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ADHD Treatment: Have We Been Taking the Wrong Approach?

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Much of what we read about adult ADHD talks about how we can overcome the standard challenges and hallmarks of the condition: disorganization, time-management problems, overcoming impulsivity, and so on.

I appreciate the latest clutter-removal tip as much as anyone, but I think we’re missing something critical.

I believe the current emphasis on practical, everyday coping strategies is at the detriment of something far more crucial to our ability to maximize our potential and lead happier, more fulfilling lives.

And isn’t that what we really want from treatment?

I don’t believe that a less-cluttered house will bring me nearly as much happiness as this one key element.

If the shoe doesn’t fit, don’t wear it!

I certainly don’t think that by you and me shoving ourselves into little uncomfortable boxes that don’t fit and might even be painful and claustrophobic, the world will somehow be a better place. Au contraire.

Many of us will be wrestling with and tweaking our ADHD strategies for the rest of our lives. Maybe that’s because the professionals poised to help us (psychiatrists, ADHD coaches, therapists, etc.) are focusing on the wrong things!

Without this one fundamental component, I think every other treatment modality is doomed to fall short in its effectiveness.

What is it?

To my mind, the foundation that will uphold any and all other approaches (including medication) used to treat ADHD – from stimulants to smart pens – is building our core sense of self-worth.

This isn’t as simple and straightforward as it might sound.

I’ve been thinking about this idea for a long time now, and written a few fledgling pieces about it, but it wasn’t until I got my recent Aha! moment that it all came together.

That moment was instigated by the latest issue of ADDitude Magazine (Summer, 2013).

I stumbled on an article called “Emotion Commotion” by William B. Dodson, a Colorado-based psychiatrist specializing in adult ADHD. (You can read the abbreviated online version here).

I can’t wait to get my hands on his upcoming book, What You Wish Your Doctor Knew About ADHD.

Dodson had me at his opening sentence:

“You cannot manage the impairments of ADHD until you understand how you process emotion.”

Every point he made after that crystallized what I’ve been increasingly becoming convinced of: until we address our underlying emotional hypersensitivity, we won’t achieve our best and highest potential as individuals living with ADHD.

Specifically, Dodson addresses a common sensitivity to rejection, criticism and our own perception that we’re deficient in some way. He describes me (albeit much less so these days) when he says that many ADHDers are constantly tense and unable to relax, that they’re continuously sensitive to the perception that others disapprove of them.

Does that sound familiar?

How can we maintain or maximize any ADHD treatment or improve our lives after diagnosis if we fundamentally don’t approve of ourselves or are worried about the approval of others? Isn’t this inherently undermining?

As an example, one of the common platitudes about the life of someone with ADHD is that we need more structure. During my recent webinar for ADDitude Magazine, I went out on a limb and said that I thought that structure might be overrated.

In context, I was referring to a creative lifestyle needing open-ended time to think, make unusual connections, and to be inspired by new experiences and spontaneity in order to have raw materials to create from.

Maybe I’m onto something

I was thrilled to see Dodson, a medical professional who treats adults with ADHD write:

“The first thing to do is for coaches, doctors, and professionals to stop trying to turn ADHD people into neurotypical people.”

Dodson suggests, and I concur, that ADHDers are

“…frustrated and demoralized by struggling in a neurotypical world, where the deck is stacked against him.”

No kidding.

But rather than suggest we try to fit in, conform, or as he puts it, live by a neurotypical owner’s manual – he says we must create our own, individual owner’s manuals, based on our current successes and strengths.

This sounds so much less painful and demoralizing than trying to be someone we’re not – and never will be.

For more on Dodson’s ideas, I’d encourage you to read his full piece in ADDitude Magazine.

What the future holds

I’ve always sensed a tension between those who are proponents of ADHD treatments that seem to have as their goal to try to fit us into structures (be they work, social, or educational) we don’t inherently fit into, and those quieter voices (including the one deep within me) that suggest that’s the wrong approach.

We’re in exciting and challenging times; with the arrival of Dodson’s book, perhaps we’ll learn more about how we can be ourselves in a world that doesn’t “get” us and thrive none the less. There have always been lone voices suggesting we ADHDers should live according to our own rules, but rarely has someone championed this idea in quite as forthright, compelling, and clear a way as Dodson.

I look forward to hearing more about his ideas. The impending debate should be interesting – and possibly even paradigm-shifting.


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ADHD Treatment: Have We Been Taking the Wrong Approach?

Zoë Kessler, BA, B.Ed.

Zoë Kessler is an award-winning author, journalist, and speaker specializing in women and Attention Deficit Hyperactivity Disorder (ADHD / ADD).

A frequent contributor to ADDitude Magazine, Kessler has also created video, standup comedy, and guest blogs on ADHD and Marriage covering ADHD-related topics.

Zoë, an internationally recognized ADHD expert, has been interviewed on radio and featured in magazine articles, documentaries, and books on the topic of women and ADHD across North America.

Her newly-released memoir ADHD According to Zoë - The Real Deal on relationships, Finding Your Focus & Finding Your Keys (New Harbinger Publications, 2013) about life with ADHD is now available.

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APA Reference
Kessler, Z. (2013). ADHD Treatment: Have We Been Taking the Wrong Approach?. Psych Central. Retrieved on October 23, 2018, from


Last updated: 26 Jun 2013
Last reviewed: By John M. Grohol, Psy.D. on 26 Jun 2013
Published on All rights reserved.