View Full Version : Therapy issue


Twimm
04-21-10, 11:35 AM
So…therapy is supposed to help me with behavior modification. And my therapist and I have done some work in that area. I can’t say I’ve done much with the techniques we’ve discussed, but I’m trying. My last 2 sessions though have been...well…different. It seems like he’s digging deeper. For instance, we somehow got onto the subject of how complacent I am. It’s true, I am. I avoid conflict if there’s any way around it at all. I tend to give others plenty of leeway with their behavior and forgive very easily any slights, letting most things roll off my back so to speak. I don’t feel as though I can expect the same thing in return from others (which I think is at the crux of what my therapist is trying to get at) so I rarely if ever let others see that I’m upset or angry. Instead I deal with it internally and then I let it go. It’s hard to ruffle my feathers anyway - although it can be done – and even if they are, it very rarely shows. Few people have ever seen that side of me and most would be very surprised to find that it even exists. People would definitely characterize me as extremely easy-going and friendly. Now, let me state here that this characteristic of myself – my ability to let things go so easily (or maybe my inability to express anger, depending on how you look at it) does not bother me. At all. My life is pretty good, aside from the ADD stuff. My life is easier because I choose not to let others “get” to me, I’m happier because I don’t brood too much about things. Still, my therapist seems intent on making me examine why I am the way I am. He even asked me if I thought I could be depressed! No. I’m not. Like I said, my life is pretty easy and I’m pretty happy. So why is he pushing this so hard? I just want help learning to organize and prioritize...help learning how to cope with my ADD. I’m not into delving into the deep dark recesses of my being to uncover my “true motivations”. I’m happy, so why bother messing around with that, ya know?

Gina
04-21-10, 04:53 PM
Sometimes therapists are trained in a certain "dynamic," and they feel they aren't doing their job if they don't pursue certain lines of inquiry. The operative word, as you say, is often "digging." ;-)

This is one reason why not all therapists are qualified to help people with ADHD, especially when it comes to examining pre-diagnosis poor coping strategies and helping the client to develop new cognitive strategies. Sometimes they just go down unhelpful avenues.

Of course, it could well be that your therapist is perceiving something in your approach to life that you aren't seeing -- something maladaptive, that is.

For example, I know some people with ADHD who were pretty happy with their lives, too -- despite the fact that they were headed towards bankruptcy, on the way out of a job, etc. In other words, sometimes there's a "disconnect" with ADHD; the person isn't "connecting the dots" in life.

In general, though, the therapist should have a solid command of ADHD's neurobiology as well as good familiarity with the evidence-based research thus far on effective therapy for ADHD. It's basically cognitive-behavioral therapy that is specifically adapted for ADHD. (This last part is important. Straight CBT is often counter-productive for people with ADHD, experts say.)

Amtram
04-21-10, 05:42 PM
Behavioral therapy doesn't work all by itself without an understanding of how the behaviors you want to change came about in the first place. A good therapist is going to be interested in what's going on in your head that makes you do what you do and say what you say. He/she is going to need to know what motivates you in order to find the motivation/reward that gets you to overcome your particular obstacles. "Just Do It" works only for sneaker ads.

I've always found that the more tissues I use during a visit with my therapist, the more improvement I see in my life.

Twimm
04-21-10, 09:53 PM
I can definately see the point to what you're both saying. But honestly, I don't think my ADD is as severe as it may be for others. To use your point about disconnect Gina - I've tried to identify that in my life, but I just don't see it. Using your examples: I'm not headed toward bankruptcy (although I do have too much debt...much more than I'm really comfortable with), I've been at the same job for 10 years and I have good relationships with those few people that I'm close with. Don't get me wrong...I have issues, no doubt, but I don't see any distinct disconnect. I really believe I'm just easy going by nature. What's wrong with that? I don't see anything bad about it, but my therapist seems to think there is.

As for the behaviors, I guess I assumed they were due entirely to the ADD, and therefore the cause was organic. If the cause is organic, then there really isn't a motivation. The behavior is a direct symptom of the cause. Treat the cause and then train yourself (through behavior modification) to change the patterns. Obviously it's not quite that simple and I'm really not trying to mimimize the work people put into trying to tame the ADD beast. But, at the root, isn't that the what the theory is? Brain works differently, causes behavior --> alter brain, stop behavior.

I'm pretty new to this whole thing and am just now trying to understand how ADD influences me, so I guess I should keep an open mind. Maybe I'm just scared. I actually like myself pretty well despite the stress and anxiety that ADD causes in my day to day life...I don't want that to change.

The_Robin_Hood
04-22-10, 08:15 AM
Twim.. Do you mind if I ask how old you are?

I only ask because I used to be very laid back myself when I was younger but have since realised that it was mostly because I was trying so hard to fit in. I'm now 33 and am much more myself these days and have only just been diagnosed.

Don't get me wrong I still try to be laid back but it just isn't as easy as it used to be with the pressures of work and homelife.

I'm just curious really :)

Twimm
04-22-10, 09:52 AM
Twim.. Do you mind if I ask how old you are?

I only ask because I used to be very laid back myself when I was younger but have since realised that it was mostly because I was trying so hard to fit in. I'm now 33 and am much more myself these days and have only just been diagnosed.

Don't get me wrong I still try to be laid back but it just isn't as easy as it used to be with the pressures of work and homelife.

I'm just curious really :)

I'm 37 so I'm even older than you. Your theory makes sense if applying it to a younger person, but obviously I'm not so young anymore :D But I guess you could say I'm young at heart, so if you take that into consideration...

ADHDTigger
04-22-10, 01:35 PM
Twimm, I am about ten years older than you.

The last time I saw a therapist was after my partner's cancer diagnosis and at a time when we were JUST starting to deal with how the chemo was going to impact us. I also had to suddenly discontinue taking Adderall- never a good plan. At that time, I was struggling to manage the complete and total destruction of my entire world... but I do not believe I was "depressed" in any way, shape, or form. I was struggling. Frankly, I believe that anyone who was in my shoes at that time WOULD be struggling.

The minute the doc came up with the line, "With everything going on, you MUST be depressed" I knew it was time to go. I was struggling, I managed to get through that struggle, and I moved on. I wasn't there so she could tell me how I felt.

I think that you have the right to regulate what you bring to therapy and what you don't. If your therapist can't respect you enough to let you determine what you want to bring to the table, it may be time to move on.

Gina
04-24-10, 01:48 AM
I can definately see the point to what you're both saying. But honestly, I don't think my ADD is as severe as it may be for others. To use your point about disconnect Gina - I've tried to identify that in my life, but I just don't see it. Using your examples: I'm not headed toward bankruptcy (although I do have too much debt...much more than I'm really comfortable with), I've been at the same job for 10 years and I have good relationships with those few people that I'm close with. Don't get me wrong...I have issues, no doubt, but I don't see any distinct disconnect. I really believe I'm just easy going by nature. What's wrong with that? I don't see anything bad about it, but my therapist seems to think there is.



Well, there's nothing bad about that. lol! I wish more people were easy going by nature. :)

Maybe I should clarify my point. Sometimes therapists who aren't grounded in the neurological underpinnings of ADHD apply strictly "psychodynamic" principles to a person's challenges. To badly paraphrase Freud, though, "Sometimes low motivation (or other ADHD-related trait) is due to dopamine molecules, not traumatic potty-training."

Bottom line: If you need some professional assistance-- and maybe you don't; not everyone with late-diagnosis ADHd does -- maybe you need a therapist or even an ADHD coach who is more geared to practical strategies, not psychodynamic ones.

For example, you say you have more debt than you'd like to have. Maybe, instead of a therapist, you could use a financial coach (or personal financial planner).

In other words, therapy should work with your goals, whatever those happen to be. If you don't agree with this therapist, and you feel you have objective evidence in your life that you're not "in denial," well, heck, save your money and time for more productive pursuits!

Gina
04-24-10, 02:03 AM
For instance, we somehow got onto the subject of how complacent I am. Itís true, I am. I avoid conflict if thereís any way around it at all. I tend to give others plenty of leeway with their behavior and forgive very easily any slights, letting most things roll off my back so to speak. I donít feel as though I can expect the same thing in return from others (which I think is at the crux of what my therapist is trying to get at) so I rarely if ever let others see that Iím upset or angry. Instead I deal with it internally and then I let it go.

Twimm, re-reading this part, I do have an observation.

Sometimes people with late-diagnosis ADHD carry poor coping strategies they don't even recognize as poor coping strategies. It's how they've operated all their lives, and it's what feels normal.

For example, my husband (who has ADHD, diagnosed at age 37) used to be almost passive when it came to standing up for himself in, for example, consumer-type situations or difficult-neighbor situations I couldn't understand this, because it didn't really seem to "fit" with the rest of his personality. After a few years of being on board with the ADHD diagnosis and medication, he became more able to articulate why he'd act passively in certain instances.

For one thing, he just didn't care enough about getting his money back. Money to him was an abstraction. And if a product didn't work, why bother to return it. Especially, he didn't relish the cognitive hassle of negotiating the return with some clerk who would potentially complicate matters, make him wait, etc. So, he'd just stick the item in the closet.

Since he also had a bit of a temper and could be easily frustrated, I think he also just didn't want to "go there" -- to tempt fate and maybe lose his temper in a BIG way. That was probably the case in difficult-neighbor situation. I had to handle any difficulties, because my husband just couldn't "finesse" things.

These probably sound like silly examples, but they're the clearest ones that comes to mind now. Oh, and he's not so passive and conflict-avoidant anymore. :o

ahcanuck
04-24-10, 06:32 AM
oh, I was like your husband Gina. Never stood up for myself with outsiders only in the home with my parents growing up. Labelled slightly as a push over. Then in my teens I was a trouble maker. Then I was tame and a pushover again. Then along with depression became anger and confrontation any chance I get. Hmmm...mellowed out again.

Gina
04-26-10, 01:34 AM
As the pendulum swings, eh? ;-)