By Michelle Frank, Psy.D.
*A note on the use of the terms ADD and ADHD: As research and understanding of ADHD has grown over the decades, the diagnosis name and description has evolved. As a result, many people, especially those who were diagnosed with ADHD or worked with individuals with ADHD before the publication of the DSM-IV in 1994, often use the terms “ADHD” and “ADD” interchangeably.
Michelle: You were a big part of early ADDA. What was it like?
Sari: In 1993 in Ann Arbor, it wasn’t called ADDA yet, but a lot of people who were part of that first iteration of ADDA – professionals and people interested in the field of adult ADD that went on to form ADDA – came together for the first time for an adult conference. It was the first time hundreds of people were together in the same room sharing the experience of being an adult with ADHD.
I went to the conference in Ann Arbor – this was before I wrote the book – because I saw that Kate and Peggy, who wrote “You Mean I’m Not Crazy, Stupid, or Lazy,” and Ned and John, who wrote “Driven to Distraction,” and Thom Hartmann were going to be there. So I flew from California to Ann Arbor to meet and hear these people.
That’s when, for the first time, we really began to understand this idea of spending your life in the closet, so to speak: hiding and pretending. And what it was like to be out, to be free for the first time, just like any minority has that feeling of being – for the first time – with people who understand you and are like you — interrupting, bumping into each other, but in positive ways too…funny, bright — just being themselves for the first time. It was a pretty inspiring experience.
Michelle: What was the energy like? Describe how you felt.
Sari: It was like being in a brave new world.
It was almost a spiritual experience; we now call it being with your tribe, but it was even more than that because it was something you never even dreamed existed!
When I wrote my book “Women with Attention Deficit Disorder” people wrote to say, “Did you follow me around?” Even to this day people write me to say that. And that was the feeling during the first years of ADDA as the field grew. At the conferences, you could be a room with people who had such similar – yet unique – experiences. You didn’t know they existed and now you’re in a room with hundreds of them saying things you’ve never heard anybody say out loud because you were all hiding, everyone had been hiding, so it was a pretty amazing experience; full of relief.
Of course, I also was somewhat intimidated with all of these experts were there in the room. The earliest pioneers.
I remember going up and shyly introducing myself to them, hoping that some day I could be one of the speakers, knowing that I had a lot to say and offer. By the next year I was working on the book.
The first “official” ADDA conference was in Merryville in ‘95…I laugh because I used to be able to recite the year and location of each ADDA conference instead of counting sheep at night! It was such a big part of my life. Those early years were unbelievable.
Many of the professionals at ADDA had ADHD…there wasn’t such the split between presenters and participants. It was very humanistic. All of us professionals becoming successful in the field were meeting other people with ADHD who were achieving a lot of amazing things, and that was another subset of experiences. We had these amazing bonding experiences.
We had a great time together; we found each other. It was like going to a reunion every year and sad to leave every year because, for a few days, you were surrounded by people who really understood you, and it was great energy and a lot of fun and a lot of love.
Michelle: It was empowering.
Michelle: When we first met one of the first things I asked you was, “How do you integrate your personal and professional life?” As a woman with ADHD who also works in the field of ADHD, how do you blend those together?
Sari: When I answered your question at that time I told you that you would have to make a decision at some point, whether you want to be “out” or not. What kind of clients and practice you want to have. You can have an ADHD practice without having ADHD, but there’s something special about going into a practice knowing that you’re understood as a client.
Michelle: I think it’s hard and it’s scary. As a psychotherapist or psychologist, the only other fields where clinical professionals own their own challenges — when it comes to mental health — are perhaps substance abuse and eating disorders. With the exception of a few people like Kay Redfield Jameson, it is rare that anyone will own a mood disorder or anxiety disorder. But in the ADHD community it’s actually seen as an empowering, supportive experience to work with a professional who gets it and has done the work themselves, knows the journey, the deep internal experience of living with ADHD. But it’s also terrifying to be a professional who is “out.”
Sari: I was “outed.” I was hiding in those early years and then, when I moved to Ann Arbor, I was giving my first professional talk here, speaking as an expert on ADD, and the event organizer sent out a flyer to the public introducing me by saying, “This woman is speaking and her husband is going to be there talking about what it’s like to live with a woman with ADD!” I mean I felt, literally felt, like I had been outed as some sort of immoral criminal, like I did something horrible or people found out I was a bad person. That’s how much shame, fear, and embarrassment there was. And that is why I hadn’t outed myself as a deliberate choice. But because of that, after that, and later writing the book, everybody comes into me with a sense of ease that I understand them and that makes things different. So making a deliberate decision about how to handle this is important.
I work a with a lot of mental health professionals with ADD and they’re all saying things like, “Well how can I be a therapist/mentor/coach, a good example? I feel like a fraud because I don’t have it together.”
But you’re a model. Not of a perfect person but as a human being. No one has it all together. What you’re going for isn’t a model of perfection but a model of what’s it’s like to live with differences, thrive with them, be challenged by them, have a human experience. We all have difficulties.
What a great model that is, for children, for teenagers, for clients. To say, “This is how I struggle, this is what I do about it, I’m a whole person.” To teach that we accept differences. I accept these differences in myself, I struggle like anyone else, and to join…with your clients or with your kids or with the human race in general. We all struggle and we’re all trying to lead a meaningful and connected life.
Michelle: Right, and I’m worth it.
I’m just as deserving as anyone else of living my dream and giving my strengths and gifts to the world. I think so many people struggle with the questions, “Am I good enough? Who am I? Am I a fraud? Should I dare to pursue my dreams?” But who are you not to? Why not you?
When you do live with certain challenges that make your life undeniably difficult at times, you can’t ignore your differences. And it also true that at some point you have to take a risk on yourself and learn to be okay with the whole of who you are.
Sari: And what would be so inspiring if you didn’t have challenges? What’s inspiration without a story of adversity?
Michelle: Right, it’s the hero’s journey!
Sari: Yeah, exactly. So, in terms of modeling for people, that’s what it’s about.
Michelle: I think our approach at Sari Solden & Associates is unique and based on the emphasis we place on authenticity and the whole person. We take a comprehensive view of what ADHD means for each person and the multiple components of living successful with these differences, as an adult, a woman.
In your experience, after 25 years of doing this work, what do you find to be the core elements of treatment for ADHD? What works?
Sari: Well, for starters, what doesn’t work is to pathologize, to minimize, to focus only on executive functioning and systems training. To collude with the client’s fantasy of “getting fixed.”
I’ve never met a woman who has come to see me who doesn’t, in some way, want to fix herself. Who wanted anything more than to get over who she was: to be completely organized, to be more like everyone else, more acceptable or normal. So what you don’t want to do is to collude with that, reinforce that, communicate that we’re going to change who you are. This is a person, a human being. So you have to see that person whole.
If I can’t see you whole in front of me, see your strengths and challenges, if I can’t see all of who you are characteristically as a human being. I’m not going to be able to help you find that picture developing inside of you if I don’t see the big picture.
So what works is to see the person whole.
What’s healing for people who have wounds because they were never diagnosed – many women aren’t diagnosed as children because they weren’t hyperactive and were smart – is to see them whole and really be present with them. And usually for quite a while. It takes time to see that picture of themselves, and then hold onto it and move towards it.
My goal is to get them to a life that’s working for them, not to get over who they are.
Michelle: Right, to live a life that works for them, not fundamentally replace themselves and live someone else’s life.
Sari: Yes, not to let them spend their whole lives getting organized and measuring themselves by some gold standard about what it means to be a good enough woman, mother, wife, friend.
There’s always a critical point, a line they cross that represents this pivotal marker where they stop this toxic comparison.
I wrote my second book “Journeys Through ADDulthood” because I saw that there was a definite progression from accepting yourself and your diagnosis to accepting your challenges as part of your life – ongoing – and going on to accept yourself as a whole person. ADHD and everything else you are.
Michelle: I work with a lot of young adults who were diagnosed as children or in adolescence, but they had a very different understanding of what that meant then. Many weren’t told much about it at all. Their view of ADHD is often tied to school performance, maybe chores at home. And now they’re adults, trying to find their identity, their passion, their career, their partners, and figure out what these challenges mean for their lives now.
I think that’s a theme that comes around every few years, certainly every decade: Who am I now with these challenges? And with these gifts?
A lot of the work is giving people a different understanding of what ADHD is, what it means to be someone who has this particular set of challenges, and also – at the same time – has this unique set of strengths. To start challenging some of what they were taught about ADHD or told to believe about themselves. Re-writing old stories of limitations and deficits. This is not just what you and I do everyday, it’s also a big part of ADDA’s mission.
Sari: It’s easy to fall into the trap of feeling like, “What’s wrong with me? I’m deficient. I need to fix it. Asking for help means something bad.” Those old stories are damaging.
Michelle: I’ve found that once there is a deeper understanding and appreciation of the big picture – ADHD and otherwise – those stories start to shift. Quickly.
Michelle: You know, I also have to add that in our treatment model we don’t leave out executive functioning skills. I don’t want to leave people with the impression that isn’t also an important part of the puzzle.
We do spend time sessions with our clients going over the nitty-gritty details of life and scheduling and time management and focus…What does your week look like? How can we take what’s on your plate and make feel more manageable for you this week? Where do you need support? We still work on skill building, but it’s based upon a broader foundation and context of personal values and passions…of what gives their lives purpose and meaning. What brings joy, satisfaction.
We’re all plagued by the word “should.” I always say, any time you hear the word “should” in your head, take a step back. That’s the critic talking. Someone once taught me, trained me, to replace “should” with “could,” and I’ll be forever grateful.
It’s important to develop a realistic sense of what’s possible – which is often both more and less than most people initially assume – and then weaving in new skills with a foundation of authenticity.
You can practice new strategies all day long, but you’ll be beating your head against a wall and they won’t remain sustainable if the story you tell yourself is “I can’t. I’m bad at being an adult. I don’t believe I’m capable.” If you’ve fallen for a false belief that you’re inherently flawed and convinced yourself that it’s okay to settle for less than you really want and deserve.
Fixing yourself is simply not possible. Nor should it be. There’s no fix for being human.
Sari: You fix dogs, not people.
Michelle: Right, you fix a leaky faucet!
Sari: Yeah, you’re a human being and on top of that accepting that you’re not going to be able to do everything on you own. We work on an interdependence model, the idea that it’s an illusion that we can do it all on our own. We are interdependent beings and there’s nothing wrong with you for getting help or support so that you are able to contribute what you have to offer.
I think that’s why we see counseling for ADHD a bit differently. Strategies aren’t enough. People often aren’t ready for strictly behavioral and performance-based services because it takes them straight into the minefields of performance and suddenly fear of disappointment and shame or resistance come up because of these deeper issues. You don’t want to set up a situation for failure. It’s hard to weave these things together, but it’s necessary.
It’s an art to weave in the counseling and skills training. You’re a unique individual trying to do these things and cookie-cutter solutions don’t work. It’s delicate work. Important work.
Michelle: Empowering work.
Michelle Frank, Psy.D. is a clinical psychologist and puts the “Associates” in Sari Solden & Associates, a private practice dedicated to improving the lives of adults with ADHD located in Ann Arbor, MI. She speaks locally and nationally. In her “spare time,” she serves on the Board of Directors and as Editor for ADDA.