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; episode 21, All About ADHD PART VII). Bobby starts by naming that a lot of self-help and business books focus on you giving one specific thing your all and focusing on that, continuing David’s idea that folx with ADHD are like relief pitchers, so don’t try to make them all around baseball players (play to your strengths rather than trying to change your vulnerabilities). David names that it can be distracting trying to be perfect. Bobby also names that being a freelancer means you are wearing so many hats and getting caught up in so much minutia. But it also is scary to say you’re going to say no to 98% of what you would normally do and only focus on the 2% that’s your focus—also, what about the fact that Bobby (and many of us) want to wear many hats and do so many different things? Isabelle relates to this in how she checks out a number of ebooks from the library and reads them all, but in patches and based on what her mood is. David names that what they’re both talking about is the structure. You are focusing on one thing, but you’re using a structure to determine what that one thing is, and how it’s more of a pattern and a rhythm than you might realize. Bobby names that he thinks it’s true because of Isabelle’s 5 year journal, that reveals they are way more into repeating patterns throughout the year than you would think. Focusing on the things you’re really good at allows you to notice what else you should pick up and add to your repetoire. People with ADHD often overcommit because they want to make people happy. So saying you can focus on what you’re good at doesn’t mean you have to do it one way, it’s more that finding what you want to do helps you feel less overwhelmed. Find what you’re good at and invest energy into it. David is good at talking and listening so that’s what he does for a living. It’s about accepting your vulnerabilities and knowing who you are, it’s about embracing, not curing. ADHD requires a variability of stimulation. In the absence of stimulation, we can’t do tasks. Example: one explorer goes ‘there’s a cliff!” While the person with ADHD goes “there’s a cliff!” and almost runs up to the very edge and sees an orchard that was hiding there. The need for stimulation is why you might get closer to the edge of the cliff, it might mean why you wait until the last minute to do something. This connects to procrastination and self-stimulation. (For MORE on procrastination, check out episode 08: Are We Designed to Procrastinate?) Which emotions help your heart beat faster, that help you self-stimulate? The ones you’ve practiced the most, usually, including: anxious, angry, or excitement (or arousal). Bobby and Isabelle both relate to the anxious/angry during transitions part. You can always expect those things around a transition. It can make you feel like less of a monster, if you can expect it. Instead of saying “why are you always so mean to me when we leave?” You say “oh my gosh, we need to leave, I’ll meet you there.” David mentions that it’s a DRO technique, which means a Differential Reinforcement of the Other (DRO), a type of behavioral technique that makes the behavior you’re trying to avoid not an option. Bobby uses accommodations to make sure he’s on schedule, so he gets anxious and needs to be on schedule and tries to be early. Isabelle, on the other hand, has her own rhythm and path and gets overwhelmed when she hears too many voices coming at her, and then gets really mad at herself. David names that it may be less about being mad at getting micromanaged and more about getting distracted. Isabelle agrees, that it feels like six competing voices sometimes, and it’s very overwhelming, she gets that way about music and sounds in general. David talks over Isabelle to demonstrate what it’s like when she’s trying to go through her list and giving her instructions, and she gets so mad at him (and it’s okay, it’s part of the example) and he points out her way of creating a sound screen is to hate somebody. So with structure and independence, you don’t need to get angry because you don’t need to self-stim (see below) to stay focused. In essence, there's no way she can take on another competing stimulus (like someone telling her what to do as she has her own thoughts about what to do) without self-stimulating unless she is on a medication. AJ posits that maybe this means don’t give competing instructions to someone with ADHD to limit this phenomena; David revises this as the person with ADHD saying “One, I need one”—it’s about a need to self-regulate the process. Or if you give someone with ADHD a task to do and they say ‘sure,’ it may get done in the next two days. So the call and response around this type of request might be “sure” and then let them do it right then, or alternately the person with ADHD saying “I can’t” and you believing them. Gabe wonders how can you do this with kids, where you have so many different variables, and how the task of getting the kids to school on time, for example, becomes lost because there’s so many moving parts. He names that if he has to get the kids somewhere and his wife has prepared a bag with all the needed things, he’s able to do it. David asks what the accommodation there is: all the stuff being ready. He asks Gabe what he would need to get to school early? Gabe answers: all the stuff being ready. You can see exactly what you need but it can be hard to put it into a different context. One tip for talking to a child or someone with ADHD is to never ask them to do something a dead person could do. Examples include: “stand there,” "sit there,” “don’t move,” “don’t touch,” “wait for five minutes,” etc. You instead say what you want them to do, and be specific. “Play quietly” doesn’t tell them what to do, it opens the door to everything. So instead, try “run around the block” or “run back and forth to the tree over there.” When it comes to asking kids to be quiet, making it a game, like a whisper game, instead of just saying “don’t be loud,” which doesn’t work. Knowing this is supposed to happen is really important, with kids, helping them recognize that the angry, frustration, arousal, stimulation needs are supposed to happen. We want to avoid saying the words “just” and “should” with kids, at all times. Don’t “should” all over yourself. Bobby acknowledges doing this too often. Avoid saying “this is easy…” and try “I know this is hard and you only have two things left.” Because when someone’s self-esteem is damaged, they’ll throw everything away, and when they’re self-esteem is intact, they’ll do everything to save the crystal ball. Gabe gives an example with his kid finishing most of the broccoli in order to earn his cookie, but then he entered scorched earth level moments because there was one more bite—Gabe noticed himself wanting to say "it's just one more bite…” and instead thought of saying “I know this is hard, you did good” and actually told his son he had done enough and gave him the cookie. David names that this was smart, you want to avoid power struggles with someone with ADHD because the whole time they’re debating you, they’re getting reinforced. Not in his cognition, he hates the whole experience, but it's also giving him so much dopamine and stimulation to debate and be locked in this sense of doing something without knowing why he's doing it. Knowing it is not personal makes these moments hurt so much less. 

Why do folx with ADHD procrastinate? Waiting for the last minute, or delaying starting can be self medication for someone with ADHD. Excitement, Anxiety, Anger are all feelings that trigger stimulate us (our heart rate increases). Once this happens we remove any delay in reinforcement, as all acts towards work completion reduce that feeling/stimulation. It can also really increase the feeling of winning, if deadlines are met. For MORE on procrastination, check out episode 08: Are We Designed to Procrastinate?)

Differential Reinforcement of the Other (DRO): Making the behavior you’re trying to avoid not an option. How to succeed without having to combat an urge. 

For example: not having the amazon app so you don’t buy things impulsively, not buying the marshmallows so you don’t have them at home when hit with the urge to eat them. If you struggle in study hall because you want to talk to friends, you switch study hall to a room that doesn’t have your friends in it.

Self-Stimulants (AKA Self-Stim) are emotions you use to make your heart beat faster, arouse your nervous system, up your stimulation level. They are: anger, excitement, anxiety/fear. 

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