Reframing neurodiversity

Current approaches to Attention Deficit Hyperactivity Disorder (ADHD) often focus on controlling or mitigating behaviors that deviate from the norm. These methods, which include medication and behavioral strategies, tend to pathologize ADHD traits by viewing them as problems to be fixed.

Internal Family Systems (IFS) therapy offers a unique approach by recognizing and valuing the different parts of a person that emerge with their ADHD diagnosis. Rather than viewing ADHD symptoms as deficits, IFS sees them as unique and necessary responses to one’s neurological makeup and life experiences. In therapy, IFS encourages slowing down and tuning into body sensations, promoting self-compassion and a clearer understanding of what is neurological, what is psychological, and the parts that bridge these aspects.

Neurologically, ADHD involves differences in brain structure and function that affect how individuals process information and regulate attention. Psychologically, people with ADHD experience the same as everyone else when it comes to the influences of family, community, and broader cultural contexts on behavior, cognitions and beliefs. These influences drive the creation of parts that strive for success, prevent pain and manage aspects of our lives in functional ways.

However, these hardworking parts often struggle because the underlying neurological architecture of ADHD makes it challenging to achieve the various levels of expectations and standards within our lives. This disconnect between their efforts and the outcomes can lead to significant frustration and shame within the systems of individuals with ADHD. Feedback from parents, teachers, peers, and partners often highlights these shortcomings, reinforcing a sense of inadequacy, defectiveness, and need to improve. Individuals with ADHD frequently face challenges in achieving the same levels of success as their peers. They may struggle to attain good academic grades, stay in jobs for extended periods, or to remain steadfast in hobbies and interests. They can find it difficult to stay calm during stressful situations or to manage day-to-day responsibilities like organizing tasks and meeting deadlines.

IFS therapy targets these diligent parts, offering them understanding and support. By working with the parts that feel burdened by the need to achieve and adapt, IFS helps individuals with ADHD understand their unique strengths and limitations, fostering a more compassionate and accepting relationship with themselves. This holistic approach reduces frustration and can help individuals understand their interaction with the wider world. This capability is explored in the case of AB.

AB, a professional in his mid-30s, had always felt like he was in a rush. Diagnosed with ADHD, he found himself perpetually anxious about his career and future. Despite outward success, he couldn’t shake the internal sense of stagnation and lack of satisfaction. In session, we focused on this anxious part of him that seemed preoccupied with career milestones, success, and the fear of not measuring up. This part was heavily influenced by the cultural markers of success—climbing the career ladder, maintaining long-term goals, and meeting the expectations set by society, family, and peers.

As we explored this part with curiosity and self-compassion, a deeper layer beneath the surface anxiety emerged. There was an exile (a vulnerable part) carrying a profound sense of not being good enough and too much. This exile had internalized the recurrent criticisms and high standards communicated by society and close relationships over the years. However, even after the unburdening process, AB reported feeling a persistent somatic sensation—a feeling not rooted in the past but ever present.

This sensation was constant, a non-intelligent rumbling that AB experienced with an undercurrent of dread and uncertainty. This sensation would surface in numerous contexts: at home, at the gym, with family, or watching TV.

Initially, AB’s parts interpreted this tremor as a harbinger of impending problems, signaling the need for immediate action. However, from Self he was able to reframe this sensation as a manifestation of his ADHD—a baseline restlessness inherent to his neurological makeup that he learned to hold and embody.

Realizing this, AB could see that his frequent urges to change jobs, relationships, or make other significant life decisions were misguided attempts to quell this internal disquiet. His parts had been reacting to the sensation as though it were an earthquake, prompting unnecessary life changes in the hope of escaping perceived intolerance of uncertainty. With his new perspective, AB’s parts began to tolerate and understand this restlessness without feeling the need to act on it.

In practical terms, AB recognized that this restlessness had influenced many of his daily decisions. By acknowledging it as a neurological sensation rather than a psychological crisis, he developed a greater awareness and curiosity about his choices. The parts of him that worried about stagnation and feared the future started to relax. By accessing Self, he understood that not every discomfort required a drastic life change.

With this newfound clarity, AB reframed his relationship with his ADHD. He learned to live with his restlessness without letting it dictate his actions. He experienced a new sense of inner peace and stability that had eluded him for much of his life. This shift allowed him to notice his restlessness and be more mindful of his responses and daily decisions. Curiosity and somatic focus can assist with separating the neurological and psychological aspects of ADHD, which in turn can lead to a deeper understanding and insight.

It’s important, however, to note that there is no direct evidence that links IFS treatment to improved outcomes for ADHD. This article does not claim that IFS is a standalone treatment for ADHD. I wrote this to highlight how IFS therapy can offer a language and framework to help individuals with ADHD view themselves more compassionately. It’s always best to also work alongside evidence-based interventions.

By combining the strengths of IFS with existing evidence-based treatments, individuals with ADHD can benefit from a more holistic and supportive treatment plan that not only addresses their symptoms but also honors their unique neurological and psychological landscape.