ADHD and the Stand-alone Day

Do you often find yourself attempting a task and being assailed by worry that you should be doing something else?

I’ve written before about the slippery relationship that people with ADHD have with time. It impacts all sorts of experiences in life, including this one, which many of my clients describe.

This experience can make it really hard to focus on what you’re doing, and can lead to a constant anxiety (“Am I doing the right thing?”), and sometimes a sense of guilt (“I should be doing that other thing.”) Talking with a client about this recently, he connected it with the experience of having what he called “stand-alone days,” days that feel disconnected from one another, out of the context of the flow of time, especially disconnected from the days that are to come. It’s an aspect of the ADHD experience of feeling the present too much, and not appreciating the future enough. This over emphasis of “now” can result in experiencing your days in isolation. Today feels like the only day, and so “the last day to do anything.” There’s a maddening sense of urgency and overwhelm, which produces stress and sometimes despair. You know all these things need doing, and it feels like they all have to happen now. How can you know what to do first, and if you do start on something how can you know it’s the right thing to do when all those other things have to happen too? Often the only guide seems to be what I “feel like doing” in the moment (and will then start second guessing, or possibly get lost in), or what has the most painfully urgent deadline attached to it. Despite your best efforts this is a stressful process, and the practical results tend not to be great. At the end of the day, I haven’t got much done, especially relative to the “everything” that needed doing. The options seem to be either to suffer through this stress and anxiety for little felt reward (even perhaps the “punishment” of feeling incompetent or guilty); or to give up, do nothing, and procrastinate, putting things off for some other stand-alone day in the undefined future.

Does this sound familiar to you? If so, you’re not alone.

working with your brain, not against it

If you understand how this experience evolves from an underlying difficulty with the experience of time, you can find ways to work with it. As Jessica McCabe* puts it, it’s about learning to work with your brain rather than against it. This does in the first place require a certain acceptance that this is the way your brain works, by default at least. If I keep thinking my brain should work some other way (“like other people”), I’m fighting against it, not working with it. A degree of acceptance is needed before much change can take place. Luckily, for a lot of people the right medication can help with the brain’s processing of time, and make these issues easier to deal with. But even then, some kind of external supplemental help in “seeing the future more” is going to be needed. Indeed, anyone with a busy life, ADHD or not, is going to need external help to keep track. Calendars, probably big ones that go on the wall, are your friend.

Seeing the future more

Calendars are a great visual representation of the fact that tomorrow and next week and next month actually exist. We can use them as a way to “see” the future, and feel the future, in a more concrete way. To-do-lists without calendars are often unhelpful because they are so overwhelming (all the many things that could / should happen on this one stand-alone day!) But laying items out on a calendar and seeing that this can happen on Tuesday and that can happen on Wednesday, can restore a sense of control and reduce the feelings of panic or despair. Over time, you can relax into the knowledge that what you’re doing now is the right thing to be doing and that other things too will have their time. In the end, more gets done, and there’s less anxiety, and less guilt.

Therapy can help with this process of acceptance and change. If you’d like support in working through your challenges with ADHD, let’s talk.

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For more on the role of time in ADHD, and more about strategies that can help, have a look at this article on my blog, and check out anything by Ari Tuckman, including his book The ADHD Productivity Manual and this YouTube video, ADHD Is All About Seeing Time & Feeling the Future.

* Jessica McCabe’s book is called How To ADHD: Working With Your Brain (Not Against It).

Individual Counselling Helps Relationships Too

Men first come to counselling with me for all sorts of reasons, but one that I hear over and over is that they are running into difficulty in their primary relationships. It seems that a lot of people struggle through their individual problems with anxiety or depression, ADHD and trauma without seeking help … until these difficulties begin to impact their relationships. The relationships that once provided a bright spot or a haven in their lives start to come under pressure. Friendship, love, sex, stability, all feel under threat. The men who contact me are seeing their personal struggles have an impact on the most important others in their lives. The ways they think, feel and behave are causing trouble in the parts of their lives they care about most. They have a hard time being present with their partners, becoming irritable and distant. They get caught up in distractions or addictive behaviour, or work. They try to communicate better, but are very often reactive and struggle to regulate their emotions, words, and behaviour.

mental health is personal, and interpersonal

In counselling sessions, we often talk about ways to communicate better, how to resolve disagreements and upsets, how to be more empathetic, how to have clearer boundaries. And we dig into the factors that underlie what’s going wrong in your relationships (as well what’s going right!) There’s often a kind of back and forth between the personal, rooted in your history (and biology), and the interpersonal, the patterns or “dance” that you and your partner may have fallen into and keep repeating. Sometimes couples are doing couple counselling as well with another therapist, but often not. Either way, the self-understanding and compassion that you can achieve in therapy will give you a much better chance of repairing, building and maintaining satisfying relationships.

For most people, good relationships play a big part in good mental and emotional health. It’s true the other way round as well; individual groundedness and emotional regulation contribute greatly to happy relationships. In the work I do with men, I’m always hoping to promote both personal and interpersonal good health. If that’s something you’d like for yourself, let’s talk.

Make the Most of Your ADHD Diagnosis

A diagnosis of ADHD has the potential to change your life for the good. For one thing, medication often works very well. Beyond that, understanding better what is happening when things get difficult for you can lead to all sorts of creative solutions to address your specific experience. For example, if you understand how your ADHD-wired brain is likely to relate to time, then you can come up with effective ways to work with it instead of against it.* This can help not just with time management problems like being late for appointments, but also with motivation, with stress, anxiety, feelings of guilt and shame, with addictive behaviours, and with relationships. Coming to understand and accept a diagnosis can provide great relief. It can help you come to terms with your past, feel better about yourself in the present, and make important changes in your life and relationships going forward. The positive ripple effect of an ADHD diagnosis into all aspects of your life can be tremendous.

I see this impact daily in my work. However, often when I first talk with men who have received a diagnosis, they don’t really know what to do with it. Medication often helps, but making the most of your diagnosis requires more. Good counselling can help.

Childhood and student diagnosis

Some of the men I talk with were first diagnosed as a child, or perhaps later as a student at college. They’ll say things like, “That was just when I was a kid, I should have grown out of it by now.” Or, “Yeah, I used the meds as a study aid at university, but that was a long time ago.” These people aren’t making the connection between their childhood and student experiences and their struggles now at work, in their relationships, or with anxiety, low mood, irritability, addictive tendencies, and more. Maybe they believe that ADHD is just a childhood thing (which may have been the consensus when they were kids but has since been shown to be mistaken). Or maybe they think that ADHD is just a “learning difficulty” that affected their ability to study but doesn’t reach beyond that.

recent diagnosis

Others get a diagnosis later in life. They’ve been prescribed medication, which may have made a noticeable difference, and they’ve thought, “OK, now I can focus a bit better at work,” but have missed out on resolving a whole host of difficulties they haven’t realized are connected to ADHD. For some, the meds had side effects that made them stop using them, and they never got good medical follow up that might have helped them try different dosages or switch to a different medication. For a few, the medication ends up not doing much, even after several different tries, leaving them discouraged, and unaware that other things, like therapy, can also help, even without the full benefit of meds.

Of course, as well as relief, a diagnosis can also bring up some difficult feelings, including anger that ADHD wasn’t recognized or properly treated earlier; regret and sometimes depression, that things could have been different if only you had known sooner; sometimes a kind of second-guessing or denial (“Maybe I’m just using this as an excuse, maybe the truth is I really am just bad at stuff.”) These feelings often need to be processed in order to reach some acceptance and understanding of the diagnosis and reap the benefits that it can bring.

If you’d like help in making the most of your ADHD diagnosis, let’s talk.

* Jessica McCabe’s book How To ADHD: An Insider’s Guide to Working With Your Brain (Not Against It) is full of useful suggestions for living effectively with ADHD.

ADHD: It's All About Time

So many of the difficulties faced by people with ADHD are somehow connected with time: being late for appointments, missing deadlines (or scrambling at the last minute to meet them), losing track of time (by getting distracted, or by becoming “locked in” or hyperfocused), procrastinating, having trouble getting started on projects or estimating how long something might take, forgetting what someone said to you just now, or blurting out stuff at the “wrong” time and regretting it later.

In fact, says Ari Tuckman, “When you really get down to it, ADHD is all about time.”

Time is slippery

If you have ADHD, time can seem very slippery. Some people have internal clocks that tick loudly and regularly and help locate them clearly in the flow of time through a day. For others, the clock is much quieter and maybe not as precise, and it’s much easier to lose track or get lost in time, and to get overwhelmed as a result. This “time blindness” is why people with ADHD struggle so often to get places on time or get projects done without having to stay up all night the night before they’re due. These things are really hard to do if time seems to pass at unpredictable, random speeds. It’s hard to get organized if you don’t know how long anything takes. Or as Ari Tuckman puts it, “It’s hard to do the right thing at the right time if you don’t know what time it is.”

Tuckman describes the ADHD experience of time as like trying to measure the physical length of something with a warped ruler, where some inches are stretched out and others are squished and compressed. Sometimes time seems to pass painfully slowly; boring tasks seem to take for ever (“Oh god, I’ve only been doing this for five minutes?”). Other times, when we’re absorbed or “hyperfocused” on something, time flashes by without our noticing (“Really, I’ve been doing this for three hours without moving?”)

too much present, not enough future

Related to this is the fact that people with ADHD tend to “feel” the future less strongly than some other people. “Now” can be pretty intense, but next Friday (when that report’s due) doesn’t have much traction. Russell Barkley calls this “future myopia,” rather like how people who need glasses don’t see what’s in the distance so clearly. As a result, things get left to the last minute; suddenly on Thursday night you “feel” the fact that tomorrow’s the day, which means either you’re up all night working on the report, or you miss the deadline.

People who don’t have ADHD tend to have an easier time with time management because their internal clocks are louder and tick at regular intervals, and because they’re more sharply aware of the future. It’s not because they’re more responsible, or care more, or because they’re smarter, or somehow morally superior. For people with ADHD (and their partners and friends), this can be so helpful to understand; if you know what the problem is (and what it isn’t), you can address it more effectively, and perhaps collaboratively (and clear away some layers of guilt and self-punishment in the process).

things you can do

If you can identify the real nature of the problem, you can figure out ways to work with it. Tuckman outlines three main categories of time management strategies that are useful for people with ADHD:

CLOCKS. If you can’t always rely on your internal clock, you can supplement it with external clocks and reminders. Maybe lots of them (something to do with those old iPhones sitting in a drawer somewhere?). Put clocks in places where you’ll see them often, maybe places you might not have thought of but where you especially need them (like in the bathroom if you daydream in the shower, or it’s your favourite place to scroll). For some people, old fashioned clocks with hands are best. Or get a watch with a big, bold display, and wear it!

TIMERS AND ALARMS. These are great to remind you that it’s time stop doing one thing and start another. Or to help you remember to do the thing you promised your partner you’d do this afternoon. Or to start getting ready for bed (bed time alarms can really help if you tend to get engrossed in stuff at the end of the evening and regret it the next day).

SCHEDULES. By putting tasks into a schedule, assigning them a block of time, you’re purposefully visualizing time, giving it a more tangible form, looking into the future, acknowledging and giving weight to the “not now.” You’re making the future important.

In my work with men with ADHD, I’ve found that there’s sometimes resistance to using these kind of strategies (for some people the mention of calendars can evoke a visceral reaction). Usually there are very understandable reasons for this reluctance, rooted in past experience, childhood, and questions of self-worth. These are important to work through; there are many rewards to addressing these issues and gaining more agency in your life. It really is worth it! Contact me to find out more.

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You can hear Ari Tuckman talking in more detail about ADHD and time on YouTube. Or get his book, The ADHD Productivity Manual.

You could also check out Jessica McCabe’s YouTube channel, How To ADHD.

ADHD Between Stimulus and Response

One of the great things I’ve found about spending time working with men who have ADHD is that it fits so well with my overall approach to therapy. Of course, I’ve learned a lot of very specific information about the particular ways in which ADHD can impact every aspect of a person’s life, and about diagnosis and treatment, including the use of medication. But I’ve also found that things that help people with ADHD are often the same things that help anyone else. This is perhaps not surprising. After all, as Ari Tuckman* often puts it, “ADHD doesn’t invent new problems, it just exacerbates universal ones.”

One expression of a universal problem, and promise, is summed up in a famous quotation from Viktor Frankl (author of Man’s Search for Meaning):

Between stimulus and response there is a space. In that space is our power to choose our response. And in our response lies our growth and our freedom.

Much of my work revolves around helping people slow down and understand their automatic reactions enough to identify that space between stimulus and response where we have a choice. This can be especially helpful in the day-to-day lives of people with ADHD, who are inclined to react impulsively in all sorts of situations. If despite your best efforts you’ve struggled to get a task at work or school or home done because your attention keeps getting dragged away by messages popping up on your phone, or by the thoughts popping up in your own head, that may be because you haven’t found enough time between stimulus and response to really choose where to focus your attention. If you’ve blurted out a reaction to something your partner or your boss says to you and regretted it afterward, that too may demonstrate how stimulus and response are so often “velcroed” together, automatic, with insufficient space between them to really exercise a choice. Likewise if you’ve ever put off an important task for days because every time you think of it you get a sick feeling in your stomach, and that feeling has directed your behaviour.

Everybody does this kind of thing. If you have ADHD you probably do it more often, and it’s having a considerable negative impact on your life. (Of course there are other reasons why we might automatically react to particular “triggers,” including trauma, and these are important to understand in therapy.) If you have ADHD, medication can really help slow down that automaticity, giving you a much better chance of making a more considered choice. And all of us, ADHD or not, can learn to understand our automatic reactions and exert more choice in our lives; and, as Frankl said, therein lies our growth and freedom. Ari Tuckman argues that ADHD medication can increase a person’s “free will.” It can certainly increase a person’s sense of their own agency, and help you feel more in charge of your own life. I think the same is true of all good therapy, whether you have ADHD or not. If you’d like more of that sense of agency in your life, whatever your history, get in touch.

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*Ari Tuckman PsyD is an ADHD expert, writer and teacher. I’m currently involved in a training course with him, and am drawing on that material to write some regular ADHD-related blogs over the next few months. His books include The ADHD Productivity Manual and ADHD After Dark: Better Sex Life, Better Relationship.

Counselling for Adult ADHD: Untangling Depression, Anxiety, and Relationships

I work with a lot of men with ADHD, and am an ADHD-Certified Clinical Services Provider (ADHD-CCSP). When I started in private practice, I didn’t reach out specifically to men with ADHD. They just showed up, often describing symptoms of depression, anxiety, and difficult relationships. Some had already been diagnosed with ADHD, as children or adults, and were aware it was part of the problem. Others had begun to wonder, especially as the reality of adult ADHD (not just ADHD in children) has become more widely understood. Sometimes I’ve initiated discussions about ADHD as a possibility, and pointed people towards getting assessed.

Diagnosis and medication can bring great relief, and for some are profoundly life-changing. But, as has often been said, “pills don’t teach skills.” There’s often lots going on that therapy can help with in terms of shifting the ways you think, feel, and behave, and how you organize your life. There’s often also a great need for understanding and healing. After all, you may have spent years hearing, and believing, that you’re “lazy,” “disorganized,” or “not living up to your potential.” A life time of ADHD, especially when it’s not been diagnosed or adequately treated, can leave a trail of problems affecting your career, your self-worth and your relationships.

ADHD contributes to distraction, restlessness, and difficulty with time management and following through on goals. It can also bring intense emotional ups and downs, and constant feelings of stress and overwhelm. Over time, this can lead to anxiety, shame, and depression. The pressure of trying valiantly to keep it together, to succeed at work or in relationships, of “masking” and self-doubt, often leads to new difficulties.

I hear frequently from my clients how these challenges show up in many areas of life – not just at school or work, but in relationships too. Many of my clients describe ongoing conflict with partners, or feeling like they’re “too much” or “not enough.” Trouble with emotional regulation, impulsivity, forgetfulness, and zoning out during important conversations or daily tasks can create tension, distance, and fighting, and can mess with your sex life too.

To cope, many men turn to “maladaptive” strategies: they might overwork themselves trying to prove their worth, rely on alcohol or cannabis to manage stress, withdraw emotionally, or get stuck in avoidance patterns like excessive gaming, scrolling or porn use. These behaviours can offer short-term relief, but often deepen the sense of isolation and shame.

I work with men to break out of these loops. Together, we untangle how ADHD, alongside other factors, has shaped their sense of identity, and contributed to anxiety, depression, and unhappy relationships. I’ll work with you to develop kinder ways of treating yourself and healthier ways of coping and communicating, and find practical strategies to support focus, time-management, and emotional balance.

Counselling is an opportunity to stop blaming yourself, which usually makes things worse, and start understanding yourself, which can help you navigate life with greater ease, confidence, and connection.

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I highly recommend Ari Tuckman’s books More Attention, Less Deficit: Success Strategies for Adults with ADHD and ADHD After Dark: Better Sex Life, Better Relationships.

Counselling for Men in Manitoba, Alberta, Saskatchewan, Plus

I am now offering online counselling to men in Manitoba, Alberta, Saskatchewan, Yukon, Northwest Territory, and Nunavut, as well as BC.

One of the great things about online counselling is that we don’t have to be in the same location to meet. However, different provinces and territories have different regulations around the practice of counselling and until recently I’ve stuck for the most part to my home province of British Columbia. But now, with the BC Association of Clinical Counsellors (the regulating body I’m a member of) providing clear guidelines on working with people outside of BC, I have extended my geographical reach.

Until now I’ve worked with men from all over BC, including Vancouver, Victoria, Nanaimo, Vernon, Kamloops, Williams Lake, Haida Gwai, and beyond. I’m looking forward to welcoming more clients from Winnipeg, Calgary, Edmonton, Regina, Saskatoon and more!

The men I work with often reach out when they are experiencing anxiety, depression, anger or addiction. You may be unhappy in your work or your relationships, and likely struggle with a harsh internal critic. Perhaps you’ve realized that events in the past continue to impact you and are preventing you from living the way you want to.

Perhaps you have suffered childhood trauma, including physical, emotional, or sexual abuse. Even “mild” dysfunction in families can deeply affect a child’s sense of worth into adulthood. Some of the men I work with have also had traumatizing experiences as teens and younger adults, involving family break-up, discrimination, bullying, the loss of loved ones, or their own physical and mental health. If any of this sounds like you, counselling can help.

Check out this post to find out more advantages of online counselling. My experience working online with hundreds of men over the last few years has convinced me of what a whole lot of research confirms, that this mode of counselling is extremely effective as well as being practical and convenient.

If you’d like to meet, get in touch.

Cognitive Distortions: Step One

I often have conversations with clients about distinguishing thoughts and feelings. People often use phrases like “I feel like …” or “It feels like …” a lot. They will say something like “I feel like I’m a failure,” or “I feel like it’s all my fault,” or “It feels like everyone is judging me.” It’s a common way of speaking. But usually what follows “I feel like …” or “It feels like …” (or “I feel that …” ) is actually not a feeling, but a thought. Yes, there’s often a feeling involved, tangled up with the thought (it’s often a negative, unhappy feeling, and sometimes paralyzing or overwhelming). But “I’m a failure,” or “It’s all my fault,” or “Everyone is judging me” in themselves are just thoughts.

Why does this distinction matter? Well, if you can see a thought for what it is, you can challenge it, and that can change how you feel and what you do. When thoughts are wrapped up in feeling language, they’re harder to spot. Sometimes misplaced feeling language even gives them a kind of sanctity, a special power. “That’s just how I feel,” we say, and the thought goes unquestioned and becomes more and more entrenched, as do the accompanying emotions and behaviours. We accept as truth beliefs that are often inaccurate, unrealistic, unbalanced. This can lead to all sorts of misery. In the language of CBT these thoughts are cognitive distortions and they tend to fall into a number of clearly identifiable categories (for example, catastrophizing, globalizing, mind reading, personalization, labelling). There’s a useful list of them here; and this post from a few weeks ago focuses on one of them.

If you start identifying thoughts as thoughts, you can get some perspective on them. You can ask yourself, “Is this thought true / realistic / balanced? Or am I thinking in some kind of distorted way?” As you begin to think more clearly, that will affect how you feel, and will give you more options in how you act towards yourself and with others. A lot of the time, the language of feeling hides a thought. Step One is to identify the thought; then you can challenge it.

If you want support untangling and taking charge of your thoughts and feelings, get in touch.