Do what you like and like what you do. Adults with ADHD have difficulty sustaining attention and effort when engaged in tasks that are not personally stimulating, or when working in a distracting environment. One of the best non-medical treatments for adult ADHD is finding the best match for a career. The wrong work environment can contribute to disabling symptoms.

Parents of college students with ADHD might be wise not to discourage unorthodox choices for academic majors, or even postponing college. One of my colleagues listened to experts who encouraged her to get a serious agent for her daughter, a gifted actor with ADHD. The daughter became a television star at age nineteen. She lives and works in Burbank, CA and could easily have been a bored college student, possibly underachieving, had she been forced to take a more “practical” path.

As a teenager, I escaped my father’s grocery store, where I had been sentenced to stocking shelves and bagging groceries. My dad just wanted me to work, no matter where, and allowed me to find jobs that provided more varied tasks. The best was working in a hardware store where I learned some useful skills. As a young adult I had a few part-time jobs in radio, getting paid to play music and read news for pay. Long before knowing I had an attention disorder, I recall often thinking that the worst thing someone could do to me is force me into a boring life.

In the early years after college, I experienced both boring and stimulating jobs. Some were about as interesting and challenging as watching the grass grow. Others were not the most stimulating jobs, but they provided opportunities to travel and expand my horizons. The best has been my career as a psychotherapist, allowing me to be useful, to have a relationship with many interesting people, and to meet with clients in a quiet environment with no distractions.

What is your ideal career? What have been the least and most stimulating jobs in your life?

ADHD researchers and experts like Dr. Russell Barkley and Dr. Thomas Brown have suggested for years that emotion regulation problems are prevalent in adults with ADHD. Although they do not appear in the DSM (the Diagnostic and Statistics Manual) among the specific criteria for making the ADHD diagnosis, they are almost as prevalent as the inattentive symptoms of ADHD and more prevalent than the hyperactive/impulsive symptoms, according to Dr. Barkley. He says that most adults with ADHD report having problems with being easily annoyed, impatient, quick to anger, easily frustrated, overreacting, and easily excited.

Living well with ADHD does not mean”controlling” feelings, but learning to observe and tolerate them, and most importantly, knowing the difference between feelings and thoughts. When I have asked clients what they felt in situations that they have described to me, they almost always answer with a thought instead (e.g., “I felt like my husband was just refusing to listen to me,” rather than, “I felt angry.”). When we experience an abrupt shift in our emotional state, the physical sensations in our bodies deserve our respect and acceptance, but we often react from our story line—the meaning we make from those feelings. We are more likely to respond throughfully when we first pause to observe our mental activity.

You can only feel what you feel, no matter that your well-meaning parents may have tried to teach you otherwise (“Cheer up, you have no reason to be depressed…don’t be afraid…don’t be so angry.”). Unless you have an untreated mood disorder, feelings are not a problem; wishing not to have them is. When we wish not to have a particular feeling, we are likely to look outside our own minds for the assumed source of our mental anguish. We are at risk for an impulsive outburst.

No doubt, our feelings often serve us to assert ourselves or solve a real problem. But the stronger the feeling, the more we are at risk of reacting impulsively—from the feeling—rather than observing it without judgment and proceeding thoughtfully. When we simply observe the feeling first, with acceptance and curiosity, we are more likely to respond to situations with equanimity, which is a nice word for balance of emotions and thought.

In my support group last night, participants suggested a number of ways to respond skillfully to strong feelings:

Take a deep breath before speaking or acting.
Exhale consciously, exaggerating and extending it like a long sigh.
Practice meditation routinely (emphasis on practice).
Practice accepting and respecting your feelings.
Pay attention to the physical sensations of your feelings.
Ask yourself, “What is the worst thing that can happen?”
Observe your reactions (e.g., observe that you are “white knuckling your steering wheel” in traffic).
Breathe deeply when stopped at a red light (They are supposed to turn red sometimes!).

I’m grateful to NAPO for allowing me to present my ideas about communication that can discourage ADHD clients and alternative communication that can empower them. I’m grateful also to members of the addnashville support group whose suggestions were incorporated into the presentation. We are helping many other adults with ADHD indirectly with the information shared with the organizers. I continue to be impressed with this profession, especially with the acceptance and sensitivity shown to persons with ADHD. Thank you NAPO organizers and members!

Visit napo.net for more information about the profession and to find an organizer in your area. Locals can check out professional organizers in the Nashville area by visiting naponashville.com. 

How would you define self-esteem? The Cambridge Dictionary defines it as “belief and confidence in your own ability and value.” No definition of self-esteem ever satisfied me because I cannot answer this simple question: Which one is the self, the one judging, or the one being judged? Where did the judging self come from anyway? Zen Master Shunryu Suzuki described the judging self as “extra.” “It is like having a head on top of the head,” he said. “You don’t need the extra head.”

I don’t believe the problem of “low self-esteem” is about judging oneself negatively. I think the real problem is the creation of a judging self. Allow me to contrast what it means to judge your value and abilities (the self) on the one hand, and your performance on the other. They’re not the same.

First, why would you question your value? Unless you believe that some people are born without value, how could you have no value? What does having no value look like? What is the value of questioning your value? I suppose my life may lose value when I’m breathing my last breaths, but I don’t think I will be too concerned about it then. I’ll get back to you on that!

What does it mean to “have confidence in your abilities” as some dictionaries define self-esteem. You may feel confident when observing a particular skill you have, but the action of recognizing an ability is observing. You may feel confident about one ability and be confident that you lack another. If you are aware of your abilities, and those you don’t possess, what is there to question? You can develop abilities, and you can accommodate for those you lack.

If you don’t read music, you can learn how. If you have a learning disability that makes it nearly impossible to learn how to read music, you can dedicate your time to another hobby, or do as my mom did and learn to play piano by ear. I can say that I’m confident in my knowledge of grammar. I’m equally confident that I have a poor memory and have learned not to rely on it. I rely on tools and strategies instead…and other people.

Evaluating performance is different from judging the self. It has a function. If you began music lessons last week, you are not going to play a recital this week, but you and your teacher will be evaluating your progress weekly. Evaluating progress helps you know how to allocate time for studying and practicing. You are not judging your value or your abilities when learning something new, you are simply observing progress in your skill development as you proceed from one lesson to the next.

Here is my suggestion for what to do about the judging self. The moment you notice that you are constructing a judging self, just observe that you’re doing it…without judgment…and say to yourself, “There’s that.” Say no more. Don’t say, “Oh, there is that damn judge again; why do I do that to myself?” That is judging. Acceptance of a tendency or an inclination is more informative and useful than self-criticism.

Saying “there’s that” allows you to simply notice the judging self. It prompts awareness that you are capable of dividing yourself into two selves. The bottom line is this: you can question your value and your abilities, or you can silence the judge.

It has always bothered me that many people, doctors included, tend to view anything that deviates from the typical as being abnormal or broken. The common medical perception of synesthesia illustrates this perfectly. Doctors don’t generally say, “This is an incredible gift; how can we give it to other people?” Instead, they say, ‘What went wrong in this poor fellow’s head, and how can we fix him? — from John Elder Robison’s book, Switched On: A memoir of Brain Change and Emotional Awakening (2016).

Synesthesia is a rare neurological phenomenon where the stimulation of one sense produces sensations in another. Robison could “see” sound waves that corresponded with the sound he was hearing. That ability made him an exceptional sound engineer for the rock group Kiss. He tells the reader that when one’s competence is exceptional, people will overlook differences as eccentricities. 

Coincidentally, I read the above quotation from Switched On a few days after writing “Don’t Fix Me” (Last week’s blog). Robison is on the autism spectrum and has been extraordinarily successful in multiple careers: sound engineer, inventor of toys, corporate executive, auto mechanic, shop owner, photographer, author, speaker. There are few people like him. Most of us will never achieve a fraction of what he has achieved. Despite his successes, he had significant social problems and has important things to say on behalf of individuals living with a neurological difference. His willingness to be different was a liberating quaility. 

I’ve read John Robison’s books and heard him speak in Nashville six years ago about his eventful life as an Aspie (his name for persons with what we used to call Asperger’s Syndrome). His books are informative, entertaining, and well written. Look Me in the Eye is an autobiographical story and his first book. He followed with Be Different and Raising Cubby (Cubby is his son).

Switched On is a New York Times bestseller and was named one of the best books of the year by The Washington Post. It is a good read that informs the reader not only about TMS (transcranial magnetic stimulation) and its effects on autism, but about how our brains work. The perpetually curious Robison started researching the science and interviewing the researchers while a TMS research subject. This book is an interesting update to his personal story, and I recommend it. 

I recently caught the end of a radio interview with someone whose wheelchair mobility was limited by lack of access to buildings in the community. To those who thought his disability needed to be fixed, he said, “Don’t fix me; fix my environment.”

The disability of ADHD is invisible to most people. The presumption that my less visible disability needs to be fixed is offensive. Here is what I wish to say to those who want to fix me: “Fix your presumptions about me instead.”

Someone recently wanted to fix the pace of my deliberation over a major decision, which was more in his interest than mine. “You have trouble making decisions,” he said. During that same period, more than one person said to me, “Don’t rush a big decision just because someone else wants you to.” I don’t think the first person intended to shame me. He just didn’t understand me and didn’t know that I’m accustomed to being misperceived (Still, being “invisible” doesn’t hurt less just because it is familiar).

My invisible disability puts me at risk for being manipulated. I protect myself by kindling the fire and poking the logs longer than most might in similar situations. I’m not insensitive to the effect on others, but my first priority is to make wise decisions. Once I’ve burned it all up, I’m resolute and ready to move on. My pace doesn’t need to be fixed.

Adults with ADHD encounter other adults who want to fix them. That often includes their spouses and even some well-meaning mental health professionals. You wish that others would be more willing to understand you. But first things first: You need to understand and accept it before expecting others to. That includes understanding and accepting its effects on others. Then maybe…just maybe, they will be more inclined to try to understand you instead of tyring to fix you. 

Living well with ADHD is not about fixing something that is broken. It is about understanding the disorder, accepting its effects without being defensive, sharpening the tool as needed (with medicine, coaching and good mental hygiene), and embracing your dream. It is much more interesting and useful to focus on what you want to do with your tool, your brain, than just sharpening a tool that you don’t use. It only needs to be sharp enough to do what you want to do with it.

Any notion that I need to fix you ought to offend you. Just as my office building is wheelchair accessible, I want my curiosity and patience—as a psychotherapist and support group leader—to be accessible as well. I try my best to abandon any presumptions, especially for those who have had enough already!

Don’t let anyone fix you! I’m reminded of how Billy Joel, in his early years, would end his live performances with fists raised in a boxing pose, yelling out to his worked-up audience, “Don’t take any shit from anybody!”

I’m not just a fan of Laura DiNello’s art; I’m awed by her courage to be who she is and do what she does. Her life’s story is an inspiration for women, and for anyone who would dare to make a career out of a passionate interest and a creative mind. Do you know anyone who could single-parent four children on an artist’s income? To achieve that feat required a commitment to nonstop hard work and production. Her children are grown now, but she remains prolific, as if her own life depends on it. Hers is a story of defiance, determination, and grit. (Click here to read a 2013 article on Larua DiNello)

With little support, Ms. DiNello was determined to have a career as an artist. I have visited her gallery in Charleston, SC twice in the past year. Her daughter Caleigh runs the business and has generously shared stories with me about her mother. Her admiration and respect for her mom was evident the first time I met her. I have not yet had the opportunity to meet the artist, despite Caleigh’s effort to persuade her to come to the gallery during my recent visit. Ms. DiNello was hard at work on a commissioned piece and couldn’t stop.

Caleigh describes a mother who never stops. She showed me pictures last weekend of her mother’s outdoor grills and fire pit, three brick structures that her mother recently built with no prior experience laying brick. “My mom just decided to do it and did it.” That is what Laura DiNello has always done, according to her daughter.

Caleigh told me that her mother’s bedtime is when she is too tired to continue working. Her mom works at a manic pace, she said, and always has to be busy. The gallery is full of nothing but her creations. Many of them are quite large and a product of painting, clipping, and pasting. She sometimes creates one painting from two canvases, cutting one of them up into small pieces and creating a mosaic overlay on the other painting. If you get up close to some of her work, you may see clippings from maps, newspaper articles, sheet music, post cards and who knows what else. Stand back and you will see human figures with Caleigh’s eyes. Caleigh says they are also her mom’s eyes. “It is just how she sees eyes,” she told me. Even her male subjects have those eyes.

Many of Ms. DiNello’s pieces show individuals holding animals or objects, like a bird or a musical instrument. Some of the images are of herself. I own two small pieces: “The Writer” and “The Painter.” My thoughtful wife bought each on consecutive birthdays. 

This is not an ADHD story as far as I know. But Laura DiNello’s brain is obviously one that was made to create. She exemplifies living well. Leaving the DiNello gallery, having felt the artist’s energy and seen what she has created, I feel good about life.

In recent months, my wife and I have witnessed death and grief among peers and friends our age and younger. At the same time, we are observing the end of a generation that came before us, and the inevitable health challenges that are natural consequences of aging. I’m reminded at times like this of the importance of our relationships, of being close to the suffering of people we love. When we embrace and support one another in times of pain and suffering, we are engaging with life where it happens, no less than when we embrace the gift of life and the beauty that surrounds us and resides within us.

I just read an essay this morning, written by an acquaintance who died last month. I didn’t know him well, but I knew from friends about the serious health problems he lived with for many years. He had been through multiple losses in his body, part by part, for a long time. He was grateful for his life. He attributed his ability to embrace unavoidable suffering in life to his willingness to accept it all, and to his daily practice of meditation:

It is the practice of staying in the moment that allows me to benefit from a life that does not stay entangled in bad decisions and their unwholesome results, or worry myself into a ball of hopeless depression over events that have not made themselves manifest, and for all I know may never. – Michael Crowder

To read Michael Crowder’s complete essay and Dawson Wells’ reflections on Michael’s life, visit onedharmanashville.com.

Blaming your partner is a weak position in a conflict. It only increases the likelihood that your partner will be defensive rather than open to hearing you. Presuming good intentions, on the other hand, allows room for productive dialogue. That rule applies to both partners.

You may think your wife is hypersensitive, for example, while she thinks you lack sensitivity. In your mind, it is not what you just said that made her angry, but the meaning she made of what you said. Correcting her misinterpretation is not the best place to start. She hears your explanation as nothing more than rationalizing your insensitive behavior. Whatever your intentions, there is an effect.

You are certain that she is angry for the wrong reasons. She acts as if she knows your motives better than you. You are now angry that she is hurt. To her, you are just impulsive and inconsiderate.

So, what is true here? Who is responsible for what? How can you frame your challenge constructively? How can you proceed in a way that moves you toward mutual understanding and resolution?

If you continue to look for who is to blame, you will conclude that it is your partner. When you “win” an argument, you create a loser, and then the partnership loses. On the other hand, if the partnership respects the imperfection and complexities of human interaction, each partner will listen with the intention of understanding the other’s experience. Simply put, mutual understanding and acceptance are much more useful than reciprocal blame.

If the non-ADHD partner can respect the reality of ADHD symptoms and still take care of herself in relation to those symptoms, the partnership will benefit. If the ADHD partner can avoid a narcissistic tendency to be right, or the self-loathing tendency to feel permanently flawed, then the actual problem is one that the partnership can resolve. That is different from trying to determine which partner is the problem.

Blame doesn’t work. The bottom line is this: Strong partnerships can deal with life’s challenges far more effectively and easily than alienated individuals.