PODCAST. ADHD Misinformation, Coaching, and Relationships with Dr. Alan Graham., PhD, PCC, MCAC.

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Dr. Alan Graham is an executive and leadership coach, a Master Certified ADHD Coach, and the published author of The Guide to ADHD Coaching: How to Find an ADHD Coach and What To Do When You Get One.

In a world where attention is a prized commodity, navigating the challenges of adult ADHD can be both daunting and misunderstood. However, there's hope and support available for Wise Squirrels. In a recent insightful interview with our Chief Wise Squirrel, Dave Delaney, they delved into the nuances of adult ADHD with Dr. Alan Graham, an expert in the field. Here, we'll summarize the key takeaways and valuable insights shared during the podcast.

Understanding Adult ADHD.

Adult ADHD, or Attention Deficit Hyperactivity Disorder, isn't just a childhood condition. Many individuals continue to grapple with its challenges well into adulthood. Contrary to popular belief, ADHD isn't solely about being hyperactive or easily distracted; it encompasses a range of executive function challenges that can significantly impact daily life.

Using a Strengths-Based Approach to ADHD.

One crucial aspect highlighted during the interview was the importance of adopting a strengths-based approach when dealing with adult ADHD. Rather than focusing solely on deficits and challenges, it's essential to identify and leverage individual strengths. By recognizing and building upon these strengths, individuals can develop effective strategies to manage their ADHD symptoms and thrive in various aspects of life.

Diagnostic Process for Adult ADHD.

Diagnosing adult ADHD isn't always straightforward and typically involves a comprehensive assessment process. While certain criteria outlined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) are used as guidelines, diagnosis often requires careful consideration of an individual's symptoms, history, and daily functioning. It's essential to rule out other potential causes and comorbidities before arriving at a diagnosis.

ADHD Coaching and Support.

One valuable resource for adults with ADHD is ADHD coaching. These specialized coaches work with clients to develop personalized strategies for managing symptoms, improving executive function skills, and enhancing overall well-being. When seeking an ADHD coach, it's crucial to look for someone with proper training, experience, and a deep understanding of ADHD's nuances.

ADHD Treatment Options for Adults.

Treatment for adult ADHD typically involves a multimodal approach, which may include medication, therapy, coaching, and lifestyle modifications. While medication can help alleviate symptoms for many individuals, it's essential to complement it with other strategies, such as cognitive-behavioral therapy (CBT) and mindfulness techniques. Each person's treatment plan should be tailored to their unique needs and preferences.

Challenges in Relationships.

Adult ADHD can also pose challenges in interpersonal relationships, particularly when one partner has ADHD and the other does not. Common patterns, such as role reversal (where the non-ADHD partner assumes a parental role), can strain relationships. It's essential for couples to communicate openly, seek support, and develop strategies together to navigate these challenges effectively.

Looking to the Future.

As research into ADHD continues to evolve, there's hope for advancements in diagnosis, treatment, and understanding of the condition. Organizations like the Professional Association of ADHD Coaches play a crucial role in promoting standards of excellence in ADHD coaching and supporting individuals with ADHD.

Navigating adult ADHD requires a multifaceted approach that acknowledges both challenges and strengths. By adopting a strengths-based perspective, seeking appropriate support, and developing personalized strategies, individuals with ADHD can lead fulfilling and productive lives. With continued awareness, advocacy, and research, the future holds promise for improved outcomes and better support for those affected by adult ADHD.

• Transcript

  0:00

  Well, actually, it's hard to say when it really started. So, back 50 years ago, I was teaching third and fourth grade, and always had a pension for the

  0:13

  kids who had a hard time focusing, even though I didn't realize that what I was doing.

  0:20

  I'm trained as a licensed clinical psychologist. And so I have seen kids forever. And

  0:29

  back then we were it was called hyperkinetic reaction of childhood.

  0:34

  And then in 1980, it became attention deficit disorder with or without hyperactivity. And then 1994, it became attention deficit, hyper activity disorder. And then with the inattentive, hyperactive, or the combined, I have a large clinical practice, medium sized clinical practice, and was getting a lot of people who were diagnosing with ADHD. And I actually hired a doctoral level pastoral counselor, who was the first adult that I came across who was diagnosed with ADHD. Oh, no kidding, that's great. And he actually started working for me, and I could see where all the symptoms of ADHD was showing up. And so that actually really became my niche. Because, you know, people with ADHD have the kind of sparkle in their eye that I love. And so, you know, that really was a no brainer for me. In the in 1999.

  1:36

  I learned about actually, in the middle 90s, I learned about coaching. And because I have an economics and math background, I went into executive coaching, leadership development, and then figured out probably should get trained in that. So I took a coach training program called mentor coach that I'm now the dean of ADHD coaching there. And in our first class, we were supposed to come up with an eight session program that we could give to people. And so I partnered with someone else. And we focused on parents of kids who have ADHD. And that created advisor.com, add V is V i s o r.com. And that kind of took me on the path of ADHD coaching, which I've been doing since then I've been teaching ADHD coaching training ADHD coaches since for the last 20 years, and I've really been developing a niche of working with high achievers with ADHD. And it's very often you have high achievers that they need see that they have not been identified with ADHD until they're older. Because they never had to work very hard to do what they did, because they were always good at it. Yeah, until things started to fall apart. And that's when they get diagnosed. That's interesting, because that Yeah, that's very much my story here, as well. And actually, I interviewed Dr. Bob Dempsey, on the podcast, who was the international space station director for NASA for 16 I believe it was 16 years, he was diagnosed with ADHD at 60. And so you know, talking about like, high achievers, I mean, you know, operating the ISS is, is a pretty badass role, I have to say,

  3:26

  I did an evaluation of a guy who had been the head of an $800 million government agency under Reagan. Wow. And Reagan cut the program. Now, all of a sudden, he didn't have a job excited to be consultant, and he couldn't organize himself. We evaluated him, he had ADHD. But in the confines of the government programs, he was able to function to do great until he had to manage his own time.

  3:55

  And that seems to be what's happened, at least in my understanding of the increase of diagnosis since the pandemic is that everybody suddenly was working from home and lost their scaffolding their offices, their their lives, and suddenly it was, you know, working from home with your families and being distracted and, and then also falling down rabbit holes on social media where, you know, plenty of ADHD, information, misinformation, hopefully not disinformation lives as well as or is that something you've seen since 2022. Like an increase? We've always had a big flow. So it's hard to see that I've seen any more increase.

  4:36

  But certainly, there's a whole Morse whole big increase of stuff on social media. And a lot of it is either neutral or detrimental. You know, a lot of people come in on on tick tock, and doing their things about how their ADHD shows up. Like that's what ADHD is, and, you know, idiocy shows up differently for everybody.

  5:00

  So, yeah, it can be very misleading. What are some of the most misleading examples that you're seeing sort of most commonly, as far as, like, you know, that type of content, some of these tick tock videos, blow me away, and I've kind of blocked them out. So

  5:18

  yeah, I don't blame you. You know, it's like, they say, you know, I like doing this, and I like doing this. And I like doing this. And I like doing this. So I have ADHD, right, that kind of thing. And it's like, you know, it's a little bit more complex than that. Yeah. And I often hear from people how not on this podcast, of course, but like, in conversation I hear. Or when I have a presentation I'm doing called the route down, which is about my diagnosis and, and helping to educate people with full disclosure, I am not a doctor, nor do I play on the internet. But I talk about, like, you know, my own experiences with ADHD, partly to remove stigma and to help educate people. But one thing I hear about a lot is, are we all ADHD sometimes? And I'm like, No, like. So here's the deal, you have to think about the symptoms of ADHD on a continuum. So on one end, is normal inattention, normal hyperactivity, normal impulsivity, which are the primary symptoms of ADHD. As you move along this continuum, there comes a point where it significantly impacts on your life. That's when it becomes a diagnosis. Right. And the further you move along that continuum, the more severe that diagnosis is, and the more significant impacts on your life, but that's the critical piece, it has to impact your life. I mean, I have lots of symptoms of ADHD, but my life is not impacted like that. I like to call if it's subclinical type? Yes, I do. Okay. Yeah. That's interesting to like, because

  6:56

  actually, this is a question I've been thinking about, which is that, you know, where ADHD or ADD back in the day was diagnosed and children, commonly

  7:07

  adult adults, when was it that adults could even be diagnosed, you know, in adult age, because this was something much later, right? Yes. So again, we used to diagnose them, hyperkinetic reaction childhood, and I remember, when we were doing the diagnoses back in the 70s. And you know, the father, a parent, usually the father would say, well behave just like me when I was kid and look at me now. And of course, my response is, yeah, look at you now.

  7:38

  But it really wasn't into the middle 80s That began to recognize that it didn't disappear at age 13. Right, just look different. So that hyperactive kid that was bouncing all over the place. It's just that it became that internal restlessness that people with ADHD often feel that's where that hyperactivity went. And the inattentive stuff stayed there. I mean,

  8:03

  you know, there's statistics suggests at least, up to 80% of the people, kids who are diagnosed with ADHD still have the diagnosis as adults. So, you know, it's, I think that's when it started to become real. But I think over the last 20 years, what happens is when what seems to be happening more is when a kid comes in to be evaluated for ADHD. And then the parent goes, Yeah, I was just like him as kid. Maybe I have ADHD. Yes, yeah. And then something. Oh, sorry. Go ahead. A lot of diagnoses are happening as a result of that. Yeah. And that's something I'm hearing a lot too. I think ADHD, ADHD is as heretical as height. There you go. There you go. Yeah. Yeah. And it makes a lot of sense. I think in my own diagnosis, it has also helped me to be more empathetic to my mom who's still around and also think a little differently about my dad who is no longer around. And the relationships I've had with both of them over the years and how now as I talked to my mom, who's in her 80s, pardon me, I, I'm like,

  9:19

  where she, you know, constantly interrupts me and she talks with her hands and she loves a cocktail and, and all these different little things that

  9:28

  I find, you know, and the likeliness of of my, of us sharing that, what the diagnosis does, and I think for late diagnosed people, it's really a critical piece is it changes their life narrative. Yes, like all of a sudden, what's happened before is looked at through a different lens.

  9:51

  Yeah, I'm actually I'm right. I'm writing my next book about this right now. And so I'm

  9:58

  it's been it's been

  10:00

  was incredible to look back at my life and understand through the lens of ADHD and realizing why without beating myself up about it either because I'm very careful with that. But understanding my operating system and now understanding like giving myself enough grace to realize, like I've run out of steam, it's okay. Or I can't use these planners, because I get overwhelmed too easily. And that's, that's not how my brain works, which is what my therapist said, Dave, your brain doesn't work that way. It's okay. Exactly. Yeah, it's been such a wonderful revelation. And you work with like, a lot of high achieving, you know, adults and who is, you know, obviously a big part of the listenership of this show. What are some some tips generally speaking for for folks, you know, being diagnosed later in life?

  10:49

  Well, once they're diagnosed, they've actually cleared the first hurdle. Yeah, because for adults who have been diagnosed later in life, they've been living with this forever. And I've been dealing with the shame of not being able to reach their potential or the feeling that, you know, there's something really wrong with them that they're, you know, there's a book by Kellyanne rimando from I think, the late 90s. You mean, I'm not stupid, lazy or crazy? You know, how people that's how adults felt, you know, and then they get that diagnosis. And it's like, wow, so So then, the next step really, is to not let's sort out. What about you as ADHD? And what about you as you and really kind of figure that out? Yeah, that's a big question that comes up a lot in my mind, too, because am I on like therapy and things because that is something very, as I've kind of jumped in full steam ahead on on learning about ADHD is, is that it's a question of like, okay, well, my humor, I think a lot about my humor. And I know that's something you you coach about, too, is coaching with humor and playfulness and things. But like I have a lot of background with with comedy and humor and studying improv and doing stand up last year for the first time before the diagnosis, which also explains why I did that.

  12:18

  But looking back at my humor, I was a class clown as a kid, and obviously, looking back at those report cards, which I actually still have, think thanks to my mom, and reading those comments being the class clown. i

  12:32

  It's funny because the ADHD cause caused me in a way to be silly and not be able to be like, kind of, you know, quiet it or what have you and being disruptive. But But in doing that I made my teachers laugh. Sometimes it my classmates laugh. So in a weird way, I think I partly learned about humor

  12:54

  in my undiagnosed ADHD, does that make any sense? It makes total sense, you know, when you look at, at ADHD, and you'll look at, and kind of looking at how your ADHD shows up and who you are as a person. Yeah, I think what's really interesting there is that humor is a part of who you are. And you can communicate and actually have the insight with people using your humor. The challenge with ADHD is to harness that power.

  13:29

  And, you know, I like to think I'm, I'm an add coach, that I like to think about coaching is helping the client to create guardrails around their ADHD, because humor and playfulness is one of my strengths, right? However, if I overplay it, then I'm a buffoon, and I lose my credibility. So to keep it in check, but it's something of who I am. And it's something of who you are. Yeah, there's a time and a place for it probably right. Yeah, you need to know when to use it. Yeah. Yeah. What about like, as far as high achievers masking ADHD? What are some of the things that you've seen? Yeah. What are some? What are some of those common masks like, says, what happens is they overdo? You know, the reality is neurotypical people are inconsistent, are consistent about two thirds of the time.

  14:27

  And many of these high achievers with ADHD, expect themselves to be consistent 100% of the time. Nobody is

  14:38

  and so it's hard for them to cut themselves some slack. Say, you know,

  14:45

  I'm not perfect, and it's okay. Yeah. I've often seen people that are high achievers, they are do great work, and then the rest of their life falls apart.

  14:56

  They can't maintain relationships that you know that that

  15:00

  their

  15:02

  personal care is not don't exercise enough to get enough sleep, all that kind of stuff, because they are so focused because they want to make sure that they're successful at work. And that creates a big burden on them. You know, that's really stressful. And so one of the things that I helped them do is to kind of create some balance. Yeah, I think with

  15:25

  you know, launching why squirrels launching this podcast and the website and things was really a way for me to share when I was learning with folks, and to learn myself, but at the same time, this passion has become sort of my mission because of helping, you know, teach people about this and help them

  15:45

  get diagnosed if they if they or at least get tested if they see or feel that they could have ADHD because I saw that Russell Barkley had a study with undiagnosed and untreated ADHD life expectancy can be up to 13 years less, seven, seven years. Really, I've seen that 13 Now, okay, but seven, 713 Whatever. Seven is really more than cigarettes and tobacco backlands. Three years? Yeah. And then you look at like the cost just alone, like the like, I've written a bit about loneliness and something that's waiting into the my book and my talk about this, but

  16:25

  how like loneliness is like, the old surgeon, Surgeon General Vivek Murphy was talking about how, you know, loneliness can have the same adverse health effects as smoking 15 cigarettes a day. And so with ADHD, and the inability or challenge in managing relationships and friendships, and subsequently, an RSD combined with that this is I'm speaking from my own experience here. But then, right, I'm compounding those adverse health effects that could affect my, my longevity, right, my Ultimate Health.

  17:03

  What are your thoughts on on managing relationships, whether it's friendships, peers, whomever? What are some strategies for that, that you have found work with adults? So there's a psychologist, her name is Michelle, in the botany, she wrote this great book called?

  17:22

  What does everyone else know that I don't.

  17:26

  And she talks about when you meet people, that usually have three questions. Ready, three questions deep. Yeah. So that means that you go into a situation and have three questions that you're going to ask the person, and then you're going to follow up the three questions on each subject. So that, that forces you as the ADHD person, to pay attention to what they're saying, yeah. Because that's going to help them feel heard. And that's going to help create that relationship. And then to be, again, self awareness is key. If you know who you are, and can sort out who you are and how your ADHD shows up. You can be authentic with another person. And that's going to help create a relationship because authenticity is what makes relationships work. What are some examples of those questions you mentioned? Like, like, if you're out meeting somebody like three? So a question might be, so what interesting and exciting. Have you done in the last two weeks? Yeah, you know, some open ended question.

  18:34

  And they respond, and then you listen, and then come up with another question based on what they're saying. And I love that. Yeah. So this is the same advice I've given my son actually who's more introverted than me, he's more in line with my wife, they're both more introverted. My, my daughter and I are more extroverted. And, you know, he told me once it like he hates getting having to go get his hair cut, because like, he's stuck in the chair and asked to like, talk to the woman. And he's like, and I said, just ask open ended questions like just ask her like, open ended questions. That way she'll do the bulk of the talking. And this is I wrote a book a number of years ago called new business, networking all about how to network better and to do it the right way not to be like whipping business cards of people or something.

  19:21

  And

  19:23

  it's interesting too. And so I do speak a lot about like helping people retain information and by asking, repeating the information out loud and you're repeating their names and asking open ended questions and things. But I also find in sort of reflecting on my own career and the work that I've created over the years with undiagnosed ADHD, so much of the problems that I assume everybody has, that I'm that I've tried to solve in the content I've created the say networking at a conference in small talk and whatever body language

  20:00

  Things like that.

  20:02

  I, I've, I've sought the answers to these questions personally to help myself without realizing. So in a way, it's sort of like the high achievers, I suppose some of your clients might have this where they have, like entrepreneurs who have created products, services, businesses, maybe to solve a problem that they had, because of the ADHD, have you ever run into any of that? I think that happens all the time. I think, you know, what we do is a product of who we are. And so if there's a challenge that we're that we experience, we're going to be looking for solutions. I think that makes a lot of sense. For me personally, having been diagnosed with anxiety, now, knowing that the root cause of that anxiety is from the ADHD and that the anxiety is a comorbidity Is that does that sound? Well? Yes. I mean, so, when you think about anxiety, depression, and any other coexisting condition with ADHD, sometimes they're independent of each other, but very often they're not. And particularly with anxiety, depression, because people, kids with ADHD, have gotten negative feedback from the environment forever. Things like, you're so smart, how come you didn't do it? You know, why can't you just do your homework? It's not so hard. It's easy. Why are you not doing that? And people start to interject that sense that they're, they're either stupid, lazy or crazy. And, and, and that kind of happens. You know, the reality is ADHD is not a disorder of knowing it's a disorder of do me. Yes. So. So? Yes, I think. So what happens is people get diagnosed with depression and anxiety, they go through therapy, and nothing changes, because nobody's seen their ADHD. And once they get the ADHD diagnosis, and they start to rewrite the narrative of their life, in, in light of ADHD, sometimes that depression, anxiety starts to dissipate. Because now they can be who they are. And that's okay. That's, that's interesting is there like, because I know, through my own therapy over the years, I remember something that was very impactful was was pre diagnosis was learning. You know, when you reflect when you think too much of the past, it can lead to loosely it can lead to depression, if you think too much of the future, it can lead to anxiety. And so the idea of being mindful, being present, being in the now is important. And of course, if you run a business, I mean, obviously, you have planning to do and you have to, like, look back and see how things have been and how you screwed up, or whatever. Or maybe that's just me. What is that fine line between what I just said, but also what you just said about like being diagnosed? And, and still looking back and looking at your life through that lens in order to set a positive way, I guess. Yeah. So I think that looking back as a way to help improve your life in the present, and the future makes sense.

  23:04

  Looking back to wallow in it doesn't help. Yes, I think same for the future, we can look to the future, to set some goals of where we want to get to, but in the service of helping us the side decisions that we make now.

  23:21

  Because we are we do live in the presence. And, you know, for a lot of ADHD years, that's okay. Because, you know, there's two times for people with ADHD there's now and there's not now. And now it doesn't exist. So. So there's that part two, and when when that that now jumps in, where you want to do the thing right away, but it's but it's not. In a way, it's sort of the impetus of my doing this podcast in a weird way. Right. Like, like it was b i started podcasting in 2005. So I've, I've had multiple podcasts over the years, of course, because ADHD, but so so knowing that I need to do a podcast about this and jumping right into it. And then realizing like looking at my schedule, looking at my time and realizing whoa, hold on. Like, my business isn't quite where it needs to be. And I'm doing this podcast all the time, like, so. Any any advice on like prioritizing that's, that's creating that balance, finding a way to create that balance. You know, I like the covey matrix, the Eisenhower matrix or Dave, whatever you call it, you know, urgent and important. Yeah, you know, it's really easy to take care of the urgent and important ones. And it's really easy to act on the urgent and unimportant ones, but you need to be able to recognize that yeah, this is unimportant even though it is urgent, and that the important but non urgent you have to plan for and maybe find ways to move it into the urgent category by giving yourself deadlines or having accountability.

  25:00

  partners, then you have the unimportant and urgent. Those are the ones you want to minimize.

  25:07

  Yeah. What is tell me about Cog Med, co G ma D working memory training? What's that? So COSMED working memory training is a brain is a computer based program that the research on it has suggested that it improves working memory, which is one of the executive functions of ADHD. Do you remember the game Simon? I mean, the yes, the colors and in beeps, and all that kind of stuff. Yeah, that's a working memory task, because you have to remember them. So what this program does is you do it five days a week for five weeks, 40 to 45 minutes a day, where you're doing these kinds of tasks. And the theory behind it is that that will help to improve your working memory, which then will help you to better manage the tasks in front of you. Now, the issues with it are generalizability, how far out does it go in terms of helping you to improve different tasks? And the the literature's mixed on that? And then sustainability, how long the after the training, how long does it stick? I've done some research that suggests after six months, it's still there.

  26:30

  But it seems like you may need boosters along the way to keep that going. If you were to say like if 100% is that everybody knows 100% Exactly what ADHD is exactly how to treat it and all the things like what percentage are we along the journey of studying and treating ADHD? Like, where are we are we 50% 30% 70%? Like what would you think? Not to cure ADHD? I don't mean that, because it's just who we are. That's our operating systems. But I don't want to, you know, not be left handed or something. That's fine. Yeah. It's the Manage ADHD? Yeah, well, it's hard to put a percentage because when you think about it, the treatment for ADHD has not changed that much over the last 50 years.

  27:22

  I would say one thing that has been different over the last 20 years has been the emergence of ADHD coaching.

  27:30

  I think that ADHD coaching has been a inter a strategy, that along with the other strategies of medication, and environmental manipulation, and those kinds of things that do help people with ADHD. You know, when you look to the future of ADHD in the SAM Goldstein did a presentation at the TED conference in November about this, he said, that NIMH is now is only funding

  28:01

  rich research programs that are looking at the biological basis of ADHD. So they're really trying to find

  28:09

  biological markers for ADHD. I don't know how close they are. But there's probably a lot to go in order to medicate properly or what once you know the biologic or the cause of it, and know the cause you can better formulate treatments for it, whether it's medication or anything else. Yeah, correct me if I'm wrong here, my understanding is it's not like, like having ADHD is not 100%. Like it's, it's, it can, like you are correct me here. Can you be can you develop ADHD at some point?

  28:49

  I've understood like maybe head trauma or lead or things like that is our there? I've read a little bit about it, but I don't know. Yeah, accurate. The only acquired ADHD is if there is some form of insult to the hip, whether it be trauma, trauma, or poisoning or something happens. Yeah, that impacts the prefrontal cortex of the brain, which is where the executive functions lie. Yeah. And that, that can someone can then have ADHD, like symptoms, because they've had damage to the brain there. The argument pretty much is, is that it doesn't just show up in adulthood. Right. Now, there has also been a couple of studies that that suggest people who have not been diagnosed and were not diagnosed as children, that it's possible that that it was there, but it just didn't reach the threshold where diagnosis would be made, because it's that clinical functioning part that they may have had some of those symptoms but it didn't rise to the point of clinical functioning. I think that happens with high achieving people all the time, too.

  30:00

  because they're usually pretty bright. And so they probably never learned how to study because they didn't have to. They just go into the class and take the test and get 100 because they were smart. Yeah, you know, I evaluated a guy

  30:14

  who was a senior in college, applying to graduate schools in mathematics. Now, I was a math major until I got to abstract algebra at junior college, and I couldn't do it. I mean, that's Wow. But, um, this guy fell apart. Because he never had to study. He was that smart that he never had to study. And all of a sudden senior came around. And he had all these theoretical mathematical classes that wasn't just intuitive. And he fell bar, it reminds me a little bit of like, how, like alcohol, Alcoholics Anonymous, you know, a or have like, these, I think it's called, like, your, your low points are like this moment of clarity where you're like, bottoming out.

  30:59

  But it seems kind of similar for ADHD peers, who seem to like, like an undiagnosed adult, who, quote unquote, bottoms out to the point where they're like, Okay, I've got to go see a doctor, I've got to figure out what's going on. And thus, then the diagnosis and treatment comes from that. But also in ADHD diagnosis, my understanding in adults is that there are certain boxes that need to be ticked, and you must have enough boxes ticked in order to receive a diagnosis, is that correct? Yeah, like it's interrupting your work life, it's interrupting your your family life, it's, so when someone comes in for an ADHD diagnosis, you have to rule stuff out. So you have to rule out any cognitive issues. So what we do is we do an intellectual assessment. And then if there's any concern, they we might do other neuropsychological tests,

  31:51

  we will do a motion, emotional issues, psychological issues can look like ADHD. So we will do some screening of that to see and with adults, you often have that. And so the real trick and diagnosis is teasing out what's what significant family disruption can create that, that you can find that in diagnostic interview, and then medical issues. And so you need to make sure that the patient has been followed by a physician, and there's nothing going on there. Once you've done that, it's primarily an observational diagnosis. So what you do is you give these behavioral checklists to the the individual and the important people around them. And that's really a survey of the symptoms they experience. You know, it's a little bit more complex than that. But that's essentially what it is. And so that the cutoff point is, there's a point on the on the the scale, where it becomes clinically clinically significant. And if the individual field sees that, and the people around them see that, then a diagnosis is made. And does it fit into is this where the DSM five kicks comes in? Because my understanding with the DSM five is that there are certain things like, like one, for example, is misophonia, right? Where like that could be.

  33:16

  And that's like the sensitivity to sounds and things, but like misophonia could be a comorbidity of ADHD, however, because it's not part of the DSM five, it's not. And I don't know enough, like, I know that Jackson Five, but tell me, but as far as the DSM five, we all know Michael Jackson and Janet, what about the others? What about Tito? Like,

  33:38

  like, yeah, that there are lots of symptoms that are not the primary symptoms of ADHD. But they also they often accompany ADHD, right? The one symptom that should be there, and isn't as much as it should be is emotional dysregulation. I, it's really not to my knowledge in the DSM, but it really should be and there's, there's a big push that that should because as you see that quite often, and people that HD and read, what is the what is that process, like without getting into the weeds of it, but like, like, how does the DSM get updated, because I've heard this from others that are a little irked by the DSM. The DSM is a political document, which means the American Psychiatric Association brings together people who they feel are experts in the area. And then they they get together and they come up with a consensus document on the different diagnoses. And some of it is research base. Some of it is who is the most powerful person in the room? And so there's a lot of there's a lot of politics too it can it can the people on these boards be voted out, but

  34:53

  I'm not sure how exactly that works.

  34:57

  For me to the inner workings of it

  35:00

  Like the Supreme Court or something, but let's not go there.

  35:05

  And as far as I'm being mindful of the time here, so I know I know. Yeah. Can I just talk about one more thing? Yeah, please, please. So, when I work with people with ADHD, because they've had so much experience where they've had so much negative feedback over time, I really work from a strengths based approach. And I want to help to discover what's right about them, you know, a person who's been diagnosed later in life, and they've gotten to where they've gotten, they've had to do some things, right? Yeah, they've had to be doing some good things. And so when I get a coaching client, and someone comes in, I'm gonna give them a strengths based assessment, there's an assessment I use, called the mind scan, which I really like,

  35:50

  created by this guy, Robert Hartman, who actually came out of Nazi Germany before it happened. Yeah, and because he saw the writing on the wall, and then he's actually a philosopher, got his PhD in philosophy of Northwestern, so he and I are alumni. But

  36:06

  he created this profile that really looks at a person's thinking styles, how they relate to others, and how they relate to actions. And it really gives a profile that you can really start from the help identify and build on the strengths of the individual, because that's where the action is, though, if you can build on your clients strengths, and help them apply those to the where the challenges are, that's creating those guardrails around them, to help them be successful and feel better about themselves. And you literally wrote the book, the guide, ADHD coaching.

  36:47

  So on that note, I mean, what are the what are some of the like, maybe red flags? I mean, I've had great coaches, everybody has been amazing on the podcast.

  36:58

  But you know, there's some people that are newer, better or worse than others, or some person who might just claim they're an ADHD coach,

  37:08

  who may or may not be good at what they do. I don't know, are there? What are your thoughts in the process of finding yourself a good ADHD coach besides calling you of course, because, yeah, that's what I would highly recommend.

  37:21

  And we'll include links as well. So there's an organization called the professional association of ADHD coaches. And I've been an assessor I was on the board for it. So you know, I'm biased towards that that organization is working hard to be able to identify what good ADHD coaching is, and then to certify people who have that, if I was looking for an ADHD coach, I would want to make sure that they have had coach training experience, and they have an understanding of what ADHD is all about.

  37:55

  A deep understanding, because you really need to appreciate the experience of someone who has had ADHD. You can't just know what the symptoms are. Because everybody's symptoms come that come up differently. And you have to understand the experience of living with that. Their life. You don't have to have ADHD yourself, but you have to appreciate what it is. Yeah, that's a that's a great, that's a great point. And it's a good, it's a good, good advice for people looking for an ADHD coach to do that, for sure. Yeah. Is there any other questions or anything that I that I missed asking you that you'd like to include?

  38:34

  There's a ton of stuff. There's, there's someone you know, the fact is with ADHD is, is there's so much

  38:42

  I was just on a right before this. I have an ADHD coaching Consultation Group. And we had Melissa Orloff was with us. She wrote the ADHD effect on marriage, relationships. And, you know, people with ADHD, they do have relationships. And there are these patterns that occur in these relationships. With the primary one that often happens is if there's a non ADHD partner, and then an ADHD partner is that the non ADHD partner starts to behave as the parent and the ADHD partner becomes the child and that that's not healthy. Great. Now my wife can listen to this episode. Thanks a lot. Well,

  39:26

  let her read the book.

  39:28

  Yeah, help.

  39:31

  Does that does ring some bells? I know you got a hard stop in a couple of minutes here. Very quickly, as far as executive function and executive functioning skills. I'm still confused by what those are because, you know, Barkley has a different definition. Brown has a different definition. Like there's it seems like there's not like one consensus on like the five or six or seven or eight

  39:59

  one

  40:00

  I,

  40:01

  because it's all theory, they haven't been able to identify any biological markers for any of them.

  40:08

  I think the general consensus is that executive functions are the functions that we need to manage our day to day life.

  40:20

  And so, you know, behavioral inhibition, working memory, internalized speech, problem solving, activation, Getting Started self monitoring, all these are their prefrontal cortex, executive functions, you know, it really doesn't matter.

  40:41

  It matters if you're ADHD, which ones are you challenged with? And that's what makes the difference, you know, and then, you know, in coaching, we work to help identify what those challenges are and create co create systems together to help you manage them. Yeah.

  40:59

  Yeah. And that's why there's so much value and I have an ADHD coach, and she's awesome. And I have found the combination of an ADHD coach, a therapist, who I've been seeing I saw for medication and kind of once we figured that out, I'm now seeing a different therapist, who is helping me with CBT with cognitive behavioral therapy, which is useful for ADHD. Yeah, yeah, I have found that to be to be really helpful, man. This has been awesome. I wish we could. Yeah. Talk Talk more. I definitely have. Yeah, I would love to keep talking when maybe we could do a part two at some point. How can how can folks get a hold of you learn more about what you do? Well, they can email me at a gram a gra h am at ACP. That's all creeping people. ACP the number 10. ACP ten.com. Okay, that's, that's great. And I'll make sure to include that. Lastly, I do. You mentioned one of your colleagues that went to your same school or the the philosopher, gentlemen. Robert, Robert Herman. As far as school goes, Can you help I guess, explain why your football team failed in every season of your high school, college and university. In your senior year. What happened there? Because I was there.

  42:32

  You were the curse. I was the curse. So they all they all went to like finals or playoffs or whatever. They're called. A grand goes here up. We can't win a game. Yes.

  42:44

  You need to go back to school and let me know where you're going. So I can start betting money on the team and we can. Northwestern is doing a whole lot better. They went to a bowl game and won this year. All right. Well, there you go. There you go. And they're in the NCAA tournament for basketball. So all right, even even those things turn around. Okay. That's a good note to leave on. All right. Well, thank you again. It's it's been been a pleasure. Great. Enjoyed it too.