Adult ADHD and Self-Criticism

We ADHD adults know too well the pain of persistently letting down others. We’re chronically tardy. We make small careless mistakes in details that can lead to disastrous outcomes in schoolwork, professions, or home life. At best we have to redo much of what we’ve done, and suffer a fresh taxing of our time and our mental/emotional energy. And these patterns begin in childhood, where the criticisms begin.

ADHD adults are familiar with the refrains from teachers, relatives, and even friends: “You’re so smart, why aren’t you doing better in school?” or “You left the refrigerator door open again, space cadet.” Or, “Hey you, I’m right here. Why can’t you listen?” We feel that we would lose our heads if they weren’t attached to our bodies, and be that as it may, over a lifetime of negative and critical feedback, from friendly jabs to outright disdain and eye-rolling, we begin to introject these ideas about ourselves. Becoming self-critical we doubt our skills and efficacy in meeting daily challenges so commonly and easily met by our neurotypical counterparts. We contend with bouts of paralysis and frequently wonder why we even bother trying. This is called rejection sensitive dysphoria.

Rejection Sensitive Dysphoria

According to William Dodson, M.D., in an online article for ADDitude Magazine, it is a common experience for ADHD adults as a manifest element of emotional dysregulation to sends ADHD adults into a spiral of self-recrimination, depression, or at times rage toward others who are critical of them (us, that is) which emerges from a long history of being the target of teasing, both negative and constructive criticism, and experiencing outright rejection as other withdraw warmth or approval. On this last bit, ADHD adults are very sensitive to both perceived and actual rejection. Once we’re in a dysphoric state, it’s very difficult to self-organize for work or play, for efficiency or love. Rejection sensitive dysphoria is also entailing negative and critical self-talk which revolves around our failures. It is a form of emotional suffering.

DBT Radical Acceptance

ADHD adults can counter the effects of rejection sensitive dysphoria (RSD) with the gentle and willing practice of the DBT core mindfulness skills. Drawing from the DBT construct of Wise Mind, I want to share with you a little of my own fallible yet steady practice of mindfulness and DBT skills. Just a quick reminder, I’m both a Linehan intensively trained DBT practitioner, and I’m an ADHD adult. And lo these many years, I have come to find that DBT is a gift for my clients, and for me.

From the wise mind construct, we connect with the affirmation that we are in fact wise. We know stuff and things, we do indeed know how to live, especially when we’re paying attention. And that is difficult for us ADHD adults. But we can do it. With practice, we can increase our sustained focus when needed, and mindful attention is a flexible dynamic. We can be mindful as we focus on a math problem, a narrow focus, and we cab mindful when we loosen our awareness into wider consciousness, a broad dynamic focus, taking in the sounds of birds with our ears, while our skin registers a gentle breeze and we observe passing cloud banks in the sky. We can turn toward our mindfulness whats (observe, describe, participate) and hows (nonjudgmental, one-mindfully, and focus on effectiveness) to exercise our attentional regulation, as well as softening our self-critical and catastrophic self-loathing. The daily practice of non-judgmental observation and labeling our mental/emotional experiences allows us to identify the fictions we have been fed over the course of our lives, and have become internalized.

Compassionate Detachment

As we watch our thoughts and feelings coming and going, we learn our thoughts and feelings are not the same as facts. Rather we learn that much of our self-referential thinking has been learned and practiced for years. The self-critical thoughts associated with RSD are automatic, reflexive. For instance, when a self-critical thought comes into our awareness, we say to ourselves, “A thought, ‘I’m a failure,’ has just entered my mind.” Or, “I notice that I’m judging myself.” As we increase our practice in observing and describing, we deliteralize the thoughts, we remain curious about our thoughts, but we don’t believe everything we think. Simply watch them without reacting to them, and without giving them analysis. Just watch. A thought is a thought. An emotion is an emotion. We are not beholden to them and we find new reserves of compassion for ourselves.

In addition to softening our automatic thoughts, we also bring compassion and acceptance to our ADHD, acknowledging the neurobiological bases, connecting with realizations that many of our incompleted tasks, time blindness, and procrastination are highly influenced by these processes. ADHD acceptance isn’t a way out of responsibility. Rather it’s a step toward better understanding our challenges, which empowers us to find, learn and implement the best tools and practices.

Mindful attention also helps us to catch ourselves on when we’re distracted or running out of emotional gas so that we can deploy extra effort in sustaining attention and use opposite action, a DBT favorite, to do what we will otherwise feel tempted to avoid. And rather than become mired in catastrophic self-loathing, we turn toward effectiveness. We can let be whatever is happening, or we can try new tools and practices. We are in fact doing the best that we can at any given moment, and we need to do better.

Acting Wisely

ADHD adults are already in possession of wisdom, it resides within us, and wisdom is something we cultivate. If we choose. Our inborn wisdom, innate to us by virtue of neurobiology, integrates rational thought and emotional perceptions and actions. We are born to connect, emotionally, from the moment we are born. Our emotions tell us if we’re safe or if we’re in danger. They connect us to relationships across the life span. RSD is a kind of vandal wrecking our innate emotional/cognitive wisdom. Mindfulness helps us to mend our relationship with ourselves so that we can connect with this inborn wisdom. As we cultivate wisdom, we find that we become more perceptive to relational dynamics and the “way things work,” whether in human relations or physics. We listen to our experiences and remember what is harmful and what is helpful and we grow in wisdom.

We find our wise minds by honoring both our reasonable mind and our emotion mind, gently bringing them into balance. Both head and heart, reason and feeling, working together in our service as we sense our way through our lives. And we return to our wise minds with the practice of recollecting our emotional and mental energies when we feel dispersed and scattered. We discover gentleness for ourselves and become more practiced in turning our energies toward what works, in mundane daily tasks and in pursuits of existential and spiritual import, and regard ourselves with increased compassion becoming skilled at accepting that we’re doing our best, even as we continue to push toward to doing better. Day by day, moment by moment, into a life of meaning, love, and connection. Even with ADHD.