ADHD ADHD - ways of working in therapy?

barefoot

MyPTSD Pro
So, I’ve always thought I’m pretty rubbish at therapy. Just, not very good at doing it. My T has always said there’s no right or wrong way to do therapy. And I get that. But…

It’s probably not so much that I feel like I’m doing it totally ‘wrong’ as such. I think it’s more…I’ve always found it quite frustrating…because I’ve never found a way to really make the most of it. Or get the most out of it?

I’ve recently been diagnosed with combined type ADHD. And, now I better understand the way my brain works - and the things my brain feels difficult - I’m wondering if the ADHD has been part of my challenge with ‘doing therapy sessions.’

I don’t know if I’m unhelpfully hoing down a rabbit hole here. Or looking for excuses for why I’m rubbish at therapy! I’m just wondering if anyone else has discovered any things that help with therapy sessions with an ADHD/ND brain? (Or the opposite - anything that gets in the way)

Just trying to see if I might be able to bring in some new ways of working in my sessions/with my T that might be a revelation to me now!

(Not talking about having therapy for/about ADHD - just having therapy as a person with ADHD)
 
When I’m doing classic office type therapy? 120min sessions. At a minimum. With at least 1 or 2 ‘get up & move’ breaks (go splash water on my face, walk or jog around the building, drink somehing or smoke, sit in my car with the music up, whatever I happen to feel like in the moment for 5-15 minutes give or take)… let’s the last section settle/percolate/clarify… and the next section have a lot of purpose/drive to it. Takes all the thoughts/questions/etc. I’d otherwise be having on the way home, and completely forgotten (or superseded by events) by next week, and puts them squarely on the table.

EMDR sessions are almost universally booked at 120 minutes, so the trauma therapists I’ve worked with have always been down for the time slot, and very quickly come on board with the breaks. They get to grab a pee or a bite, too. And refreshing? Is good. Whether it’s required to make my brain work, or a bonus for someone whose noggin is less all over the place.
 
Taking short breaks in a session is a good thought. I don’t generally feel I need a break in the moment (I’m actually really ok just sitting still for ages, so don’t feel a desire to get up and move, for example).

But I do have a tendency to go off on tangents and end up wittering on about all sorts of stuff (and it’s rarely the things I intend to talk about) So, I guess, a quick break breaks the momentum if I’ve gone way off track and encourages a bit of reflection about what I’m talking about and if that’s what I want to be talking about and how I want to be using the time. Allows the opportunity for a bit of a reset if I’m on a roll talking talking talking…

Because, as you say, otherwise I get to the end of the session and then feel disappointed/frustrated that I ‘wasted time’ and didn’t bring up the stuff I wanted to bring up.

Thanks!
 
Taking short breaks in a session is a good thought. I don’t generally feel I need a break in the moment (I’m actually really ok just sitting still for ages, so don’t feel a desire to get up and move, for example).

But I do have a tendency to go off on tangents and end up wittering on about all sorts of stuff (and it’s rarely the things I intend to talk about) So, I guess, a quick break breaks the momentum if I’ve gone way off track and encourages a bit of reflection about what I’m talking about and if that’s what I want to be talking about and how I want to be using the time. Allows the opportunity for a bit of a reset if I’m on a roll talking talking talking…

Because, as you say, otherwise I get to the end of the session and then feel disappointed/frustrated that I ‘wasted time’ and didn’t bring up the stuff I wanted to bring up.

Thanks!
I also have combined-type ADHD and have done about 15 years on and off of talk therapy (CBT and similar).

Things I’ve found helpful:

- tell my therapist “I want to talk about x, can you help me stay on track” either prior to the session or at the start

- having a bottle of water, chewing gum or something to discretely smell to give me a bit of a sensory break/wake-up (they make these lovely rub on migraine stick things that often have peppermint and other things in them. I find they really help me snap back into my body and refocus. You can find them at most chemist/pharmacies I think).

- having fidgets with me, particularly ones I can wear (rings, bracelet, watch band, whatever)

- normalising that this is just what therapy looks like for me. Often we are external processors (we don’t always have a big internal monologue, we talk our thoughts aloud or just respond do them in the moment) so it can feel like we are wasting time when we follow a thought and it turns out to be a weird tangent.

But that’s also just our brain. And often if we try and limit it we end up having to follow the tangent anyway because it’s like an itch you have to scratch. So knowing that this is just how we are wired, I would suggest asking your therapist to help you come back to the main goal of the session but also just be kind to yourself. If you get off track you get off track. Exploring thoughts isn’t a waste, even if it might feel like it sometimes.

And often a huge part of therapy is all the dancing around important topics we do. Good/experienced therapists KNOW when we are avoiding talking about stuff or when we hint at important things even if we don’t - they are trained to piece that stuff together. So know that even if it feels like you are focusing on the wrong things sometimes you can have really great outcomes anyway.
 
i'm wondering --just wondering-- if you need to be more gentle with yourself and more trusting of the process. i'll second your t's notion that there is no right or wrong way to do therapy. i'll take it a step further to say therapy is not a race nor are there any pass/fail exams. you are right where you need to be. trust yourself.

i'm pretty clueless on the ADHD yaddahs, but my hyper-vigilance/flight instincts often kicked in during my own therapy sessions. some of my most effective therapists would finish the session walking with me to help me channel the agitation. it worked beautifully.
 
But I do have a tendency to go off on tangents and end up wittering on about all sorts of stuff (and it’s rarely the things I intend to talk about)
....and sometimes you are telling your T things in those moments you don't realize you are either.

I am somewhat the same and when we were not doing EMDR we were doing talk therapy and in my mental wandering? Wandered into stuff that was really helpful. Yeah, its weird in a way but you are really leading your T to things you need help with sometimes.......
 
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