Journeys Through ADDulthood




  • The following article has been published with kind permission
    from
    Lew Mills, PhD, MFT, a Bay Area psychotherapist working with Attention Deficit in Adults.

    Book Review: Journeys Through ADDulthood: Discover a New Sense of Identity and Meaning with Attention Deficit Disorder

    by Sari Solden, M.S., MFT (2002)

    Reviewed by Lew Mills,
    PhD, MFT

    An insurance company recently claimed that if ADHD is a
    neurobiological disorder, then it ought to be treated
    biologically&emdash;with medications. Psychotherapy ought to be
    unnecessary. This will surprise any of us who are familiar with the
    extensive psychological consequences of ADHD, particularly in
    adulthood. We know that ADHD has a neurobiological basis, but that
    far from precludes that there are virtually always psychological
    implications.

    So why do we focus so much on those first treatment decisions
    about diagnosis and medications? Even the insurance company mentioned
    above ultimately had to admit that this is a superficial approach to
    treating ADHD in adults. Nonetheless, many adults diagnosed with ADHD
    stop their own exploring of their ADHD once the medications are seen
    to work (or not). Too often, ADHD adults fall into this medical model
    of ADHD and, like the insurance company, they conclude that treatment
    of their neurobiological condition ends with neurobiological
    treatments.

    This can lead to dangerous disappointments when the medication
    does not “cure” ADHD, nor solve the heap of life’s problems that have
    accumulated in the pre-diagnosis years. This setback, in the context
    of a life of many unexplainable failures, can lead to the discouraged
    ADHD adult abandoning hopes for real change.

    Sari Solden’s new book takes the longer view. She elaborates on
    the period from before diagnosis through a full acceptance and
    embracing of the authentic self with ADHD. This life’s work she sees
    altogether as a voyage of “three journeys.” The first
    journey&emdash;discovering the diagnosis and treating it
    medically&emdash;is the most familiar. It is also the one that most
    other ADHD books primarily address. And Solden also covers this
    ground well.

    But after diagnosis and medication, what should an ADHD adult
    expect? What should they try to do? The second and third journeys
    pick up from this point and fills in what the ADHD adult is really
    going to have to do. Reaching past advising that we all need to
    self-advocate, we need to build on our strengths, that we need to
    accept ourselves, Solden lays out the maps for these journeys in
    detailed, practical terms.

    There are many nuggets to be mined here, but I would share one of
    my favorites. I often tell clients just starting work with me that
    there are two jobs that they can do in therapy. The first is to
    problem-solve about how to make their future work. They already
    expected that one. The second, less obvious one is to revise the
    history that they have created for themselves in their explanations
    of the their own behavior since childhood.

    Their reaction may be to tell me that when they were in therapy
    before, they already had all of those “insights”, and it didn’t help
    at all. A therapist has already asked them to consider whether they
    may be expressing aggression or dependency in their irresponsible
    behavior, or suggested that they may have some unconscious desire to
    sabotage themselves. But these “insights” are the same toxic
    attributions about their behavior that they and everyone else
    inflicts on them to no avail. Like the injunction to “try harder”,
    there is no way that the ADHD adult can use these to improve their
    ability to function. It condemns the ADHD adult for not controlling
    these things which they really cannot. So the ADHD adult is carrying
    a heavy load of self-recrimination that is not deserved, does not
    motivate or guide them, and about which they are not even fully
    aware.

    So one of the greatest problems that an ADHD adult will
    immediately face is that they have acquired a distorted sense of who
    they are and their culpability in their difficulties. This is the
    history that therapy can help them revise. The ADHD adult can
    understand that the history they have created of themselves is flawed
    and inaccurate. There are other explanations for themselves which do
    not condemn them for not “trying harder.”

    Much of Solden’s book revolves around how to reclaim an authentic
    self in the face of this distorted history. And from that, one can
    recreate a life which has gone off course. The ADHD adult has to
    separate themselves and their self-worth from the symptoms of ADHD.
    Solden emphasizes reconnecting with the dreams that unexplained ADHD
    symptoms may have prematurely cut off. With the spark of discovering
    who one really is, and recognizing one’s strengths again, in the
    context of their challenges, Solden envisages a new life for ADHD
    adults which goes way beyond discovering how many milligrams of this
    or that one must take.

    Solden’s narrative includes both stories of others who have been
    on these journeys before and short exercises for self-exploration
    around the same issues. Perhaps the hidden gem is in the appendices,
    where she lays out in a more linear form all of the issue areas,
    approaches that may work, pitfalls, and suggestions about how to more
    forward. Some of this is detailed in the form of advice to a
    potential therapist, but we know that every ADHD adult is going to
    read this part of the book as well!

    Solden somehow conveys the sense that she will be by your elbow as
    you move along these journeys. She also advocates that you find
    warm-blooded versions of her support in the people around you.

    No doubt, some readers will be tempted to concretely measure
    themselves against Solden’s mileposts. It will be tempting to ask
    whether they are finished with “Journey Two”, or halfway through
    “Journey Three.” The answers will only be partly discernible from
    this book. So much about these journeys is about how an ADHD adult
    connects with others in the world, giving the gift of their authentic
    self and receiving back the appreciation of others. The answer as to
    whether the journey is working will inevitably have to come from
    those connections themselves. Part of the journey may be testing out
    where one is on these excellent maps. But the map is not the
    territory, and only the journey will reveal the destinations.

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    One Response to Journeys Through ADDulthood

    1. Christia Luz says:

      Academic difficulties are also frequent. The symptoms are especially difficult to define because it is hard to draw a line at where normal levels of inattention, hyperactivity, and impulsivity end and clinically significant levels requiring intervention begin. To be diagnosed with ADHD, symptoms must be observed in two different settings for six months or more and to a degree that is greater than other children of the same age.

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