Stepping into the shame zone with ADHD
“I don’t fit in.” It is a common experience for people with ADHD to feel misunderstood, like something unexplainable is wrong with them. And the feeling that goes with that – which is often barely recognized – is shame. Attention Deficit Hyperactivity Disorder. What a mouthful! Over the last ten years, our understanding of ADHD has changed quite a bit, and if it were to be named today, it might not even be called a deficit or a disorder. It used to be considered a childhood problem, but now it is acknowledged that it affects adults. Like shame, ADHD has many faces, but they all seem to stem from one constant – an impairment of executive functioning. Executive functioning is the ability to track and manage sensory and mental input, making moment by moment decisions. It relies on short term memory– you can think of executive functioning as the air traffic controller of the mind. When executive functioning is impaired, the person has trouble getting things done, that “normal” people seem to accomplish without great effort. Shame can arise from feeling “I should be able to do this”. The person feels something is wrong with them. They feel different from others and often frustrated with themself. Not knowing how to address the problem can also lead to a feeling of powerlessness. What is shame? At its core, shame is the sense that something is fundamentally wrong with me (contrasted with the belief that I have problems to work on but that I am fundamentally okay). Shame is an emotion that blends with other emotions, such as sadness and anger, and almost any behavior. Shame is a real chameleon – and to complicate the picture, not all shame is bad. But the shame we are talking about here is painful and debilitating. Factors that may further complicate the picture (keeping in mind that ADHD is both under and over diagnosed, and that many people feel “everyone has ADHD”): The ADHD person may not be diagnosed. Without a diagnosis it is difficult to address the practical and relational issues. Remember, in a shame state, the person thinks it’s their fundamental identity that’s flawed, not what they do. The ADHD person may be diagnosed, but may feel stigmatized, or may feel that it is an “excuse” diagnosis. This indicates that in the past they have not gotten proper treatment, and support. This can happen when people are medicated as children but haven’t received therapy, coaching or social support to deal with the negative self image that can result from ADHD. ADHD often co-occurs with other conditions, such as trauma, depression, anxiety, substance abuse, bipolar disorder, learning differences and sensory processing disorders. All of the above can lead to feeling – and being – misunderstood. While hyperactivity is part of the name of ADHD, there is also an inattentive type. Because they tend not to attract attention to themselves, people with the inattentive type often do not get help. In school these students are often told that they do not perform up to their abilities. (Noticing that others are disappointed in you leads to shame). Both types hate being bored, and you could interpret both the daydreaming and the hyperactivity as an avoidance of boredom. People with the inattentive type may be shamed by labels such as “bad at following instructions”, unmotivated, disrespectful, or even rebellious. People with ADHD receive repeated negative messages about their ability or willingness to perform according to expectations, as Dr. William Dodson explains. This usually starts in school and often continues into the workplace. Many people with ADHD...
Read MoreHow to find a psychotherapist in the East Bay
Finding a therapist can be a daunting task, especially in an area where there are many to choose from. First off – if you are in a crisis, call the Alameda County Crisis line at 800 833 2900. They do crisis counseling and can give referrals. It is available 24/7. There is also a special line for teens: text “SAFE” to 839863. Otherwise, the rest of this article describes what to do if you can take some time to look around. I’ll suggest a two step process: Get yourself ready to look. Describe what‘s going on for you. Consider what kind of therapist would suit you Write a list of questions for the therapist. Search for therapists. Talk to people you know, if you feel comfortable doing so. Do some on line research Call those you want to interview. 1. Getting ready to look Logistics – time, place, and money Sometimes people just choose a therapist by their office location. Of course convenience is important, but if this is your primary criterion, this is probably not the choice that will serve you best! Most therapists prefer to meet with clients on a weekly basis. For this reason you should look at your schedule and your budget to determine how much you can spend and when you are available. Insurance The Affordable Care Act has brought many changes to health care. Contact your insurance company to find out what your co-pay is for in-network providers, and what they reimburse for out of network providers. Don’t think you are covered for mental health? Check again – parity laws require that mental health coverage be on a par with medical coverage. What to say about yourself, and what questions to ask Interviewing therapists is hard! You’ll be talking about deeply personal topics with a stranger. It’s usually not necessary to go into extensive detail. Describe your situation, using your own words to say what is causing you to search for a therapist. You don’t need to use psychological jargon or a diagnosis, just what you are experiencing. Make sure to say who the therapy is for. Do you want couples or family therapy? If you are having issues with your partner, realize that sometimes your individual therapist may or may not work with you as a couple. It’s a good question to ask when you are interviewing the therapist. Here’s a suggested list of questions to start with. Add your own as needed. I am looking for a therapist because_____________________ or to help me with_____________________________for (myself/my child/me and my partner?other). My current situation is________________. Where is your office? What are your fees? Do you take my insurance? Have you dealt with my problem or issue before? Can you describe your approach? Do you have openings? When you talk to the therapist, pay attention to how you feel as you interact with them. Do they return your call promptly? What’s your impression? Do they seem to understand you? For one reason or another, it may not be a fit. If it’s not, you might consider asking if they can refer you to someone. It’s perfectly ok to tell the therapist that you are talking to multiple therapists to find out who is the best match for you. What do all those initials mean? There are several different types of licenses issued by the state of California that allow the person to practice psychotherapy. They vary in their emphasis, and training, but all have a minimum of a master’s degree and 2 years of internship. MFT or LMFT stands for Licensed Marriage and Family...
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