On Being a Therapist with ADHD
Sometimes when people find out I have ADHD they ask me, “How on earth do you sit still for an hour or two-hour sessions? How could you possibly pay attention for that long?”
There’s a misconception that people with ADHD or ADD always have short attention spans. Untrue. We have very high levels of attention to things that interest us! In fact, we can lose track of time and space and our bodily needs as we zoom in with our superpower of hyperfocus on things we are interested in and enjoy doing. This can be great; I can talk with people about their emotions, sex, love and relationships for days on end! I love my work; listening attentively to the people I’m supporting and developing a deeper understanding of their worlds and conceptualizing a treatment plan to help them achieve their goals, reflecting their strengths and challenges and providing insights and ideas, challenging them to learn and grow in the direction we’re collaboratively creating together… Focus during sessions is rarely an issue.
On the other hand, there are aspects of my job that are much more challenging to focus on. Marketing and paperwork are activities that take me about 10 times as much energy as seeing clients. Learning new technology to implement intake forms and online groups, for instance, has taken a lot of patience. Being at the bottom of the staircase of learning a new skill can be frustrating. We like to be good at things, to have mastery. Who doesn’t? People with ADHD just tend to give up on things a bit faster if we are not instantly good. It takes a lot of patience, practice, and sometimes a support network of encouraging people or gamified goals to stick the tougher things out. But we can do it!
It feels relaxing to know that my clients know I have ADHD. When I fidget during sessions, it’s not a matter of being impatient or anxious, the way some people interpret movement during conversations. It simply helps me to focus. If I have to sit still for long, I’m taking up valuable brain space with my smaller working memory to coach myself to sit still rather than being comfortable in my body and fully present. It would feel hypocritical to suppress that need to fidget - I train people to listen to their body’s signals and their emotions, so naturally it feels good to “walk the walk” so to speak, by letting myself move a bit. Or to literally walk the walk when people want to do their sessions while walking with me.
Entrepreneurship suits a lot of neurodiverse folks. A lot of people with ADHD prefer not to work for an authority figure or being told what to do. Not all of us have ODD (Oppositional Defiance Disorder, though we do have higher rates than the general population) but a lot of us consistently question the rules (“Why? ...But why?”) and do not like hearing, “Because I said so,” or, “Because that’s the way it’s always been done”. Developing my own private practice has been challenging but wonderful, even if it means I wear 10 hats. The novelty is happy-making!
ADHDers tend to be good in crisis response positions as many of us actually enjoy the chemical reactions our bodies have – namely, a boost in adrenaline and dopamine, hormones that are energizing (temporarily) and that help us focus. I love working with couples, for instance, partly because it’s so challenging – you’ve got enough complexity with one human being in the room plus another, plus their relationship to contend with; it keeps things interesting which helps me to help them.
A lot of my clients apologize profusely for jumping around (changing topics rapidly, but sometimes literally moving a lot) in session, but that is exactly how my brain works too! I usually follow, and if I don’t, I’m happy to ask for clarification to keep on the same page with people. One of the strengths of ADHDers is our divergent thinking, or capacity to make connections between seemingly unrelated concepts and creatively problem solve. Mind mapping is one of my favourite tools for brainstorming direction and unravelling a chaotic mess of thoughts and feelings into something more cohesive, clear and workable – broken down with smaller, more manageable steps.
Sure, I can get impatient; mostly with paperwork which I find boring and thus frustrating. Issues with impulse control that manifest as impatience or mood swings are a hallmark ADHD thing. I’ve done my own work over the years with counsellors and coaches to manage my delightfully (and sometimes infuriatingly) scattered mind. Becoming certified in ADHD coaching also helped me to learn skills and techniques to manage the impulse control, emotional dysregulation and energy to better focus. I think all counsellors should do their own mental health work to better understand themselves. This gives insight into the change and growth process in a rather uncomfortable way; we have to face our own resistance and challenges so we can learn to empathize more effectively with the people we support.
Take gentle care.