Turns out I’ve been an ADHD therapist-coach all along…

I became an ADHD therapist and coach accidentally. That is to say, in the years immediately following the pandemic I realised I was one. There is something endearingly ADHD about this kind of career progression, a result of following instinct and passion, of veering off script, not even noticing the playbook has been abandoned. But it is also poignant, revealing as it does how very much of our lives as therapists are intertwined with our own therapeutic work. I did not know I was ADHD, but the clients who were drawn to me and stayed with me described pain and challenge and difference in a way that made my heart both sing and break at the same time.

“’ADHD the medical condition’ must reduce your quality of life – otherwise, from a legal and medical perspective, you don’t have it. But something about that feels so unfair; that this core part of who we are and how we move through the world can only ever be defined by the impairment it causes us.Matilda Boseley, The Guardian 20/09/2023

There is often impairment, no doubt about it, even if we only acknowledge that the world wasn’t designed for us. ADHD is hard. But it’s not all about impairment, despite a not-fit-for-purpose diagnostic system that acknowledges nothing but. Now we know more, can we move beyond this?

Covid, it has been said, was the Great ADHD Reveal Party (apologies to the uncredited person who said that somewhere. Remembering details isn’t my forte) and the Guardian article above, in highlighting the positives in the new community that has arisen, spoke to my experience not just as a therapist but as one of the many adults who have had the lightbulb moment about their own neurodivergence over the last few years of stress and upheaval.

It also speaks for my clients, an extraordinary majority of whom turn out to be ADHD too. This probably shouldn’t have surprised me as much as it did – the discovery that neurodivergent people form strong, healthy, life affirming therapeutic relationships with neurodivergent therapists is, with hindsight, far from shocking, but realising we’ve all been groping around in the dark for years and have now stumbled into the light together has been an emotional experience. It has shone light not just onto our mutual experience of living weird in a world of normals (I claim the right to use these words) but personally for me, onto my value as a therapist.

So many conversations float back to me. The many, many times people have said “It’s silly, I can’t want/do that,” and I, authentically baffled, have said “Why not?”. The client who made me silently scream “Me too!!” by saying “I just feel everything far more strongly than other people” – I’d never acknowledged that people experience emotion in dramatically different strengths. The heartbroken man, wringing his hands as he broke up with his equally heartbroken partner, unable to explain beyond “I can’t breathe, I need something more, I’m suffocating, it’s not you…”. The many, many people I now realise suffer Rejection Sensitive Dysphoria, unable to move past a throwaway hurtful comment or a perceived slight from peers. The super bright 15 year old from a loving stable home who nevertheless spent nights driving around with older men, refusing to go to school because it was boring. ADHD “boredom” should have a different name. It’s legitimately deadly.

We have, as this article says, formed our own identity and community without even realising it and without any formal validation or support. I am three years into what is now apparently an 8 year wait for an NHS diagnosis. This year I gave in and paid privately, as have several of my clients, to have the obvious confirmed (re: That Panorama Programme – of course most private paying patients get a positive diagnosis! Do you think they’d shell out a grand if they weren’t already damn sure?). When I initially suspected, I was nervous mentioning it. How could I know? Had I just made it up after watching Tik Tok? By the time I booked my assessment, however, the formal diagnosis seemed almost irrelevant. If a psychiatrist had told me I didn’t have it I would have laughed. That would make no sense at all. Regardless of whether I ticked the right boxes I knew that I have/am something and it’s a something I share with most of my clients, all of my family and huge numbers of my friends. Neurodivergent people – whether autistic, ADHD or other – see each other at a deep, intangible level and connect in a way invisible to most.

As the not-for-profit Flourish Network that I co-founded was set up to highlight, there is something deeply wrong with using a medical model for mental and psychological human experience. This seems especially true for neurodivergence, and with the label ADHD specifically. We don’t have attention deficit for starters. For years I assumed I wasn’t ADHD because when inspired I could write for 10 hours straight barely pausing to drink or use the toilet (clue: this isn’t normal). Psychiatry has given us a start, identifying the tip of the iceberg – those who perhaps for other reasons (trauma, learning disabilities, disadvantage) have been less able to mask and manage their differences and hence have been noticed and given the label. But the rest of the iceberg is rising up and revealing itself. Those of us who are not severely traumatised or disadvantaged but can still get stuck in paralysis unable to start a task, have no sense of time, switch jobs or relationships unable to tolerate repetition or lose entire days and nights to obsessive hyperfixations (this, of couse, sometimes produces genius).

Twenty three years ago I packed in my safe permanent job and went to live on a tropical island with my young son for a year because life was just not enough. Four years ago a desperately unhappy client told me all she wanted was to abandon her career and go and live on a remote island hundreds of miles from her family. “People don’t do that though do they?” she said. “Some people do,” I said.

She packed up her life and went. We still talk on the phone and she’s still there, liberated and healing.

Those of us with that brain need each other. We understand each other. Talking to a same-brain person is like coming home, and being able to be that person to my clients is a heartstopping privilege. We know each other, we recognise each other and we find each other. The ADHD-dar is real.

We have evolved far beyond the medical model. Excitingly, right now, and despite some of the prejudice and pushback, it feels society is for once moving with us.