Isabelle & David welcome Isabelle’s husband, Bobby, and their friends, Christina, AJ, and Gabe, to continue to listen and learn from David’s tried and tested presentation on ADHD, which he normally gives to fellow clinicians (for the 1st-6th parts of this talk, please see episode 4, All About ADHD Part I; episode 6, All About ADHD Part II; episode 9, All About ADHD Part III; episode 12, All About ADHD Part IV; episode 15, All About ADHD Part V; episode 18, All About ADHD Part VI). Gabe starts by asking about bedtime, or really any time when you have unstructured time or less to do/less responsibilities (for example, during the weekends). How can you get yourself to go to bed early, for example, when you don’t have as many boundaries and commitments already? How do you deal with variability in a routine or unstructured time? David names that you cannot make use of your time if you don’t know what you want to do it with. You can outsource choice through routine—practice going to bed/waking up at the same time, having the same bedtime routine—you don’t want your commitments to be punishing, you want them to be your commitments. David’s example is he’s not a great therapist before 10am, and knowing how he spends his mornings and how he spends his time. On his days off, he’s up at the same time, because it doesn’t make his days working a punishment—he calls them “luxury mornings,” he gets to have a coffee, and listen to this playlist, and cook a dish he gets to have for lunch. He’s not just waiting to do something else, there’s a bonus time fill. Isabelle gives an example if you get a last-minute cancellation or you get an unexpected chunk of free time: you give yourself a treat that’s only for that time, like a show you only get to watch if that happens. Isabelle saves her super weird indie films that no one else wants to watch, and it’s in five minute increments, now when someone cancels on her, she enjoys it—it’s about how to enjoy things, not giving yourself ‘free time.’ If you’re doing free time, you’re effed. When kids say they want free time, they want you to leave them alone, they don’t actually want free time, there’s always structure, like the games they want to play or who they want to play with. What about the chaos and drive within being connected to our productivity-focused Western culture? Gabe describes he behaves as he does because of the party he’s in—is it our culture as well? ADHD exists everywhere and we have different political understandings of what we call this diagnosis; ADHD is a medical issue, we can see how it processes information differently, it’s an objective difference in the development of a human, it’s not ‘caused by America’ or people being reinforced for inattentiveness. David names that he thinks ADHD is linked to a survival of the species (see below-Orchid Children article or “The Science of Success”). Referencing allele cells and epigenetic (see below)—in a nutshell, your grandmother’s environment influenced which of your genes are turned on/off—we pass on survival traits. David uses an example of humans abusing rats, where rats were abused and taught to associate a neutral smell (cherry blossom, see article below) with getting hit on the tail and eventually their tails were cut off—they later went on to have children, and those children were introduced to this new neutral smell (cherry blossom) and showed the same stress/fear response their mother’s did.  For folx with ADHD, it’s similar in that there are some environments where we are distracted, scared, in our heads, etc., and other environments where we have mastery and feel less distracted, more in our zones. So you have to think about the environmental variables that help us do a task. AJ describes his ‘dough island,’ his place of working in the kitchen where he is noticing he has less distractions (no photos, no tv, etc.). You can then figure out which environments you are more successful in or less successful in. A lot of people have a stereotype of what studying should look like, like how Norman Rockwell invented a lot of associations with what Christmas looks like—now what does studying look like? Churning, grinding, giant books, painful, quiet library, crumpling up paper. Some people may study well just studying in a group never taking notes or writing anything, and if they succeed in school, they’re going to believe they’re cheating, which makes their self esteem take a hit. But wait a minute, the person may feel safer in these environments (allele cells are being activated) and the accommodation is working, it’s not so random. First question: where does the behavior NOT happen? If every time you transition you get anxious, think about if there’s ever a time when it doesn’t happen, and if you’re always anxious, accept that you’ll be anxious instead of thinking you’re failing. It’s about embracing it, finding what works for you, and radically accepting it, and throwing out what doesn’t work. Isabelle names how there can be a resistance to things being so easy (and accommodations being so easy)—David names that there’s a belief in ADHD that things should be hard: you’re only validated if things hurt. The mixed message of that is incredible, it sets us up to self-stimulating, but figuring out how we can navigate these relationships differently. You’re like a relief pitcher, good at some things and not at others—cultivate your strengths. David references D&D (Dungeons and Dragons) and the concept of mid-maxing: you minimizing what you’re not good at by outsourcing it and knowing it’s not in your repertoire, and then maximizing what you are good at. A good tip for those with ADHD knowing what they should work on: you can tell someone what to do, you can’t tell them how to do it. And it works both ways. So if it’s a task that you want done in a specific way, you gotta do it (even if you don’t enjoy it), and if you don’t care, it doesn’t matter. This can help you figure out what to outsource (and how to talk to someone with ADHD). It’s important for people with ADHD to not get bombarded with instructions and get in their flow, which might look so different. If they’re listening to music and if it’s not distracting them, they will fill in the blank (and know what distracts them). 

 

Rat abuse study (the neutral smell is cherry blossom, btw) of fear being passed down through generations of rats.

Allele cells: in a nutshell, a variant form of a gene (part of the cells that make up the code that helps make you, you). For more nitty gritty on this.

Epigenetics: Environmental factors influence which genes turn on/off. Your grandmother’s, when she was carrying your mother (who herself in utero contained all the eggs she would ever have, in other words, one half of the genes that make up YOU), turned on/off certain genes. And interestingly, even if you never experience the same things your grandmother experienced, you carry the residual effects of those adaptations. David cites rat abuse studies where essentially a female rat was hurt every time it smelled a neutral smell, with her tail eventually being cut off. She was not pregnant at the time, but contained all the eggs she would ever contain. She then went on to have children, and when those children were brought into the experiment, they had the same reaction to the neutral smell that she did (a trauma/fear response).

Mid-maxing: A Dungeons & Dragons (D&D) concept — minimizing the things that you’re not good at, outsourcing those and knowing they’re not part of your repertoire, and maximizing what you’re good at.

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