PODCAST. Mindfulness, Meditation, and Procrastination with Dr. Lidia Zylowska, MD. (Replay)
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In this episode of ADHD Wise Squirrels, Dave had the pleasure of speaking with Dr. Lidia Zylowska, MD, a psychiatrist and faculty member at the University of Minnesota who specializes in adult ADHD treatment using mindfulness. Dr. Zylowska is also the author of Mindfulness Prescription for Adult ADHD, a resource praised by many, including our host, for its valuable insights and practical advice, and Mindfulness for Adult ADHD—A Clinician’s Guide.
Dr. Zylowska's Journey and Expertise
Dr. Zylowska shared her professional background and personal journey into mindfulness and meditation. Her interest in holistic medicine during her residency at UCLA led her to train with Jon Kabat-Zinn, the creator of the Mindfulness-Based Stress Reduction (MBSR) program. This foundation in mindfulness became crucial as she began exploring its application in treating adult ADHD, a field that was not widely discussed during her training.
Dr. Zylowska explained mindfulness as the practice of being present and fully engaged in the current moment without judgment. It involves an awareness of thoughts, emotions, and sensations, allowing individuals to respond to situations more effectively rather than reacting impulsively. Mindfulness can be practiced formally through meditation or informally throughout daily activities.
Meditation and Its Role
Meditation is a key tool for cultivating mindfulness. Dr. Zylowska described different forms of meditation, such as focused attention on the breath and open monitoring of thoughts and sensations. She emphasized that regular meditation practice can improve attention, emotional regulation, and overall mental clarity.
Using Mindfulness to Achieve Goals
Dr. Zylowska highlighted how mindfulness can help individuals set and achieve goals. By fostering a deeper understanding of one’s values and motivations, mindfulness aids in setting realistic and meaningful goals. Practical strategies include breaking down larger goals into smaller steps, regularly revisiting and adjusting goals, and practicing self-compassion when facing setbacks.
Overcoming Procrastination
Procrastination, a common challenge for those with ADHD, was another key topic. Dr. Zylowska explained that procrastination often stems from underlying fears and difficulties with self-regulation. Mindfulness helps individuals recognize these fears and develop greater self-awareness. Practical tips for overcoming procrastination include:
Mindful Time Management: Breaking tasks into smaller parts and setting specific deadlines.
Self-Compassion: Being kind to oneself and acknowledging that procrastination is a common experience.
Focus on Process Over Outcome: Shifting the focus to the process of doing the task rather than the end result.
The STOP Practice
Dr. Zylowska introduced the STOP practice, a simple and effective mindfulness exercise:
S: Stop or pause.
T: Take a breath.
O: Observe the present moment.
P: Proceed with awareness.
This practice can be done anytime, anywhere, helping to create a mindful check-in and fostering greater self-regulation.
The Distinction Between Mindfulness and Meditation
Dr. Zylowska clarified the difference between mindfulness and meditation. While meditation is a formal practice to train the mind, mindfulness is a way of being that can be integrated into daily activities. Both are essential for developing present-moment awareness and self-regulation.
Mindfulness for ADHD and Self-Esteem
Dr. Zylowska discussed the impact of ADHD on self-esteem and self-doubt. ADHD can affect relationships with others and with oneself. Mindfulness helps individuals reframe their experiences and develop a more compassionate and understanding relationship with themselves.
Practical Tips for Belly Breathing
Dr. Zylowska provided tips for practicing belly breathing, which can induce a relaxation response and counteract the stress-related tendency to breathe shallowly through the chest. Techniques include observing your breath, using a hand on the belly, and practicing a 1:2 ratio of inhaling to exhaling.
Resources and Further Learning
Dr. Zylowska recommended several resources for learning and practicing mindfulness, including:
Attention Deficit Disorder Association (ADDA): Offers a mindfulness group online.
University of Minnesota's Bakken Center for Spirituality & Healing: Provides mindfulness resources and classes.
UCLA's Mindful Awareness Research Center: Offers beginner-friendly mindfulness classes. Tune into our conversation with Diana Winston, the director of UCLA Mindful.
YouTube Channel "Mindful Rx ADHD": Features free mindfulness practices.
Dr. Zylowska encouraged listeners to explore various mindfulness practices, find what resonates with them, and incorporate mindfulness into their daily lives.
Thank you for listening.
Dr. Zylowska’s insights provide a comprehensive understanding of how mindfulness and meditation can enhance goal setting and help overcome procrastination, particularly for those with ADHD. Her practical advice and strategies offer valuable tools for improving mental well-being and productivity.
For more information on Dr. Lidia Zylowska's work, visit LidiaZylowska.com and explore her publications and resources. Thank you for joining us in this episode, and stay tuned for more inspiring conversations on mental health and personal development.
Visit Substack for Dr. Lidia Zylowska’s guided Body Scan Meditation and follow along now.
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I'm a psychiatrist and also a faculty member at the University of Minnesota. And I specialize in treatment of adult ADHD, in particular, using mindfulness as part of that treatment. Yes. And you are the author of the mindfulness prescription for adult ADHD, which is a book that it's one of the one of the first books that I read, when I was diagnosed last year with ADHD, and found it incredibly helpful. It's a great resource, not only for those with ADHD, but even for others who want to learn about ADHD, maybe a spouse or partner of someone who's recently diagnosed. I think it's a great, it's a great book, it has so much good content in there. So we'll and we'll definitely discuss that today. But yeah, just thank you. Yeah. And so before we hit record, you mentioned, you're asking me about how I kind of started this this podcast, was that right? Yes. Yeah. So it's a couple things. So one of them is that I have been, I've been part next year will be 20 years podcasting. I've, I've hosted multiple podcasts, or co hosted some over the years, and I've trained and taught people how to create podcasts and things like that. So it's always been a labor of love. And last year, I was diagnosed with ADHD at 50, just before my 51st birthday, but I was 50. Being the hyperfocus creative nerd that I am, I jumped right into it and launched Why squirrels.com as a resource to share what I was going through for other late diagnosed adults. But then the podcast also came as a way to speak to subject matter experts like yourself and high achievers with ADHD to also share their stories to inspire others. And yeah, that's kind of what brought me here. Yeah, that's great. And what prompted you to seek technosys? Was it something you've been thinking about yourself? Or was it a notch from somebody else? It was a nudge, I was in a mastermind with a couple of friends and one of them for our business. Basically, one of them I knew, and one of them I didn't know. And the one I didn't know, after a few months, kind of helping one another out, text me out of the blue. And as Hey, Dave, do you have ADHD? And I said, No. And he said, I think you do. And he said, You need to go talk to your doctor, because I have ADHD. And I, I see a lot of myself in you.
2:43
And so I went to see my doctor, and was diagnosed, the longer shorter version of this story also goes that in 2016, after my wife urging me to go and get tested for ADHD, I saw a psychiatrist a couple times. And somehow I missed the memo, that I was, in fact diagnosed with ADHD. And I don't know whether it was
3:12
a failed communication between the therapist and my doctor, or whether I missed it somehow, I'm not really sure it's a blank. But I figured what's what's a few more years
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in the majority of my life, not knowing so that's kind of how it how I came to learn.
3:30
Ya know, it's great to hear your story. And it's, you know, I'm always curious how people come to realize they have ADHD, because, especially if you're diagnosed as an adult, you know, they're many years before that, that you might not really look at yourself through that lens and not understand some of the things that you're doing, or what's hard for you.
3:54
And so, you know, is it, I'm always curious, is it that?
3:59
You know, it's something you read, there's so much more now information on online about it, is it that you're maybe a family member gets diagnosed? And then you think, well, maybe, you know, they sound just like me? Or maybe it's, you know, another notch from someone else? Like in your case? Yeah. Well, I, I have an ADHD coach, and she said, Dave, at this point, I think, you know, more than I do,
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because I've gotten, you know, fully into learning about ADHD for myself, and I always, you know, preface my presentations and conversations in this podcast that I'm not a doctor and nor do I play one on the internet. But, so, but it's always important to share that. But I have learned a lot and you know, especially, you know, to your point about, you know, adults discovery they have ADHD, like I know with women for example,
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far more women are being diagnosed these days only because they were men.
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because they were never looked to as candidates for ADHD because it was like the naughty boy syndrome right back in the 80s. And so women were just basically ignored or not even considered for ADHD. And it's only after having their children, a child diagnosed often that they see it in themselves or the father too. But you know, that That at least is my understanding of how a lot of different adults and especially women are diagnosed later in life. Yeah, that's, that's very true. And, you know, women tend to have more of the inattentive type of ADHD, so it's not as obvious. And it's also often comes with other things like anxiety, depression, a
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host of other challenges that become focus of treatment, and then the ADHD is never considered. Right. So you may, you may be seeing therapists, you might be seeing psychiatrists who are not always attuned to the fact that ADHD may be, maybe they're in the picture.
6:07
And so it's sometimes it is this moment, like an aha moment, right? Like, this really describes me or, wow, I, we, you know, if I really focus on this, things could shift and often they do, once you do address ADHD, a lot of other things can shift. Yeah, it's interesting, I started treating my ADHD before I was diagnosed in a way without realizing it. And, and what I mean by that is in in 2020, you know, the world was imploding for all the reasons that we know. But in addition to that, we had a tornado that came through Nashville, destroying my kids school. And then three months later, another storm that basically put 10 holes in our roof. And so we were displaced from our home for three months. And my job as a as a keynote speaker, and somebody who, who speaks a lot on stages, obviously, all the events had ended abruptly because of the pandemic, right. And so I had this, like, extreme stress from this financial crunch. And then also, my full time job became, you know, juggling insurance, my insurance company with contractors to try to fix our house so that we can move back in. So plus, my dad was sort of in his later stages of Alzheimer's, and dementia. And so there was that, and close borders, so I couldn't go see him. And it was just a lot. And because of all this, I was drinking a little more than I should have. And, and so I took 30 days off. And that 30 days became 60 became 90, and I'm now four years sober.
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And eight, yeah, thanks. And also during that time I started,
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I started a mindfulness like a meditation practice, and started taking meditation and journaling.
8:09
More seriously, in my own sort of mental health, I was seeing an online therapist in 2020, as well, who diagnosed me, you know, with, like, like a little depression and a lot of anxiety. But the ADHD, wasn't it that didn't come up. And getting back to your point about anxiety and depression and things or anxiety, at least is that knowing what I know, now, these are comorbidities of ADHD and that if you are not treating the anxiety, or if you're not treating the ADHD, then however you're treating the anxiety and depression may not have a lasting effect enough, because you're not treating the root problem, the root cause, which is the ADHD, which is something I've learned from Dr. Russell Barkley.
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And something that I've read from him also is life expectancy of those who are undiagnosed and untreated, can be up to 13 years less. And that's partly because of this. So I just rambled on for a long time, like a true ADHD ear.
9:16
Well, I mean, everything you said is, you know, is it's really true and important to know that, you know, there are these
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that ADHD and I often talk about it as vulnerability factor and vulnerability to stress that often ADHD doesn't travel alone, that you have some other difficulties that can evolve, like anxiety, depression, it partly because it's, it's hard to manage stress. And of course, life doesn't stop for you. There's you know, there's these periods of time when there is tremendous stress that can, you know, a lot of different stressors piling up like in your case, and it can be very difficult to kind of make
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your way through it.
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And people do tend to medicate self medicate, whether it is, you know, through substances that's more, you know, alcohol or smoking or other things like cannabis, that's pretty common with ADHD. It could be with work, you know, some people are work, that's not always the case of ADHD when there may be more of kind of paralysis and procrastination.
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But, you know, there are ways people try to cope without fully understanding what's going on. So once you address that, that core, or the root cause of ADHD, it can really make things different in terms of how you manage your stress, how you how often anxiety comes up, how much depression is in picture. Yeah, and I like, you know, you talked about in the book about how, you know, part of it is not with everyone, of course, and you know, no two ADHD cases are the same, of course, but with low self esteem and self doubt, and how those are common in ADHD. And certainly, those are common in myself.
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Yeah, you know, I like to say that ADHD, definitely can affect relationships, but the relationships with others, but also relationship with yourself.
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Because there's so you know, we know that ADHD is, you have good intentions, you have knowledge what you're supposed to do, but then you get in your own way. And that that can be very difficult, that can be demoralizing. And often people are self critical.
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And that's, you know, that's, that's what I see a lot in adults, there may be low self esteem, self doubt, self criticisms.
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And that's not necessarily in vacuum. Oftentimes, as children, you get these messages to write, that maybe you are not performing the way others expect you to perform. And so you're getting negative stuff coming at you. ADHD behaviors are often irritating to others, and frustrating. So you know, that you can you, you can pick up this this, that people are annoyed, or they're expecting you to do something different, and yet you can't control it. So that's, that's a difficult place to be in as a child. And then as you you know, become an adult than you yourself, you see yourself, you know, getting in the way.
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And that's, that can be very frustrating, and discouraging. And I like Oh, in the book, you talk about reframing ADHD, from being a deficit to more of a difference like a biologic, like focusing on Biological Diversity, for example, like, can you talk a little bit about maybe how we,
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as like, ADHD, or is that just we anyone can reframe? You know, ADHD? Yeah. So I think it's helpful to think of ADHD as an example of neurodiversity. I think there's a lot of talk about neurodiversity now, which means it's an you know, it's a, it's an example of differences that we have, the human race has in how they're wired,
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how they're, you know, how they're functioning physiologically how they're, and, and how on the cognitive level biologically. And we know that ADHD is a developmental disorder means you, you're born with it.
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As a child you already have in the signs of ADHD, we know it runs in families. So there's a strong genetic predisposition. It's as heritable as height.
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Of course, you know, we also know it's not kind of a gene that you turn on or off, it's often multi factor or multiple genes are contributing to the risk for ADHD. And so it's, you know, it's under spectrum, this second biological trait and the spectrum. And depending on, you know, the genetic loading, as well as an environment, early environment is so, so important.
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You know, you can still have more symptoms or less symptoms.
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And so, it's really important to, to have that framing. And it's, you know, it's, we focus so much on this the Deficit Disorder aspect,
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for good reason, because people are often struggling, and it can be seen as a disability and we have, you know, laws to protect those with disabilities at school and at work. And I think that Ross Barkley is you know, very vocal about that. Make strong point that you know, we can
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You don't want to minimize the struggle of ADHD. At the same time, you know, if it's a trait that can come with some
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other qualities that can be positive. What I see in it's not well studied that, but there is no indication that creativity or divergent thinking
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is heightened when you have ADHD. In my clinical work, I often see people being,
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you know, having
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a lot of interest, being kind of
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kind of Renaissance people. They have, you know, they know a lot about a lot.
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And they make connections between things and unique ways. And then you can see tremendous enthusiasm, tremendous heart. And despite, you know, these, you see these ups and downs in people's lives, people are quite resilient.
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Yeah, I find for myself that I get, like, I'm working on my next book right now. And I'm 18,000 words in and it is very much about ADHD in my life. And it's part memoir, part part professional development, or personal, personal development. And within the book, I've hit a wall. And I've gotten to this point where I know in myself that when I get overwhelmed, when I get too many choices, then I start to stall out. And it's why like, you know, I can become hyper focused on on something creative, like writing. But then when, when, but then I hit a wall suddenly, and this is something that actually I'm going through right now. Yeah. So you know, it's helpful to also we're talking about reframing ADHD, it's helpful to reframe ADHD as self regulation, or executive function disorder. I'm sure you've heard those terms before talking to others. And this is, again, a nod to Ross Barkley for
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talking a lot about this, that it's really a difficulty regulating attention, not necessarily deficit of attention, right. You can have distraction or distractibility. And you can have hyper focus. So it's just difficulty regulating the attention to, to the context, there's definitely, also definitely difficulty regulating emotions, and then also actions or behavior. So it's on these three levels, it's not just attention. And executive functioning has to do a lot with your actions, your task management skills, time management skills, and prioritizing, because there's this difficulty with filtering out information
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and active mind, right, so you're kind of seeing a lot and you connecting a lot of ideas, and then it can be overwhelming. You know, like, where do I start? Or how do I
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get focus and maybe stay somewhat linear in my thinking? Yeah, absolutely. Absolutely. Let's talk a little bit or let's talk a lot about mindfulness and meditation. What is your background in in exploring meditation? How did? How did that come about? For you?
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Yeah, so I was a resident in psychiatry, so I was doing my training and Psychiatry at UCLA, and became quite interested in holistic medicine at that time, I had a chance to
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leave my residency for a year and to take a deep dive into integrative medicine, working at the East Coast Center
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at UCLA. And during that time, I was exploring a lot of different tools, different methods in that space. And mindfulness is one of them. I did training with Jon Kabat Zinn, he's sort of the father of, of mindfulness. He created a program called MBSR, Mindfulness Based Stress Reduction Program, which is sort of the model of mindfulness training and in clinical settings and for stress in general. So I did the training there with him, became interested in another program that's just coming up, called mindfulness based cognitive therapy or NBCT. That was developed, particularly for depression. But it was a
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really a nice model of bringing ideas from psychology from cognitive therapy and mindfulness. And it was in the in the world psychology was a bit of a departure from just talking about things. And you know, and maybe looking at your thoughts and changing them to bringing mindfulness which is a training in
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By
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shifting your relationship to thinking and shifting your relationship to experience, and bringing the body a little bit more noticing body sensations more, and that's very helpful and awareness of emotions and self regulation of emotions. So it's very fascinated by that. I found it's super, super helpful for myself.
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And, you know, training is difficult medical training in many ways,
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you know, is is a practice of ignoring yourself and not paying attention to yourself, it just kind of learn to keep going.
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And there's often stress and burnout. And, you know, we know this is affecting a lot of physicians, in practice as well. But so it was, it was really sort of a different way of being with myself to do some of these trainings. And I went to meditation retreats.
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You know, that's, if, if anyone is ever interested in like a deep dive into mindfulness or meditation, I do recommend
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filing retreats for a few days, maybe starting just with two, three days, and then seeing how that goes, and maybe increasing to a week.
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And you know, that in those environments you really focus on like, how is my mind working? How is my body, you know, what's coming up for me? What feelings Am I feeling.
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And so that was, you know, that was partly, you know, my own personal exploration of that. And
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not after that I was doing a research fellowship, it was a
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Clinical Scholars Program. So I had, I was in a kind of lucky position of having some money to develop a research project of my own choosing. And
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I was actively exploring mindfulness and simultaneously starting to learn about adult ADHD. And this is came separately from mindfulness. This, this was
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when I was still training in psychiatry, I had actually couple patients,
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in, in my practice, that were women with ADHD, and I was working at the Women's Health Clinic
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at UCLA, and I had one after another, to patients that just had their children, and they were just falling apart, struggling tremendously. And it turns out that they were diagnosed with ADHD before they had their children, and had systems and had ways to pace themselves and, you know, take breaks and some strategies like exercise to help ADHD. But that, you know, that's very hard to maintain once you have a child, especially in those early days, right. And so,
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it was kind of a quick education for me in adult ADHD, particularly with women, because it was not a topic or subject that I learned about through most of my training.
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You know, adult ADHD was not talked about as much then. And I train as an adult psychiatrists. So it this, the topic was really not
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taught.
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So it, you know, I really
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had to quickly learn about it. And I was interested in that. I met
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a mentor that later on, became a research mentor. This was Susan Smalley, who was doing
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studies of families with ADHD. And so through that relationship, and through my exploration of mindfulness and adult ADHD, it became clear that these two areas can merge that they can really benefit from, from studying. And initially, when I proposed mindfulness for ADHD, I often talk about the pushback that I got that this was a setup for failure. That, you know, you're asking people who have trouble sitting still trouble paying attention, to do that in meditation, which is already hard for most people. And so, you know, it wasn't like a slam dunk idea that mindfulness should be used for HD. But when you
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experience mindfulness when you study it, and you know those, at that time, there was also a lot of interest in bringing the lens of cognitive psychology into mindfulness world. When you when you start looking at mindfulness as cognitive training, you start realizing you, you're doing a lot of attentional training. It's all about, you know, shift
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thing moving attention, creating a different awareness of your attention.
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And in that sense, it's a perfect match for ADHD, you know, when you when you, when you have a weak muscle, you exercise that muscle, right? Yeah. And so if you, if you want more control your attention, you, you exercise your attention.
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And it's not just attention training, it's also very much
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a global or, you know, overall self regulation, training, mindfulness is self regulation training teaches you to know, there's notice, notice your attention, your thoughts, your emotions, your impulses, your what you what you are trying to do, or are drawn to do. And it creates a space between you and those inner experiences. So you can make a choice or you have it have an opportunity to say, Hmm, you know, I could do something different, or I could stay with this a little longer to understand it a little.
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So it really builds awareness and build some skill and how you respond. Yeah, I find that's fascinating. I mean, the things that I've, I've discovered, through my own
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education, and mindfulness and meditation and my own practice that, you know, I tried to, I do every day, you know, at least for a few minutes here and there. But, you know, I read wherever you go, there you are by Jon Kabat Zinn, and who you mentioned, and found it to be, honestly, the best book I had read at that point on meditation. Certainly, reading yours, after the fact, was just such a good revelation of connecting the dots between ADHD and mindfulness. And I think a lot of people I was also going to ask are going to mention that the, the fact that my understanding, at least is that with ADHD diagnosis, increasing in adults, it was partly because of the pandemic and how our scaffold, we lost our scaffold, and we lost our offices to go to and so on. And I'd never thought about,
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I'd realized that that was a source of increases in diagnosis because of people losing their their quote, unquote, scaffolding. But how women after giving birth, losing their scaffolding and in their lives, also accounts for that increase in diagnosis, which I hadn't thought about before. I think one thing that I often get asked about is the difference between meditation and mindfulness, right, because the to get used to kind of hand in hand all the time, and your book doesn't. At least the title of it doesn't mention, meditation, however, it talks about mindfulness. And at least my understanding, really is that meditation is the training one needs to do or at least part of the training one needs to do in order to increase their mindfulness, because the opposite of mindfulness is mindlessness, right? And not focusing on on things. Can you talk a little bit about that difference between mindfulness and meditation? Yeah, that's a really important distinction.
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You know, many, meditation has many different forms. And mindful meditation is one form. It's derived from Eastern traditions called the persona or insight meditation. So in that context,
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when we look at some of these older traditions, mindfulness is almost synonymous with, you know, with meditation practice. But mindfulness can be really looked at as a different way of being with your experience, a shift in how you are noticing experience, highly relating to experience, and that can be done anywhere, anytime, in the midst of daily activities. So it does not have to happen in the midst of meditation. So we often talk about training mindfulness in two different ways. One is the formal way, which is doing meditation practice. And that could be an entity could be two minutes, it could be half an hour, you know, whatever the person's able to do. You know, it's this formal practice of carving out some time, and doing something a little differently than than what you normally are doing. It's almost like going to the gym for your attention. The informal practice of mindfulness is all the practices that help you focus on the present moment. And also utilizing that what you learn maybe meditation to start noticing your breath. As you are walking to Office, for example, like these many shifts in the midst of your of your day. It could be you know, tuning into how the water feels.
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As you're taking a shower, so this informal practice is also training mindfulness, these many shifts. And there are also other things other than meditation, or even this informal practice of mindfulness that can train mindfulness. So we think like journaling,
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you know, can help with that being in nature can shift you more into present moment awareness. So, I often like to think of like mindfulness as present moment awareness. And that present moment, awareness
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can happen in through meditation, meditation encourages that, it can also happen through different activities, and certain activities can actually help you with that, like being in nature, maybe gardening or cooking, when you really, you know, focused on the next moment as you as you're doing something, so you're not so.
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So there, you know, there are these different ways of, of being mindful.
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And I think it's, you know, you mentioned mindlessness, which is helpful to countries with mindfulness, another way of thinking about it is being an automatic pilot, right?
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So we do so much in our lives. And in the automatic pilot, which is not necessarily bad. You know, it's preserves cognitive abilities. Like imagine, I talked about in my book, like, if you were if you, if driving was always feeling like, it's your first lesson, right? Like, oh, I have to do this. And I have to do this, I have to pay attention to how am I moving the steering wheel? That will be exhausting. Right, if every time you got in behind you, do you felt that way? Well, if you rehearse something many times, and that goes for driving or any other habits, even mental habits, you know, they become more automatic. We're not thinking about it. Yeah. Well, our body's just doing it, or our mind is just doing it. And so mindfulness is kind of trying to step out of that, stepping out of that automaticity automatic pilot, and being more aware of what's happening at it as it's happening. And that creates a choice because, you know, we, we get stuck in our habits, right. And some habits can be especially mine habits can be really painful for people. And a lot of ADHD behaviors are out of that automatic pilot. Yeah, no, it makes it makes a lot of it makes a ton of sense. I mean, I was gonna mention Sam Harris, do you know Sam, Harris's work? I do. Yeah, yeah. So I was I use his meditation app waking up and quite enjoy his work. And yeah, he mentioned that once about, to your point about driving where like you drive to work, I believe the reference was driving past your exit, without realizing. And that's happened to everybody where you're deep and thought about whatever, and you're driving, and you pass your exit, where you know, you're supposed to get off, you get off every day, where was your mind at that moment, and why wasn't your mind on the cars around you and focusing on what was most important, which is, you know, which also accounts my understanding, at least partially about, you know, that life expectancy of ADHD errs, who are not treated, you know, where you're mindlessly driving, and suddenly you get an accident to talk a little bit about your acronyms stop, because that's a big focus I find in the book and something that really stood out to me.
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To this point about mindful, yeah, yeah, that is one of my favorite practices, partly because you can do it more as a formal practice of like sitting down and, you know, doing quiet meditation, and, or you can do it, you know, in the midst of your day, like, it could be very brief. And still, the steps can can be done, you know, it could be a minute, or less than a minute, you kind of learn how to
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how to do it. And so, the stop practice that each letter stands for something. So it's a little pneumonic or reminder of what to do, which I think is helpful when you have ADHD. Right. So it's like, it can help you say, oh, can cue you
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what the practice is about. So as is stop or pause, tea is take a breath
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or a few breaths, oh is observe in the present moment. And then P is proceed and, you know, proceed with more awareness and maybe creating a new choice.
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So, the way it happens, you know, is even as we're talking right now, but we can for a moment,
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like pause, even as I'm talking, I can do a little bit more of like a
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C
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Have her breasts. And then you know, observe a little bit how,
35:05
how things are like, how, how am I feeling? You know? Any, like, how am I sitting, how's my back feeling? What, you know what else may be there in the background of my mind, but I can bring more attention to it.
35:22
And, and it's a really mindful check in practice. And once you check in, then you proceed with that with this deeper self awareness of, you know, do I need to change something?
35:38
Is there a need that I rent recognize for myself? Do I need to,
35:45
you know, continue as I am? Or do I tweak something. So I liked that practice, because it is a practice of that isn't
35:55
is an antidote to being
35:57
elsewhere that then yourself or elsewhere, then the present moment, which is an issue with ADHD.
36:05
You know, with ADHD, that there's, there's so much often activity in the mind, right, there's this very active mind cloud.
36:13
And you're also distracted by things in the environment, sounds or other people.
36:21
And, you know, all of us now have so much attention pulled by devices, whether it's the phone or the computer. So the attention is often
36:34
out, it's not, you know, it's in your cloud space. But that can take you to the past or, you know, to the future, doesn't always focus on the present regularly, you know, when you're in your mind, you are somewhere else.
36:51
So, it's, it's hard to actually be fully aware and in the present.
36:58
And, you know, there's lots of things in the present. It's kind of maybe, maybe just to make it more concrete, there's lots of options in the present moment to, to focus on. And sometimes people may say, like, what's the point of focusing on, you know, my, my breath,
37:16
breath, of course, there's, there's a, there's ability to like deepen your breath, you can, with deeper breath, get more relaxed. So, so that's often a focus of meditation. But in mindfulness practice, you can also focus on
37:33
you know, the sound of traffic, that could be a practice.
37:38
And then just notice, you know, is it pleasant or unpleasant. But what you're training, when you focus on traffic, is you really training meta awareness, meaning, you are moving your attention at will, someone returning to that if you get distracted, you're observing this process yourself.
38:00
And you're just a lot more aware of that experience. You can also choose
38:06
to drop that focus and move to something else. You talk about that in the book about like, dropping into awareness, that meta awareness of, of what's going on around you, or whatever is happening inside you to talk a little bit about because something I found very helpful, in my own practice from your book is about labeling thoughts.
38:31
Yeah.
38:33
You know, there's a saying in psychology, psychiatry, you name it, you tame it, there's such value in putting words on your experience, because it creates a lot of ships. So being able to observe and also name what's happening, it can help create space between you and that experience. And it's also helpful to think about how naming happens, you know, we get so attached to our thoughts and feelings. So it may be helpful to just name them as a certain phenomena, as opposed to I'm thinking this, I'm feeling this.
39:08
I remember, when I was learning mindfulness early on, there was a training and, you know, going through your body, what's called body scan, when you put attention on the top of your head and you notice your forehead and you move your attention to your chin, or your cheeks and shoulders and arms and so on.
39:29
And there's an emphasis to say to not say my shoulder, but Oh, shoulder, right? It's not your, you know, moving attention to your, to your hand, but moving towards the hand or noting to some arm and Oh, knee.
39:48
And that it's also helpful to, to, in the practice to eat when you have your thinking about something is to just say, oh, there's a thought. It's a thought.
40:00
or emotion, or you can name that emotion. Like, there's fear, I see fear.
40:08
And try not to personalize too much of what you're observing. So the language helps you with that shift.
40:15
You know, there's rejection sensitivity, which is an issue who ADHD or there's, there's pain, I feel hurt, I feel hurt or there's hurt.
40:26
So the labeling however it comes, you know, I don't want it to make it too hard for people to label but it's just, it's, it's a nice practice to play with this naming experience and creating some space. Yeah, you mentioned body scans, and I have had you in my ears, going through your own body scan meditation, which, Can I include that so that people can do that? Would that be okay, sure. Okay, awesome. Yeah, um, one thing that has come up recently, and then it's come up, you know, here and there, and the sort of Zeitgeist is at least alleged or perceived, or perhaps real dangers associated with the practice of mindfulness? Or you? Can you speak to that at all, as far as you know, one thing that I read was a push to add disclaimers or warn people of possible, you know, negative side effects of the practice of mindfulness and meditation. Can you speak a little to that? Yeah, that's, that's a great question. You know, there is some caution of doing prolonged form of practice, meaning prolonged meditation, like at a retreat, or,
41:43
you know, especially like a silent retreat when you are just with yourself, and you creating almost like a very
41:52
new state for yourself, that if there's history or vulnerability to things like psychosis, or borderline and bipolar disorder, or mania, that sometimes that you know, that intense meditation can precipitate the symptoms. And so you have to be careful when you have that history. When you have this, this may be family history and doing very intense, and, you know, very extreme, you know, meditation practice.
42:31
If the practice is short, and you know, for no of mindfulness, if, if you're doing this for five to 10 minutes, and if it's more than midst of daily activities, that caution is not as you know, not as strong.
42:46
I don't, you know, I
42:49
that, that is that likely that you will create this, this altered state in a way that will provoke symptoms. What can happen though, when you have this briefer minute mindfulness practice meditation practices that,
43:04
you know, you can sometimes get really discouraged or frustrated, or get lost more in your mind. And that's difficult if you already are struggling with significant anxiety or depression.
43:19
Big because you, it's just very hard to step away from those thoughts. So when you do practice, they can actually flooded or that can also happen if there's some history of trauma. And so if if someone has significant anxiety, significant depression, mindfulness practice might not be for them, it may be a practice to incorporate in the future, once you're out of that acute state, or phase. When you
43:48
when you do mindfulness with with trauma history, might be helpful to do it with someone else, like with a, with a therapist that can help you learn some tools to recognize when you're getting flooded too much with memories and, and then come back and grounded in the
44:06
present moment. So mindfulness can be very helpful in those situations, but there may be a nuances that you need to know about, and somebody can help you with, when you have this history
44:20
of you know, some mental health struggles. So I think that's the caution in general, you know, brief mindfulness in daily activities. I don't, I don't worry about my patients doing struggling with that. But you have to you know, you have to think about these and see if what's true for you. Yeah, that's great. And that's that's a good point, I think. Yeah, some of the meditation, some of the practices and things that I've done, usually guided through different sources, but like one of them was was like in front of a mirror looking at myself, and that got a little weird
45:00
because, you know, there you are staring at yourself for an extended period of time, I think there are a lot I, at least in my own experiences, certainly and again, not a doctor,
45:12
I have found the rewards of mindfulness practice and daily meditation practice to be just just so, so helpful of just reframing thoughts. And being, you know, giving myself more grace, I have friends who, you know, I'm not one that pushes things on people. But, you know, I have a couple close friends. And we've talked about meditation before. And, you know, often the, the feedback is, well, I can't, you know, I can't concentrate on my breath for that long, you know, I think about stuff. And I always say, one of the one of the things that I've learned is, is to, like, as you have a thought, instead of trying to like, get it out of your head, think about the thought and let it play out, like a little short movie in your head. And I found this to work really well. So that if I'm thinking like, if something I need to do, let's say, pick up my kids from school or something, then I just imagined myself driving to the school, you know, in the car line, picking up the kids, they say, Hello, we play some music, I drive home.
46:18
And that's it. And that thought goes in and out of my head just as quickly or even faster than I just articulated it to you. So
46:29
I find giving yourself permission to let these these visions or thoughts play out like short films, and then returning to the breath has been really helpful for me. Yeah, you know, just, you know, something to know about is it's helpful to learn mindfulness in a group with others. With a teacher. You know, we have so many mindfulness apps and things like that, there's maybe a little bit less opportunity to check in with someone, like, Hey, I'm having this experience with this difficulty, and getting feedback. But that can be tremendously helpful when you're first learning mindfulness. And mindfulness is versatile. So there is different practices.
47:15
And sometimes, you know, some some practice may resonate with someone more than other.
47:21
And they're different practices at different times,
47:25
that are more helpful. So, you know, if there's a talk in my book, you know that there's times when you return your attention to your breath, and you practice, just kind of ignoring your thoughts, though you'll never empty your mind. That's one misconception. But you sort of notice the thought, and then you return your attention to your breath, and you try to stay on your breath. And I like to say it's practice of returning to the breath, not staying on the breath, because it's impossible to stay on the breath.
47:56
So it's, you know, if you get distracted 100 times you return 101.
48:03
And, yeah, that's one practice. And there's another practice, which is more like awareness of thoughts, which is a little bit I think, what you were talking about, which is, you use your breath as kind of an anchor, but you also practice just being like a witness or observer of this stream of thoughts. You know, in, in our program, we talk about watching thoughts as if there were clouds in the sky, you know, they come in your view, you can see that and then you let it usually go away, or some other cloud comes through.
48:38
Another visual that sometimes used is, you know, their thoughts. They're like leaves on the stream, and you're sitting on the bank and watching the leafs go by, and you don't hop on the leaf, right? You don't float with the thoughts you don't let the river take you away, try to stay anchored. And the breath is the the way to stay anchored. So if you start noticing that you got lost in your thoughts, as you were watching them, you come back to your breath, ground and then again, kind of bring the curiosity to to, to see like, what you know, what else do I notice? Yeah, that's awesome. You talk in the book you mentioned and I'm being mindful, pardon the pun, of our time of our time here. So I do want to make sure I don't, you know, take too much of your time here. But you wrote that if we practice belly breathing, we can induce the relaxation response. If you tend to be a habitual chest breather, a trait linked to anxiety and stress. Breathing through your belly may feel unnatural at first, so don't force it. Can you talk a little bit about steps to breathe with your belly? Because this really stood out to me because after reading that, I realized like so often I am breathing through my chest and not through my belly. I think, you know, I've got the former beerbelly tiny
50:00
but it's still there. And so, you know, as so many self conscious people, you know, I'm always I think I'm naturally sucking in my belly at any given time.
50:11
You know, you almost like, I haven't thought about this before, but I almost think about the image of the Buddha and his big ol belly hanging out.
50:20
I've never really, I've never really connected those thoughts. But there you go, like, yeah, maybe that's why he's like, you know, letting it all hang out. can tell us a little bit about some some strategies for focusing on the belly when you breathe. Are there ways to do that?
50:35
Yeah, well, first of all, you know, we naturally
50:42
shift into like chest breathing, or a little bit of like a shallow breathing, when we're stressed, anxious or even busy. Sometimes I see often people that what they need to do when they focus, they kind of hold their breath.
50:57
And so there is that tendency to breathe more shallow, maybe more faster, it's kind of associate with more stress and anxiety type of breathing. And that can become habitual.
51:11
We also know that if someone is relaxed,
51:16
you know, or kind of, the more the parison. So the stress state is more sympathetic nervous system, the relaxed state is the other nervous system, parasympathetic nervous system, when you, when you are kind of softer, your muscles are softer, you're breathing more deeply, and you're breathing lower in your belly.
51:38
So the a lot of practices of meditation is to try to help you induce the relaxation. And it's a two way street. So when you relax, to tend to breathe more through your belly, but if you kind of force yourself, not force yourself, but like invite yourself and practice doing more belly breathing, it can shift the physiology towards relaxation.
52:02
So, you know, there's value in this people called diaphragmatic, or belly breathing, that you can induce more relaxed physiology. But, you know, if you're really stressed trying to do that, it's like trying to put a brake on a car in motion, right? Like you revved up and you try to switch it to, to stop and it's not going to happen right away. So there's, there's a need for some, like gradual shifting. So sometimes when people have a lot of,
52:33
you know, have the habit of breeding to their chest, I often recommend just starting to observe that tendency first. And you can observe that by putting hands on your chest and your hand on the bell and just noticing, like, what's moving on your head on your chest or your your hand on your belly. And as you observe your breath, oftentimes, people do relax a little bit, just by kind of being a little quiet and observing the breath. And it becomes easier than to do a little bit more of the belly breathing. And what can help can help is
53:11
thinking of inhaling to count count of one and exhaling to the count of two. So the exhaling is little longer, okay? Like one to two ratio, in a way, there are different ratios people have for breathing, but I like the simple one, take a breath in, and then, you know, pause for a little bit, notice the transition, to exhale, and then you exhale a little longer, maybe twice as long as the inhale.
53:41
It can, it can help to have like an your hand on the belly. Or you can, it can help to have an image of like a balloon that you expanding in your belly. In general, if you lay down on the floor, it's easy to breathe through your belly. So that could be one way of kind of exploring that, like, you know, stretching out on the floor, and then putting your hand on your belly and breathing through your belly. You know, seeing how that feels. Some people say you know, if you, if you play with the breath, it may be helpful to inhale through your nose, and then exhale, slowly, slowly through your mouth as if you were like blowing out a candle. Right?
54:29
So it's like a little naturally start navigating that that exhalation, one of the debuts with people and, you know, maybe that will resonate with some listeners is that, you know, belly breathing is in the more relaxed breathing is often like climbing up a slide on the playground. You climb up by inhaling, you pause on top of the slide, and then you exhale and it's like a little longer.
55:00
So this is one practice, it's almost like you're
55:03
taking a little sigh, right? So that's another practice to kind of shift into more of that
55:13
parasympathetic, longer exhalation, belly breathing. Yeah. I love that analogy of the slides. That's that's a great one. Yeah. Well, just before we wrap up, I did want to ask you about achieving goals. And using mindfulness as a way to do that, of course, that's part of the the sub on the title of your book, can you maybe share quickly some some tips on using mindfulness to help help you achieve your goals, whether they're professional, personal, yeah, my things can be used in different ways. In this context, one is learning to observe what gets in the way of your goals, right, because a lot of people that Ichi know what to do, it's just that they have trouble engaging and overcoming avoidance and procrastination.
56:00
So mindfulness can be used to kind of tune in when you are procrastinating and trying to tease out what's getting in the way, is it stress and you completely overwhelmed, as you recognize that you can then have more skillful next steps, like, maybe go for a walk and come back with a fresh mind, maybe I need to write things out for myself. Because in my mind, it's, it all feels too big, once I put it on paper, it may feel a little different. Maybe I need to call someone and tell him that this is what I wanted to do. And as you're talking and declaring what you're doing, it's a little bit of an accountability. And then, you know, you can mobilize you and help you get over the hump of the procrastination. So in that sense, you know,
56:48
mindfulness can be helpful. It can also be helpful, you know, when you recognize, let's say, the procrastination or avoidance,
56:57
to to have this what I call Mindful self coaching voice. So there's part of you that
57:04
is stuck. And a part of you that you can try to engage to mindfulness to talk, you talk to yourself, and it's very important not to talk to yourself through self criticisms,
57:17
and saying, Well, what's wrong with you? How come you're not getting this done.
57:21
But you know, mindfulness is very much about also shifting your attitude towards kindness or compassion towards yourself. So, you know, talking to yourself, as you know, first you tune in, you notice, I'm stuck, I really don't know how to start. I don't want to do this, I rather do this. But, you know, this thing is over there. You know, this paperwork is staring at me, that you tell yourself, you know, this is hard for you, you know, how can you help yourself get get started, maybe just do one little thing at a time, maybe put some music on. Maybe think of what's most important today, and not let all of the things on your to do list flood you, right with like, so much stress. So some of these tools are used in you know, in coaching and cognitive behavioral therapy. But Mindfulness helps you kind of activate that knowledge and not let the overwhelm or the avoidance of procrastination be, you know, drive you and keep you stuck. Yeah. And the other piece that I just and that's a bigger conversation is, it's so easy to be scattered and have too many goals when you have ADHD, and say yes to too many things. So there's another, you know, play. It's, there's also a place to either by yourself or with someone else, help you narrow those goals down. Right? Or learn how to how to prioritize and say no to some things.
58:55
Which it's easier for some harder for others. Yeah, I feel that firsthand, often. So this has been incredible. Is there anything I didn't ask you about that you'd like to like to share? I think, you know, we've touched on a lot, a lot touched on a lot of different things. And I would just emphasize that mindfulness is very versatile. You and you don't have to meditate, to start learning some practices. I think what's often very helpful is to maybe take a class,
59:29
explore different things around mindfulness, maybe
59:34
check out a couple different books and different apps and finding something that works for you. Sometimes people think they, you know, they're failing at mindfulness, but there's just so many different ways to become more present. And oftentimes, it's helpful to find what what is happening for me already in my life that I do. And it's a kind of natural place where I can bring more awareness
1:00:00
That's where mindfulness to, that's the informal practice of mindfulness of saying, you know, I like cooking. So maybe when I cook, I can be more aware of, you know, chopping, and noticing the vegetables or the food and smelling connecting to my senses through the, through the cooking, or maybe you know, you're a gardener, you'd like being on site, or hiking in nature, it could be just finding one activity could be when I'm with my pet, you know, my cat, my dog, you know, I really tune in to them. And I'm a pets often do that there's a spontaneous shift into present moment.
1:00:38
Same thing with children, sometimes, you know, especially little kids, when they're just see things in a different way through a different lens, it helps us to tune in differently, as well. So I just want to emphasize that that, you know, there's no one way to do mindfulness. And I hope people just explore and be curious about their experiences, or they engage with different types of practices, and find the ones that they can do for themselves. Like, not one size fits all, I would say, if people are trying to find classes, do you have any tips for that I know, there's like, you know, TM, which I hear is so many good things about, but I've never pulled the trigger on spending 1000s of dollars on getting my mantra,
1:01:24
or mantra, any, any thoughts about or resources that you can think of, like from a community in person? I know, obviously, you're in a different part of the country than I am. But any tips for listeners? Yeah, so you mentioned TM, which is actually a different tradition of meditation.
1:01:44
Although there's some overlap with mindfulness, like, you know, in mindfulness, the mantra is the breath. In TM, there's more of like a word or sound and you trying to train yourself, maybe to have a bit of an altered experience, with mindfulness you're more aware of, to experience as it is. So there's some, you know, the different different styles, different practices. But if someone wants to, you know, start with mindfulness practice, there are so many online versions now, especially since the pandemic, there are different centers that offer online classes. You know, there's a University of Minnesota, we have the backend center for spirituality and healing. And there's lots of there's a place
1:02:38
there's lots of mindfulness resources, if you go to that website, and some online classes. So I would encourage people to explore that. There's UCLA Center,
1:02:51
UCLA, mindful awareness center, they also have online classes, they're very much based on the work I did with ADHD. So they tend to be very gradual, starting with five minutes. And, you know, increasing meditation very gradually.
1:03:08
So, so that there are, you know, in most communities, there may be
1:03:14
MBSR class or MBCT class.
1:03:19
Those are kind of friendly, beginner friendly classes, too.
1:03:24
And there are, you know, the home of mdsr, the University of Massachusetts, and also Brown University, they both have centers for mindfulness, and offer things online as well. So I would say, you know, checking out what's closest to you, the, a lot of places will have this, you know, option of online or in person. There's lots of, you know, mindfulness is derived from Buddhist contexts, Eastern meditative tradition. So, in some communities, you may find a meditation center that's more steeped in that tradition. You know, that's of interest. There's often a community there and an options of attending different classes.
1:04:10
So,
1:04:12
you know, I,
1:04:13
another one, I want to highlight it, UC San Diego has lots of online classes, the mindfulness center there, including for teens,
1:04:24
and parents and adults. So.
1:04:27
So there's, I would say, those are the, you know, checking out some of the academic mindfulness centers is a good place to start. That's great. Well, the book is called the mindfulness prescription for adult ADHD. It's a fantastic read and lots of great resources. I took tons of notes. So thank you for creating such a valuable resource for both, you know, neurotypicals and neurodivergent people I think, yeah, it's it is a really great books. I do encourage everybody did
1:05:00
to check it out, Lydia, how do people get a hold of you? They'd like to learn more about your work. Sure, they can tell me reach out to my website, Lydia's alaska.com.
1:05:12
And, or they can find me to the University of Minnesota and and check in. There are two more resources I want to mention that I forgot to mention. One is
1:05:24
either the attention deficit disorder Association, nonprofit serving adult ADHD, they do have a mindfulness group online.
1:05:35
And so if you want it to, if people want to connect with other add adults doing mindfulness, that's a really good place to check out. I also recently created a YouTube channel which is at mind for our x, ADHD and put a free mindfulness practices there as well. And so that could be a place in addition to my website.
