I often hear ADHD referred to as “a disease of motivation,” but my ADHD clients belie this description. They are highly motivated to achieve their dreams; in fact, they are so wedded to this future version of themselves, the present feels entrapping. The steps along the way to becoming their future selves trip them up, because they require engaging fully in this entrapping, uncomfortable present.
The minds of many people with ADHD are usually in the future, where they are restlessly waiting for the next thing, daydreaming, or worrying. When not in the future, they visit the past to relive guilt, shame or hurt, or they enter a zone of hyper-focus so acute that the present is absent of all markers, such as a sense of time passing and an awareness of sensory or emotional events happening around or within them. How can one possibly attend to the demands of a present, such as organization, focus, remembering, and self-control while being mentally absent when that present is occurring?
So for me, ADHD is a problem of presence rather than a disease of motivation.
Why is the present so uncomfortable for people with ADHD? It could just be a trick of the brain, inherent in that type of brain. I notice though, that while ADHD is an aggravating problem for parents in the elementary school years, often an ADHD crisis hits around eighth grade, sometime a little earlier, sometimes a little later. One theory about why ADHD symptoms worsen around this time is that smart kids with ADHD can manage the relatively easy early school years without great executive functioning, but not the middle and high school years. Certainly this is a factor. But I think that the heightened emotional states that are par for this phase of adolescence are even greater for those with ADHD, and thus, so is their vulnerability, to failure, to teasing, to bullying, to pressure, and to the hugely important but highly tenuous social relationships as they are conducted in this phase of life.
People with ADHD tend to be extremely sensitive. And because of their disorganization, their forgetfulness, their seeming carelessness, their impulsiveness, the feedback they get from parents, teachers, and even peers is mostly negative, and therefore, mostly hurtful, horribly hurtful. So, an already existing tendency to escape the present becomes a necessity for emotional survival in those overly poignant early teen years, when acute anxiety and depression become specters in the already unpleasant house of the present.
The more people with ADHD continue their flight from the present, the more they are victims not only of their ADHD symptoms, but of its evil companions, anxiety and depression. That’s why I believe the best way to treat clients with ADHD is to help them gradually move into the house of the present, to help them realize that they own this house and possess the power to transform it into a place they can safely and effectively inhabit.
Because this living in the present is such a simple thing, something that people without ADHD do automatically, I use simple methods for helping my clients arrive there anew: breathing exercises, mindfulness meditations, body awareness exercises, emotional awareness techniques, outside exercise in all weathers, discussion of in-the-moment thoughts and feelings, automatic negative thought questioning, impulsiveness curbing techniques, and so on. But it is not an easy process for clients who have always found safety by escaping the very place where these treatments will deliver them.
The best present you can give a loved one with ADHD in the upcoming holidays is help engaging in the present moment. Because those with ADHD can be very difficult, it is tempting to let them escape into their rooms, their video games, their phones, so you can have a little peace, or focus, for a change, on other family members. This is understandable, but as your gift to your loved one with ADHD, resist this temptation. Instead, insist on conversing with them during meals – no screens, no reading material. Make eye contact. Encourage them to savor each bite of food. Do the dishes together, getting them to sing some holiday songs, and just be silly together.
Include your loved one on shopping trips to buy gifts for friends and family, eliciting his or her ideas. Even if your efforts are unappreciated or result in arguments, try to cede your righteous position as a secret holiday present, and hug your unreasonable, but struggling loved one. Physical contact is very present-oriented.
Involve your loved one in the decorating and baking procedures, even if they make a mess. Continually point out sensory details, and how lovely they are: frost on the trees, cold cheeks, lights, the smell of cookies baking, the beauty of choirs or carolers singing, the wonderful taste of a candy cane. These things are testament to the pleasures of the present, and invite your loved one to engage within it.
When your loved ones with ADHD behave badly, instead of getting angry and punishing them, ask what they are feeling. Help them identify their emotion. “You seem angry. Do you feel angry? Why do you think my asking you to clear the table made you angry?” Listen carefully and non-judgmentally to the answers to each question. This not only defuses an unpleasant scene, but fosters emotional awareness, a huge entryway into the present for those with ADHD.
The present is a wonderful present that you can give your ADHD loved ones this year. The gift of the present will enable your loved ones to glide, rather than trip up the staircase to their future best selves.