ADHD & ADD in adult psychotherapy

ADHD & ADD in adult psychotherapy: Hidden neurodivergence that can mislead the clinician and short-change the patient

with Phil Mollon

Most psychotherapists will at some point have clients who have ADHD or related forms of neurodivergence but many will be unaware of the nature of these conditions that are part of the neurobiological template.

Although the name directs a focus on a disorder of attention, this is not the main problem. ADHD is a condition of deficit in the brain’s regulation of itself resulting in impulsivity, difficulties in affect regulation, outbursts of rage, states of anxiety and panic, and moods of depression. ADHD can be a core condition giving rise to the spectrum that attracts a diagnosis of ‘borderline personality disorder’. There are overlaps and comorbidities with autistic spectrum, addictive personalities, and bipolar. The person with ADHD has an enhanced need for empathic responsiveness from others to assist in regulating their own brain and emotions.

The genetically inherited ADHD characteristics of the person’s developing brain interact with the environment, often in ways that result in profound pain for both families and the individual. If that person subsequently sees a psychotherapist who does not understand the nature of the problem, the feelings of shame and despair are intensified. Any attempt to understand ADHD characteristics purely in terms of psychodynamics will be futile and misleading.

Instead, the focus can more usefully be upon helping the person understand their basic temperament, their sensitivities and needs, and how their personality has been shaped by the interplay of neurobiology and the family, school, and peer environment. Shame is often a key feature of the ADHD experience.

See trtogether.com for full details.