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.