The very name “Attention-Deficit / Hyperactivity Disorder” is so ill-guided, it’s no wonder the general public and even mental health professionals completely misunderstand the disorder. The disorder is not about attention or hyperactivity, and as Russell Barkley often says, “calling it Attention-deficit Hyperactivity Disorder would be like calling Autism Hand-slapping disorder.” The reality is that the basis of the disorder lies in a difficulty perceiving emotion in time, or a “temporal myopia.”

To help clarify, I have decided to illustrate how John and I often explain ADHD to a client:

What’s going on underneath?

Your problem is not actually with attention. What you have is a difficulty recognizing the importance (relevance) of things you perceive. If you look at a “normal” person (someone without this difficulty), their brain naturally connects feelings to the things they perceive around them and to the possibilities of choices about the future. They may feel fear at the prospect of not finishing their current task, or excitement over the future rewards if they do. In other words, they have a strong internal language of emotions that help guide them throughout the day.

The ADHD brain lacks this powerful language, leaving an emotional void often described with words like boredom, dullness, or monotony.

Most people develop this connection between thought and feeling early in life, allowing them to develop an automatic system of self-control to move from the external (like teachers and parents) to the internal (self-motivation).

The result?

As you sit trying to decide what to do next, the future is not emotionally present. It is out of focus, emotionally speaking. Without emotional meaning, it is difficult if not impossible to continue looking at it! Instead, you look to the present, where the emotions still exist.

This is why, despite being told you “can’t pay attention,” you’re really good at attending to video games for hours on end or watching TV or playing a sport. All of these activities have quick, immediate emotional rewards, for better or worse. As long as you stay in the present, you are able to feel.

And this is why you might have had people call you “hyperactive.” Not because you have too much energy, but because you’re desperately trying to find something, anything, that isn’t painfully empty of emotion — as if you were stuck in a lonely, emotional void.

Understanding this unique way of being in the world is only the first step, but it is an important one if we want to work together to help with the difficulties that can come with it. Next time we will talk about some of the ways we can work together to do just that.

A colleague of mine, Robin Mohilner, recently asked a support group she leads for people struggling with bipolar disorder their thoughts on having a therapist self-disclose and the prevalent myth in our field that “if people know your story and that you continue to struggle, you cannot truly be of service.”

One of the unfortunate consequences of being human is that people naturally veer toward dogma when faced with the alternative of having to think hard about a difficult topic. As counselors are taught the mantra of “serving our clients and not ourselves.” Self-disclosure is vilified, as it can easily lead to therapy being a place for the therapist to receive help instead of the client. We are taught to never self-disclose — to be a “blank slate” where in a room of two people, only the client exists.

Unfortunately, reality is not nearly so tidy. You are in the room with the client, and you are a person too. Your experiences inform your work far more than your schooling or theoretical orientation. Disclosing what you have experienced should not be written off as a cardinal sin, but rather examined as a powerful tool. In a sense, you are always self-disclosing. Even when you choose to not narrate the details of your experience, your experience defines who you are with your client. The question, then, is not whether to self-disclose, but rather how — ask yourself whether providing specific details would be helpful or harmful to the client.

Sometimes therapists will counter with something to the effect of “but if you can’t be sure, you’re better off just keeping it to yourself.” This is half true. If you are hesitant about a response, it is often (and I would argue usually) best to think and feel more on the topic before moving forward. But choosing your words is far different from embracing a dogma of silence. While sharing nothing might prevent you from making certain mistakes, it will also prevent you from ever doing your best work.

What are your thoughts? Do share below!