Ten Percent Happier with Dan Harris - Do You Have ADHD? | Dr. Mark Bertin
Episode Date: October 18, 2023The difference between ADHD and human distractibility, and strategies for managing ADHD that can improve your focus, even if you don’t have it.Today’s guest is Dr. Mark Bertin, a developm...ental pediatrician who specializes in ADHD and developmental disorders. He’s the author of How Children Thrive, Mindful Parenting for ADHD, Mindfulness and Self-Compassion for Teen ADHD, and The Family ADHD Solution, which integrates mindfulness into pediatric care. For more information, please visit his website at www.developmentaldoctor.com.In this episode we talk about:The difference between ADD and ADHD, and the subcategories: hyperactive and inattentive.Whether ADHD is a new condition brought on by the distractions of a modern world, or one that’s always been around. The difference between being human and distractible, and having ADHD.Strategies for managing ADHD that can be used even if you don’t have ADHD.Episodes Mentioned:Kryptonite for the Inner Critic | Kristin NeffSelf Compassion Isn’t Always Soft | Kristin NeffThe Scientific Case for Self Compassion | Chris GermerJoin Dan: LIVE!Dan will be in upstate New York at the Troutbeck hotel on Sunday, November 17 — it's a Q and A and live guided meditation, and it's gonna be a great time. You can buy tickets and get more details here: https://troutbeck.com/culture/troutbeck-x-dan-harris/ Full Shownotes: https://www.tenpercent.com/podcast-episode/mark-bertin Additional Resources:Download the Ten Percent Happier app today: https://10percenthappier.app.link/installSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
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It's the 10% happier podcast. I'm your host, your boy Dan Harris.
Hello everybody. Here is a thing you hear people say all the time, at least I hear it all the time and maybe you've actually said this thing.
Here's the thing.
I'm so ADD.
We throw this term around a lot, but what is it really?
What's the difference between ADD and ADHD?
How do you know if you have it or if somebody you love and maybe even your kid has it?
And what do you do about it?
We're going to answer all of these questions today and the good news is that on that last question, what do you do about it? We're going to answer all of these questions today. And the good news is that on that last question, what do you do about it? The answers are going to be useful
not only for people who have ADD or ADHD, but everybody. My guest is Dr. Mark Burton. He's a new
friend of mine. In fact, we live near each other. He's a developmental pediatrician and author of
several books, including How Children Thrive, Mindful Parenting for ADHD, and the
Family ADHD solution to be clear.
This interview is not focused just on children or parents.
It's for everybody.
We talk about the difference between ADD and ADHD and the subcategories, hyperactive and
inattentive.
Whether ADHD is a new condition brought on by modern life for something that's been
around forever,
the difference between being human and distractable
and having ADHD and strategies for managing ADHD
that can be used even if you don't have it.
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Dr. Mark Burton, welcome to the show.
It's great to be here, Dan.
Good to see you.
I quest.
Nice to be doing this in person.
Some very basic questions for you to start.
What is ADHD and what's the difference between that and ADD? Those are both great questions to start with.
The simplest thing to start with is just that we now use ADHD as a term for all of it.
So in the textbooks, even though I think sometimes the textbooks are just meant to confuse
people, we now just use ADHD for either the inattentive type or the hyperactive type of ADHD.
So really we're supposed to say ADHD with predominantly whatever
type of symptoms an individual has that may change again in the future. But the basics of it,
the reason for that change is that it's so variable, it changes over time, it changes situationally
that they've just decided that ADHD is like a blanket term for everything. So that's the
terminology. The most important thing about talking about ADHD probably is reframing it as a condition
that affects a really wide skill set called executive function.
So for anyone listening, who is living with ADHD,
wants to understand who has it or doesn't have it,
the way we understand ADHD now is that it is practically speaking
and childhood initially a developmental delay
of this self-management skill set called executive function, which includes attention and behavior, but also kind
of anything that requires management and coordination.
So executive function is about long-term thinking and goal setting and coordination planning.
So the simplest way to answer that question is ADHD is a medical disorder that just
runs executive function. That's extremely helpful. I'm going to ask a million questions based on it.
But let me just start here. You, I'm sure, and I, we hear people say to us all the time, and I'm sure
this is just a common thing people say in the culture. I'm a little bit ADD or ADHD. How do we know
whether we might, in fact, have ADHD and we're not just saying it in a
casual way? I think the most important part of understanding why a diagnosis of ADHD matters
is that impairment is part of the diagnosis. And that's really the shorthand, I think, for the
difference between like, I'm a little abstractable, I'm a little AD, all that kind of everyday stuff
is that there is a wide range of typical development. You know, I'm a lady, all that kind of everyday stuff is that there is
a wide range of typical development.
Everyone has their strengths, everyone has their stuff, they got to work on.
To have an actual diagnosis, it has to be chronically impacting life in some way.
And that could be academic for kids, it could be work-related adults, it could be stress-related,
it could be relationship-related.
The difference between the casual stuff people joke about or maybe even real, it's like
impacting life and an actual diagnosis is that you have to show that it's impacting life
in a significant way.
Okay, well, that seems to be the difference because I think a lot of people who complain about
being, and I think usually people use the term ADD instead of ADHD, but people who are
complaining about being ADD,
I'm a little bit ADD.
It is impacting their life.
Otherwise, they wouldn't be saying it.
They're finding themselves scattered.
Their attention diffused throughout the day.
They're scrolling through TikTok instead
of doing the work they need to do.
And so that is an impact and it's not insignificant,
but I think what you're saying is that
in order to qualify for a diagnosis
of ADHD, the impact has to be reasonably profound.
Absolutely.
I mean, obviously, people have been distracted forever.
I'm sure in different ways.
And in the way we're living nowadays, it's getting more and more significant.
And yet, yeah, diagnosis means you have a chronic pattern that's persistent over time and
significantly impacting life. So certainly, there's degrees of it. Yeah, diagnosis means you have a chronic pattern that's persistent over time and significantly
impacting life.
So certainly there's degrees of it, but yeah, the bottom line is you don't have it if it's
not really causing a problem.
Given that so many people feel like we're quote a little bit ADD, it puts me in mind of
recent history of we're now surrounded by these devices that rob us of our attention.
And it makes me wonder whether ADHD, as it's properly known in the clinical community,
is it a new condition because society has changed so much, or is it a long-running condition
that we evolved for and it's just become more popularized in the culture because all of us are having our attention challenge.
There's so many questions you're opening up there.
All of which are important.
On a medical level, ADHD has been described
in different ways for a century or more.
One of the things I love quoting
is a Mark Twain translation of German folktales,
one of which was Johnny Head in the Air,
and one of which was Fijidi Phil.
And when you read those two little poems,
it's like they're diagnostic checklists
for the intent of type of ADHD and the hyperactive type
of ADHD, and that's from the 1860s idea.
So medically it's been described for really long time
using different names.
And I think one of the most important things for people
to just understand about why it's real,
you know, it's clinical medicine.
It can certainly be misdiagnosed.
The risks of the disruptive,
the more external type of ADHD being misdiagnosed
is higher, but the risk of the inattentive type
being miscompletely is also true.
So misdiagnosis cuts both ways.
It can be overdiagnosed. It can be overdiagnosed.
It can be underdiagnosed.
Two facts really help summarize the reality of ADHD.
First of all, the genetics of ADHD are usually quoted as being somewhere around the same
genetic heritability as height.
So there's a lot more research to back that up, but I think that one fact sort of hits
home how this is a real medical condition.
And then in spite how people tend to look at it as being new to our society or demographic
or all these different things, in control studies, it tends to be very consistent in its
rate.
It's around one in 15, almost anywhere they've looked.
One in 15 people have it.
Absolutely.
And that goes across different parts of this country, different parts of the world.
I mean, that number goes from maybe four to eight percent.
The number varies a little bit, but that's basically the typical binding and it's consistent.
So would it be fair to say 15 out of 15 of us struggle with distraction on occasion,
but only one out of 15 of us actually has ADHD.
Yeah, that's about right.
And I think it's actually, it's an interesting thing that comes up sometimes talking to people
with ADHD too, is just recognizing that distractibility, you know, happens for everybody.
It's normal with or without ADHD.
It's just, there's a whole lot more of it if you have ADHD.
If I'm listening to this and I've wondered my whole life, huh, this ADHD described me.
How do I know?
I mean, one of the things I think this has to do with the internet era of just too much
information being on there, and some of it is going to find someone who's an expert to
help talk you through it because you don't necessarily want to be figuring it out on your
own.
If you go to a clinician, what they're going to be trying to confirm, although it's much harder in adults than kids,
is that it's a persistent pattern.
It shows up differently over time for different reasons.
Your brain matures into your 20s.
It's changing.
You're trying to prove a trait, basically.
So it's a persistent pattern that's been around most of life
when one way or another is one part of it.
And then you have to show that that persistent pattern exists to the point
You're causing yourself chronic issues of some kind
What those issues are can be pretty subtle especially in adults?
I mean a lot of people they did she are very successful, but it's undermining them in other ways
So the answer is go see an expert that is good medical advice in general
I think you know you don't want to be figuring it out from a checklist online, all the time. You do have a vested interest in making this good.
It's true. You don't have to come see me, but you should go see somebody who understands ADHD
to help talk it through with you.
Right. So for myself, I've struggled with attention issues since I was a little kid,
but even in talking to you, I'm realizing I don't need to go see an expert because
it doesn't even come close to meeting the level of
persistent and profound That you're describing and so I realize like everybody I have my distractibility
But I doesn't sound like I am qualified for a clinical diagnosis
I wouldn't want to sit here and make a diagnosis for you right now
But I would say the one thing to think about a little bit for you or for anyone else is that some of the subtleties are not, some of the typical markers people think for ADHD.
It's not like you have to be failing out of school. So ADHD can affect your health in different
ways. That is one of the biggest bodies of research that's developed over the last decade or so
because executive function or the skills that relate to things like living healthy lifestyle,
sleeping consistently, you know, driving safely, all these different things.
There's health risks to it.
There's a lot of highly perfectionistic motivated people with ADHD maybe by the external
markers doing great, but just chewing themselves up inside, trying to do it.
Everything's taking five, ten times the effort chronically to get from beginning to end,
because a lot of people think that as you get older, one of the core issues of ADHD is actually something called time blindness, which is
just managing time, keeping track of time, breaking projects up into parts. That is just happening
day to day chronically undermining things. And that can be the chronic issue with ADHD. By the obvious
markers, you're okay, but on a lot of the internal stuff,
you're really struggling. Okay, let me ask some nuts and bolts questions about the condition.
You have repeatedly referenced ADHD as the inattentive kind and the hyperactive kind. So can you
say more about those differences? In the textbooks, there's two types of ADHD described. The true reality is this for most individuals,
there's a lot of overlap, a lot of mix and match.
It's not so clean.
When you're making the diagnosis,
there's one group of symptoms you're looking at
for hyperactivity and impulsivity,
which are a lot of things like fidgeting kids in particular,
just constantly on the go,
and moving all the time, impulsive behavior,
impatient behavior, you know, interacting a lot. Those moving all the time, impulsive behavior, impatient behavior,
interacting a lot.
Those are all the external features of ADHD
that lead to a hyperactive impulsive diagnosis.
And then the subtler ones, the stuff that sometimes gets missed,
that doesn't get picked up until people are much older
are the inattentive symptoms,
which have to do not just with distractability,
distractability and daydreaming are kind of the stereotypes,
but it's a lot of the internal stuff like organization planning, time management.
And the truth is most people have that.
It's rare to have the hyperactive impulsive type without some of that.
And then it also tends to change as you get older.
So the more disruptive behavioral symptoms tend to tone down as you get older, regardless
of what they had as a child.
I appreciate the delineation there.
And you've described this just to take us a step deeper.
You've described this as a condition
that affects executive function.
So we think of it, you know, for those of us
who don't know shit, like me,
we think of it as just attentional,
but actually it has to do with executive function
which can impact many aspects of life.
And in researching you, I was looking at something you wrote, which you sort of make a little
taxonomy of the aspects of executive function, and they include attention management, action
management, task management, information management, emotional management, and effort management.
Can we walk through those and have you sort of clarify what each is?
Absolutely.
And I just want to start by saying that that is based on Thomas Brown's model just to give
him credit.
Shout out to Thomas Brown.
Exactly.
Yeah, he's great.
He's out in LA doing all this.
The shorthand for that and then I'll get into the details I think is almost anything you
can put the word management to probably has executive function to it.
You have to manage attention in life.
You have to manage project, accept to manage. You have to manage attention in life, you have to manage projects, you have to manage
emotions, you have to manage relationships.
I think that's like a easy shorthand for understanding anything that requires supervision
and planning, like a CEO of a business or like the conductor of an orchestra.
You have all the skills in the brain, you have all these things you know, and this is
the part of brain that's coordinating and supervising it all.
And one of the things I often start with when I'm working with families is if you really
think you're living with ADHD, you don't want executive function to sound like a wonky,
scientific thing that you heard of once. I mean, this is living with ADHD.
So to really understand the diagnosis and interventions for ADHD or how to help kids with ADHD,
you really want to understand executive function. So to go through them, attention management is important to understand because it doesn't
mean you specifically have a short attention span.
It means you're mismanaging your attention, which for people with ADHD usually leads to
pattern where you can almost hyper focus on things that really grab your attention and
are easy to you individually.
And that often can lead to like a delayed diagnosis, like if you can focus on that for so long,
why can't you focus on everything else?
But what it really comes down to is for you,
that isn't demanding.
So attention mismanagement is one of extremes.
It's that you hyper-focus on the couple of things
that are most in your wheelhouse.
You can't focus when the demands go up.
You often struggle to shift attention as well.
That's a good example of how executive function can be practical. So if you're parenting a child who has attention issues
and they're watching TV or really engrossed with their legos and you yell across the house
dinner in five minutes, they may come across as being difficult because if you can't shift
attention, you don't even register that question. They might hear noise, but they're not actually
registering the words. So that's the attention piece of it.
Action management is kind of the cliche of ADHD.
It's real, but it's what people think about ADHD.
So managing your actions is like controlling your impulses, controlling your physical activity
level.
That's what most people understand.
The rest of it, which is actually a developmental path.
I mean, you learn to manage life in more sophisticated ways as you get older, things like task management, which is organizing, planning, coordinating time.
And that is like the heart of getting through school, running a business, running a household
that's all task management, information management. For a lot of people in the modern world, the
way to understand that is it's almost like the RAM of a computer, which is like the active part of the computer for those who don't know computers all that
well.
So in a computer, you have a hard drive, which is like all the stuff that's like fixed
and learned.
And then you have an active part, which is like the short term memory as you're listening
to me, your information management, your working memory is holding on to all the facts that
you're going to try to coordinate to come up with your next question.
Or in a classroom, it's how you're listening to a teacher, and you're trying to figure out what's the important part to learn and write down.
So that's the information management part.
The fifth one is emotion, which is a huge part of ADHD,
at least half of people, kids with ADHD struggle with a lot of emotional reactivity.
Emotions happen all the time, and with ADHD, with an executive function that's been impacted in this way,
it's immediate, it's out there right away, quick tantrums, quick crying, quick frustration,
you can't filter in that way. We all need to be able to recognize our emotions without that
immediate meltdown, which is by the way one of the biggest overlaps between the value of
mindfulness in ADHD care because mindfulness is, well, it's a whole other tangent,
but mindfulness helps with the management of emotions, and that's something that
medication-free ADHD doesn't really necessarily help with all that much at all.
An effort management is the last part of it, which is really nuanced, because I think
culturally or just in general, it's sort of intuitive
that if you want to work really hard,
you just put the effort in, you know,
that's a message we all get.
Effort management that goes along with executive function
is kind of like the neurologic endurance
that goes along with that.
You can have all the desire in the world,
but your brain has to be able to just stick it out
when things get hard from beginning to end.
And when you're struggling with executive function,
that isn't necessarily possible.
So it's not a desire issue.
It's that your brain just starts getting distracted
and going off task,
even though you're trying to put this sustained effort in.
So that's the quick overview of the six parts
of executive function,
which, I mean, if you want,
we can spend a minute on it to develop.
Not only the short of it is to say that if you or somebody, like your child or your teacher
working with a child with ADHD, some people estimate it can be like a three or four year
gap in executive function, which means you can be 10 going on 13 or 14 in some parts of
life, but 10 going on six when it comes to managing your homework.
Right.
Now, as you discuss these six aspects of executive function, you brought up children a lot,
and I think that's natural given that that's what you do today, but I assume these all
apply to adults.
Oh, thank you for asking.
It's 100% the same model for adults.
Oh, yes.
The only difference with kids is that it's a developmental skill set.
So it's a little more complex in kids in that when you think of something like time management
skills, you don't expect a very young child to have any, so they're not going to be behind
in those yet.
Right.
You know, with adults, it's more a fixed set of skills, but the same model applies directly.
So, no, as I listen to somebody, I'm reasonably confident, I don't have ADHD, but as I try
to channel some of the 14 out of 15 folks who don't have ADHD and nonetheless feel like
they have challenges in all of these areas,
I can project myself onto all six of these areas
of the executive function and say,
yeah, I screw that one up on the regular two.
So how do we compute that if we're in what we might call
the worried well, but likely not clinically diagnosable.
I think there's a couple of things to think about.
Actually, I just want to clarify one thing,
by the way, that one in 15 numbers in childhood.
It's a little less than adults, I think,
most people would quote.
Again, for individuals, it really comes down to being two things,
I think.
I think there is, unfortunately, a lot of judgment
that is, I think, unnecessary related to the concept of ADHD and people.
So people are often avoiding it or they don't want to go down that path and consider it.
So part of it is just that idea of non-judgmental awareness a little bit of just looking at am I struggling in some area of life.
And then if you are struggling in some area of life, if something just seems like I am constantly being undermined by this.
If it has to do with executive function,
then it's probably worth digging out more.
So I think it always comes down to that,
you know, life is challenging and we're all gonna get
distracted sometimes and we're all gonna get swept away
and make a mess of our schedule sometimes,
but it shouldn't be happening all the time.
Got it.
Okay, just to repeat that back to you,
it is completely natural to suffer from dysregulation in any of
these six areas of executive function.
I might start tasks and get distracted from them.
I might forget information that I've been given.
I might lose my shit sometimes, so that would be emotional mismanagement,
but that doesn't mean I have ADHD,
that just means I'm a human.
Oh, totally.
And I think in fairness to people who have ADHD,
I mean, that's what's often misjudged of them in essence.
Because everybody does this sometimes,
somebody says they have ADHD, it's easy to just miss it.
But the difference is when you have ADHD,
it's just always there. It's a real intense
struggle that people have been living with for a long time. One of the best one-line descriptions
of ADHD, which has a lot of implications, is that it's not a disorder of not knowing what to do.
It's a disorder of not doing what you know. And that has huge implications for people growing up
or adults of like, you know, you go into a situation and you have a really good idea of what your intentions are and what you should do and how it should play out.
And then because your brain managers not doing its job well, things go off the rails anyway, which again happens once in a while for everybody, but you shouldn't grow up that way, you know, shouldn't be just like, this is life. Right. Just to stay on this point, because I'm trying to help the listener
think about where they are here.
I am writing a book.
There are some days when it's like, oh, TikTok.
Let's look at TikTok, you know?
But most of the time I write the fucking book, you know,
it's like I do the thing.
I don't enjoy it, but I do the thing.
I stick to the task.
Yes, and so do I like anybody else get drawn into emails or somebody calls me
and I much rather talk to this person and figure out some problem and paragraph on page 112? Absolutely.
But there's a pretty clear delineation between a chronic, intractable problem and a normal human
tendency. I think there is. There's one thing you've alluded to a couple of times
that's worth touching on too,
which is when it comes to technology,
we're all undermined by that.
It's an attention-driven economy.
It's probably under-discussed how much they're working
to make sure it grabs your attention
and it's disruptive in a way.
And one of the things that happens
is if you have challenges with those skills to begin with,
it actually undermines you even more.
High schoolers nowadays, when they're doing homework, quite often they're doing homework
and they're doing all the things you're talking about, too.
They're on TikTok a little bit and they're FaceTiming with a friend and they're jumping
around.
That is totally inefficient and not a great way to get work done.
But if you have average or strong executive function,
you still get it done, right?
The distraction happens, it's imperfect.
You'd be even better off if you didn't do it,
but because you have strong executive function,
you still get to the end point anyway.
And what's often happening is within that friend group,
somebody with ADHD is just trying to keep up with their friends.
But every distraction takes five times as long,
and every time they lose touch with what they're doing, they don't even remember what they're supposed to come back to.
So it's undermining those kids even more than it would, you know, everybody else who's
having these challenges.
Coming up, Dr. Mark Burton talks about strategies for people with ADHD that all of us, even
people who don't have it, can use to support executive function.
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Before we get into what can be done about it,
because I want to go deep there,
what causes ADHD?
The largest thing that causes ADHD
is it's a genetically programmed disorder.
Whether there are other things that influence that,
maybe true, one of the reasons, for example,
we know that ADHD
is a medical disorder.
Are things like being born prematurely
can put you at risk for ADHD,
which clearly has nothing to do with environment.
So the bottom line is that all sorts of societal things,
all sorts of lifestyle things can make living
with ADHD harder, but the cause of ADHD
is medical, it's genetic.
And again, you said this a little earlier,
it's not a new phenomenon, the result of smartphones.
There was an article in the New Yorker,
I think it was about months and the 1400s
who were having trouble paying attention
in their rare in meditation.
I mean, look, the Buddha talked a lot about,
you know, staying focused in meditation
and developing concentration.
We have wild and racing minds,
we evolved for this because we needed to have
highly attuned skills of threat detection
and a hostile and dangerous environment on the savanna.
So this distractibility is in all of us,
it can just be way worse in some.
Yeah, I think that's a reasonable way of looking at it.
I wish I've never been able to find it again, but someone I was listening to when a talk once quoted something from like 500 years
ago in some text, and it was describing someone who was struggling in life because they couldn't
focus and they couldn't, you know, they're always late and they totally forgetful. And this was,
I forget the exact year, but it was like from the 1500s. I mean, it's just part of human nature,
and like a lot of things, there's a wide
range of typical and then it can cross over to that inch where you're struggling. Is there anything
here on gender variation? ADHD is typically diagnosed more in males, but at the same time, some of what's
going on there is females are more inclined to having the inattentive type, which can be missed
more easily. So yeah, ADHD, like a lot of things inattentive type, which can be missed more easily.
So yeah, ADHD, like a lot of things in my field,
does definitely come up a little bit more in genetic males.
But in ADHD in particular, some of that may have to do with
underdiagnosis.
Okay, so let's talk about what can be done about ADHD.
Sure.
The things you're going to recommend that can be done
for people who genuinely have ADHD.
I have this suspicion, but you'll correct me if I'm wrong, that many of them actually
might help the rest of us do our life better in terms of attention or any other executive
function.
I think that's 100% true.
I think it's an important idea in all of life.
Executive function is like the skill set all of us used to persist and plan and stay on top of things. And there's things we can do to support it. There's
things we can any of us can do to undermine it. I usually break up my thinking of how to
support someone with ADHD into four areas, because I just think it helps organize my thoughts,
one of which is going to be different when you're talking about kids and adults. So the overall
plan for helping someone catch up with ADHD, I sometimes think of is,
I'm trying to do kids and adults, but with kids in particular, the concept is a short-term safety net,
meaning if someone's behind an executive function, as adults, we want to create a support system so
that they can still thrive, you know, while in the long run. So it's short-term safety net, long-term plan.
In the long run, we're going to teach them those skills. You don't want someone
learning to self-identify with all these struggles or just getting swamped.
There was one study that said something long lines of bi-kindergarten kids, or they'd
age to be corrected more than they're being praised at like a three to one ratio,
which has a huge impact on them. So in the short-term, we're trying to set up support. So the first area of supports we typically talk about
are educational supports.
This is the one part that's hardest when you try to
like generalize it to adults.
It's not so straightforward in the workplace.
But in kids, there's a law that says,
you know, any medical condition
you're entitled to supports that let you learn.
So with ADHD, part of the intervention
is just setting up a support system in school
that lets you learn. Some of them are things that any of you living with ADHD might have heard of,
like preferential seating, extended time, anything we can relate to executive function, we can
try to create a support. People sometimes worry those are going to come across as like a crutch,
but the truth is, is kids so want to be independent, almost all of them, even if
they don't look like it, that as long as we're looking for an opportunity to get back out of the way,
they'll thrive, they'll become independent. So you help them initially with all of their
planning on their projects, because they have no idea how to plan on a project, then eventually
they pick it up on their own. That leads more until I think what you probably want to be talking about,
which is sort of outside of the school setting or in general for in general for anybody, how do you work on executive function skills?
And there's several different things to think about.
The larger level of like, what are your resources out there,
and then there's like the detailed level of,
how do you do it?
So if you're looking for resources,
there's kind of two fields that are known right now
for helping with executive function related issues.
The most evidence-based non-medical approach
ADHD is working with a cognitive psychologist,
which is kind of like if you have a speech language
to lay your work with a speech language therapist,
if you're struggling with the executive function,
you can go work with someone just like roll up your sleeves
and try to learn how these skills develop.
And it's hard to summarize quickly
because it's kind of different for each of those six aspects
of executive function I talked through.
So it's not like, oh, just do this. You know, for attention,
you can work with things like how do you manage your attention? How do you set up a work
environment without getting as distracted? And there are things that can help, you know,
even some of the programs that are out there that allow you to like monitor yourself on the computer
where you shut off the distractions. And certainly, the attention piece is one of the places that mindfulness can be supportive
in ADHD care.
It's important to say that as of this point in time, there isn't research saying that mindfulness
can replace any other part of ADHD care.
But as you know, as well as anybody, it certainly can help with attention and executive function.
The task management part of ADHD, that almost overlaps a lot with really
the science of habit formation. So when you're struggling with task management skills,
that's best looked at as like a skill set. There isn't like a miracle to getting on top of it
as much as a lot of hard work. So the concept in ADHD care is often called externalizing the system,
and it really just means recognizing that something like procrastination
when you have ADHD is a really complicated, hard thing to overcome.
If it was just as easy as like start sooner, you wouldn't have ADHD in the first place.
It's one of those like judgmental things people with ADHD come up against quite often of
like, you know, just stop procrastinating.
Don't.
It's like that implied message, like if you cared enough, you wouldn't leave it to the last minute,
underestimates the fact that losing track of time,
managing time, avoiding effort,
these are all symptoms of ADHD.
So for the task management part of ADHD,
it comes down to like a lot of challenges in life awareness.
So you have to start from recognizing,
like this is executive function.
I'm not a procrastinator. It's that I have ADHD and I can't help
myself but to procrastinate and really try to tease out, you know, where am I
struggling? And that's what do I have to do differently? So for that part of it,
it's a lot of direct skill building. And a cognitive psychologist can help
with that. There's also a rapidly growing field called an ADHD coach that can
help with emotion.
That's another aspect of executive function
where clearly interventions have to be different.
Learning to manage your emotions differently.
I would say touches on several different aspects
of things you can try therapy can help.
Obviously, one of the most profoundly life changing parts
of practicing mindfulness regularly
is really can shift how you're managing your emotions.
There's at least one study showing that specifically affected within ADHD care.
It is one of the places that medications can be helpful to.
So in terms of how are we going to work with executive function?
I think you have to look at the larger picture of how my structure in my life and can I work
within that level and then also the interventions that are possible.
Even as I'm saying, it sounds simpler than it is.
If you have an actual condition like ADHD, the ideas are easy, but the implementation
is hard.
It takes a lot of work.
One thing that's very important to say about ADHD is executive function skills are your
planning skills.
So very uniquely, ADHD gets in the way of ADHD.
I was just going to say, I mean, in order to attack ADHD, you got to figure out
which of these six areas of executive function am I struggling with?
And then I need to go talk to experts in each of this areas.
In other words, what needs to happen in order to address ADHD is to have a good
executive function.
And you already don't have a good executive.
100%.
I mean, it's so hard.
I talk about that all the time.
It's really, yeah, ADHD is a planning disorder.
So if you have ADHD, you're undermining the plans to mentor an ADHD almost inherently.
So you can overcome it, but it really gets much harder because of that.
You know, there's a whole national issue with like resources and being able to afford this
and being able to get in the door for it.
But it's certainly, if you can collaborate with someone,
it makes it a whole lot easier.
Collaborate with somebody.
Like having a therapist or a coach
or somebody who directly can support you
because almost by nature, when you have ADHD,
you're struggling with planning, like you said.
Right, well, if you're a kid,
you've got your parents, hopefully.
Hopefully.
Well, it's a little subtler than that. I mean, the two things are the fact that most
or many families of kids with ADHD have at least one parent with ADHD is certainly routine
and you just need knowledge, of course. And that makes it really, again, same thing you're saying,
if your parents start with an executive function that makes it harder to do a lot of these things,
but much easier if you acknowledge it and it's sort of part of the discussion, most clinicians working with ADHD
are aware of that. But the subtler thing, I think, with parents is letting go of just like
all the preconceived notions many of us have of things because executive function often looks like
it has to do with motivation and effort and caring and realizing like, oh, this is ADHD.
Within the last year or so, I had a family I saw who
came back after we had done nothing but talk. Like, I had met them a few times and we decided on
the diagnosis and they came back and one of the parents said, you know, things were already better
at home. And I could tell they were joking around and I said, well, we haven't done anything yet. Like,
why is anything better at home? And she said, well, you know, I sort of recognize now that when
he's yelling and screaming and stuff, he doesn't mean it. It's just this executive function.
So, you know, it doesn't mean that's any better at home, but I don't blame him for it.
Yeah. That's huge. And that's huge. That changes everything. So I sometimes ask people,
when kids have ADHD, there's almost like a mental exercise you can do of looking at a problem
and imagining like, what if this was all executive function? You know, life's more complicated than that.
I'm not saying that's true, but you can sort of try reframing things through that lens,
but it takes all the blame out of it, all the judgements.
Yeah, I often talk about how, if you can understand this Buddhist notion of causes and conditions,
which is, I mean, the Buddhists put it out into the world, but it's pretty much a non-negotiable
reality. Everything's changing all the time and has been since into the world, but it's pretty much a non-negotiable reality.
Everything's changing all the time and has been since the Big Bang, and everything that's
happening right now is the result of an incalculable gumbo of causes and conditions.
And as long as you can understand that, it's a huge gateway to compassion.
And so you can look at anybody's behavior and say, I don't like that behavior, But I understand that there's a whole set of causes and conditions that is creating it right now
100% and that goes across ADHD in so many different ways it goes back to that what I said earlier about how by kindergarten kids
With ADHD have often just been corrected way more than they've been praised, you know
What sort of self-image what sort of mindset what what sort of behavior it is that, you know,
potentially lead to.
The same thing goes for emotional reactivity,
you know, if somebody yells and screams
and somebody yells and screams it back,
what happens?
It's very rare in life that when yelling and screaming
starts that leads to a lot of calm and household
and it's hard, every parent screams once in a while.
But you can, like, your suggested things,
start looking at the cause and effect of it
and realize like, okay, if on my end, I can work on a great thing. I think that's a great thing. I think that's a great thing. I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing.
I think that's a great thing. I think that's a great thing. I think that's a great thing. I think that's a nap and he went in and woke her up anyway.
And I had a few stern words with him about it.
And later he said to his mother, what daddy yelled at me for doing that.
And I said, I did not yell at you for doing that.
And he said, well, mommy, didn't you hear him yelling?
She said, no, I didn't hear him at all.
He's like, I guess he didn't yell.
Because I know, I mean, I'm not, I'm not Mr. Perfect emotional regulation.
I've got lots of things to get me dysregulated, but I'm pretty well aware that yelling at
my son unless he's about to walk into traffic is unlikely to make things better.
That's exactly and well said.
I mean, no one responds to yelling by becoming calmer.
Yes.
You know, and doesn't mean we'll never yell.
But I mean, one way to look at it,
is even when we do yell, it's important to recognize
that if my child yells back, that's kind of to be expected.
Yes.
That doesn't mean that they should,
or it doesn't mean they might not get in trouble.
But you've got to recognize that like the cause
of an effect of putting them in that spot.
You said a while ago, I said, well, can we do about ADHD?
And you said, well, there are four things.
And then we started talking about the different types
of therapy available for the different types
of executive function challenges.
If I don't have ADHD or I'm pretty sure I don't,
and I do hear myself in these challenges of like,
yeah, well, task management sometimes
and that's a good ad-emotion regulation,
I would imagine going to see any number
of these same therapists would also be good for me.
Yes, I think all of the non-medical side of ADHD really could support anybody. As it turns out,
strong executive functions can help any of us stay resilient and stay on top of things. So
there are ways we can work on our own in different ways, whether that's just working on time
management and the more refined
that life gets easier, it can be working on our emotions because that's beneficial.
That's true for anybody.
If parents follow these kind of structured lead with positive feedback and be sure you're
clear about your limits type approaches to parenting, that helps all kids for lots of
different reasons, helps relationships.
I think it's definitely true that anything any of us can do to keep our executive
function strong and learn to just be more effective and less stressed by managing day-to-day
life will help any of us stay resilient.
I think executive function to me is actually part of what goes into being resilient,
which is kind of what we're all looking for in life to some degree.
The ability to just manage day-to-day life.
And if you look at what goes into resilience as a whole,
some of it has to do with relationship,
you know, having steady, healthy relationships in life.
Some of it has to do with what's sometimes talked about as mindset,
which is like really valuing our effort in a situation.
And I think like you said a few minutes ago,
the third part of resilience to me is executive function,
because there's just the nitty-grittyitty of like when stuff happens, we have to problem
solve and figure out how to navigate it. So everything I'm talking about supports everybody,
it just becomes more vital for ADHD. Well, I think we've only gone through two of the four.
Two of the four things I was going to say about. Let's keep going. Let's go. Let's keep going.
So the third one is relatively new in the field.
It wasn't talked about much when I started.
And this is one of those vicious cycles that I think goes for all of us, is the health
part of ADHD, or to put it in the context of something more general of executive function.
Executive function is how we sustain routines and stick to our return goals, which means
that it's related to things like sustaining our sleep routines,
sticking to exercise routines, healthy eating. This goes for all of us, although it's stronger with ADHD.
As those routines fall apart, that undermines our resilience and executive function all day long.
And then they sort of double back on each other, right? So then you're in a really bad sleep routine
and you're not really exercising. So your mood goes and you're tired and wiped out. Your executive function isn't as strong as it was.
And then you get swamped by stress, which undermines your executive function, keeps you up late at night.
And that cycle is really foundational for all of us. I do think that in the middle of everything
going on now, there's so much intensity and so overwhelming sometimes. Sometimes I think about
it as like the modern science of getting back to the basics, staying resilient isn't like rocket
science on some level. There isn't like some miracle drug we can take or do to take care of ourselves
in many ways. It's that idea of like, well, wait, to be resilient, we have to take care of ourselves
in some of these basic ways that we're often pulled away from from long stretches of time.
care of ourselves in some of these basic ways that we're often pulled away from from long stretches of time.
So that's true for everybody, and it's particularly true with ADHD.
That's one of the bigger bodies of research in ADHD recently.
Russell Barkley did a long-term study showing that ADHD really does undermine your physical
health over time if you don't manage it, not because of some direct effect, but because when you're
struggling with these executive function, it impacts all these other things.
It puts you at risk for unhealthy habits, substance abuse, driving issues,
undermines relationships, which are then part of resilience. Also, I mean, all these things start
accumulating. So that's the third area of life to look at, you know, hard to manage, but available
to anybody. And then the fourth one is I think it's really important
to understand the role of medication when it comes
to ADHD at least.
So the short of it there is I think it's completely unfair
to people living with ADHD, how they've been portrayed
and marginalized.
The short version of medication for ADHD
has used appropriately for someone with ADHD.
They've been around about 100 years.
They're incredibly safe and effective,
if they're used appropriately.
A lot of the things that are portrayed
as definitive side effects are actually side effects.
They're manageable.
So the actual success rate is quite high,
at least somewhere around four out of five people
with ADHD can get some benefit from the medication
without significant side effects.
So the way I typically want people to look at ADHD medication
is really as a decision like any other medical issue.
Like with any other medication,
no one should use a medication.
They don't need for anything.
And if you need a medication,
you shouldn't feel judged or blame for it either.
But it's become this really intense overwhelming decision
with a lot of judgment added to it that makes life miserable for parents in ways that just, you know, isn't fair.
Because the recommendation to try the medications, you know, separating all the politics of it
are very concrete based on the research.
What about people who worry that we're over-medicating our kids?
Well, I think there's two discussions there that are different. You know, I think as a society, we can look at whether medications are over prescribed.
That may be true, certainly in some sub-populations, there are numbers that are really disturbing.
Individually, if you think your child has ADHD or if you're an adult living with ADHD, we
know what the research says, we know that if you use them well, you shouldn't have any
side effects.
It doesn't fix ADHD entirely.
You still got to do all this other stuff,
but it's a huge step forward for a lot of people.
And it's not a crutch, you know, it's medically no different than treating your asthma if
you have asthma every day, you're putting on your glasses if you can't see, you know,
if you actually have ADHD.
So if I am an adult who's realizing I have ADHD and I've seen a doctor and I've gotten
a diagnosis, I shouldn't feel guilty or deficient or like a failure if I'm going to take these medications
and if I'm a parent and this is particularly wrenching in my limited understanding here
and I have a kid who's got a diagnosis of ADHD and the doctor's recommending medications.
I don't need to feel like I'm committing child abuse by letting my kid take these meds.
Oh, I think it's awful that people are all led to think that way.
I mean, it's a hard-and-up decision without that.
Who wants their kids on medications for anything?
Right? I mean, it's scary and upsetting for any chronic condition
to be told that your child's going to need to take this for a really long time.
So to add, those layers of judgment and stuff is totally unfair
and just, you know, makes things harder for everybody.
Coming up, Mark's going to talk about the role
of mindfulness can play in managing ADHD.
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Can you recapitulate quickly the four steps that you mentioned when we talked about dealing with ADHD because I want to make sure that there are not some areas that I should double-click
on?
Yeah, absolutely.
The way I typically organize it is school supports, which could be work supports in some
situations.
Then there is the sort of non-medical supports outside of school, which are things like
coaching or working with the psychologist.
There's managing the health impact, and then there's understanding
the medication options.
Okay, so I'll just put in my own language.
There's special accommodations that should be made at school, perhaps work, coaching
or psychologist, or help for various aspects of executive function, medication, and lifestyle
changes.
Let me go back to coaching for a second because you briefly mentioned this within coaching,
but I think it might deserve a lot more attention, especially for this audience.
We have not discussed this yet, although I would have said it in the introduction.
You have a long history with meditation, long and deep history with meditation.
What benefit does meditation have on ADHD and any of us with executive function challenges,
which is to say all of us?
So, when it comes to the role of mindfulness and ADHD or meditation and ADHD care, I think
it's actually a good model for all of mindfulness in a lot of ways.
I mean, that's really how I came to it.
It's almost like from a research point of view, the research is like two sides of the same coin where, you know, mindfulness, all the
research accumulating over time shows how if we develop these self-management skills,
it helps with resilience, it helps with concentration, it helps with all these tasks that are
many of them related to executive function, and then we have the converse how ADHD impacts all
these things in the other direction. The starting point for me with mindfulness is I think different than people often come to it,
which is to say that part of mindfulness practice and meditation practice is working with
building attention and concentration. And that's real. There is some research suggesting you can
actually measure some of those changes and some of them actually have to do with executive function also.
So in one of the first pilot studies of mindfulness for ADHD care, which was small,
one of the things they showed was some improvement in attention shifting in addition to concentration.
That was looking at like maybe 15 minutes a day. So I don't know what the implications of
like an intensive retreat might be on ADHD. I think the way more important part of it as a
starting point is that ADHD is a overwhelming
stress-producing disorder in many ways. If you are struggling day-to-day with life management skills,
that's exhausting. It affects your well-being, it affects your resilience, and then if you're
feeling that way it affects your ability to manage things. People are giving you these complicated
plans like now what you're going to do when your child's misbehaving or now what you're gonna do to manage this project.
And that takes a lot of work and effort.
So ADHD is causing you to feel quite often swamped
and overwhelmed and just having a hard time keeping up
and then if you don't get ahead of that,
you know, how are you even supposed
to manage your own ADHD?
To me, what got me interested in integrating mindfulness
into ADHD care initially was stress management and resilience.
It was just to me totally under-addressed.
You know, you look at a family, parents of kids with ADHD are at risk for anxiety and depression
and marital stress and all these things that are going to just undermine all the different
things we've been talking about today.
So, as a starting point for why mindfulness can be so powerful
and working with ADHD, it has the due, I think, what is one of the more foundational premises of
the practice and mindfulness to begin with, which is we can develop the traits that help us relate
to whatever challenges are going on in life with as much skills we can muster, which then helps us
manage those challenges. It doesn't fix the challenges, but it sets us up to manage them better.
And that's the starting point for me
of mindfulness and ADHD care.
You know, can we learn to develop patients
and resilience in a way that helps us
then do whatever next has to be done?
So that's part one.
And then part two is the attention piece.
And then the third thing I think,
which is incredibly valuable with mindfulness
in ADHD care, is the sort of the second wing of the practice which has to do with the development
of self-compassion and compassion in that if you're going to feel good about yourself and
thrive in life, you often have to manage any of us. The idea of the inner critic, which I imagine,
is something you've brought up before. There's this intrinsic self-judgment that is just part of life for all of us,
but it gets totally blown out of proportion when you're struggling chronically.
I alluded to that Russell Barkley quote of quite often with ADHD, you know exactly what you're
meant to be doing and you're just not getting it done. And that begins to impact things in huge, huge ways. So that aspect of mindfulness
in ADHD care can also be life changing. There's Chris the Nefs work about directly using self-compassion
practice as its own free-standing mindfulness practice. You know, I feel like any mindfulness
practice has self-compassion and compassion kind of as part of it if you're practicing it fully.
And that's, you know, no small thing to be able to work with
that self-criticism or the conflictive feelings
you're having, you know, living with somebody else
with ADHD, that third piece of things
also changes things a lot.
Let me just jump in and provide some definitional support
for people who are new to the show.
It's possible we're gonna have
Indian flux of new listeners attracted by the title
and don't know much about mindfulness or self-compassion.
And I apologize to my long-time listeners
who will know all of this,
but I just wanna serve everybody if I can't.
Mindfulness meditation for the people who are new to it
is often practiced by sitting close your eyes,
although you don't always have to bring your full attention
to one thing
that's naturally occurring like the feeling of your breath coming in and going out or sounds in
the environment or the feeling of your body on the chair or lying down or whatever. And you try to
bring your full attention to this one thing and then every time you get distracted you start again
and again and again. A lot of people think getting distracted is proof of failure but it's actually
proof of success because the whole point is just to get increasingly familiar
with how wild your mind is,
so that when you're ambushed by anger
or a desire to eat a sleeve of Oreos
off the cushion in your real life,
you're not so owned by it.
So that's the quick and dirty mindfulness meditation
self-compassion developed by a person
as a personal hero of mine.
Dr. Kristen Neff has been on this show many times. You can go back and listen to her episodes. We'll
put the links in the show notes. Self-compassion incorporates some mindfulness. In other words,
you have to be aware of what you're feeling in any given moment in order to apply what I'm about
to describe. So you have to be mindful of your emotions. Often those emotions are like self-loathing,
self-criticism, shame, and then you do this counter-intuitive thing,
which is instead of tripling down on the aforementioned toxic emotions,
you actually send yourself good wishes,
which may seem just unbearably cheesy and saccharine to people,
but there's a ton of data generated in large measure
through the work of Kristen Neff and her colleague,
Chris Germer, has also been on the show before,
where if you can stop, if you use your mindfulness
to be aware of a moment of suffering,
that's the first step, the second step is to recognize
that you're not the only person in the world
feeling this way right now.
There are unquestionably tens of millions of people
who are having this struggle.
Literally right now, you can feel connected
to a larger community of sufferers.
And the third is to actively send yourself good vibes,
which again, this is where people like me get hung up,
but putting your hand on your heart,
giving yourself a hug, some sort of supportive self-touch,
and talking to yourself the way you would talk
to a friend or a child who is
suffering similarly. And all of that together, that is my understanding of self-compassion and it
has been shown to be extremely powerful. And I can say from my own end of one laboratory
that once I got over myself and started doing this stuff, it was extremely helpful. So just
clarify some of what you just said. Yes, I would agree too, by the way, one of the most profound things that's changed for me
having practiced, and since my 20s is that the inner critic doesn't win all the time anymore.
It's so easy to assume I'm the only one who ever does this kind of stuff, you know, especially
if you make a mistake that really matters, you just sort of isolate yourself. Like I'm the only
smocker ever that has this stuff happen.
So it's a huge deal.
I actually was at a conference recently
and I had introduced self-compassion practice
and I walked past a table during lunch
and I can hear them all.
Like they were just, this relieved joking around
and like, oh, that kind of stuff happens to everybody.
And just remembering that is so powerful.
And the third thing is just a little exercise
you can do that's so useful.
And it's not forcing
yourself to feel different, it's not forcing yourself to be nice to yourself.
It's just this reminder of, you know, if I do this, my first reaction is like, you idiot,
you know, but if my best friend did it right next to me, my first reaction would be like,
it's okay, everyone does this kind of stuff. And so the third part of the practice is just such a
powerful reminder.
And it's not pretending that other thoughts not happening.
It's just like, oh yeah, I can do this.
It's okay.
Yeah, the third part is actually the part I go right to.
Obviously I have the mindfulness
to be aware that I'm suffering.
But I go right to the third part, which is,
what would I, if you were telling me
about what an asshole you were,
I would put my hand on your shoulder and be like,
dude, X, Y, and Z reasons.
Yes, that was a dumb thing you did,
but X, Y, and Z reasons why that does not indicate
that you're holistically shitbag
and you're incurably awful.
And I would remind you of other good things you had done
and that would be how the conversation would go.
The radical good news here is you can do that service,
you can provide that service for yourself and the data show that it works. And that is great,
because when you wake up in the middle of the night worrying about something which I do,
I don't want to wake my wife up to ask her to talk to me down. I can do that for myself. I can lie.
I sometimes just like curl back around in the sleeping curl, put my hand in my chest,
talk to myself a little bit, and I'm out. I fall back to sleep.
Yeah. And there's another aspect of it that ties back to what you said about mindfulness practice
itself, which I think is really important, which is that perspective of like the distractions
going to happen. You know, I'm setting this intention. I'm going to try to focus on my breath,
and then the distractions going to happen. That's just life. And that perspective you take of coming back
without blaming and criticizing,
and I suck at this, and I can never meditate,
and that person over there looks so calm,
but I'm just, you know, letting go of all that,
and just folding into your day to day,
you're just going to do five minutes of breathing practice
cool, and you're folding into it.
Like, I'm going to get distracted.
I'm doing my best, and then I'm going to get distracted. I'm doing my best. Then I'm going to get distracted. Without frustration, it's like, what? Tell me back now. That
self-compassion too in a way. Just letting go of all that stuff.
That attitude is incredibly helpful for everybody, but even more so, perhaps, and you'll tell
me if I'm right, for people with inattentive ADHD, if they're going to try to meditate.
Yes. One of my favorite things anyone ever said,
and I used to teach a class in mindfulness
for people with ADHD, and somebody in one of the groups,
he said, Dr. Burton, you gave that instruction of like,
distractions are just gonna happen.
So when they happen, don't worry about it.
Just come back to the next breath.
Is that something that you teach everybody,
or is that something just for the ADHD group?
And it was just this moment of,
yeah, that's almost the common humanity part of it. I've just recognized it like, yeah, you know,
with or without ADHD, life gets distracting and people make mistakes and the only way to keep
growing the awareness of like, okay, this is what's going on and I don't love it, you know, and then
through that awareness, you can make changes and it's going to be imperfect and it's all just part of,
you know, moving forward with ADHD. Any other techniques you recommend specifically for people with ADHD
for meditation because this seems like another snake eating its tail aspect of trying to treat ADHD
because you can tell somebody to do a thing but they can't do the thing because their brain
manager is offline. Right. And then of course with meditation, that is all about training the attention, but these
are many of them, especially if they have the inattentive flavor of ADHD, their attention
is more fleeting than the rest of us.
So what are the tricks and tips for these folks?
I can think of three different things.
The first one, which I think is valuable for everybody, is reframing the entire meditation
process itself as not trying to stop
thoughts, which is always true. This is a reframe for everybody. It's a practice of developing awareness
and patience so that if your mind stays busy the whole time, that's fine. That's what your mind
was doing that day. If you go into meditation expecting something different than that, you're
going to quit pretty quickly. So part of it is really validating the reframe
of like whatever your mind's doing is fine,
you're not meditating badly,
there is no good or bad meditation,
you're just doing the work.
At the same time, I think for people with ADHD,
they sometimes prefer movement practices,
which are equally valid and that's totally fine.
So, you know, yoga can be a meditation practice,
walking meditation is certainly a meditation practice and that can be simpler. So, you know, yoga can be a meditation practice, walking meditation,
is certainly a meditation practice and that can be simpler. So that's the second part of it.
That's huge. That seems like huge. Yeah. One of the things I like to play around with is you
can play the edges of that a little bit. I think most people find a practice that they're most
comfortable with and that's perfect. And then there's some value to saying like it's really
hard for me to sit still. So maybe what I'll do, you know, is I'm just going to try sitting
meditation for a few, instead of avoiding it completely,
you know, you can play the edges a little bit. Like, what would it be like to just for five
minutes get my best to sit? So both are true, but your core practice is going to be something
that probably fits more easily. The only other thing that goes back to where we start with
executive function is everybody has a hard time getting started with meditation and remembering
to meditate. I mean, that's just like routine.
All these things are true for everybody, but since you're struggling with executive
function with ADHD, if you're going to start the scheduling side of it, it is something
to pay attention to also like any other habit in life.
It's a little harder to stick with things when you have ADHD.
So if you're really serious about doing it, you really want to look at like how am I scheduling
it, how am I setting reminders, who's going to remind me and just trying to get the routine off the ground can be harder with ADHD also.
We've talked about how if you have ADHD, how you should think about it and treat yourself,
we've talked about this from the perspective of parents who have children with ADHD. What if I have
a colleague or a boss who peers to, I don't want to be freelance diagnosing
these people, but they have some of the symptoms that you've described.
Any thoughts about how best to work with people who are displaying some of these symptoms?
Well, I think if it's your boss, it's kind of important not to tell them that you think
that ADHD probably, I think like in any collaborative situation, you want to try to navigate the
situation in a way that focuses on, first of all, what you agree on, your goals that you both
want to set together, you want to look during collaborations on being clear in a person first
time away. Like from your side of things, what would be most helpful for you in terms of navigating
the next project, so trying to not say you're not doing this, but it would be useful for
me if I knew ahead of time X or things like that.
Another thing that's valuable, I think, in a collaborative situation like that, is trying
to break things off so that everyone is doing something in that situation that plays
to their own strengths.
Some of me have to do with how you choose to delegate things. If issues come up, I think it almost falls into more the art of strong communication of how do you communicate through a difficult situation, you know, looking for points of agreement, trying to be clear without finger pointing.
And, you know, you may never be able to really determine or say whether they have ADHD or not, but you can try to define a first small step that
might make things better and define that one realistic thing.
Like the last three projects, this went wrong.
Maybe on this project, we can try this one step and see if it goes differently.
I think this is a good model for all of ADHD or any challenge, but certainly ADHD is certainly
impacts relationships of all sorts of different kinds, and that's a particularly complicated
one.
If you have ADHD, should you be up front
with your boss about it?
I think you have to use your judgment
in a perfect world that would certainly be true.
Like in an ideal situation,
you'd want to say like, look,
sometimes I'm a little forgetful,
just remind me, I'll make sure I get it done,
or I'm better with this type of project
than that type of project.
So I don't like that type of blanket advice,
but it's so relational.
I think it depends for your bosses and your comfort zone. It's great to be able to say,
like, these are my strengths, and this is not over here, but I don't know that that's always
going to be realistic in a work situation. Is it possible that it's the case that if neurodiversity
to the extent that I understand exactly what that means, but that if neurodiversity becomes more deeply integrated into how corporations
are run, that it could eventually be a safe thing
and in fact a helpful thing to say to your boss,
well, here's what I know about how my brain works.
100%.
That's the upside of the sole discussion
on neurodiversity.
Like if an understanding of what various neurological conditions
are and how they show up in day-to-day life grew.
That would help in these situations for sure.
And that's the upside of an advocacy movement like that.
Something as simple as,
you think most people understand that time blindness
is part of having ADHD.
Most people think ADHD is either an impulse disorder
or a focus disorder.
So if they could actually understand
that time management is my biggest challenge here.
I'm really talented at all these other things, could only be of a benefit
in the big picture, but there's a lot of education
to be done out there before we get there.
Yes, on the boss side, for sure.
Before I let you go, you've done a lot of writing
about this.
Can you please plug your books and any other resources
you've put out into the world so that people can go access them?
Sure, thanks for asking.
I've done three books specifically around integrating mindfulness into ADHD care, the
family ADHD solution, and then a workbook called Mindful Parenting for ADHD.
My most recent book was actually in collaboration with someone who's done research with Christen
Nuff, so it's self-compassion for teen ADHD.
And then I did write one book called How Children Thrive,
which is actually looking at this concept
of understanding executive function
in general child development,
and why that's useful in raising resilient kids.
I have various classes available mostly
on insight meditation timer right now.
And then I have a lot of other stuff,
just I have posted on my website,
I try to keep my website itself,
which is developmentaldoctor.com kind of as a resource hub of valid information.
We'll put all these links in the show notes. I should have, if I was a professional interviewer,
I would have asked you this at the beginning, I'm just curious, do you struggle with ADHD?
And is that why you've gotten so interested in it? Or do you just want to treat kids and
saw that this was a huge issue? No, I don't have ADHD, but I grew up around the field of special education, really, and
I've been more sort of working in the field of special education in various ways since I was a teenager.
Strange question to ask, class. Harris. You can cut and paste it.
Dr. Mark Burton, thank you very much for doing this really great.
This was great. Thanks for letting me be here.
Thanks again to Mark. Great to have him on this show.
One last little note here before I let you go, deep cuts is a new feature where you, the
listener, get to choose your favorite TPH episode from the archives.
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Finally, thank you so much to everybody who works incredibly hard on this show. 10% happier is
produced by Gabrielle Zuckerman, Justin Davie, Lauren Smith and Tara Anderson. DJ Kashmir is our
senior producer, Marissa Schneiderman is our senior editor and Kimmy Regler. These are executive
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