How Therapy Can Help ADHD

Before we get into what therapy CAN do, let’s talk about the thing it can’t do. Therapy isn't going to rewire your brain into a neurotypical one. If that's what you're hoping for, I'd be lying to you and I'd rather not do that. What therapy can do is help you stop fighting your brain and start working with it which, it turns out, is most of the battle.

I know this one personally. In my last post I shared some of my diagnosis story, what I didn’t share was how I actually found help. The first therapist I went to see when I felt like I was drowning in my first therapy job but kept a perfectly color coded planner facade said “Sounds like ADHD” which was an amazing moment of realizing that I needed a whole new approach to the problem. What she said next was the beginning of a really long journey to find help, “ADHD really only benefits from medication, therapy doesn’t help”. Then she gave me a referral and all but threw me out saying she would not schedule another appointment with me. As a therapist myself I logically knew that wasn’t true, but I still felt like I couldn’t access help. Medication is a whole other story, but let’s just say it wasn’t as easy as making an appointment.

I eventually tried again and the therapist did not believe that I could have ADHD because I made it through grad school. She was also using a DSM that was almost 40 years out of date at the time, so I didn’t really give her opinion much value. After 2 more tries I found someone I clicked with. I couldn’t explain why, other than he specialized in ADHD. About 6 months in he offhandedly said something about his own ADHD, having forgotten that he never told me in the first place. It suddenly made sense why I never had to explain my symptoms or why neurotypical solutions didn’t work for me. Also why the suggestions he offered actually made sense and worked with my brain.

So when I say therapy can help, I'm not speaking theoretically, but I also know it can be hard to find the right person for the job.

Getting the right diagnosis (or the right reframe)

For a lot of people, therapy is where the puzzle pieces finally get named correctly. Maybe you've spent years believing you were anxious, or lazy, or "just bad at adulting," when what's actually happening is executive dysfunction. A good clinician can help sort out what's ADHD, what's anxiety, what's both, and what's neither — because these things overlap constantly, and untangling them matters for figuring out what actually helps.

Building systems for your actual brain

A therapist who understands ADHD isn't handing you a generic productivity system and hoping for the best. In therapy, we work on matching strategies to your brain. Whatever actually moves the needle for you specifically even if it sounds silly. What works for one ADHD brain can completely flop for another. All of it is information even (and sometimes especially) when it doesn’t work. You likely need skills to stop feeling overwhelmed by executive dysfunction. This is where I almost always recommend starting.

Undoing decades of self-blame

Here's the part nobody warns you about: getting diagnosed doesn't automatically undo the years of thinking you were the problem. It didn't for me. That conversation in my intake session was the beginning of a lot of work, not the end of it — closer to three decades of self-blame doesn't dissolve in one appointment, no matter how validating it is.

Once you no longer feel like you are underwater with the day to day we can begin working on this part. I often use the example of digging a hole in sand. It’s possible, but really hard without the right tools. Managing your day to day is the sand. The deeper roots are the part we are digging to. It's about slowly replacing "I'm lazy" with "my brain struggles to initiate boring tasks" until the kinder version actually starts to feel true. This may happen naturally from building those day-to-day strategies, but it also may take some additional effort. For some people a simple reframe when the thought occurrs is enough, for others we explore EMDR which I will explain in a separate post.

A place where you don't have to perform

Maybe the most underrated thing therapy offers is simply this: an hour where you don't have to keep up the color-coded-planner version of yourself. You don't have to explain why you forgot something, defend your worth, or pre-apologize for existing the way your brain exists. That kind of space is hard to find in regular life and it matters more than people expect.

You don't have to figure this out alone

If any of this sounds like what you've been needing — a place to get the right language for what you're experiencing, someone to help you build systems that actually fit your brain, or just somewhere to stop performing "put together" for an hour — that's exactly the kind of work I do.

If you're ready to talk it through, reach out here and let's get started.

ADHD Is Not a Personal Failure

I want to say this as clearly as possible, because I don't think it gets said enough: ADHD is not a character flaw. It's not a discipline problem. It's not what happens when a person just doesn't try hard enough.

And yet almost everyone I talk to who has ADHD — whether they were diagnosed at seven or forty-seven — carries around some version of the belief that they are, at their core a little bit lazy, a little bit careless, a little bit too much.

The stories we tell ourselves are older than the diagnosis

By the time most people get an ADHD diagnosis, they've already spent years building a personal mythology to explain why things are harder for them than they seem to be for everyone else. I'm disorganized. I'm flaky. I'm bad with time. I just need to try harder. These aren't neutral observations they're verdicts, and they get handed down long before anyone mentions executive function.

The cruel irony is that the diagnosis, which should come as relief, often arrives after the shame story is already fully written. So even with a name for what's happening, the old narration keeps playing in the background like a podcast you forgot was on. long before anyone mentions executive function.

If you are diagnosed as child AND have a knowledgeable support system then you have a much better shot at undoing that negative self talk. Unfortunately most people aren’t knowledgeable about it and even if your parents are knowledgeable they aren’t the only ones giving feedback. So you have to be consistent with working against those thoughts when they creep in.

If you were diagnosed as an adult you likely have decades of thinking this way to undo.

What ADHD actually is (and isn't)

It isn't a lack of willpower. ADHD affects executive function, the brain's system for planning, starting, sustaining attention, and managing time. That's a difference in wiring, not a deficit of character. You can want something with your whole chest and still not be able to make your brain cooperate on command. Wanting to the thing isn't the missing ingredient.

It isn't inconsistency for no reason. People with ADHD often hear some version of "but you did it fine last time" as if the ability to do a thing once proves it should always be effortless and we can easily make ourselves do it again. In therapy we sometimes call this the "spiky profile": real strengths right next to real struggles, with very little flat, predictable ground in between. That unevenness isn't proof you're not trying. It's just what the condition looks like.

It isn't a modern excuse. ADHD has a long research history and a real neurological basis. Calling it an excuse is a little like calling nearsightedness an excuse for not seeing the board. Sure, in theory you could squint harder, but that's not actually how eyes (or brains) work. You’ve likely heard “everyone thinks they have ADHD now”. There could be some truth to this in the same way that “everyone has a little ADHD” has some truth. ADHD (and everything else in the DSM) is a set of symptoms of being human that have reached a point where they are interfering in your daily life. Most people have forgotten important information, or had a little too much energy, or gotten lost daydreaming something more interesting than the lecture they are in, but this doesn’t mean they have a diagnosable condition. The threshold for these symptoms to be ADHD is about consistency and frequency. Sometimes people hear a familiar symptom without understanding the intensity that ADHDers experience it and think maybe they have ADHD too. This is just a lack of understanding which is my job, not theirs. So if you hear these types of comments try to remember they likely just don’t understand.

Why the shame sticks around anyway

Shame is sticky because it feels like it's protecting you. If the problem is a moral failing, then in theory you could fix it by being better. Which feels more within your control than "my brain processes reward and time differently than a lot of peoples." Shame offers the illusion of a solution. It just happens to be a solution that doesn't work and costs you your energy in the meantime.

I'll be honest: knowing all of this intellectually doesn't automatically switch the shame off. You can know ADHD isn't a personal failure and still feel a hot flush of embarrassment when you're the one who forgot, again, or the one who's late, again. Understanding the mechanism doesn't erase the feeling — it just gives you something to hold onto besides the feeling.

I was diagnosed at 27. I was in my first therapy job after grad school. My whole life I had believed that if I just tried harder I could be a “productive and organized person”. In fact most people who met me back then did think of me as organized. I kept an immaculate planner and color coded everything. Once people got closer they saw that it was a facade to hide my personal shame - that I was actually a failure who couldn’t keep herself together. I was struggling to keep on top of admin tasks (I still do) and had no idea what to do. A whole graduate degree in clinical mental health counseling and I convinced myself it was anxiety not ADHD. The first therapist I saw about this concern, during the intake said “sounds like ADHD” and thus my life was changed. It was the first moment of what would eventually become my specialty in therapy. I’m super lucky and grateful that I had a therapist who knew enough about it to set me down this path. However that conversation did not change myself image overnight. It took a lot of work to start thinking differently and undoing the nearly 3 decades of blaming myself for things that were never in my control.

What actually helps loosen the grip

• Naming the pattern instead of the person. "My brain struggles to initiate boring tasks" is a lot kinder than "I'm lazy". Try to catch yourself mid-sentence and swap it out.

• Separating the behavior from your worth. Forgetting an appointment is a scheduling problem. It is not a referendum on whether you're a good, competent, lovable person — even though it can feel that way at 11pm.

• Finding people who get it. Whether that's other ADHDers, loving friends and family, or a therapist who actually understands the condition, being around people who don't require you to explain or defend your brain is its own kind of relief.

• Building systems for your actual brain, not an imaginary one. A lot of shame comes from comparing yourself to a neurotypical standard you were never wired to hit. The goal isn't to become someone else's version of organized it's to find what works for your wiring, besides all those “rules for adulthood” were completely made up from the start.

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You're not the exception to being a good, capable person

If there's one thing I'd want you to walk away with, it's this: struggling with something does not disqualify you from being competent, worthy, or doing meaningful things with your life. ADHD makes certain tasks genuinely harder. It does not make you a harder person to love, or a lesser one to be.

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If you're ready to stop white-knuckling this alone and want support figuring out what actually works for your brain, I'd love to help. Reach out here and let's start that conversation.

Why Do I Procrastinate Even When I Know What I Need To Do

I have been meaning to start this blog since I created my website in 2023. But I didn’t. I didn’t know where to start so I put it off. I finally decided I was going to do it and made a list of headlines, only to stare at blank documents on my computer for several days before actually typing anything - instead trying to determine the perfect order to put the headlines in.

Have you ever felt the specific frustration of knowing exactly what to do and still not doing it?

Not the garden-variety "I'll get to it later" procrastination — the kind where your brain and your intentions seem to be running on two completely different tracks.

ADHD and procrastination go together like screaming kids on airplanes, it’s gonna happen and it feels like there’s nothing you can do about it. The good news is that you can do something about procrastination (technically you can also try to keep your kids from screaming on airplanes, but I’m not qualified to offer advice about that).

Procrastination is not one thing.

When people picture procrastination, they usually picture laying on the couch watching Netflix. But it shows up in a lot of different ways:

Productive procrastination. Suddenly the laundry gets folded, the inbox gets zero'd out, the dishes get done, the corner of your garage that you’ve been meaning to organize for years actually gets tackled. It feels better than other forms of avoidance because something is getting done — it's just not the thing that actually matters.

The vertical scroll. You start out with good intentions. You open your phone to check one thing and resurface twenty minutes later having absorbed nothing.

The freeze. This is the worst one. You're not doing anything else. You're just sitting there staring at the task fully aware of what needs to happen, often wanting to do the task mentally, and yet completely unable to make your body start. The freeze is the one that confuses people most, because there's no obvious "distraction" to blame. It's just you, the task, and a wall between you and it that you didn't build on purpose.

It's worse with certain kinds of tasks

Procrastination doesn't hit everything equally. It gets sharpest aroundoesn't hit everything equally. It gets sharpest around certain kinds of tasks:

• High stakes takes. These feel expensive to get wrong, sometimes literally. Often this kind of task is accompanied by dread or overwhelm

• Tasks with an unclear starting point. A blank document, a doom pile, creating something new. This is the one that had me stuck for years on this very blog. This will likely have you staring at whatever the task is for an extended period of time unable to move because you just don’t know how to start.

• Boring/disliked tasks. In therapy we call these non-preferred tasks. This is the tasks that make you go “I don’t wanna”. Things that don’t feel interesting or novel. Sometimes this is because there’s no immediate obvious pay off - like working out, eventually you will feel better from doing it, but eventually isn’t today. Sometimes there is an immediate payoff but the action is boring - like chores. These tasks often get filled with distractions or productive procrastination.ten this kind of task is accompanied by dread or overwhelm

Tasks with an unclear starting point. A blank document, a doom pile, creating something new. This is the one that had me stuck for years on this very blog. This will likely have you staring at whatever the task is for an extended period of time unable to move because you just don’t know how to start.

Boring/disliked tasks. In therapy we call these non-preferred tasks. This is the tasks that make you go “I don’t wanna”. Things that don’t feel interesting or novel. Sometimes this is because there’s no immediate obvious pay off - like working out, eventually you will feel better from doing it, but eventually isn’t today. Sometimes there is an immediate payoff but the action is boring - like chores. These tasks often get filled with distractions or productive procrastination.

All of these can be met with the previously mentioned forms of procrastination, but notice what I didn’t say. You won’t find “laziness” on either of these lists, because it’s much more complicated than being lazy. I often say that if you are not physically or mentally able to complete the task you aren’t being “lazy”. You either need rest or better supportive tools. It’s a disconnect between what your logic brain knows and wants and what your novelty/rewards based interest system needs.
And then there's the part that makes everything worse: shame. Beating yourself up for not starting doesn't create urgency — it drains the energy you'd need to start in the first place. Shame and procrastination feed each other in a loop that has nothing to do with laziness and everything to do with how depleting self-criticism is.

Deadlines are complicated

A deadline can help enormously, but typically only if you didn't set it yourself. A deadline you gave yourself starts to feel optional almost immediately. If you are the only one enforcing it or holding yourself accountable it becomes really easy to adjust it until the deadline means nothing.

On the other hand deadline someone else sets feels real, even if the actual work still doesn't start until right before it's due. Think of cleaning your house right up until the doorbell/ “I’m here” text comes, or a work deadline for a meeting at 2pm and at 1:30 you’re furiously typing. An example from my own life: I finished my grad school capstone project in three days. I was finishing my transcription on the train ride to campus and arrived five minutes late to my own presentation because I had to print it when I got there. The deadline was real, external, and unmovable, and it worked, right up until the very last possible second.
External deadlines often come with a lot of anxiety and frustration. Many ADHDers struggle to get started until right before the task, but that doesn’t mean the task isn’t top of mind. It’s often there nagging you and making you feel guilty for not working on it. So extended deadlines don’t always help.

Why doesn’t the advice I find help?

First off it depends where you are getting your advice. Advice for neurotypical people likely involves making a list or schedule and simply sticking to it. I don’t know if you’ve tried that…. but it typically doesn’t work for those with ADHD no matter how pretty and well organized the list is. Often the advice assumes you have a problem with motivation or organization. If that’s true find things specific to that problem could be helpful, but many time we know exactly why we should to the task and have spent plenty of productive procrastination time building out the perfect strategy for how to do it.

A note on to-do lists. Lists are genuinely useful for tracking what needs to happen and I’m not against them as a general concept. But having a list doesn't necessarily move you any closer to starting. So being told to “just make a list” often isn’t helpful.


What actually helps
The frustrating and freeing truth is that there's no single fix. What works can change from day to day or task to task, so the goal is to build a flexible toolbox rather than finding the answer. Some options worth trying:oesn't hit everything equally. It gets sharpest around certain kinds of tasks:

Body doubling working alongside someone else, even virtually, even if they're doing something unrelated.
Breaking the task down further than feels necessary, until the first step is small enough to not need motivation.
Setting a timer for a short, low-stakes chunk of time or choosing a small number of a repetitive task - such as washing 3 dishes.
Recording a time-lapse of yourself working something about being watched, even by your own camera, makes many people more productive. Plus they can be really satisfying to watch.
Gamifying the task turning it into something with points, levels, or a race against yourself.
External accountability telling someone else the deadline, or handing the deadline to someone else entirely.
Picking priorities not tasks chose 1-3 priority items for the day rather than a whole to do list with every possible option

None of these work every time. That's not a failure of the strategy it's just how this works. The move is to stay flexible and keep a few tools in rotation rather than expecting one trick to solve it permanently. Our brains crave both structure and novelty. So changing it up and trying something new can be a tool within itself, as can returning to something that has worked in the past.
If you're reading this and recognizing yourself

Maybe you're wondering for the first time whether ADHD explains what you've been calling laziness for years. Maybe you already know, and you're tired of hearing advice that assumes your brain works like everyone else's. Either way, the same thing is true: the gap between knowing and doing isn't a discipline problem. It's a wiring problem. And wiring problems respond to strategy, not shame.

If you feel like it would be helpful to have someone work through these strategies together reach out here and we can start that process.