Adult ADHD with Dr. Pam Davis

Have you ever wondered if you or a loved one may have adult ADHD? It’s estimated that more than 8 million Americans, nearly 5% of the population, are living with this condition – many without even realizing it, as reported by WebMD.

While ADHD is a neurodevelopmental condition present from birth, it often goes undiagnosed until adulthood. This topic is gaining increasing awareness, and an adult diagnosis can lead to newfound self-awareness, helping individuals shed years of shame and confusion.

Joining us as our esteemed guest is Dr. Pam Davis, the Director of Graduate Programs in Counseling at Gordon Conwell Theological Seminary. Dr. Davis is a Licensed Professional Counselor Supervisor in North Carolina and a Registered Play Therapist Supervisor for the Association of Play Therapy.

In this episode, Dr. Davis answers our questions about the symptoms of adult ADHD, the reasons for missed childhood diagnoses, and how to navigate this condition, whether it’s within yourself or in your relationships with others. 

Please note that this episode, like all of our podcast content, is not intended to replace medical advice. If you suspect you may have ADHD, it’s advisable to seek professional assessment and treatment options from a healthcare provider.

About Our Guest:

Dr. Pam Davis teaches at the Charlotte campus where she also serves as the Director of Graduate Programs in Counseling. She is a Licensed Professional Counselor Supervisor (North Carolina) and a Registered Play Therapist Supervisor for the Association of Play Therapy.  She received her MA in Counseling Ministries from Wheaton College (2002) and her PhD in Counselor Education and Supervision from Regent University (2012).

Previously serving twenty-two years as a missionary in Thailand, Dr. Davis provides clinical consultation to missionary organizations and offers online supervision to counselors working in remote, overseas locations where counseling resources are not available. She has a keen interest in cross-cultural populations and has a first-hand understanding of the unique contribution that counselors can make to families serving cross-culturally. Dr. Davis is passionate about research in the areas of missionary care, missionary resilience, and third culture kids.  She is a sought-after speaker both across the US and internationally on topics involving member care and counseling for children and families. When not working, she enjoys kayaking on Lake Wylie, hiking, and experiencing almost anything new.

Episode Transcript:

Dan: Sometimes the topic that we’re engaging is very important. And today it is. We’re going to be talking about ADHD, but other times, topics also include the privilege of talking with dear friends who I’ve not been able to be with in a long time. And so this just happens to be a very important topic, but also just a delightful friend. So Dr. Pam Davis, who’s the Director of Counseling at Gordon Conwell Seminary in Charlotte. So Pam, we have known one another for many decades…

Pam: 20 years this year.

Dan: Oh my gosh. That is so sweet. I think our first conversation, of course, was in Chiang Mai, where you were a missionary for let’s just say a few decades, 25? 25 years. And we won’t go into all the details of that, but there is a moment I want to bring back to your memory. And that is you and Becky were sitting on a couch and we were watching Monk, actually a lot of three or four episodes. And the two of you started laughing and I was watching Monk and not really paying attention to what you two were giggling about, but somehow eventually I began to have a sense that my wife kept pointing at me, and you were talking about certain symptoms that were showing up and a constellation that eventually came to be a conversation about Hyperfocus ADHD. And that was the first possible encounter I had with, could this diagnosis be another category that would fit me. Do you remember enough of that moment to…

Pam: I don’t really remember the incident, but it sounds just like me. I think I remember watching Monk together in a few different countries, actually, that we’ve been together.

Dan: Yeah. Actually, I dunno why we…

Pam: I don’t know either, but yes, I do recall multiple times when we’ve been able to speak into each other’s lives in therapeutic ways. And so I don’t remember this, but it feels honoring to hear you name it as the first time you had considered that maybe ADHD fit for you.

Dan: Well, let’s just say between the two of you, it was both very playful, but also really serious. And that you were… Becky was being able to name with a deeply gifted professional, but deep friend, things about me that I was of course, very dismissive, thought it was a ridiculous, but the more we talked, the more there was a connection with, there is something here to be framed. So what I want for folks to be able to engage is what is ADHD and how is it that it is showing up or has been there for a lot of adults? And how important is it to be able to know enough about it to be able to understand how people with this unique configuration of both relational, personal, but also neurological structure can be in many ways, both very gifting, but also sometimes very difficult to be engaged with. And Rachael, you were saying before we jumped on about some of your friendships.

Rachael: Yeah, it’s something, it’s kind of come into the atmosphere more explicitly with people I either follow online and I’m learning from, or close friends who have had recent diagnoses of ADHD in their forties and fifties and kind of revolutionizing one the way that they’ve understood themselves for so many years. And honestly, a lot of places of shame and confusion around these are really high-functioning, gifted public facing people, pastoral people, therapeutic people, and so in some ways probably had to power through. But I’ve just been aware that it’s being diagnosed more readily and it’s really helping people I love, and it’s something I’ve been paying more attention to, even in myself and just holding open curiosity, is this something I need to explore more? So it’s a really vulnerable thing to say, but I just think anytime something’s just becoming more clear and more clarified.

Dan: So jump us in, Pam, help us come to understand this.

Pam: Sure. Let’s start with just briefly, what is ADHD? And I’d love to speak too to this idea that it’s being diagnosed more. A ADHD, first of all is neurodevelopmental, so people don’t develop it in their forties or fifties, but it is so often diagnosed for the first time, even at age 25 or 30, 40 or 50. But you’re born with it, right? Neurodevelopmental means you’re born with it, which also means it’s not a choice, it’s not a behavioral choice. It also means it’s not due to parenting. Some of these things that sometimes we can carry a lot of shame about. I could do better about this than I’m doing. It’s not due to a lack of discipline. But when I think of ADHD, and I do think the symptoms shift from childhood to adulthood, but when I think of ADHD, I think of the broad categories of focus. And that can either be hyper focus or hypo focus, where I can’t focus on anything. I’m easily distracted. So this idea of focus, whether it’s under focus or over focus, impulsivity and hyperactivity. And so those three categories are the large markers of ADHD. But what we see shifts from childhood to adulthood is hyperactivity almost always reduces. So you don’t see the same hyperactivity in adults as you do in children, but impulsivity and emotional dysregulation, like the shifting moods, easily sensitive to criticism, those things stay stable across the lifespan.

Dan: Oh, I’m so curious, Rachael, what you’re beginning to think about as you hear though those phrases, because I know somebody on this podcast is being indicted, and I hope it’s someone other than me.

Rachael: I’m just grateful. It’s just the framing is really helpful. Again, because when something has been so stigmatized and it’s only been portrayed as one thing for me as a very detail-oriented person, a much more anxious person, hyper focused and able to accomplish things. But the impulsivity is one I’ve always been like, oh, I’m not impulsive. I’m not one to take risks, but my impulsivity for sure comes out in mood and sensitivity to criticism and sensitivity to stress. And so it’s been a really interesting season, and I’m scared to talk about this on the podcast because I’m like, I don’t want people to think I’m going into rages with my baby not. But the impulsivity that I have in this postpartum season, I have a 14-month-old, has caused me to reckon with ways I am wired differently than any other season of my life. So just lots of curiosity, but I’ve never heard it framed that way, that it can be the emotional dysregulation as part of the impulsivity, as opposed to taking risks or risky behavior or different things like that, which I know they’re linked, but I’m risk averse. I’m risk averse. So…

Pam: Yes. And I think that’s why sometimes the diagnosis is missed in childhood sometimes. So if we talk about diagnosis, usually we say this has to be diagnosed before age 12. In other words, people don’t develop it at age 30 or 40. I should probably reframe that to say it doesn’t have to be diagnosed before age 12, but the symptoms needed to be present before age 12. But a lot of times we miss it. We miss the symptomology. Like if the child is really highly intellectual, smart reads well, speaks well, we can miss it. And instead they will get diagnosed with things like OCD. They will get diagnosed with behavioral problems and things, and you can miss the ADHD in those children. But then later as they learn more about it, maybe they’re reading, maybe they’re listening to a podcast and they say, wow, these categories fit me.

Dan: Well. When you talk about impulsivity, I know that that would’ve been true between the ages of zero and maybe 40, 50 maybe tomorrow. But it’s an important phrase to say, people who are high risk takers often look impulsive or feel impulsive. But you’re talking about again, some means by which we’re metabolizing different brain processes. What would you put words to as to what’s happening in the brain of a child or adult with struggles with attention? Be it either too little meaning scattered or too much meaning hyper-focused? What’s happening with the interplay of all that?

Pam: Yeah, and so it’s a good question because ADHD is one of the most treatable neuropsychiatric disorders that we come across, but sometimes it’s missed. And what’s happening in the brain is two neurotransmitters, dopamine and norepinephrine that are missing or lower than the average person. And so that’s why sometimes the first line of medication is a stimulant medication, which immediately increases the dopamine or norepinephrine or some sort of combination of these. There’s also really good non-stimulant medications and sometimes the interaction between the two. But what they’ve discovered is that if you can raise the levels of dopamine and norepinephrine, then a lot of times, particularly the impulsivity and the focus dysregulation can really be helped as well as the mood, the moodability can really be different. But I do want to say this in saying that I want to say this because I think that it’s a misconception about all of this, which is I don’t think medication is enough. So there is sometimes you hear this perspective that I just said, which is this is really highly treatable. And then the second half of that phrase is, so just get on medication. But I want to be clear that I don’t think medication is enough. Medication’s an important component for a ADHD, probably more than some of the other disorders, but I don’t think it’s only medication. I think there’s other things that we also have to do, psychosocial things, therapy, strategies, like literally just learning strategies. Yeah.

Dan: Well, I remember on the couch as the conversation didn’t remain, shall we say, a singular 30 to 40 minute that didn’t have continuation. But even in that process, we were in your home for I think a week before we traveled together. And in that process, the next day or the day after, Becky was beginning to look at me in different ways and she was able to articulate so many of the things I just am irritated with so frustrated with how he’s, he can sit in a chair and not move for six to eight hours and read a book forever. And does he want to eat? Does he have to drink? Does he have to go to the bathroom? How is it possible he can do these kinds of things that feel so weird or irritating? And there was a beginning of a shift, and I think that’s one of the gifts of being able to, not label and diagnose, but to have a sense of what are the parameters that begin to be, we’ve used this phrase in the podcast many times, there’s something very broken about us, but there’s also something very beautiful about that. And I think that conversation that we began decades ago has evolved. I’ve never had a official diagnosis, I cannot say without question that that would be true of me, but it has helped me frame, it’s helped Becky frame, some of the behaviors as simple as why can’t you seem to put your keys back in the one drawer we have both agreed upon will be the place where they’re kept, and I’m much better certainly than I was 20 years ago. But there are still issues of disordered, more chaotic, but at times also very creative ways of thinking about the world. So as you hear that phrase broken and beautiful, where does that take you, Pam?

Pam: Right. Well, I think I want to connect that to what Rachael said too a minute ago about how she’s noticing impact on her relationships, because that phrase broken and beautiful feels a lot like our relationships too, broken and beautiful. And I think that as I consider ADHD and the ways that it can show up in our relationships, I think what you’ve articulated, Dan, is really common in people in relationships where there is a spouse who doesn’t understand or who doesn’t see it that way. And so sometimes you can hear, you’re not listening to me. I feel like I say things over and over, or I feel like you can get done what you want to get done, but you don’t get done what I need you to get done. And in these ways, this feels broken. But then there is a shift that occurs. There is a shift that occurs in relationships when two partners can come together and see their brokenness as something unique. And actually, there’s a good side to ADHD. There’s an upside, right? Maybe you can get a lot done in a short time with that hyper focus. So there are things, and as partners can come together, as friends can come together and recognize that, again, this isn’t a lack of discipline. This isn’t your behavioral choice. You were born this way. And while you might need to learn some strategies, Dan, you might need to learn, let me set a timer every hour so that I turn and speak to my wife. You might need to learn some strategies. And timers is a great one. Using calendars and calendar apps is a great one for people who are feeling disorganized and forgetful, and then that creates the beauty of redemption in that relationship.

Rachael: Could you speak Pam too? I find myself even questioning like, okay, we know all these ways that, so what I hear you saying is ADHD is something you’re born with. We also know that trauma and the impact of trauma can disorder and disrupt the brain and bring about really similar symptomology. So if someone’s trying to discern, is it trauma, is it ADHD, is it both? How would someone go about, and maybe part of the question is, what steps would someone take if they’re questioning, does this fit me? Obviously, you could go take a test online but may not be as helpful as talking to a care provider. So what does that look like and how do you begin to discern the differences between trauma ADHD, where they’re connected?

Pam: Right. I’m so glad you asked this question because I can never talk about ADHD without talking about trauma and talking about the ways that the symptoms overlap. In fact, they’re so overlapping that you’ll often even see them written as Venn diagrams, right? Here’s trauma symptoms, here’s ADHD symptoms, and oh, there’s this whole list in the middle of disorganization, hyperactivity, difficulty sleeping, restlessness, easily distracted that are also trauma symptoms. And I think I want to say this too, particularly in children. Now, y’all know I can’t do a podcast without talking about kids, right? In some way.

Rachael: That’s good. That’s good.

Pam: Even though we’re really focusing today on adult ADHD I want to bring this in that particularly in children, because we don’t have a good trauma diagnosis for children, we need that complex developmental trauma or what was originally touted as developmental trauma disorder, meaning a child has grown up in their developmental years in a traumatic situation that recurs, whether that’s poverty, whether that’s racism, whether that’s abuse, these are the types of what I would love to call, it’s not in the DSM, but I would love to call it developmental trauma disorder. And what we see, particularly for those kids, because we don’t have that kind of diagnosis, we see a litany of diagnoses, oh, this is an ADHD, oppositional defiant, OCD, anxiety, autistic. We see, and every time I sit with a family or consult with a school or meet with a supervisee and they say, yeah, this child has these seven diagnoses, I immediately say, yeah, I think we need to look at complex trauma because we don’t have the diagnosis for that. So we just throw all these other diagnoses, however I want to say this, what are the differences? Then how do we tease that out? And to me, there are a couple of ways that we can do that. One is thinking about symptom onset. So were they born with this? Do we notice these symptoms? Do you sit with the person and they say, oh, I remember you in third grade, I couldn’t really pay attention, and I always lost my homework, and I was always getting in trouble for… so symptom onset. Whereas now, again, sometimes with children, if they’re growing up in an environment of complex trauma, we could miss that too. But if someone says, no, a lot of this started for me in my twenties after this traumatic event. So that feels to me like a pretty important differentiation. The other one is whether or not which medication helps. So if you have a trauma diagnosis, and you take stimulant medication, and you don’t have ADHD, those symptoms don’t reduce at all. So these symptoms of distraction and disorganization and hyperactivity and restlessness that we get sometimes in a trauma diagnosis, the ADHD medications won’t touch those symptoms if you don’t need them. It’s one of the things I like to say to parents actually, when I’m working with them and they’re a little bit hesitant to put their child on medication, they think, oh, I don’t want my kid to be on medication the rest of their life. I don’t know if I want to start this. I say, here’s the thing, try it. And if it doesn’t work, and ADHD medicine works the first day you take it. So if it doesn’t work, then you know that we’re not looking at ADHD. So to me, those two things, symptom onset and the efficacy of the medication really help us know. One more thing though, that I would say is sometimes I don’t think diagnosis matters. It doesn’t matter. I like to say this a lot to my students, and supervisees diagnosis is only as important as informing treatment. So if we have a big question of is this trauma or is this ADHD, let’s treat, let’s start by treating those symptoms, getting the story, hearing some of those things, and going from there. And then if we think that working through trauma isn’t really helping some of those symptoms, then you might look at ADHD symptoms too.

Rachael: That’s really helpful. Thank you.

Dan: What do you know either the research or just anecdotally of the interaction effect, meaning let’s assume, and I’m speaking obviously of myself, that we have photos of my mother having  roped me to the garage door because at age two, and this is how I would put it, I had enough sense to escape. It was a crazy world to be in. And so at age two, I’m running away, and the only way she could figure out to keep me from escaping is just tie him to the garage door and it can’t escape. So there’s trauma. Trauma comes even more intensified eventually with the death of my father and a great deal of developmental, certainly in terms of traumatic experiences, much abuse later, et cetera. But I’m assuming from the data that I have collected that indeed ADHD was present, is there a kind of interaction effect where ADHD interacting with trauma in one increases the trauma but may increase as well as some of the symptomology of ADHD.

Pam: Right. I definitely think we can say that it increases the symptoms. So it’s not causation, right? It’s not that a ADHD causes trauma or trauma causes ADHD. I don’t think so, because again, a ADHD is neurodevelopmental. You’re born with it even if you don’t develop symptoms till a little later. But, can being exposed to childhood trauma trigger those symptoms? Absolutely. Right. Because they are overlapping symptoms. So a child who is exposed to trauma or some of these things, Dan, that you’re talking about, would they develop hyperfocus? Absolutely. Right now to say, well, was that part of their ADHD or part of their trauma? That’s where I want to go back to. I don’t think that matters. I don’t think it really matters what caused it.

Dan: Though. I agree totally with what you’re saying. The dilemma is that when you have some degree of dysregulation, irrespective of causation, our school systems, our churches, often our families are not well prepared to address, and therefore, oftentimes the symptom cluster creates enough complexity that the response of the world–parents, church, school–is to engage in a way that actually does create more trauma. Would that be something that you would concur with or differ?

Pam: Yes. I actually haven’t thought of it in those terms, but I think I would agree with this because again, so often we think of children, children with ADHD, as that this is behavior they choose, they can control it, all of these things. And what we’ve discovered in the last 20 years is that actually these things even occur in utero so that children can develop the neurodevelopmental deficiencies of the dopamine and the norepinephrine in utero because of the way the mother is experiencing her pregnancy. So mothers who really want a child who have a lot of social support, those individuals have less chance of having a child who’s born with ADHD, but we don’t see it till age five or six. So we don’t see the symptoms start till age five or six. But it was actually maybe came from this unwanted pregnancy that, and I feel alone in the world, and I was sad through most of my pregnancy, which created the neurodevelopmental deficiency. And yet, I want to say this because I don’t want people to feel guilty. And there’s a lot of shame in ADHD. There’s a lot of shame in ADHD. In fact, I think that’s why we end up with so many ADHD adults who are perfectionists, which doesn’t seem to make sense to us, right? We’re like, wait a minute, if people with ADHD are forgetful and lose the details, then how in the world. But it’s actually true that so many people who are diagnosed with ADHD are also perfectionists. Why? And Rachael, you hit on this a minute ago, it’s because of the shame. It’s because of the shame and shame causes us to say shame causes that individual to say, I’ve got to prove to these people I can do it right. I’m such a failure. I don’t want to be a failure. This time I know I’m going to do it right. This time I’m going to keep this job. I’m not going to bounce from job to job. I’m going to keep this job because I’m going to keep my relationships. I’m going to show up on time. And so they become a perfectionist, but then the cycle just continues and they fail again because they don’t have the social support. They aren’t implementing the strategies, and sometimes they don’t want to take medication.

Rachael: Understand, I understand that war. I have a lot of compassion for that war. Yeah.

Dan: And what do you see in terms of the role or the place of creativity and ADHD?

Pam: Oh, that’s a good one. Well, I’m a play therapist by trade, and so I love to incorporate play. And there is a lot of understanding now that the importance of play or creativity, art, making mandalas, these kinds of things can actually have a really calming effect on the nervous system, which is often overactivated in a person with ADHD. They don’t know why, but they feel anxious, right? The comorbidity of anxiety and oppression with someone with ADHD, and it makes sense because they’ve lived their lives. Many people with ADHD live very chaotic lives, always trying to catch up to the next thing, always trying to get out of their financial struggle to reduce the stress in their lives, but they can’t quite get there. So the role of creativity, the role of getting onto a kayak, the role of painting, watercolor, the role of spending time doing something that allows you to access part of automatically increases dopamine.

Dan: As you think about then your work, particularly with children, play therapy, sand tray, what would you say would be some of the characteristics that are somewhat unique for children and for adults with ADHD?

Pam: Can you clarify that? Do you mean in therapy approaches?

Dan: Yeah. Or how you experience people’s creativity who seem to have the dimension of ADHD.

Pam: Oh, I see. Yeah. Well, I’ll be honest with you that in counseling, I don’t experience clients, children or adults with ADHD vastly differently than other clients or other, and this is because so many of the symptoms overlap. So I’m not sure that I would be able to draw a firm, any kind of firm correlation between creativity and ADHD. But what we do know is that many times people with ADHD actually have high intelligence, high creativity, but they’re held back sometimes by these structures of, I forget things, I lose things. I’m not on time, and so on.

Dan: Well, let me test and see how both of you respond to this. I know a number of pastors who I think either by their own self proclamation or the data being sufficient have unique configurations of ADHD and some of their sermons or some of the most compelling I’ve heard, because they’re surprising. They’re not people who function in a kind of expected logical process. It’s sort of like a part of their brain is scrambled, but it’s not just chaotic. It’s intriguing. It opens up ways of thinking. I wouldn’t think easily when I approach a passage and hear it being taught, I have to admit most of the time when I hear the beginning read in the bulletin what’s going to be preached, I’m thinking about, well, what would I say? And then several of the pastors I’m thinking about that I get the privilege of being around how they bring, find strong, beautiful exegetical and hermeneutical skills, and yet how they organize and bring it to very surprising. So I find people with that, shall we say peculiarity, sometimes surprising and lovely and intriguing ways.

Rachael: Honestly, I’m just sitting over here. Do I have ADHD? So that’s the look on my face. I’m like pondering what you’re talking about, Dan. And I am thinking about my very right brain approach to most public speaking, which is funny because I often think of myself as a very left brain communicator, right? Because just the way we think about these,

Dan: If there’s this conversation, I know, but Rachael, what wrong?

Rachael: But it’s how we think about these things. It’s how we talk about public speaking and preaching and teaching and how we conceptualize the way people would bring these things. So it’s just, I’ve always thought of myself as like, yeah, I’m very linear. I’m very organized because I’m a little bit type A, I am a perfectionist. So when you said to me a couple weeks ago, Dan, that I was a right brained public speaker who needed to establish more left brained anchors for the left brain thinkers in the room, that was revolutionary for me. So I’m mostly just really taking in this conversation. And what I appreciate is I did not know before this conversation that ADHD was neurodevelopmental. And that is such a helpful category. It also brings me just feeling a lot of compassion. I think that’s where my brain is going. As I’m thinking back through many iterations of my childhood and looking with a new lens, more out of curiosity and exploration than anything substantial, but it just helps me have a lot of compassion for people who have been having to navigate a world that requires a certain way of being, who have had, when you just think about it as biochemical deficiencies that result in a different wiring and processing of the brain, it kind of makes me angry and it makes me feel a lot of compassion. And I mean probably starting with myself, although I have a lot of questions around is it trauma? Is it something else? I’ll have to go explore a little bit. But that’s where I’m like, Dan, because everyone can’t see my face. But I’m just aware that I’m kind of like, I didn’t know that. So this is really helpful. And I’m hoping that it’s helpful for others who either encountered something like ADHD when they were 20 years ago, when, yeah, I think we had a very different understanding of what it was and how to treat it. So I still have question for someone. If they were to say, okay, I want to explore this more, are they reaching out to a therapist? Is there a certain kind of therapist they need to reach out to? Are they seeing a medical doctor… D, all of the above. What’s the next steps?

Pam: Yes, all of that. Right. One of the things I think that I’ve been so encouraged in recently when talking about ADHD is that it does seem like there is a much more lifespan perspective about a ADHD than there used to be previously. I think this speaks to Rachael you mentioned earlier that you notice a lot more people in the forties and fifties are being diagnosed and curious about that. And I think it’s largely helpful because up until now, it seems like there has been a bifurcation that ADHD is a childhood disease or it’s an adult disease, but we haven’t had this bridge that this is something you live with all your life. So surround yourself, first of all with people who understand you having others, meeting with people, having an ADHD tribe, if you will, can be really helpful to say, yes, this is something we live with across our lifespan. That community and social support, finding a job that works for you can also be really helpful. And we do that. We find that people with ADHD can be very successful and stay in one job because they find a job that lets them shift a lot, move a lot, change a lot. That also is so important. And some of the things are really things like strategies. We talked about those already making lists using timers. I think all of these things contribute to this lifespan perspective rather than saying it’s something you’re going to outgrow, which I dunno if you guys have heard that, but there used to be this old wisdom that you would outgrow ADHD, and it’s actually a misnomer. What really happens is you learn to manage your symptoms, you learn strategies, you marry somebody who helps keep you organized, all of these kinds of things that it seems like you outgrow. And in fact, a lot of the studies will say that about one in seven or eight report that they outgrew their ADHD. But two points about that is that often it’s that they’ve learned to manage symptoms and you still have six or seven out of eight that have not report that they have not outgrown their ADHD. So I love your construct of compassion, Rachael, because I hope that that’s what’s more in this lifespan perspective of ADHD more in this understanding that you’re born with it. And if you’re not diagnosed till your fifties, I’m so glad you’re diagnosed now, but you’ve probably experienced a lot of harm and a lot of hurt that maybe you didn’t have to because people labeled you as lazy, not listening, disorganized. Why don’t you try harder? And I’m grateful to hear that there is more openness to understanding a new category.

Dan: Pam, before we end a person. Hearing goes, okay, there’s some of the symptom structures that seem to fit. I love the fact that you’ve, in one sense said the Venn diagram between traumatic histories and ADHD is so overlapping that at one level it doesn’t really matter as long as you’re tending to the symptoms, caring for the process in a way that bears kindness and compassion, and that you’re in a community that does not demean you, therefore create even more dysregulation. So with that said, what would be the next steps for a person who says, I’d like to do a little bit more. I’d like to do a little bit more to see what’s going on for me.

Pam: Yeah. Well, I would start with a therapist, start there, and to see if, to hear a little bit of, I’m not sure what this is, but I listened to this great podcast and this is what I came out with, right? So yeah, I think you could start there with just talking through the structures. I think many, many therapists will say, well, why don’t you see your psychiatrist or a doctor to see about which medication works for you? And again, understanding which medication works can really, really help you tease out what’s what. But I still say even with that, there are times when the symptoms overlap and you can’t tease out is this hyperfocused due to trauma or is it due to ADHD? So after seeing a therapist, seeing your doctor, I would also say find a community. And if there’s not one around you, build one because all it takes is a few conversation and you suddenly know four people and build, right? Like we’re talking about that even today. Build a community of can we get together and talk about this? And particularly, what strategies work for you? What do you need to do to help manage your symptoms?

Dan: Marry Becky Allender. And your point being the ability to be in tender, caring, but honest relationships. Again, I go back to the couch and the conversation that the two of you playfully, but very seriously had awakened an awareness, certainly reading and thinking. And I think even though it’s never a finished work, a growing sense of this is heartbreaking. And I can see all sorts of complications for my life. And probably the one that was most significant was going, I’ve always thought of myself as stupid. Just I did not do well in school. I graduated within an ACU that in the state of Ohio, it’s illegal to graduate with. Isn’t that enough of an indication? I’m not smart. I’m kind of street smart, but I’m not smart. And so the degrees post, we know that experiences in life do not eradicate the effects of trauma. You have to engage trauma. You have to engage the reality of ADHD to begin to go, where has this left me? What judgments, what accusations? We’ve addressed this at least a bit, what shame remains. But in that process of exposure, there are so many things that I would say immediately I would go, oh, there are five or six things we do, Becky and I do with Becky, that are part of the regulation to keep some of the symptomology from being more divisive. So your invitation is to kindness, not mere knowledge, but to kindness, but also to an intentionality of there is good that this has brought, and likely this is harm you have had to endure. Let’s do the work to engage it. And for that end, Pam, again, we would love to have you on several hundred more times, particularly I want at some point to do a conversation about sand tray. But for the moment,

Pam: Oh, I would love to do that.

Dan: Simply just say thank you so much for being with us.

Rachael: Yes, thank you.

Pam: Yeah, you’re welcome. Thank you for having me. This was fun.