Something Shiny: ADHD! - What happens when we make mistakes?

What happens when we make mistakes?

Explicit content warning

08/03/22 • 25 min

Something Shiny: ADHD!

David asks: what about brushing your teeth and things that don’t have immediate gratification, necessarily, but you have to do them over and over again? How do you motivate yourself to do them? It’s preventative-you don’t see what you save, you don’t know what Past You did for Future You when you’ve brushed your teeth. David’s answer is to outsource a lot of decisions that he doesn’t want to make to ritual, and the world of pain is part of everything we have to do. He just does it because it’s the routine (like getting up) even though it is so hard, so very hard, to do the things we don’t want to do. The fact that we can feel this much pain helps us want to prevent other’s pain, makes us think creatively. David might be willing to bet that a lot of technology and innovation that makes things more efficient and helps us skip the boring tedious parts is perhaps invented by folx with ADHD. For folx with ADHD, you are tested in fire all the time, and it does things—there is negative stuff (sucks experiencing rejection, sucks making mistakes, sucks not being perfect, sucks being found out)—but our ability to think outside the box because we’ve had to struggle our whole life is something he doesn’t want to surrender. Isabelle names that it feels that David saying that expressed compassion to the part of her that didn’t get that before. She thinks about how in trauma work there’s this mythology around the trauma making you stronger, but also—you could’ve been great without the trauma, thank you. Isabelle didn’t really give herself credit for the strengths, and often assigns the strengths and things that she has achieved to good fortune or luck, while taking full ownership of the blame, shame, and mistake-making parts. It has taken her a long time to not just jump straight to “I got so lucky!” And recognize that maybe she had something to do it with—and wonders if she’s the only one? David names that this is so relatable—it is so hard to acknowledge that our strengths are coming from the same place our vulnerabilities are. It’s so easy to say we got lucky or it was chance, because we don’t get to refine the skills to know we did more than get away with something. We don’t fit in the Normal Rockwell image of how things appear and so we don’t think about doing things the same way others do, either. David names how a part of him would be ashamed about getting ready for a school presentation in ten minutes—instead of practicing every night for twenty minutes, like he thought he should. Never mind that he still got an A, was able to speak with great energy, that the fact his tone of voice was a little more engaging—all of those things are ADHD. David is just thinking he got away with it, because he’s not counting all the times he thought about doing the thing and then didn’t, because they were ‘dumb anxious thoughts,’ never mind that he got it done and got a good grade, he was still a fraud because he was different. Now he can look at it in a balanced way, it’s all ingredients to who we are. In the real world, you’re not in trouble if you get it done too fast. Isabelle convinced herself people would think she cheated if she was honest about how she did something. We encounter so much pain, we don’t need any help seeing the fault of our actions, David is really good at that—but we all need someone to remind us of what we’re really good at. Folx with ADHD are used to calling out ADHD behavior when something is not going right; getting use to calling out ADHD behavior when things that are happening that are excellent, and would not be happening if not for a person’s ADHD. There’s so much pain, let’s honor the great things. Isabelle thinks about how she was at the park with her kid on a playdate and had a snack bag and thermos with tea. She proceeded to leave this tea everywhere and put the tea everywhere, on slides, wherever, forgetting she had it, circling back, and meanwhile, her kid is playing and pushing their amazing boundaries. She always thinks someone has come in and moved something, like the realization in the film A Beautiful Mind that someone’s hallucinations are so real to them they feel like reality. David calls Isabelle on calling this a delusion: somebody did move it. It was you. And you don’t remember it because you didn’t make a memory because you were busy doing ten other things. The whole thing is accurate. Isabelle laughs so hard and thinks she might need to get that tattooed on her: “Somebody did move it, and it was you,” Memento-style (see below). Isabelle notices that over time she is much more open and discloses more quickly that she has ADHD, in an attempt to normalize it and make it a safe conversation for the other person, too. And she notices that in the past she would maybe make it more of an apology or an explanation—d...

Previous Episode

Frustrated with your frustration tolerance?

David begins by naming that dealing with a lot of a frustration is part and parcel of ADHD—and yet, we don’t want to make everything easy, some things are supposed to be hard. Essentially, there is a certain amount of frustration and discomfort that someone with ADHD has to be ready to experience. Isabelle is hit with that and explains that frustration tolerance is how much discomfort we can handle—when we’re waiting, someone’s running late, we’ve lost an item, pick a thing—and as much as it might be nice to hit the easy button and want this all to be squeegee’d away (so satisfying), it cannot be. It’s more like an old rag that barely gets the soap off. David names that Noah and him have long conversations about it, and his friend focuses on what you can do to experience discomfort, tolerate it, and build accommodations about it. He’s the kind of person who sees a big scary book and decides to read it, and David oppositionally wonders why you would put yourself through that? He sat down and taught himself how to read—David wonders at what it takes to sit down, take time, stare at a book, and flip pages, and reread a page or paragraph over and over again. For David, a lot of those hurdles felt unfair and unjustifiably frustrating, so watching Noah tackle a task simply for the mastery of it was a new idea. In very general terms, the grey matter around our brain gives us a little more impulse control. The more time you spend practicing something, the act of practice—a puzzle, a book, sitting and breathing, going for a daily walk, etc.—the act of continuing to do it even if you don’t want to builds grey matter, it builds your frustration tolerance for the thing you’re trying to do. Isabelle clarifies that this is a task that you can’t require your hyper focus to do, because you’re not as interested in the thing. David describes how he was struggling with fifteen minute car rides, and then got stuck with the first to be picked up, last to be dropped off slot on the bus route for school—hour long experiences. Suddenly, after having practice taking the bus, which sucked, it happened that he gained a greater tolerance from that. Isabelle asks if the the strife and frustration got him something, that wasn’t needless suffering: short term gain v. long term gain? David names that it is important to honor that it is more painful for us to do things we don’t want to do than people understand. You want to ball up your hands and stomp your feet, the amount of restraint it took to not swear more than once in traffic—there are so many places where we don’t fit. We encounter the pain of not doing the things the first time, then the double pain of judgment—is it me, or them? What’s the best way, and how do I know? Folx with ADHD tolerance for distress is much higher for a lot of things than others understand, but not for all things (like people walking slowly, waiting in a long line with a delay, being stuck in traffic). The example of people walking slowly made Isabelle cringing at the very thought of the moment: it is actual, physiological pain. It makes Isabelle think about childbirth and the practice she underwent called mindful birthing, which meant she slowly tried to acclimate herself to discomfort and pain (such as from holding an ice cube) and then to practice different approaches to noticing it mindfully and riding it out. She describes how she noticed in the labor process, which took many days, that there was this internal, full-body sensation (beyond the contraction) in response to the discomfort she was in, not dissimilar to the response she feels when she’s stuck behind people walking slowly, and she noticed that her endurance surprised her, not being naturally athletic or very physically gifted in that way. She describes telling herself “it’s only one minute” or “it’s only ten more minutes,” like a button to counter the impatience she feels (similar to the “Unbreakable Kimmy Schmidt”). David is stunned and wants to relate to what Isabelle is saying because though he cannot fathom childbirth, he resonates with something for him. He goes back to his psychology class sophomore year and names that it’s a duration measure: something that has a beginning and an end. Everything that is crappy has a beginning, and an end. He had the kind of learning that things stink, so you avoid them, but it gets in the way as he gets older. All of a sudden, something clicked, that he learned if you get something over with, it’s over with. When we’re talking about how much pain people with ADHD experience and how much we need to experience those things, we need to remember that the time you’re doing the thing you really hate, it’s going to be over with. Maybe you’re only going to have to do it once, or twice, or six times. “I can’t do that thing, I have no more room for pain....

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All About ADHD - Part X

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-9th 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; episode 27, All About ADHD Part IX). David launches right into why we get into fights when we leave and we procrastinate, imagine a scalloping bar graph that shoots right near the end, and then right back down. David uses the example of how when assigned a paper, he realizes he has three weeks to work on it, so he plays video games, he does other things, and then his anxiety grows as he gets closer to the deadline, and then it shoots up very rapidly, and he goes into “oh my God, I’m going to be homeless, I’m going to fail, no one’s going to love me, I’m stuck in a van by the river.” Worst case scenarios to the extreme. Now, everything he does related to the paper brings him terror and so everything he does toward the paper gives him the immediate gratification of relieving some of the terror. Any action toward task completion is naturally reinforcing at this point. And the flow feels better and better because it’s getting you further and further away from the dragon. And then you turn the paper in, misspellings be damned, and you sleep the rest of the weekend. The anxiety level plummets down. The same graph can be used toward anger and task completion, too. We are using anxiety or anger as self-medication. David is not quick to throw medication at people but he does say that the second that anxiety and anger around the procrastination get in the way of your life and your relationships—can you see how a stimulant medication might help? A stimulant medication raises your ambient level of stimulation without you having to be anxious, angry or aroused. You need that stimulation to be able to work (like the allele cells and environment). Medication gives you a sense of urgency without a crisis. If you give ADHD medication to a neurotypical person, they will not perform better on the task but they will believe they did. They will write a five page paper and then they’ll turn it in and get an A (they would’ve gotten anyway). A person with ADHD will do significantly better on the task, believe they cheated because they used meds (and because of the knocks to their self esteem) but they also have a better evaluation of their work. The side effect is to give you a better ability to appraise their work more accurately, and it reinforces doing more work because it reinforces a sense of mastery. When someone doesn’t need ADHD medication, the medication will make transitions harder, it will make them more angry, more anxious over times and more rigid. With ADHD population, it helps with distress tolerance, transitions, and flexibility. We procrastinate when we need more medication. We procrastinate on packing for a trip, making lunches, making a list—the more boring a task, the more stimulation we need to do it. Gabe asks: where’s the balance of that? What if you accommodate yourself and never touch socks again? But you have to be an adult and do things you don’t want to sometimes. And David responds: Why not? Why not have only the same sock and not pair them at all? Or outsource that particular task. But, Gabe counters, what if he wants to learn the skill of folding laundry? How does he gain that skill? Medication is one option, but David asks more basically: how do you up your level of stimulation? Another way is to make it about time. Set a timer, don’t cheat, how many socks can you pair? Gamify it somehow, you can experience winning/losing. AJ names that this is something he did but didn’t have a name for. The reason he started folding his laundry is because his partner appreciated it, so it’s a win because it’s his partner’s love language. And once you’ve started you can always listen to one more song because there’s structure and progress. What if you say “ugh, I gotta clean my room” — what’s wrong with that statement is it’s too broad. You have to make it a smaller objective, like clearing everything off the counter. So with kids, day one, we’re going to clear the counter. Then we’re going to sift out the clothes. Now find all the cassette tapes, etc. Isabelle gets super excited about the KonMari (Marie Kondo’s organization method, see links below) because it’s literally this: taking everything of a category and putting it into piles, then deciding if each thing sparks joy. It’s simple, it’s structured, and it uses pile...