Since July this year, I have been working part time with the charity ADHD Ireland, as a facilitator on the Understanding and Managing Adult ADHD Programme (UMAAP). UMAAP is a novel online programme integrating psychoeducation with Acceptance and Commitment Therapy (ACT) to cultivate knowledge of ADHD, self-acceptance, self-compassion and psychological flexibility in participants, with the aim of improved quality of life. UMAAP has been developed to address the lack of services available for adults with ADHD, referred to as ADHDers, in Ireland and as an early intervention within a stepped-care model.
The programme is run by ADHD Ireland in collaboration with University College Dublin’s (UCD) School of Psychology and the Health Service Executive’s (HSE) National Clinical Programme for ADHD in Adults. It is completely free and runs online across six sessions with multiple times and days available to choose from. The full programme information is available on adhdireland.ie to anyone who is interested. I have experienced much growth myself, as a neurodivergent person, through facilitating the programme and I have been honoured to witness the growth of participants at the same time. ADHD Ireland is doing excellent work with UMAAP and creating support groups that are available up and down the country and online too.
I also regularly work with ADHDer clients in my psychotherapy practice and find that quite often the challenges experienced, and brought to therapy, stem from shame. ADHD has long been framed through a narrow medicalised lens but recent research, neurodivergent -inclusive practice and people’s lived experiences have shown that ADHD is not a disorder or something that is wrong with a person. ADHD is simply a differently wired brain, which leads to a person experiencing their own unique set of challenges and strengths in how they go about their life.
Dr Ned Hallowell, a psychiatrist and seminal figure in the field of ADHD, writes in his book ‘ADHD 2.0’ that “A person with ADHD has the power of a Ferrari engine but with bicycle-strength brakes. It’s the mismatch of engine power to braking capability that causes the problems. Strengthening one’s brakes is the name of the game”. Thomas E. Brown was a pioneering psychologist in the field of ADHD who passed away this year. He wrote about ADHD being a set of differences in a person’s ‘executive functions’, which he described as the “management system of the brain”. These executive functions, such as activation, focus, effort regulation, emotion, memory and action, shape how a person navigates everyday life. When these processes become overwhelmed, misunderstood or invalidated, the person often begins to live within a narrative of failure that was never theirs to begin with. As you can imagine, schools, workplaces and life in general is designed as a one-size-fits-all experience to suit the majority of people who are not neurodivergent. Therefore, neurodivergent people can often encounter shaming from the get-go in life, when they don’t ‘fit’ the mould so to speak.
I find many of my ADHDer clients speaking about common experiences of being told they are “too much” or “too emotional” or, conversely, “not enough” or “lazy”. I very rarely hear those clients say that they were understood or supported in those moments. These internalised messages develop because society often expects neurodivergent minds to perform as if they were neurotypical. Dr Russ Harris is an internationally-acclaimed Acceptance and Commitment Therapy (ACT) trainer and is the author of the world’s best-selling ACT book, ‘The Happiness Trap’. He writes that “Our suffering is amplified when we fuse with harsh, self-judging stories about who we are”. For many ADHDers, the stories they were told about not enoughness and the harmful experiences they have had are more than thoughts, they worm their way into the mind and start to become entangled with one’s identity.
Therapeutic work for ADHDer clients often focuses around validation. Simply acknowledging that a person’s difficulties are real, relationally-formed and usually exacerbated by environments that were never designed for their executive functioning and nervous system can bring a sense of relief. This is supported by neuroscience too. Dan Siegel, who is one of my inspirations in the work that I do, is a seminal figure in the field of Interpersonal Neurobiology. He emphasises that brains develop within relationships, shaped by attunement, safety and co-regulation, regardless of neurotype. Inconsistent attunement, punitive schooling, cookie cutter workplaces and societal misunderstanding can leave neurodivergent clients living in a state of heightened arousal, easily tipped outside their Window of Tolerance, the natural capacity to tolerate stressors in life. Often, when the world around an ADHDer has activated their nervous system, it is labelled with judgement and harsh criticism such as not “good enough” or “too much’.
This is particularly relevant when considering shame, which is pervasive in ADHDer experiences and leads to unhelpful things such as perfectionism and procrastination. These can lead to shame, mental health challenges and even suicide. ADHD Ireland found in research completed with UCD a few years ago that 50 per cent of ADHDers have had non-fatal suicide attempts in their lifetime. Brené Brown, in her wonderful book ‘Daring Greatly’, described shame as “the intensely painful feeling that we are unworthy of love and belonging”. For ADHDers, shame is usually not constant but it is chronic as a result of the daily implicit and explicit labelling of ‘failures’ that accumulate over years. Missed deadlines, forgotten appointments, unfinished tasks, impulsive decisions or emotional expressions are not understood and become things that are shamed.
Shawn Achor, in his book ‘The Happiness Advantage’, writes that “the human brain is wired for social comparison long before it is wired for logic”. This is true because it keeps us safe so to speak, this drive to compare and ‘fit in’ keeps us all a part of our tribes and ‘socially acceptable’. Something that was very important way back when being in a tribe or not equalled life or death. For ADHDers, being repeatedly compared to a neurotypical standard can lead to believing a deeply painful story of self.
Further harm is caused nowadays with throwaway comments like “everyone is a bit ADHD” or “everyone has something now”. It was only 64 years ago, in 1961, when the first human travelled to space, yet we are not all astronauts now. It is also only in more recent times that understanding and diagnosis of ADHD has been advanced, hence people are getting the support and recognition that they deserve. ‘Everyone’ does not experience chronic challenges around organising, emotions, focus, impulsivity, memory and energy. The World Health Organisation (WHO) has found that ADHDers make up only five per cent of children and 2.5 per cent of adults worldwide. It is also recognised that diagnosis is more than likely not a fully accurate figure, as there are many who go through life never receiving the understanding or support they deserve due to the stigma and shame that exists along with unhelpful and harmful comments about ADHDers. Therefore ‘everyone’ is not a “bit ADHD” today.
In psychotherapy and counselling sessions with ADHDers, Acceptance and Commitment Therapy (ACT) offers something profoundly healing. It emphasises acceptance, values and committed action, which aligns beautifully with neurodivergent inclusive practice. ADHDers often describe feeling stuck between overwhelm and avoidance, which produces cycles of procrastination that feel both logical and at the very same time quite impossible. ACT helps clients ‘unhook’ from the critical internal voices that tell them they are lazy or broken, and instead orient toward values-based living even in small steps. As Dr Russ Harris writes, ACT invites us to “open up, be present, and do what matters”. For ADHDers, doing what matters can involve navigating tasks in ways that honour their actual cognitive structure and way of being in the world, not society’s expectations of it. Therapy can support ADHDers to honour themselves, shed shame and live authentically in the world with ease.
For more information on Leo’s services, phone: 085 1300573
email: info@leomuckley.com
web: www.leomuckley.com
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