ADHD Therapy: The case for psychotherapy as a vital component of ADHD management
By Carly Fleming, Registered Psychotherapist
For the vast majority of adults diagnosed with Attention Deficit and Hyperactivity Disorder (ADHD), medication management is the first line of treatment. The good news is that medication is highly effective and can be revolutionary in the lives of people with ADHD. Adding psychotherapy to the management of ADHD, along with medication, can impact the trajectory of treatment in an incredibly positive way. But how?
Negative view of self
When an adult is newly diagnosed with ADHD, the diagnosis itself may be new, but the impacts of ADHD are far from new. Most people have been living with symptoms such as distractibility, disorganization, impulsivity, restlessness and mood impacts for almost their whole life. And the reality is that in a world designed for neurotypical brains, the struggles that many people with ADHD face are viewed negatively by the people around them. This can lead to the person with ADHD viewing themselves through a negative lens. This negative sense of self can have major impacts on identity development, relationship with self, and relationship with others. This can lead to negative self-talk like “I can’t do anything right”, “I am a failure”, “I am powerless to make positive changes”, or “I will be rejected because of the way I am”.
One of the most powerful things about an adult ADHD diagnosis is that it has the power to shift these views of self and revolutionize the person’s relationship with themselves. But this can be a complex process and one that is hard to do alone.
The inner experience
Soon after diagnosis, most people can grasp, intellectually, what the diagnosis means and how it explains many of their struggles. However, their emotional and psychological understanding (their inner experience) can take far longer to catch up. This is where psychotherapy comes in.
The experience of living undiagnosed with ADHD for most of a person’s life can be painful and traumatic. Medication can’t heal those kinds of wounds. But psychotherapy can.
Using various well-established psychotherapy techniques such as Cognitive-Behavioural Therapy, Emotionally Focused Therapy, Narrative Therapy and others, people can truly begin to re-program those incorrect messages, understand how they have been hurt by them, reframe their view of self, and be empowered by the new diagnosis.
The case for psychotherapy
While medication revolutionizes ADHD symptoms for many, when it is started without an intentional focus on reframing/re-programming these negative views of self, the old (incorrect) messages can actually get in the way of maximal treatment effect. The negative self-talk can stand in the way of creating new habits, engaging in self-compassion, increasing psychological flexibility, and creating new ways of viewing oneself. Each of these things is essential to effective and holistic management of ADHD, most importantly medication compliance.
What does this look like in real life?
Once on medication, a person begins trying to create new routines to support their health. Because they are human, they likely experience struggles establishing a new routine. Very quickly the old negative self-talk is activated (for example, “it’s because I’m lazy”), and they give up on the new plan. While medication may help the person create and stick to a plan, it’s psychotherapy that will help reveal how the negative self-talk is getting in the way and create a more balanced way forward.
A new diagnosis of ADHD may mean that a person wants to tell loved ones about the diagnosis and the struggles they’ve faced. They get up the courage to tell their story but they are met with neutral reactions and responses. Immediately the negative view of self shows up and the self-talk might say “you’re not good enough” or “no one cares about you”. While medication may help to organize the thoughts and intention to communicate about the diagnosis, it’s psychotherapy that will help reframe the reliance on others’ views of self for approval.
Looking for some support?
A new diagnosis of ADHD is complex and can be overwhelming. If you’re curious about how psychotherapy can help you get the most out of your medication for ADHD, help heal the wounds you’ve been carrying or create a new way of viewing yourself and your place in the world, reach out whenever you’re ready.
Looking for more information?
You can read more about the services we offer to support people navigating ADHD here.
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