Ten Percent Happier with Dan Harris - Do You Have ADHD? | Dr. Mark Bertin

Episode Date: October 18, 2023

The 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.

Transcript
Discussion (0)
Starting point is 00:00:00 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?
Starting point is 00:00:42 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
Starting point is 00:01:17 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. Bosch legacy returns, now streaming. Madden's been taken.
Starting point is 00:01:41 Oh, God. His daughter is in the hands of a madman. But the police have been looking for me. But nothing can stop a father. We want to find her just as much as you do. I doubt that very much. From doing what the law can't. And we have to do this the very way.
Starting point is 00:01:58 You have to. I don't. Bosch Legacy. Watch the new season, now streaming exclusively on Freevy. Bosh Legacy. Watch the new season now streaming exclusively on FreeV. Ghosts aren't real. At least as a journalist, that's what I've always believed. Sure, odd things happened in my childhood bedroom, but ultimately, I shrugged it all off. That is, until a couple of years ago, when I discovered that every subsequent argument
Starting point is 00:02:19 of that house is convinced they've experienced something inexplicable too, including the most recent inhabitant who says she was visited at night by the ghost of a faceless woman. And it gets even stranger. It just so happens that the alleged ghost haunting my childhood room might just be my wife's great grandmother. It was murdered in the house next door by two gunshots to the face. From Wondering and Pineapple Street Studios comes Ghost Story, a podcast about family secrets, overwhelming coincidence, and the things that come back to haunt us. Follow
Starting point is 00:02:50 Ghost Story on the Wandry app or wherever you get your podcasts. You can binge all episodes ad-free right now by joining Wandry Plus. Emily, do you remember when Wandry was called it a day? I think you'll find there are still many people who can't talk about it. Well luckily, we can. A lot. Because our new season of Terribly Famous is all about the first One Directioner to go it alone. Zayn Malik. We'll take you on Zayn's journey from Shilad from Bradford to being in the world's
Starting point is 00:03:20 biggest boy band and explore why, when he reached the top, he decided to walk away. Follow Terribly Famous Wherever You Get Your Podcasts. Terribly Famous. 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.
Starting point is 00:03:38 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
Starting point is 00:04:16 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
Starting point is 00:04:50 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
Starting point is 00:05:34 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.
Starting point is 00:06:03 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.
Starting point is 00:06:27 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
Starting point is 00:06:46 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.
Starting point is 00:07:07 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.
Starting point is 00:07:50 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,
Starting point is 00:08:10 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.
Starting point is 00:08:29 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.
Starting point is 00:08:47 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.
Starting point is 00:09:16 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.
Starting point is 00:09:45 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
Starting point is 00:10:13 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.
Starting point is 00:10:36 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
Starting point is 00:11:01 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
Starting point is 00:11:37 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
Starting point is 00:12:13 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
Starting point is 00:12:59 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,
Starting point is 00:13:21 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,
Starting point is 00:13:39 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.
Starting point is 00:14:04 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
Starting point is 00:14:21 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.
Starting point is 00:14:49 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
Starting point is 00:15:05 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.
Starting point is 00:15:35 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?
Starting point is 00:16:08 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
Starting point is 00:16:29 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.
Starting point is 00:16:56 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
Starting point is 00:17:32 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.
Starting point is 00:18:04 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
Starting point is 00:18:42 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,
Starting point is 00:18:58 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.
Starting point is 00:19:15 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.
Starting point is 00:19:41 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.
Starting point is 00:20:00 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,
Starting point is 00:20:30 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.
Starting point is 00:20:52 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.
Starting point is 00:21:19 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.
Starting point is 00:21:42 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,
Starting point is 00:22:06 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
Starting point is 00:22:27 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.
Starting point is 00:23:12 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
Starting point is 00:23:42 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.
Starting point is 00:23:59 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.
Starting point is 00:24:22 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.
Starting point is 00:24:40 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. We can't see tomorrow, but we can hear it. Tomorrow sounds like hydrogen being added to natural gas to make it more sustainable.
Starting point is 00:25:18 It sounds like solar panels generating thousands of megawatts, and it sounds like carbon being captured and stored, keeping it out of our atmosphere. We've been bridging to a sustainable energy future for more than 20 years. Because what we do today helps ensure tomorrow is on. And bridge, life takes energy. I'm Rob Briden and welcome to my podcast, Briden and. We are now in our third series. Among those still to come is some Michael Paling, the comedy duo Egg and Robbie Williams.
Starting point is 00:25:54 The list goes on, so do sit back and enjoy. Briden and on Amazon Music, Wondery Plus, or wherever you get your podcasts. And don't miss out in celebration of Sharon Salzburg's new book. We've made her course on loving kindness, which we call 10% nicer. Free over in the 10% happier app until October 23rd. Download the 10% happier app today wherever yourd. Download the 10% happier app today, wherever you get your apps and get started for free. Before we get into what can be done about it,
Starting point is 00:26:31 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.
Starting point is 00:26:46 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,
Starting point is 00:27:06 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.
Starting point is 00:27:24 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
Starting point is 00:27:50 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.
Starting point is 00:28:25 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.
Starting point is 00:28:47 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,
Starting point is 00:29:20 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
Starting point is 00:29:56 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
Starting point is 00:30:18 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,
Starting point is 00:30:49 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?
Starting point is 00:31:14 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,
Starting point is 00:31:34 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,
Starting point is 00:31:56 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,
Starting point is 00:32:30 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.
Starting point is 00:33:02 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.
Starting point is 00:33:24 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.
Starting point is 00:33:49 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.
Starting point is 00:34:11 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
Starting point is 00:34:38 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.
Starting point is 00:35:06 100%. 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.
Starting point is 00:35:27 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,
Starting point is 00:35:42 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
Starting point is 00:36:14 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.
Starting point is 00:36:47 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
Starting point is 00:37:23 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,
Starting point is 00:38:05 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.
Starting point is 00:38:21 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.
Starting point is 00:38:30 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.
Starting point is 00:38:38 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.
Starting point is 00:38:48 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.
Starting point is 00:39:17 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.
Starting point is 00:39:32 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
Starting point is 00:39:47 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,
Starting point is 00:40:13 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.
Starting point is 00:40:44 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,
Starting point is 00:41:09 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.
Starting point is 00:41:38 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.
Starting point is 00:42:13 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
Starting point is 00:42:55 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.
Starting point is 00:43:27 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
Starting point is 00:43:55 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.
Starting point is 00:44:12 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,
Starting point is 00:44:33 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.
Starting point is 00:44:57 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,
Starting point is 00:45:25 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.
Starting point is 00:45:58 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.
Starting point is 00:46:24 Coming up, Mark's going to talk about the role of mindfulness can play in managing ADHD. Deep in the enchanted forest, from the whimsical world of Disney Frozen, something is wrong. Airendel is in danger once again from dark forces threatening to disrupt the peace and tranquility.
Starting point is 00:46:47 And it's up to Anna and Elsa to stop the villains before it's too late. For the last ten years, Frozen has mesmerized millions around the world. Now, Wondry presents Disney Frozen, Forces of Nature podcast, which extends the storytelling of the beloved animated series as an audio-first original story, complete with new characters and a standalone adventure set after the events of Frozen 2. Reunite with the whole crew! Anna, Elsa, Olaf, and Kristoff for an action-packed adventure of fun, imagination, and mystery.
Starting point is 00:47:24 Follow along as the gang enlist the help of old friends and new as they venture deep into the forest and discover the mysterious copper machines behind the chaos. And count yourself amongst the allies as they investigate the strange happenings in the enchanted forest. The only question is, are Anna and Elsa able to save their peaceful kingdom? Listen early and add free to the entire season of Disney Frozen Forces of Nature podcast, along with exclusive bonus content on Wondry Plus. Join Wondry Plus in the Wondry app, or Wondry Plus Kids on Apple Podcasts. What if we told you that there's a darker side to royalty?
Starting point is 00:48:02 And more often than not, life as a prince or princess is anything but a fairy tale. I'm Brooke Sifrin, and I'm Arisha Skidmore Williams, and we're the hosts of Wonder E's podcasts, Even the Rich and Rich and Daily, and we're so excited to tell you about our brand-new podcast called Even the Royals, where we'll be pulling back the curtain on royal families past and present from all over the world. On Even the Royals, we'll cover everything from stories you thought you knew, like Marie Antoinette, who was actually a victim of a vulgar propaganda campaign which started a wild chain of events that led to her eventual beheading.
Starting point is 00:48:30 Or Catherine de Medici, who was assumed to be responsible for one of the most devastating massacres in French history. But in reality, she was a mother holding on to her dying dynasty. Royal status might be bright and shiny, but it comes of the expense of everything else, like your freedom, your privacy, and sometimes even your head. Follow even the royals on the Wendry app or wherever you get your podcasts. If you don't want to wait for more episodes, join Wendry Plus today to listen exclusively and add free. 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
Starting point is 00:49:08 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.
Starting point is 00:49:26 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.
Starting point is 00:50:00 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
Starting point is 00:50:38 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
Starting point is 00:51:17 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
Starting point is 00:51:52 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
Starting point is 00:52:15 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
Starting point is 00:52:47 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
Starting point is 00:53:06 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
Starting point is 00:53:53 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
Starting point is 00:54:19 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
Starting point is 00:54:38 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
Starting point is 00:55:07 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.
Starting point is 00:55:24 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,
Starting point is 00:56:03 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.
Starting point is 00:56:21 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,
Starting point is 00:56:41 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
Starting point is 00:57:18 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
Starting point is 00:57:35 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,
Starting point is 00:57:59 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.
Starting point is 00:58:17 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
Starting point is 00:58:35 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,
Starting point is 00:59:05 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,
Starting point is 00:59:33 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
Starting point is 00:59:59 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.
Starting point is 01:00:19 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
Starting point is 01:00:50 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
Starting point is 01:01:23 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,
Starting point is 01:01:51 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
Starting point is 01:02:13 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
Starting point is 01:02:43 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,
Starting point is 01:03:16 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
Starting point is 01:03:58 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
Starting point is 01:04:45 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?
Starting point is 01:05:08 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.
Starting point is 01:05:21 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,
Starting point is 01:05:52 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.
Starting point is 01:06:10 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
Starting point is 01:06:26 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.
Starting point is 01:06:45 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,
Starting point is 01:07:12 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,
Starting point is 01:07:33 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.
Starting point is 01:08:05 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. It's simple, just give us a call and leave us a voicemail. That includes the episode you want to hear and why. The number is 1508656-0540. We'll put it in the show notes so you don't have to write it down. 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
Starting point is 01:08:38 senior producer, Marissa Schneiderman is our senior editor and Kimmy Regler. These are executive producer scoring and mixing by Peter Bonaventure of Ultraviolet Audio and Nick Thorburn of Islands wrote our theme. We'll see you all on Friday for a bonus. Hey, hey, prime members. You can listen to 10% happier early and ad-free on Amazon Music. Download the Amazon Music app today, or you can listen early and ad-free with 1-replus in Apple podcasts. Before you go, do us a solid and tell us all about yourself by completing a short survey
Starting point is 01:09:30 at 1-3-dot-com slash survey. We can't see tomorrow, but we can hear it. And it sounds like a renewable natural gas bus replacing conventional fleets. We're bridging to a sustainable energy future, working today to ensure tomorrow is on. replacing conventional fleets. We're bridging to a sustainable energy future. Working today to ensure tomorrow is on. And bridge, life takes energy.

There aren't comments yet for this episode. Click on any sentence in the transcript to leave a comment.