Something Shiny: ADHD! - Live Q & A - Part 2 - Overexplaining, Taking Breaks, and How to Recharge

Live Q & A - Part 2 - Overexplaining, Taking Breaks, and How to Recharge

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06/22/22 • 32 min

Something Shiny: ADHD!

Isabelle & David welcome guests to a live Q & A (previously recorded) and start by addressing the question: What is it about folx with ADHD and overexplaining? Isabelle really relates to this as she overexplains the question. David describes the intersection between mastery and guilt. When you have a lot of mastery around the topic makes it hard to structure a response. You have so much to say, and as you start talking, you realize the holes in what you’re saying, so you go back and try to respond more and try to fill in more and more, and because you have a lot of mastery you have a lot of information. There is also a sense of guilt: when people are trying to be understood, or are feeling misunderstood, people can overexplain when they’re trying to explain themselves. This is literally what structure looks like: over explanation is a structural issue, thinking about the beginning, middle, and end of what you’re going to say. With ADHD we often had a good beginning, a solid middle, and then...it’s just supposed to end. Why are people still looking at me? But I’m still talking...(awkward silence). Isabelle names there’s a look on people’s faces when she’s talking too much and often makes a joke about talking to much to end it; David notices when people start checking their watches or phone, or starts looking around the room, he just assumes that people are done. YAY for the podcast format that helps them both talk longer than might usually be socially welcomed. Isabelle describes how many a part of overexplaining is wanted to clue someone in to what’s going on in her head when she unmasks, like it’s the closest thing to seeing her thought process and the tangents and longwinded way she sometimes gets to things. She also finds herself wanting to fill in silence with jokes and facts and anecdotes and is often the one to try to break the ice. David names that this could be something else: namely, how comfortable are we with nothing? David has a low tolerance for someone asking a question, let’s say in class, that no one’s answering. It could also be called mansplaining, in the form of David just taking up air time, but he’s noticed it often helps start off conversation. Isabelle agrees that her awkwardness often brings people together. Noah chimes in to name it as being natural pickle jar looseners. Noah names gaslighting, and if someone has been gaslit (by others or themselves) their whole life, they may walk around feeling like they need to prove that they’re not “crazy” —Noah describes that he often asks himself “is this weird? Should I say this? Are people going to think...” before he says something. Everyone on the call starts nodding vehemently. David names that folx with ADHD often are very connected to someone else’s inner state, they have lots of mirror neurons (neurons that fire when you’re witnessing or anticipating someone else doing a thing AS IF you are doing the thing yourself, which some folx think can be linked to empathy—see fuller definition and resources below). Isabelle and David open it up to even more questions. Noah starts with the challenge of working with clients who keep developing structure to get something done and it works for a week, but then they have to keep recreating or honing the structure week after week and it’s not working. David responds that there’s often an overcorrection when people are putting in structure, for example, they plan out every minute but it’s not sustainable. Also there’s novelty: novel plans can be attended to and are often stimulating, but once something is not novel, it can’t be attended to the same way. Even if you don’t really like the thing you’re doing, it may still give you a dopamine hit. Noah gives an example of the Pomodoro method, which uses timers. David names that not all interventions work well for different tasks and people. Think of the brain of someone with ADHD as a jet engine—it’s not disabled, but it might find it hard to go in the slow lane or try swimming. So now introduce an intervention that means you take a break quickly after starting (and started a jet engine can take a while)—is the person having trouble taking breaks or having trouble starting? Start a seven minute timer and have to start before it goes off. If it’s a taking a break intervention, maybe take a break when you next go to the bathroom. Breaks and ADHD is hard, people will believe they need to take more breaks, and that’s not true—people often need less breaks, to stay in rhythm longer, and take breaks when it’s effective. For example, instead of a break after school, knowing your medicine is not going to work as well later, going to punch a wall (or do some movement) and then resume homework. It’s like the intervention of needing extra time on a test, when we often need less time....

Previous Episode

Live Q & A - Part 1 - Prescribers, Meds, & Relationships

Isabelle & David welcome guests to a live Q & A (previously recorded) and describe the origins of the podcast, when the two were working together. David had given a presentation and had been gifted a microphone to record his presentation and turn it into an audio book. Isabelle had been welcomed by David to the tribe of folx with ADHD as she slowly realized her own ADHD diagnosis, and was hopeful she had it because it could remove so much shame, blame, guilt, and doubt and increase her understanding of herself. She was brimming with questions for David. They wanted to make a podcast to remove the barriers to this information, which you may normally pay a therapist for—not everyone can pay for a therapist, let alone reach one or feel comfortable going to one. David recalls his brother, who’s mission was to increase understanding to reduce suffering, which is a great way to sum up what the podcast is all about: to increase understanding about ADHD to reduce even one person’s suffering. Without further ado, the two begin to answer questions asked by Q & A participants, the first being, why, when asked [a broad question like: what do you want to know about ADHD?] Their mind goes blank and they can’t think of anything? David names that it reminds him of straddling two countertops like Jean Claude Van Damme (see clip below) and could come from two angles. If someone has ADHD and they’re reading a structureless question, it’s so broad, too little to think about—structuring the question would be very helpful and sparking specific ideas. If the asker is someone without ADHD, they might not know how many parts of the world ADHD touches, how people learn differently, how people hum at different energies, what natural homeostasis looks like for different people. You might not think ADHD has something to do with someone’s sexual appetite, why textures feel strange, why someone seems selfish, why someone doesn’t take care of themselves, why someone is ruggedly independent and ask people for help (fill in the blank), etc. Isabelle notes how she’s noticing that a particular shade of pink on her screen always makes her feel nauseous when she sees it. How to narrow down a broad question, or deal with ordering food—think about categories. As an adult you can (sort of) get whatever you want, and that is a huge question. On a side note, why do buffets exist, Isabelle wonders, while David likes a buffet. What kind of food do you want, hot or cold? Hand food or silverware food? Spicy food, etc.? So one way to rephrase the question is to sprinkle in a category or detail. How important is it to see someone (as a prescriber or therapist) who has a lot of experience with ADHD? Maybe not so important. David names that he would consider what somebody’s biases around ADHD are and ask that question: what do you think of that diagnosis, do you often see people with this diagnosis, etc. We often forget that we have hired them, that psychiatrists and other prescribers work for us, we hired them, we can decide that we don’t work with it. Someone who is willing to try together to find something that works for you and be willing to experiment with you, v. When someone is naming the connection between stimulant medication and drug abuse, the question is not, is it the right thing to do, it’s: does it work? Examples include people who have been off of meds but now drink 13 cups of coffee? David makes it clear that psychiatrists work with psychiatric issues—ADHD is a medical issue. A general practitioner or doctor can prescribe you medication; you don’t have to go to a psychiatrist unless there’s a psychiatric issue. In the ADHD world you’re often working in one of two ways: do you need gas, or do you need brakes? Do you need something to speed you up or slow you down? When people look at it as a psychiatric issue, they try antidepressants or anti-anxiety meds, but when people are medicated to reduce anxiety they act out to increase stimulation. David also names neuropsych evaluations have a hard time differentiating between anxiety and ADHD—sometimes it’s less important to know what it is, than to see what works (more sleep, which meds, which interventions?) Next question: What about people who’s partner has ADHD and gets irritated by their behaviors that may connect to ADHD? David names how important psychoeducation to understand what’s going on. Is it the person’s ADHD or their middle finger? Is it their inattentive type behaviors or do they really want to hurt you? David names the study (cited below) that shows that when someone feels like someone is intentionally shocking them, it hurts more, and when it’s not intentional, we feel the pain less. “He did it again, didn’t mean to,” and when you were in a fight and realizing what someone is ...

Next Episode

All About ADHD - Part IX

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-8th 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; episode 24, All About ADHD Part VIII). David describes how with ADHD, the context matters. As part of a respite care program, he once took out this amazing kid out who loved to scream--not angrily, he just enjoyed the sensations of screaming. The behavior would get to his parents and they felt they couldn’t take him out to eat, etc. because the screaming would bother people. David took him to a football game. Is there ever a point in a football game where it’s not okay to scream? The same behavior is contextually appropriate. Gabe thinks about violence or hunting, which he is wondering about connecting to ADHD and appropriate/inappropriate behaviors—David does not see a connection between violence and ADHD. Instead he talks about danger and stimulation. He picks up an agate coaster (rock) and says if someone with ADHD was handed this, they might start tossing it around. But tell that person that this is a one of a kind, very valuable thing, and they’re not going to toss it, the added risk has raised the stimulation so you don’t have to toss it anymore to be stimulated. It’s about safely increasing the danger or risk of something, pushing the limits. Another example is the water cooler. David describes working with kids where they press the button to fill up their cups with water to the very top, to see how high they can make it, and then have the added risk of trying to carry the cup without spilling it. In those moments, they are actually attending so well to the water, really focused on it. Bobby wonders if his “That’s So Raven” (see below) moments, where he has flashes of what might come to pass, like the danger in taking one route or another. Isabelle hypothesizes that it's a way to introduce danger to a scenario that doesn’t hold any. David describes that it’s a way to safely visualize danger so you can organize your thinking, but not actually have to experience it. Everyone has a different level of tolerance to danger, and it’s not about “hugging the danger,” it’s more about introducing structure. Like at a garden party, telling a kid to make sure this guest has enough water and whatever you do, don’t step on this other person’s shoes, and suddenly, it’s not a dead person command (something a dead person can do, AKA, not what you give someone with ADHD), it’s actually structure. Isabelle wonders at how this seems to help with their toddler (setting up some ground rules to think about ahead of time before visiting a place) and at how she might do that for herself, setting up rules for a meeting, let’s say, where she knows she’s going to doubt what she said so she’s going to say something silly and get it over with first thing. Bobby likens it to an accusational audit, which is a negotiation strategy, where you make all the accusations you’re scared of hearing up front, you get them out of the way. Bobby gives an example of asking for a raise and starting off by saying “I know I might seem ungrateful or like I don’t understand how tight the budget is...” This connects to David’s DARE technique for asking for accommodations. D=Describe the dilemma. “I really want to ask for a raise because I think I deserve one but I don’t know how to do it.” A=Ask for accommodation. “I would really like a raise.” R=Reinforcement, no matter what they say. “Thank you for saying no, I appreciate your honesty and being up front with me.” E=Empathize, or remember that the other person is a human and negotiate closer to what your want is. “I hear you, when’s a good time to come back to this conversation?” AJ seconds that this is a technique similar to what is taught in his sales-based organization, and David describes that he stole it from DBT (dialectical behavior therapy, see below) and it’s acronym DEARMAN, because it simplifies it for someone with ADHD (too many things to remember). Gabe asks about the romantic nature of danger, how he pushes limits, like when he was younger, see how far he could ski down a black diamond ski run without turning, which led to him being injured. David wonders about this: is there any way that him telling Gabe no wouldn’t stopped Gabe from doing this? (no). Would Gabe have just gone back another day to do it? (yes). The potential consequences on that day might’ve been worse? (yes). David says there is no way Gabe would’ve lea...