focus so much on intensity of experiences (for Isabelle’s family, the most intense all-inclusive Disney trip EVER!) versus frequency, when actually, you need more frequent interactions in order to have a template for how to be with each other. So maybe we do more time off or together time—more often, and lower the bar for what we have to do in that time? Isabelle struggles with this, however, in how she tackles family game nights, as family dinner might be something of a challenge for folks (let’s not assume all families are functional and you want to spend time with each other, either). She goes to great lengths to set it up, get the snacks, the music, the setting…and she always wants to make it 2% better, but it often backfires or doesn’t match up to any expectations. This brings her to her new hyper fixation, on perfectionism (see book she names, below). She describes how there’s a type of perfectionist that seeks to have every part of a process go well, and if one part goes wrong, they throw it all away. This relates for her to being so in the present moment and struggling with what happened just before or just after, so she wants to nail each part of a get together. David does not relate to this, it brings up the fact he knows nothing can be perfect and in fact, he felt so ‘not enough’ for much of his life, that he does not carry this. Isabelle describes how there’s this type of perfectionism where you work really hard but you try to appear effortless (effortlessly styled, cool, fit, etc.) and David names how he wants to unlock peak experiences with minimal effort. Isabelle and David get into a debate about whether or not David might be a type of perfectionist, if you think of perfectionism as ambitions or goals or striving toward and ideal, and Isabelle’s own journey exploring if she has autism, makes her think that maybe this is how she uses scripts in social settings, like she knows what her role is and what is expected of her and she wants to do it well. David names that if he puts great effort into it, then it doesn’t count, except when he’s making “D’s Nuts,” a holiday spiced nut roasted sugared nut blend that blows minds in little mason jars every year. Isabelle finally gets what David means; he’s going for peak efficiency, like he puts in no effort, and it’s a HUGE win for the person. With D’s nuts, it’s extremely labor intensive and he’s proud of it. Isabelle likes to give people shortcuts, like discount codes and bargains and feels so seen when David names he has benefited from her use of this many a time. 

The Perfectionist’s Guide to Losing Control by Katherine Morgan Schafler

Types of perfectionists (per the book above, taken from Medium summary article)

• Classic perfectionist — They attempt to control essentially everything. This is the type we’re all thinking of. They like structure and consistency. They tend to hold themselves to extremely high standards and are overachievers.
• Parisian perfectionist — This type wants to be perfectly liked by everyone in an effortless way. They have a sense of ideal connection and tend to be people pleasing to bridge that gap.
• Procrastinating perfectionist — These folks want the conditions to be ideal before they get started on a project. They have an ideal notion of how something might go, and are afraid of having it ruined with the reality of actually getting started.
• Messy perfectionist — This doesn’t mean physically messy. What it means is that these folks have a hard time following through once a project has gotten underway. They believe that they can focus on multiple things without having to give anything up, but frequently don’t finish what they started and have multiple projects in various states of completion at any given time.
• Intense perfectionist — These people can be extremely demanding of others. Think the boss that is exacting and keeps you at the office late. They have an ideal outcome or vision and are willing to be extremely unlikable in order to bring it to fruition.

David makes “D’s nuts.” For those not familiar with Chicago accents, here’s an old SNL sketch that makes big use of this.

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Cover Art by: Sol Vázquez

Technical Support by: Bobby Richards

Just in time for the mounting stress at the end of the year, here’s an ADHD-friendly gift-giving guide! David and Isabelle have ideas, accommodations, and acceptance around giving and receiving gifts with neurodivergent folx. How hard it is to buy things for folx who impulsively purchase all (cheaper) things for themselves? How to tackle the mystery of huge shopping carts and no good memory if you bought the thing after all, or not? What to get your brilliant neurodivergent child (psss…it’s the experience, not the shiny thing!)? And MORE!
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Aside from discussing how Isabelle has a cold and David thinks they could be like Voltron, David describes how he only buys things he can touch or get a use out of: dopamine will make you think something that looks shiny and cool (like a skin in a video game) is the thing to buy, but then the rush fades and your left without something useful. Dopamine releases around the potential of awesomeness, not actually the awesomeness. Think about how quickly something Isabelle gets hooked into having loaded shopping carts at various websites, especially around gift giving—she’ll spend two hours hyper focusing on what to get and getting it, but when it comes time to buying something, she freezes and forgets to buy it and then doesn’t remember if she bought it or not. David points out this is the inattentive part: the difficulty of making the choice. You also then log a memory of the check out screen (but not if you actually bought the thing or not). The shopping cart loading is externalizing your memory, using an accommodation to assist with working memory as you find things that might be potential gifts for people. David makes a point around buying something with a use case, even more so than quality of experience: can you specifically use it for something? Does it do something other than just sit there? Sometimes we don’t want to use something up (like candles) because it feels too precious to use them. David names that he gets overwhelmed with too much stuff: he wants it all, but he doesn’t want it all. For example, at a birthday when he got all five video games he wanted, when we get all that we want, all at once, we don’t actually want it all. Give him five video games, but give him one each throughout several months. What if you could rotate toys (Isabelle calls this toy store with her kids) and wishes she could do this with herself. They hit upon that subscription boxes as a cool solution. David names as that someone who is impulsive, there is nothing he wants under $20 he hasn’t bought for himself. If you’re debating getting the expensive thing but caught with decision paralysis, average out how much the thing costs per use (for example, a coffee machine ends up being $1 per cup of coffee for a whole year) and then decide if it’s worth the 5% boost in your day. David names finding the win for yourself: finding the win/lose condition and setting yourself up for a win. That includes receiving gifts: make it simple for your gift givers! You like bunnies? Get bunnies. Set up your givers for a win. Isabelle describes loving to browse a store, but hating to have to make a buying decision, while David thinks of the gift that someone would be embarrassed to buy for themselves but could not reject (without it being silly, such as a 15 lb. Bag of gummy bears). Both inattentive and impulsive types of ADHD lead to self-doubt, but it’s how many times we touch that doubt: for inattentive type, it’s a lot before buying something. For impulsive type, it’s huge the moment you hand the gift over and wonder if you haven’t made a mistake. Isabelle ponders a giant sized Toblerone, David recalls how disconcerting holding a huge gummy bear actually was. For kids, consider the experience of going to the store and getting to impulsively choose the thing they want for themselves. Preserve the magic of the buy: the parent/guardian/gift giver has zero interest in how great the gift is: if they have buyer’s remorse, that’s learning, it’s important, not a failed gift. 

What is Voltron? I mean, the logo alone… 

Quick visual searches (not endorsing any particular brand, just for reference):
Giant Gummy Bear
Giant Toblerone  

DAVID’S DEFINITIONS 

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. Can be present a lot with folx with ADHD.

Use case: Does a thing do something other than just sit there? There is a case for how you’d use it.

Thoughts on gift giving

• Dopamine releases around the potential of awesomeness, not the actual awesomeness. 
• Make it a win/lose, and set yourself up for a win, and those giving you gifts for a win: pick something you 
• Harness your impulsivity: follow your first instinct. Be outrageous.
• Don’t expect doubt to go away: there’s a chaotic variable in giving in a gift, a novel way the person could react.
• Think about things that people maybe would never buy for themselves but they would not reject (run the scenario, pretend you’re mad at the gift you just gave)—for example, two 15 lb. Bags of gummy bears. It’d be silly for someone to reject it and it’d make a funny story if they do.
• Advice for kids: create a day to go to the store with the kid so they can pick out what they impulsively want that day. Give them the power to choose. Predetermine budget or safety issues, but otherwise, no micromanaging. Even with buyer’s remorse, there’s a lesson and it’s okay. 

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Cover Art by: Sol Vázquez

Technical Support by: Bobby Richards