Beth Main's blog

The link between ADHD and trauma

I used to think my professional interests - adult ADHD and complex trauma - were an odd combination. Would I have to give up my work with ADHD adults in order to pursue my new(er) passion? Do these two issues have enough commonality to make sense for me to specialize in both?  Would people get it?

Over time I've noticed that many of my ADHD clients are also struggling to heal from neglect or abuse sustained during childhood. This is actually a big part of the reason I decided in 2013 to get my master's in counseling - so I could help them with both. Conversely, one of my internship supervisors shared her belief that all clients with trauma histories will also have ADHD symptoms.  This has been echoed by multiple professionals in the Equine Assisted Psychotherapy (EAP) field during my various trainings.

Why is this? 

ADHD is characterized by inattention and / or impulsivity and hyperactivity. It is diagnosed via a symptom checklist rather than blood work or scans. Medical professionals often don't ask about trauma histories when responding to a request to identify "why is my kid so out of control" or "why isn't he doing better in school". If ADHD is suspected, the checklists are administered and the diagnosis is made. If trauma is asked about, it isn't always disclosed, or is considered secondary.

Hypervigilance (constantly scanning for threats) and dissociation (checking out) can look a lot like inattention.

Impulsivity can be a response to unmanageable stress.

It's hard to sit still when you don't feel safe.

Neural pathways are created in the brain that entrench these behaviors over time until they become the norm. The trauma is pushed to the back of the mind and not talked about. After enough time passes, the two feel more and more separate. But they aren't.

I've concluded that my specialization doesn't have to be - indeed it can't be - one or the other.  If you're looking at ADHD, you could also be looking at trauma and vice versa. It can be extremely helpful to work with a professional who deeply understands both.

To be clear, I'm not saying that ADHD is always caused by trauma. The current working theory is that it's a genetic condition. Scientists generally agree that there could also be other causes, and trauma could be one of them. I'm just saying we need to correctly identify the underlying cause, so we can treat it appropriately and effectively. 

Check out this article for more details on how childhood trauma could be mistaken for ADHD.

Where to have lunch if you take food quality seriously

ADHD is neurobiological. So it makes sense that we need to feed our brains. That means clean, healthy eating.

At home, I eat local pasture-raised meats from animals that are humanely raised. I eat lots of organic fruits and vegetables. No refined simple carbs. It's been challenging but I have finally acquired sources and recipes for everything I want and need.

Eating out is another story. I bring my lunch to work most days, but I end up eating out about once a week (nobody's perfect).  I try to make good choices but really, there's not much around here that I can get to and back in the short amount of time I have for lunch.

Enter Little Bird.

I just had the best lunch ever, at a little place called Little Bird.  It's just a window inside the Ever Grain Brewing Company, at 4444 Carlisle Pike, Mechanicsburg. The phrase "best kept secret" is a cliche, but in this case, it's utterly true. There isn't even a sign on the road for it. You almost have to know about it to find it. From their website: 

Our food is crafted with real ingredients, sourced locally whenever possible, and never overly processed.  We use whole grains, real butter, real olive oil, and make our own stocks and sauces.  We bake our breads, ferment our kimchi, and cure our bacon for three weeks before it goes in the smoker.  When our farmers plan for the season, they call our Chef to find out what they should grow.  When our foragers (sometimes our Chef) find a honey hole of chanterelle mushrooms, they call us first.  Spent grain in our recipers comes straight from our Lauter Tun.  Our micro greens, leafy greens, and edible flowers come from an aquaponics system in New Cumberland, PA.  We support youth programs like L.E.A.F. Project and Jumpstreet.  We promote sustainable, biodiverse agriculture in all forms. 

All this in a craft brewery?  Yes. This is no ABC.

I had the Best Damn Chicken Sandwich ever. That's the name of it. And it really was the best damn chicken sandwich ever.  It looked and tasted like something that my husband or I would make at home. Probably because it is - the chicken came from Foxwood Run Farm in York County, which is coincidentally (or not) where we get our chicken when we run out of what we've raised ourselves on our farmette. The birds are sustainably and humanely raised on fresh pasture and sunlight, which is in keeping with my personal values. Anyway, back to the sandwich. It looked healthy and tasted amazing. It was served with hopped remoulade, wallaby cheese, and yucca fries, which are a delicious and nutritious alternative to potatoes (which are no good for you so don't eat them).

If you're a foodie, this is your place.

If you have ADHD and are trying to figure out how to eat more nutritiously when you go out, this is your place.

If you just want real food that tastes amazing, this is your place.

Go.

Here's the address again: Ever Grain Brewing Co., 4444 Carlisle Pike, Camp Hill PA. Call 717.525.9772 for takeout.

Are you more like a boa constrictor or a cat?

Marketing experts say consistency is the key to building a successful business.  Apparently it’s best to regularly engage in marketing activities instead of only doing big productions when business is slow.  This prevents the “feast or famine” cycle, they say.  My marketing strategy calls for two blog posts a month and two Facebook posts per week. But as you can see from my blog history, that’s not really the way I operate.

House cats eat a little bit at a time throughout the day, no matter how much is in their bowl. If I give my cat any more than half a cup of food, it will still be there the next morning. The marketing experts would be pleased with her consistent approach.

Boa constrictors are different.  They will swallow a whole rat (or oh look! a squirrel) and do absolutely nothing else while they’re digesting it for the next 4-6 days. They might not eat again for months.  Marketing experts agree:  NOT COOL.

I’m more like a boa constrictor. In marketing and in life.  No, I’m not cold blooded, and I certainly don’t squeeze my food to death before I eat it.  It’s more my way of taking on projects.  When I do something, I jump in and do it in a big way.  Then I’m like, “OMG I’m so overwhelmed my head is going to explode”.  Who can write when her head is exploding? 

Things inevitably calm down after a while.  The problem is that until this happens, it feels like I’m going to be overwhelmed – or worse – forever.  It’s the ADHD tendency to perceive that the way things are right now is the way they’ve always been, and always will be.  We tend to not remember that things change.  Life ebbs and flows.
  
I really like this boa constrictor metaphor. Just like the snake always digests the rat, I too always get hungry again for a new project. Then I take on too much once again and can’t even move.  But you know what? I’m not going to try to change this.  Not only is it the way I’m wired, but I actually think it’s more productive. I’m guessing that many people with ADHD are like this.  I just have to remind myself that this is a CYCLE, like the boa constrictor’s eating habits. Then I can trust that things will eventually calm down. Most of the time I can even predict when digestion will be complete, if I think about it.  Knowing that things will eventually calm down is what keeps my head from actually exploding.  

Don’t get me wrong, consistency is important for a lot of things, like diet, sleep, and studying.  Maybe marketing, too. But projects? I’d rather be a boa constrictor than a cat. How about you?
 

The Full Moon Lunch

I had lunch with a good friend yesterday.  We both have ADHD, so we don't get together as much as we'd like. This seems to be a common problem amongst the ADHD set: the weeks slip into months and next thing you know it's been half a year (or more) since you talked to each other.  You're busy, you forget... you know how it is.  We have no sense of time and often aren't aware of just how much time has gone by.

That's how friendships deteriorate.  I don't want that to happen.  

My grandfather and I were very close.  We had a standing "phone date" every Thursday evening from when I started college in 1983 (yes I'm that old) until he passed away in 2011.  That worked out great.  I only forgot to call him a few times in all those years.  Much as I'd love to, it isn't practical to do that with everyone I want to keep in touch with (although I do have recurring calls set up with a few people).  Mathematically, there just aren't enough hours in the day for a weekly chat with everyone I want to stay close to.  Plus, some people think Facebook is an adequate substitute for actual human contact.  But that's another issue...

My friend had a brilliant solution.  How about a lunch every full moon, he asked?  Perfect, I replied. So that's what we're going to do.  Now we have a naturally-occurring event that we can use to mark the passage of time.  

See you on the next full moon, G!

Sometimes ADHD makes me cry

Sometimes ADHD makes me sadI went to the grocery store on my way home from the gym this morning.  I had just started to pay for my groceries when a tattoo on the arm of the man behind me caught my eye. It was a beautiful tattoo, a line of soldiers in silhouette around his bicep. I wondered if he was a veteran. I thought about the Equine Assisted Psychotherapy program I want to develop for veterans, and briefly considered talking to him about it.  I thought about paying for his groceries as a token of my appreciation for his service. Then I thought that would probably be over the top, plus he was buying a lot of junk food, and decided not to. That led to thoughts of healthy eating, and... you know how it goes. Suddenly I noticed all my groceries were in bags and it seemed like it was time to go.  I pulled my card out of the card reader and started to put it away. 

Uh oh. The threatening DO NOT REMOVE CARD message was still on the screen.  What happens when you remove your card too soon? Does something explode? Do you get arrested? I was about to find out. The helpful cashier explained to me how to use the card reader, as if I had not already used it a hundred times before. The transaction had to be started over. I did it right the second time, but she didn't give me my cash back.  She said that I didn't ask for any.  I knew that I had, and I told her so.  Apparently I had asked for it during the first transaction, not the second, which the receipt confirmed. This resulted in another lesson on how to work the card reader and being called sweetie. Clearly she thought I was senile. Or stupid. I felt senile AND stupid. 

I managed to hold back the tears until I left the store.

Usually when something like this happens my husband tells me “You're not senile or stupid, you just have ADHD. You were distracted.” And he gives me a hug, and all is right in the world again. But he wasn't there. So I had to tell myself. 

I went back and reviewed the episode in my mind.  I identified the moment where I became distracted, and how things fell apart as a result.  Okay, I can understand that. I guess I'm not senile.  Stupid as I felt, it really had nothing to do with intelligence. I have ADHD, and sometimes it sucks, but usually it's not bad at all.  I have an incredibly full life.  I pursue interests that average people don't even dream of.  I’m spontaneous. For the most part I do what I want, when I want, and it works for me and my family.  I’m never bored. The to-do list is long, but the important stuff gets done.  I’m happy.  
 
A fellow counselor once said to me, “It’s not how smart you are, it’s how are you smart”.   Things happen that make me feel dumb. My short term memory is AWOL.  But I know I’m good at figuring stuff out, at solving problems, and I have a very high emotional IQ.  

I just need to remind myself of that every once in a while.
 

I got my license!! Which means...

As of today, I am a Licensed Professional Counselor (LPC)!  As I've written previously, I got my master’s degree in 2015 and have been working under supervision for the past two years in order to meet the requirements for licensure.  And now I have it!  

This is great news for you too:  If your health insurance plan offers out of network benefits, you can use them for counseling with me.  (Coaching is not covered by insurance, but there is a LOT of crossover between coaching and counseling.) I am not currently participating directly with any carriers, so I won’t be able to submit claims for you.  But I’ll give you what you need to submit to your company for reimbursement.  

I’ve been branching out into other areas besides ADHD. While I love working with Attention Deficit / Hyperactivity Disorder, and intend to keep doing so for a long time, a little variety is nice.  I’ve gained experience helping people with depression, anxiety, obsessive-compulsive disorder, life changes, relationships, recovering from childhood trauma, and more.  My new website, bethmain.com, goes into more detail about my counseling services.  

As always, I offer a free initial consultation to help you decide if I’m the right therapist or coach for you. So if you’ve been thinking you’d like to work with me, this is a great time to request a consultation using the link on the right side of just about every page on this site.  I’m happy to answer whatever questions you have about how I can help you.

Hope to talk with you soon!
 

Audio: Overcoming Analysis Paralysis - How to make effective decisions

Earlier this month I participated in Dr. Kari Miller's "Closing the Intention Gap" event, where 18 productivity experts gave talks on how to close the gap between what you intend to do and what you actually get done. My topic was "Analysis Paralysis: How to Make Decisions More Effectively".  Here's the promo copy:

You’re working on an important project.  Things are moving along and you’re in the zone. But then you have to make a decision where the best choice isn’t obvious. The whole universe opens up before you.  Now, instead of one path to follow, there are dozens. What do you do?  If you’re like many people, you become overwhelmed and go into avoidance mode. You procrastinate. Welcome to analysis paralysis.

But by using Beth’s strategies, you’ll be able to get back in control, get moving, and get stuff done. In this presentation you will learn:

  • How to recognize when you’re stuck in analysis paralysis
  • A clear cut process for making your very best decision in a reasonable amount of time
  • How to know when a decision is “good enough”
  • What to do when you’ve done all that and still can’t decide

Although the event is over, you can hear the audio from my presentation by clicking here.  It starts right after a brief (< 1 minute) introduction from Kari.  Enjoy!

2017 Shire ADHD Scholarship

ADHD scholarshipShire PLC has announced the return of its ADHD scholarship program for the 2017-2018 school year.   Applications will be accepted from December 2016 (exact date TBD) through March 8, 2017.  The scholarship awards U.S. recipients $2,000 in tuition assistance and one year of ADHD coaching services provided by the Edge Foundation. A similar program, operated by Shire Canada, offers Canadian students $1,500 in tuition assistance and one year of ADHD coaching services provided by the Edge Foundation.

The scholarship program is for legal residents of the United States or Canada who have been diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD), are accepted to or will be enrolled in a 2- or 4-year undergraduate program at an accredited college, university, trade school, technical school, or vocational school, and are under the care of a licensed health care professional for ADHD.

Visit the Shire ADHD Scholarship website for more information:  http://www.shireadhdscholarship.com.

Election 2016, ADHD-style

You can usually count on people with ADHD to speak their minds. To be just a little bit outside the traditional box (or maybe a lot).  To not do what everyone else is doing just because everyone else is doing it.

This election season, I’ve heard a lot of people say they’re voting for Clinton because they hate Trump.  Or for Trump because they hate Clinton and the establishment she comes from.  When I point out that there is another option, third-party candidate Gary Johnson, they brush it off.  “He’ll just take votes away from <the candidate I hate>.  That’s what happened with Ross Perot in 1992.”  But if everyone says that every four years, we will be stuck forever with the same flawed two-party system, where we vote for the lesser of two evils.   This isn’t a horse race where it pays to bet on the person with the best odds.

I don’t want to get involved in anyone’s politics. Everyone has the right and the responsibility to vote for the candidate they believe will do the best job.  I guess that’s the point I want to make.  My wish for this country is that everyone finds the ADHD-like courage to let their voice be heard, to step outside the box, and do what makes sense to them.  Sadly, I think most people probably won’t.  They will continue to walk through the cattle chutes of their existence and do what everyone else is doing.  

But what about the ADHD community? I think we can do better because that’s how we’re wired. Can we leverage our ADHD-related strengths to do right by our country? To be bold? To jump right over that cattle chute?  To be the impetus for change? I want to be clear, if you really LIKE Clinton or Trump, by all means, that’s who you should vote for.  But if not, there is another choice. Gary Johnson will be on your ballot in November right next to the candidates more people loathe than like. 

Do your homework and vote what you believe.  Not what you’re told “makes sense”.  If enough of us do that, we can make a difference.

May the best candidate win.

Email management: I'll get back to you

 

Email

Many of my clients want help organizing their email.  Some of them even aspire to "inbox zero", the practice of keeping the number of messages in one's inbox at - you guessed it - zero. On the surface, it seems like a simple problem that could be resolved by setting up some folders and unsubscribing from email lists that are no longer relevant.  But really, where you put stuff is only a small part of the issue.

The real problem with email management – or lack thereof – is perceived responsiveness. Someone sends you an email asking you to do something.  You procrastinate, but you know the request is in your email, so you don’t worry too much about it.  You’ll get to it “soon”. But the requests keep coming in, and next thing you know, your inbox is a mishmash of to-dos, information, and guilt.  Hours turn into days, which turn into weeks, and next thing you know, you’ve been labeled as a person who doesn’t respond to email.  Or worse, is incompetent or doesn’t care. 

Email was never meant to be a task management tool.  It’s a communication tool.  So let’s separate the tasks from the talk.

There are a couple of reasons why you might not respond to an email right away:

  • You have to do something first
  • You have to decide something first
  • You have to think about how you want to respond 

All are valid.  But no matter what the reason, you can save your credibility with five little words:  “I’ll get back to you.”  Send a quick reply right away letting the person know you got the message, so they don’t have to wonder if it – or you – got lost in cyberspace.  This gives you time to do the thing, make the decision, or compose your response. 

Of course, you do have to actually get back to the person eventually. How will you remember to follow up?  Put it in your task management system.  If a decision has to be made, “decide what to do about ____” is the appropriate to-do list item.   Then when you’ve made the decision, or completed the task, send the full response.  

This two-part approach to answering emails will go a long way towards building – or saving - your reputation as someone who can be counted on.  No matter how many messages you have in your inbox.

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