David and Isabelle are joined by two fellow therapists who have ADHD, Caily & Sarah. They talk about how ADHD and anxiety can go hand in hand in women with ADHD, how anxiety and discouraged anger relate, how gender norms for women set up neurodivergent women to mask, and the value of just TAKING AWAY THE CHAIR. All this in twenty-some minutes? Believe it. (Part II of a series)

-----

David and Isabelle continue their conversation with colleagues Caily and Sarah, two therapists who identify as women who also have ADHD. David names that there are some sexist structures that women are supposed to be ‘daydreamers’ and ‘forgetful’ and when someone fits those norms (misogyny) and they are also fitting inattentive ADHD norms that impacts their ability to build self-esteem, an identity, why am I different? Why am I deficient? Etc. Caily names that so many women with inattentive ADHD go undiagnosed or get misdiagnosed with anxiety, because there are many overlapping characteristics. And women are socialized and feel the pressure to perform tasks that require high levels of organization, executive functioning, and task switching, all of which are super hard to do when you have ADHD. This is true of women and mothers, and it can feel like it’s okay to be messy or disorganized when you’re a man, and it’s okay to get help from someone, but if you’re a girl, the message we get is you can’t be messy, because then we’re told “you’re lazy.” There’s a layer of rage Isabelle is noticing rising up, and also she wants to go 100 places with this and picks one. With the anxiety piece, there’s a way where you walk around with this high bar for moms that is not as high for dads (see Jimmy Kimmel’s asking dads info about their kids). Imagine you are walking around with a higher bar, and Isabelle, for example, is not great at any of these things, people judge you as not only a person who is struggling with some things, but you’re seen as not a good mom, because your role as mom is to run the constant ticker tape of all the things, not just keeping your kids alive. But also single women carry more of this burden and pressure than single men, too—how would this not promote anxiety? And then Isabelle doubles down on the soapbox of how an emotional component that is often missing in women she works with is a healthy sense of anger.  One of the reasons Isabelle looks up to Sarah is that she has a fight in her, because we’re so socially conditioned to be peacemakers, to be nurturing, to carry the emotional load and not ruffle the waters. And it all combines to SUCK. Sarah seconds this, how could you not be anxious if in the message you do something and you’re told you’re bad—how does that not create anxiety and an urge to hide these things because you feel like you’re doing something wrong? In her case, Sarah was not very anxious, because her anger got to come out at the injustice of the system itself—internalized anger can translate to anxiety.  But if you express your anger, if you get to externalize it and depersonalize it, you also get to know that you’re not the problem. She wants Isabelle and Caily to know that it’s not you, you were set up for failure. Everyone with ADHD is set up for failure. Sarah recounts a moment when her and Caily were both on a zoom call and they both stood up to recross their legs to sit back down because neither likes to sit with her feet on the ground, and this was a moment of connection and shared understanding that can be so rare. Sarah has been shamed her whole life for not keeping her feet on the ground, hearing phrases like “Can’t you just sit with your feet on the ground”—and even the ways we talk about  “getting grounded” is the opposite of how she gets grounded.  She sees this with her daughter, who also has ADHD, who has a hard time focusing while sitting at dinner, so Sarah takes away the chair—take away the chair, take a bite, twirl in a circle, do whatever you need to do to attend to the thing I am asking you to attend to. That would  have been so lovely growing up. And she heard her own parents’ voice saying “can’t you just sit down and eat your food?” Sarah realizes that her daughter cannot, so let's actually take away the chair, because the system is what’s setting you up for failure. David names that when you’re authorized to fight, things are different. Get it done, not about how—there’s a lot more HOWs applied to women, rather than men. Having anxiety is different from having healthy fear responses to threats, and the threats are everywhere, and is how the world tends to articulate experiences. David starts to explain that there’s this relationship researcher guy John Gottman, of the Gottman Institute—which Isabelle points out is actually founded and run by the Gottmans, (it’s not just John, it’s Julie and John Gottman)—which David checks himself and names he is regurgitating another societal narrative that leaves women out. (Isabelle also names that Erik Erikson’s wife (Joan). David references the Gottmans’ work on the four horsemen of relationship apocalypse (see below) and that there is a significant difference between a complaint, which is not great, and contempt, which is worse. Complaint is about a behavior; contempt is about a person’s character. An example is “you didn’t take out the garbage today” v. “you never take out the garbage.” With the criticism leveled at women is contemptuous stuff, it’s not “i’m not good at organizing” it’s “I’m disorganized and a mess.” Take away the how’s and let yourself be: be messy, take away the chairs, who cares? Caily brings up how if you’re taught to not be angry, we pathologize anger, you are going to ignore the signals and messages that a need has not been met. If you are going to tune out those signals, or it’s not allowed for you to express those signals, then it also then sets you up to go along with a system that is wrong or not healthy. Sarah chimes in that then the anger is stuck in your body, if you can’t let anger out, it gets stuck in her body. And that as much as you can personal take away the chair and challenge these norms and systems at home, you are still navigating a world that is not set up for you and doesn’t know enough about neurodivergence. There is still a lot of judgment and stigma and workplaces that are not going to allow the accommodations you need. Compliance is a big thing, and compliance comes with a lot of privilege. You get compliance privilege if you do the thing that everyone else is doing. I don’t know know anyone who doesn’t fit in, it feels good, and privileges come with that. Sarah got in trouble a lot, but was also an entertainer, that gave her a sense of fitting in, or set up a place for her, but she would also get if she doesn’t fit in, she saw it as the wrong place for her. She didn’t care what people thought, including fashion trends and other markers of ‘fitting in,’ and that made it hard for her to fit in with her peers, and even if she didn’t care, the people around her did care, and it’s layered in families. David names what LeDerick Horne (see Episode 042: A Conversation with LeDerick Horne - Part II - “Being seen by somebody like you”) said about near-peer mentors, and it’s so important for us to talk about this and for women to talk about it. It’s incredible to hear someone speaking to you that knows your experience in a different way. It’s also going against the image of ADHD that was propagated for so long which was a white teenage boy—there is so much more to gender, sex, biology and more that adds layers of nuance and variation to what is already a very unique experience. You know one person with ADHD you know one person with ADHD. And there are people who are extra vulnerable and may not feel ready to pull the chair away. But the importance of modeling solutions and safety (like taking the chair away) is real.

Complaint v. Contempt (see Four Horsemen of Relationship Apocalypse)—complaint is regarding behavior, contempt is regarding character. Words like “always” and “never” can take a behavior and make it stretch to the character of a person. For example, “You never take out the trash” carries a different load to “you didn’t take the trash out today.”

Compliance privilege: how systemic privileges are extended to those who comply with societal rules and norms—picture how anyone who varies from those in power (White, cis, het, male, Christian, able-bodied, etc.) is punished for noncompliance or rewarded for complying with the system itself, even just for survival, even if it’s set up against them. This can connect to the pressure to mask as neurotypical (see below)

Masking: Often used in referenced to folx with Autism Spectrum Disorder (ASD), it also applies to folx with ADHD (or both!), 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. It can be (and feel like) a matter of survival. 

From a great article on the topic:

Subtypes of ADHD (using the metaphor of a car with a gas pedal and brakes, in this case the car is the brain)

 -inattentive type: too much brakes

 -impulsive (or hyperactive) type: too much gas

 -combined type: too much of one or the other depending on the environment someone is in (often having mastery or familiarity in an environment can cue the gas to kick in, versus the brakes).