Beth Main's blog
I used to think my professional interests - adult ADHD and complex trauma - were an odd combination. Would I have to give up my work with ADHD adults in order to pursue my new(er) passion? Do these two issues have enough commonality to make sense for me to specialize in both? Would people get it?
Over time I've noticed that many of my ADHD clients are also struggling to heal from neglect or abuse sustained during childhood. This is actually a big part of the reason I decided in 2013 to get my master's in counseling - so I could help them with both. Conversely, one of my internship supervisors shared her belief that all clients with trauma histories will also have ADHD symptoms. This has been echoed by multiple professionals in the Equine Assisted Psychotherapy (EAP) field during my various trainings.
Why is this?
ADHD is characterized by inattention and / or impulsivity and hyperactivity. It is diagnosed via a symptom checklist rather than blood work or scans. Medical professionals often don't ask about trauma histories when responding to a request to identify "why is my kid so out of control" or "why isn't he doing better in school". If ADHD is suspected, the checklists are administered and the diagnosis is made. If trauma is asked about, it isn't always disclosed, or is considered secondary.
Hypervigilance (constantly scanning for threats) and dissociation (checking out) can look a lot like inattention.
Impulsivity can be a response to unmanageable stress.
It's hard to sit still when you don't feel safe.
Neural pathways are created in the brain that entrench these behaviors over time until they become the norm. The trauma is pushed to the back of the mind and not talked about. After enough time passes, the two feel more and more separate. But they aren't.
I've concluded that my specialization doesn't have to be - indeed it can't be - one or the other. If you're looking at ADHD, you could also be looking at trauma and vice versa. It can be extremely helpful to work with a professional who deeply understands both.
To be clear, I'm not saying that ADHD is always caused by trauma. The current working theory is that it's a genetic condition. Scientists generally agree that there could also be other causes, and trauma could be one of them. I'm just saying we need to correctly identify the underlying cause, so we can treat it appropriately and effectively.
Check out this article for more details on how childhood trauma could be mistaken for ADHD.
This quote (author unknown) has really been resonating with me lately. There are so many things in life to be afraid of. Slipping on ice, getting sick, the death of a loved one... the list is endless. We can worry and worry about what could happen until we drive ourselves completely crazy.
What if, instead of trying to convince ourselves that bad things won't happen, we learn to trust our ability to cope when they do?
I recently spent a few days in Miami Beach. One of the highlights of my trip was the service I received at a little street-side café. All I had was a $12 burger and a glass of water. I asked for the burger with no bun (I don’t eat refined carbs) and no onion like I always do. Ten minutes later, the burger arrived encased in a bun and garnished with onion. No biggie. I just put the bun and onion on the extra plate and pushed it to the side. The burger was delicious. I was very impressed with the place: elegant atmosphere, delicious food, fabulous prices for a resort community.
The waitress came over a moment later and noticed my discarded bun. She apologized profusely and took it away. She came back several times during the meal to check on me, each time apologizing for the erroneous bun. This is over the top, I thought. Why are they making such a fuss over a bun? Next thing I knew, the manager came over. He apologized for the bun and said, “This is not acceptable. We want to make it up to you. How about a complimentary glass of champagne?” I told him he was crazy, that everything was wonderful and there was no need. But he insisted, and I accepted. Moments later, he arrived with a chilled glass and presented me with a new bottle of champagne as if I were paying $500 for it.
I shared this story with my husband that evening. He said they are probably accustomed to demanding people in Miami Beach and just wanted to be proactive. I could have been a scout for Madonna or someone for all they knew, and they wanted to make sure to send the right message. None of that mattered to me. What mattered was that they made me feel like I mattered.
How often does it happen in the course of our lives that random people make us feel important for no reason at all, other than that we exist? Maybe it happens to Madonna, but not me. I’m just an average person living an average life. But in that moment, at that little café, I was the center of the universe. It was a wonderful feeling that stuck with me for a long time.
Now I hope you aren’t thinking, what is wrong with this woman, doesn’t she have any friends or family? I do, and I know I matter to them. I guess it was the total randomness of the experience that hit me. Like kindness in unexpected places. I hope that the people at that restaurant know that their gesture mattered to me.
I like to think I help people recognize that they matter every day. That’s what therapists do. I guess my wish for the world is that every one of us gets to feel like they matter to someone. Both in a rockstar kind of way like I experienced on my trip, and the more day-to-day “you know I love you even if I don’t say it” kind of way.
Because you do matter.
I just want you to know that.
Many Americans are concerned about what will happen when Donald Trump is sworn in as our 45th president next week. Which of his outrageous campaign promises will he keep? What will happen with immigration and civil rights? How will other countries react? Is the zombie apocalypse on the horizon? No one really knows what will happen. And that is uncomfortable, to say the least.
When my brother was six years old, I asked him what he thought happened when people die. His reply? Maybe we're not meant to know. I thought that was incredibly profound for a young child. (He was always a really smart kid, now he has a Ph.D and is researching cures for cancer.) That bit of precocious wisdom has stuck with me through all these years.
Some things just cannot be known.
Do your best to prepare in whatever way makes you feel comfortable, but accept that there’s no way to know for sure what will happen after the inauguration, bad or good. Make peace with uncertainty. Welcome tomorrow with openness and a sense of curiosity.
As President Obama said on election night, the sun will come up tomorrow. That much we can count on. I'm still me, you're still you, and we still have the same strengths, talents, and gifts we had yesterday.
Hold on to that.
I’ve always loved the Serenity Prayer: God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. Here are some other thoughts on how to feel more at peace in the upcoming days, weeks, months, and years:
- Become aware of fear-generated, irrational thoughts. Notice them, challenge them, and replace them.
- Use positive self-talk. Replace statements like “I can’t stand the uncertainty” with “I don’t like uncertainty, but I can handle it”.
- Take inventory. Identify what you know, what you don’t know yet, and what you can’t know. Then learn what you can.
- Let go of the idea that you must know what you can’t know. Accept that life is like a box of chocolates, as Mrs. Gump used to say.
- Make decisions based on what you do know. If you have to bet on what you don’t know, make sure you can afford to lose if it doesn’t go your way.
- Trust your intuition.
- Develop contingency plans as well as you can. But don’t go overboard, otherwise life becomes a big, complicated flowchart.
- Know that uncertainty is tough to sit with, and take good care of yourself. Learn self-soothing strategies, like deep breathing or progressive muscle relaxation. Focus on where you feel the anxiety in your body until it dissipates. Eat healthy foods, exercise, and try to get enough sleep.
- Live. If you can’t know, there’s no use in sitting around worrying. Go about your life, do the things you enjoy (or used to enjoy, or think you might enjoy). Stay in the present moment.
- Know that clarity will come eventually. If you can determine a timeframe, wonderful. If not, trust that the truth will emerge in its own good time.
Once you’ve peeled away the layers of irrational thought, created contingency plans, and identified the things you do know, you’ve arrived at the kernel of uncertainty where there is just nothing else you can do. You can either drive yourself nuts or accept it. Call up your inner serenity and accept that which you cannot change. Or cannot know.
As you may have read elsewhere on this site, I favor a solution-focused approach to psychotherapy. Traditional therapy tends to spend a lot of time analyzing the history and scope of a problem. Solution-focused therapy, on the other hand, starts with a vision of how you want things to be. We look for exceptions to the problem, focus on what is working well, and discover sources of strength.
This metaphor from internationally recognized psychologist Fredrike Bannink describes it perfectly:
"You are hungry and decide to go eat at a restaurant. After you have waited awhile, you are invited to take a seat. The maître d’ introduces himself and starts asking you questions about your hunger: How severe is your hunger; how did you come by it; how long have you had it; have you been hungry before; what role has your hunger played in your family or in your relationship with other relatives; what disadvantages and, perhaps, advantages does it have for you? When you ask to eat after this, hungrier still, the maître d’ first wants you to fill out a few questionnaires about hunger (and probably about other matters that the maître d’ feels are important as well). After all this, you are served a meal that you did not choose yourself, but rather one that the maître d’ claims is good for you and has helped hungry people in the past. What do you suppose the chances are that you will leave the restaurant satisfied?”
Seems like it would make a lot more sense to just ask you what you want, right? In solution-focused therapy, we do just that. Then we figure out how you can get it.
To all you veterans out there: I sincerely thank you for everything you've done to keep our country safe and free.
Came across this nugget of wisdom today while doing some research:
"Suppressed emotions don’t go away; they putrefy into toxic thoughts and habits, eventually evolving into mutant forms that relieve the pressure in less conscious ways, undermining health, happiness, and usually a few innocent bystanders."
- Linda Kohanov, from "The Tao of Equus"
Yes. They always come out sideways, as my mother once said. I love the part about innocent bystanders. :)
Better to acknowledge your feelings, process them, and accept them. Emotions always have important information to share. We ignore them at our own peril.
As you've probably gathered, I've been an ADHD and life coach for a long time. I received my master's degree in counseling in 2015 and am now offering psychotherapy as well. The range of issues I'm able to address continues to expand beyond Attention Deficit / Hyperactivity Disorder and its related co-existing conditions. So it seemed like time to branch out and create a web site that speaks to people who do not have ADHD. It's moving slowly, but I intend to post things on this blog that pertain to mental health, wellness, and the quest for joy. I'm glad you're here. I hope to have more for you to enjoy soon.