ADHD and Executive Dysfunction: Confronting Shame and Embracing Healthier Ways to Adapt
Published on
June 6, 2023

ADHD and Executive Dysfunction: Confronting Shame and Embracing Healthier Ways to Adapt

Tyson sits down with Dr. Baylee Hoey to discuss the kinds of executive dysfunction someone with ADHD might encounter, the kind of shame they might feel throughout their life as they have difficulties adapting to the world, and how they can create healthier and creative coping strategies to help navigate life.
Hosted by 
Tyson Conner, MA

Tyson Conner  00:10

Do you want to learn about psychological growth without sorting through the jargon? You're in the right place. This is the Relational Psych podcast. I'm your host licensed therapist, Tyson Conner. On this show, we learn about the processes and theories behind personal growth, and experience a little bit of it ourselves. Join me twice a month for candid conversations about therapy and psychological concepts with real mental health professionals using understandable language and simple experiments that you can try yourself. Keep in mind this podcast does not constitute therapeutic advice, but we might help you find some. And today, my guest is Dr. Baylee Hoey. 

Baylee Hoey  00:52

Hey there! 

Tyson Conner  00:53

Welcome to the show.

Baylee Hoey  00:54

Thank you so much for having me. I'm excited to be here. 

Tyson Conner  00:57

Dr. Hoey is a therapist and postdoctoral psychology resident at Relational Psych. And today, we're going to be answering the question, how does executive dysfunction impact people with ADHD? So, how does the executive dysfunction impact people with ADHD?

Baylee Hoey  01:17

What a multifaceted question, I'm so excited to talk about it. So I'm really passionate about things around executive functioning with ADHD. And I really like to come at it from a standpoint of paying attention to how shame and self concept can be really impacted by understanding or not understanding how executive functioning issues might affect you, particularly if you have ADHD. As we talk, we'll talk about how it can impact -- it can come from all sorts of different sources, not just ADHD. But starting off with just the idea of what is executive functioning.

Tyson Conner  01:53

Yeah, that was gonna be my first question.

Baylee Hoey  01:57

So executive functioning, it's a set of cognitive processes that help us self regulate, so we can effectively plan and prioritize and sustain effort toward our long term goals.

Tyson Conner  02:07

So to slow that down a little bit. Executive functioning, when you say "a set of cognitive processes," what I'm hearing you say is that executive functioning is kind of a bunch of things that fall under that umbrella. Executive functioning is sort of a broad term that covers a bunch of things that we do with our brains. Cognitive functioning is like brain functioning. And these are specifically things that help us plan, prioritize, and put our energy towards a certain goal or certain activity.

Baylee Hoey  02:33

Yeah. So this is all the stuff that makes us go from, "I know, I need to do this thing or want to do this thing" to actually executing that thing. Especially when it comes to not just short term goals, but with long term things where there can be like, so many steps involved. All of those executive functioning processes are very helpful or necessary, toward organizing ourselves to be able to get to the place we want to be.

Tyson Conner  03:12

Gotcha. So if we like, if we imagine, you wake up in the morning, and you look at your folded clothing that needs to be put away, and we think, "Oh, I should put away my foot clothes," executive functioning is everything necessary to put away those clothes?

Baylee Hoey  03:31

Yes, exactly. Also, the fact that they're already folded. I mean, like, that's handy. 

Tyson Conner  03:35

That's true. 

Baylee Hoey  03:36

And if you have executive functioning issues ,that already might be a win for the day. Just having them folded is enough. It might be, but that's a good example. Exactly.

Tyson Conner  03:47

So what are some specific things that fall under this broader category of executive function? What's an executive function?

Baylee Hoey  03:56

So one executive function is something like just self awareness, being able to direct your attention toward yourself and what you're doing. Sometimes with executive functioning stuff, it can be really hard to direct that attention toward yourself. Or it can be really difficult to direct your attention elsewhere, you can get kind of stuck either paying far too much attention to what you were doing or what's happening inside your own head or own body. Or that you can get a little blind to it and get distracted by other things. So that's just one. But one thing that we already talked a little bit about, just with idea of getting up and folding clothes, is the idea of like self motivation. So being able to get up and do the thing you need to do - like the 'umph' you need to just start something. That's something where with some people, that's not that hard, they see a thing that they need to address or that they need to go get and I can get up and go do it. If you have issues with executive functioning, just that act of getting up to do it can be so difficult and sometimes a little bit impossible for a while.

Tyson Conner  05:01

Hm gotcha. So self awareness, self motivation. These are a couple of executive functions. Are there more?

Baylee Hoey  05:11

There are several more. A couple others have to do with working memory. So that can be nonverbal working memory. So visual imagery, or how you hold things in your mind, how you can manipulate information in your head.

Tyson Conner  05:25

So is that what working memory is? So working memory, that sounds like that's different than, "I remember what it was like to turn 10." Like, what's working memory?

Baylee Hoey  05:38

Working memory -- I like to think about is what you're working with in the exact moment, like the information that you want to be able to draw from or work with in your head in the moment. Like being able to hold numbers in your head, not just  from looking at a piece of paper to typing it into your phone, but having to hold those in your mind for a minute without forgetting about them.

Tyson Conner  05:58

Gotcha. So when we use the word memory, we're often talking about like, "I remember when I first met my partner," right? And that's like a narrative memory. And working memory is more like what you just described, right? Someone says, "The door code is 521" right? And then you don't have to double check the text message with the door code on it, between getting out of the car and walking up to the door. Sure. Okay. Okay. Gotcha.

Baylee Hoey  06:26

Exactly, exactly. Another example could be almost just holding the image of someone's face in your mind for a moment. Like you meet someone new and maybe their face really sticks with you. Maybe other times, it almost feels like you've forgotten what they even looked like, or what someone was wearing or something just two seconds later. And so it's the idea where it might not just be information that can be numbers, or it can be words or whatever. But it could be images too. Other ones also include emotional regulation. So being able to use words, use images, use self awareness to process and I guess manage emotional states. That's something that's a big part of again, that organization and regulation of of how you're feeling

Tyson Conner  07:15

Interesting. So it sounds like emotional regulation is kind of not one specific thing, but it's kind of the result of a lot of different executive functions working together. Is that true? 

Baylee Hoey  07:26

I think that's fair. Yeah. 

Tyson Conner  07:27

And that's just the ability to have a big emotional experience without having some kind of a meltdown or feeling too overwhelmed or feeling a kind of like, being dissolving inside.

Baylee Hoey  07:41

Yeah, exactly. Exactly. And so if you do have more difficulties with this part of executive functioning, those emotions might feel really intense. Sometimes that can be great to be able to feel your emotions that intensely, but also it can involve a lot of burden or effort or exhaustion, or difficulty figuring out how to manage yourself in your day when you feel things so deeply.

Tyson Conner  08:04

Gotcha. Okay, any other executive functions that we should make note of?

Baylee Hoey  08:11

Two more. One is about inhibition. So being able to restrain yourself to be able to delay gratification. That can be something that gets difficult when that impulsivity can come out?

Tyson Conner  08:27

Yeah, that was the word that I had in my head. Like when when people say they're impulsive, they might have an executive function issue around their inhibitions. 

Baylee Hoey  08:35

Exactly. And that can be for different reasons, too. I mean, when I think of someone with ADHD, sometimes it feels like that impulsivity is coming from that lowered inhibition. Other times, it might feel like, "Well, if they don't do it right now, then they're gonna forget, or they'll never get done." And so that can look impulsive, but part of it is about that self management of, "Well, you know, if I think of it, now I just have to do it now or else, it'll never happen." And then the last one that I'll bring up, is about planning and problem solving. So how you come up with ways of doing things, how you can work with issues in your head to tease out all those different parts, all those different steps, reorganize, map out, see how to address a problem. All of that - if there are issues with executive functioning - can get really messy or difficult. And maybe you zero in way too much on all the details, or it's hard to hold all those details in your mind at once. And so the process of actually planning out and sticking to steps of a plan can be hard.

Tyson Conner  09:36

Gotcha. Okay, so that's a lot of executive functions.

Baylee Hoey  09:43

So if you have issues with that, watch out, because it's impacting your whole day.

Tyson Conner  09:49

Are there other things that can impact executive functions besides ADHD?

Baylee Hoey  09:59

Yes, absolutely. So other things, where in a more chronic or long term way with ADHD, if you have issues with executive functioning, you can learn how to manage, but that's kind of how your brain works. 

Tyson Conner  10:11

Sure, yeah. 

Baylee Hoey  10:12

And so similar with that it can be be very similar for folks with autism, to also experience difficult difficulties with executive functioning like that. And then as well, with learning disorders, with physical trauma to the prefrontal cortex, that can be an issue, because a lot of those executive functions are really involved in prefrontal cortex area of the brain.

Tyson Conner  10:33

So prefrontal cortex for our Listener, the prefrontal cortex is a specific area of the brain, that's basically right behind your forehead. So what I'm hearing you say is, if someone has a concussion from playing football, and they smash their helmet into someone in a way that you're not supposed to, and they end up getting damage to that part of their brain, then that can cause executive function issues.

Baylee Hoey  10:56

Yeah. And so then other things, kind of again, in that same line, there can be concerns with in-vitro exposure to substances as well. And then more in the possibly long term, possibly short term, as with as much of these disorders or conditions are present in your life - anxiety, and depression can also really impact executive functioning. And then also with trauma. And so with maybe more of a trauma in adulthood, maybe those issues might be more temporary. When it comes to complex trauma from childhood, those issues might be more long term. But it can often be present in all those kinds of things. 

Tyson Conner  11:40

So it sounds like pretty much anything that impacts a brain and how it works, or the mind and how it works can impact executive functions. What are some common ways that executive dysfunction shows up?

Baylee Hoey  11:58

So some of these ideas might feel a little vague, but just the idea of difficulty beginning to start a task. So like I said earlier, you see something across the room that you need to get up and go get, just that act of getting up and getting it - the idea of initiating that task can be really hard - or doing the dishes, or starting a paper, or whatever, all of those things can be --

Tyson Conner  12:20

Making a phone call --

Baylee Hoey  12:23

Might also be a little impacted by the anxiety or hate of making phone calls. And then issues around time blindness. So the idea of almost not having a really solid internal clock where you know how much time has passed, you know how close you're getting to a thing that you need to do. That can be difficult, where, you might notice that a lot of folks with ADHD, they might set themselves a million alarms and a million reminders. So you can have more external markers of time passing. Because it might be hard to hold that in your brain unless you go with a constant awareness of the time, which can lead to a lot of anxiety-- 

Tyson Conner  13:05


Baylee Hoey  13:05

-- and difficulty doing anything else. Because your whole brain is just set on trying to remember how time is passing.

Tyson Conner  13:11

So sometimes - what I'm hearing you say is that - sometimes somebody with ADHD, for example, might have time blindness, where, just, their internal clock doesn't tick. And so they'll either need to have a lot of external reminders that they set up to track time for them outside of them, or they develop this anxiety and this kind of hyper vigilance, which our Listeners should be familiar with. We talked about hyper vigilance as a category, just as a brief reminder - hyper meaning too much, vigilance mean looking out. So just a lot of energy and anxiety around keeping track of time and checking in on it, almost as a way to try to offset that lack of an internal clock. 

Baylee Hoey  13:59

Yeah kind of like an overcompensation. But it takes up so much of your time. And a lot of these things with executive dysfunction, you'll notice that either you can kind of develop external systems to help you or you develop a lot of hypervigilance around the issue. Or I guess third option, maybe you learn not to care. Maybe, but that seems hard. Maybe some people go that route early on. 

Tyson Conner  14:28

Yeah. Always an option.

Baylee Hoey  14:32

Yeah. But other things that might come up with executive dysfunction. If you're in school, difficulty, organizing your schedule, or organizing the materials, maybe you might be more apt to lose track of things, just where you put your stuff. Or what you need to do or --

Tyson Conner  14:53

Lose your keys, lose your phone -- 

Baylee Hoey  14:56

Lose your papers, lose whatever, and then you're scrambling trying to find it or it's just lost and you're never gonna find that again.

Tyson Conner  15:01

And you also said, like, not correctly estimating how long it will take to do things.

Baylee Hoey  15:06

Yeah. So often you can really overestimate how much you can get done in the span of an hour, five hours, whatever. And part of that might have to do with that time blindness of, "I don't know how long each individual task is going to take me." It might also have to do with a bit of that overcompensation of, "Well, I feel like I should be able to do this amount of things. And so I'm going to promise to do that amount of things." But realistically, there's no way. But the awareness of how unrealistic that is might be hard to access sometimes when you're just going according to maybe what you think you need to be doing.

Tyson Conner  15:45

Right. So intuitively, without sitting down and putting effort into it, your assumptions about what's required will just be way off. And so again, there's this issue of needing to compensate in some way. And that takes effort.

Baylee Hoey  16:01

Exactly. Another area that executive functioning issues might impact - or how it might look - is trouble soothing, intense emotions. So like we talked about earlier with that emotion regulation piece, if you do have these difficulties, being able to soothe yourself, when you do experience something rather intensely can be really difficult to do. And not only can be really difficult to actually manage, it can feel really embarrassing or confusing at the same time. Which can add another layer of difficulty regulating because it can feel like, "Not only am I struggling to manage this, I'm also now maybe directing some self criticism my way, or am concerned about what other people are thinking or whatever when I'm having this big feeling, and it's really hard to be with it, or difficult for it to pass."  And then another one is around regulating impulses. Not being able to regulate those impulses, again, with that issue with inhibition. That impulsivity can really come out where you have the urge to do something or other and, one since task initiation can be hard, if you do have an actual urge to do something, it can be very satisfying to actually follow the urge to go do that thing. When often it feels like those urges that you feel like other people experience, you don't get those as much. And so it can have a lot of satisfaction of, "Oh, I feel like I have that motivation. I have that pull, that drive to actually go do this thing. And so I want to do that thing." But sometimes those things can get in the way of our other priorities, or they're not actually what we need to do. And that can be rough too.

Tyson Conner  17:48

Yeah. Yep.

Baylee Hoey  17:54

And then, one more example, is struggles with efficiently shifting attention back and forth between different kinds of information, different kinds of tasks

Tyson Conner  18:02

Right. So this is making me think about the idea of multitasking. And, as far as I'm aware, all the research I've seen seems to indicate that multitasking isn't actually a thing that human beings can do consciously, our conscious mind doesn't actually have the capacity to be doing multiple things at once. But it does have the capacity to shift between multiple things quick enough, that it kind of seems like we're doing multiple things at once. Is that kind of what you're talking about? That ability?

Baylee Hoey  18:32

I think, in a way. In a way, yes. Where shifting between different kinds of tasks to different kinds of information. That process, where maybe for some people, it can happen so quickly that it just looks like they're doing two things at once. For folks with ADHD, or for folks that just have issues with executive functioning stuff, that switching might be much more difficult or might involve a lot more effort, especially when those two things don't have anything to do with each other. And part of it can be - again, routing back to that issue of task initiation - so it feels like starting something new, it might feel like starting something new every time. So there's so much effort involved in that, that it can be really hard to get your mind to be comfortable with doing that level of shifting, where it might be easier to really stick with one thing for a while, if you can get into it. And at the same time, if you do know someone with ADHD or you do have ADHD , you might notice that maybe they fidget with stuff a lot or doing other things as you talk to them. And so in some way, it might be, "Well, looks like they can multitask." But for things that are relatively mindless - so doing something with a fidget,  putting clothes away while you talk to somebody - if you don't really have to think about it, it can really satisfy the restlessness that can come up. And so you can still be paying just as much attention. But in that way, it's almost like there's not really a shifting happening. It's mindlessly working with your hands or something, to regulate that kind of energy that's in your body. But that can be really different from if you're at work, and you need to shift from one task you're working on -- Well, I mean, for me, you know, prepping an outline for a podcast and then responding to an email, or writing a note or whatever. All of those things can feel like really different tasks in your head. And so interrupting one to do the other can feel like a big disruption. Yeah, and it sounds like it also - if you're halfway through an email, and then you get a text message from someone, and then you need to respond to that. It sounds like - when you go back to the email, you don't pick up where you left off emotionally, the experience of it is the experience of starting over. Yeah. And that's if you remember to go back to the email, right? Because if you've shifted out, with working memory struff that might be really hard to do, because you've now shifted out and so shifting back in, it often doesn't happen fluidly.

Tyson Conner  21:06

Yeah. So let's talk about executive dysfunction and shame. You mentioned this at the top that this is something we're gonna get into today. How are these things -- How do these things interact? What's going on with executive dysfunction and shame?

Baylee Hoey  21:24

Yeah. So I feel like this is such a rich topic. Whether you have - again, I'm talking about it from a more ADHD sort of lens, but like we already mentioned, it can happen with so many other conditions too - from ADHD lens, if you were diagnosed as a youngster, or as an adult, you might have a different view of yourself, or how these certain things developed. But I think where shame can really come in with executive dysfunction is a lot of the confusion around it of going, "Why is this so hard for me? Why is this taking so much effort? Or why does it feel so impossible when other people seem to just do it without even thinking? I'm exhausted, or I can't, or I'm messing up here," or maybe you get feedback from teachers, from parents, from friends. And a lot of this can I think happen a lot in formative years, which is why I call back to teachers, parents, friends that age. Where maybe as an adult you don't get as much direct criticism as you do as a kid. But if you do receive those kinds of messages as a kid, it can really cause some trouble with that internalization of that shame of, "What's wrong with me? Why can't I just do this? Why can't I just do this? How can I even accomplish these things?" When it feels so impossible.

Tyson Conner  22:54

Yeah, I'm thinking about something that happened to me recently, actually, where I had a day where I was just feeling awful. Like, my body felt bad, I felt like I'd been punched in the face - just felt awful. And I was trying to take care of my kid. And usually, when I'm hanging out with her, I can get other stuff done, right? I can get back to people and do emails, and I can prepare dinner, while also attending to the needs of a child, I can usually do both. But this day I just couldn't, it was one or the other. And so, you know, kid takes priority. So a bunch of stuff I was supposed to do didn't get done. And I felt awful about it. And I felt bad about it. And then later on in the day, I was talking to someone about how I was feeling. And they were like, "Tyson. That sounds like a sinus infection." I was like, "oh, yeah, huh?" And all of a sudden, the shame I'd felt about not doing the dishes and not making the dinner I was planning on making and doing a quick frozen thing that I just throw on a skillet instead, kind of lost a lot of power, because now I could explain it. Right? There was a reason why - I wasn't just broken. I wasn't just lazy. I was sick. I was physically ill. It's not a one to one comparison. But it came to mind as you were describing this process.

Baylee Hoey  24:25

I think that's a great example. It's a great example. Because there is so much power in going, "Oh, that's what's going on." It doesn't take away the struggle. It just didn't take away the loss of being able to do what you wanted in your day. Like it doesn't take away any of the effects of all of that, but it does take away or at least kind of take away the impact of that shame, the criticism, the self judgment, the labeling of, "yeah, am I broken? Am I defective? Am I lazy?" All of those things that rattle around your head when you're already struggling. So it doesn't take away the struggle, but it takes away at least a layer of it. Which, I mean, I love a good Brene Brown quote once in a while - and so this one, while she's not talking about executive dysfunction, I've claimed it. She says " What we don't need in the midst of struggle is shame for being human." So if you already experienced executive dysfunction, that already sucks enough. That's enough for one day. That's already really hard, and it will impact your day. And understanding it doesn't take it away, but at the very least, it can maybe impact that layer of sometimes self hatred, or, again, the confusion can be so big of just not knowing what's going on. And not knowing how to address it, or how to care for yourself in it. Because you can get really caught up in the criticism and in the confusion where you can't really move through it to go, "Realistically, what do I need right now? How do I work with this? If this is an issue in my life and if this is something that's hard for me in my life,  how do I accommodate myself? How do I build supports around these things?" Instead, we can get really caught up in, "Gosh, I'm such a loser, or, I'm such a disappointment, or what's wrong with me?" And never move into, "What do I do about it? How can I help myself?"

Tyson Conner  24:52

Yeah. Oh, I had a thought - where'd it go? There's some executive dysfunction. There's that working memory there. Oh, hang on. I got this. Oh, yes! I remember now. So in my story about my sinus infection, right, I went most of my day without realizing what was going on. And I had all these stories I was telling myself about, "I'm just not feeling it today. I'm just not putting in the effort, right." And I imagine that when you take that same kind of idea, and apply it to a lifetime - if you're a kid, and there's no one around who's paying attention to your executive functions and helping you make sense of them, and you don't get diagnosed with ADHD until you're an adult -- whatever, then I imagine that's a lifetime's worth of stories you've been telling yourself that might add up to not the best self image?

Baylee Hoey  27:37

Yes, absolutely. I think that's one area where, obviously, not only can personal self reflection be great. But I mean, as a therapist, I go, "Ooh, that's something that would be so great to address in a deep way in therapy." But again, you know, you don't have to. But yes, it can really, really impact this very overarching way of understanding yourself and seeing yourself that can be so cloaked in the confusion, in the judgment, in the worry about how everyone else is perceiving you. And how you're never matching up, never caught up. And it can be so anxiety provoking. Often also why ADHD can be, at least from this lens, really linked to other mental health concerns. If you have a lifetime of that, if you're anxious as hell, that might make a lot of sense. Or if you have a really hard time looking at yourself with compassion or grace, that might make a lot of sense. And so if you don't really have this idea of, "Oh, I experience executive dysfunction," if that's not woven into your life narrative as a way of understanding your experiences, then there can be so many gaps of, "What was going on there? I don't know. I'm going to fill in those gaps with with what my mom said about it, or what my teacher did, whatever," when they probably didn't know what was going on.

Tyson Conner  29:03

Yeah. What are some common stories that people will come up with or common themes that you notice that people use to fill the gap, that maybe a Listener might be carrying around with that you might want to draw some attention to,

Baylee Hoey  29:19

I think certain words of how to describe yourself is something that I noticed to be really common. There's a couple that happen over and over again, and one of them is lazy. Like that idea of, "Well, I just didn't do it because I didn't want to," even though the person who says that, they don't really believe that, but they don't have any other way to understand it. Or "I'm just undisciplined. I just can't do that. I can't discipline myself that way," a lack of willpower or a lack of self control. "Yeah. I don't know, that's just what I've always been told." And those words can really stick and really sting, and be carried around for a long time. But other ones can also be being selfish or being uncaring. When you think of the kid who couldn't remember to do the chore he was tasked with, maybe one of the parents is like, "What, are you doing this on purpose? Be a member of the family - blah blah blah" That can be really hard, where it's like, "I know, I do care." But there might be a lot of, "Well, no, you're too focused on you, or you don't care enough to remember," or things like that. Meanwhile, it's not about an issue of a lack of caring. In that example, maybe forgetfulness or distractibility, right. But then also, sometimes maybe issues with actually getting that thing up and going.

Tyson Conner  30:45

Yeah, and these things are framed as kind of moral failures. It sounds like. I'm thinking of people I've known who were, diagnosed with ADHD as adults, and in the lead up to their diagnosis had this obsession with developing habits. They were like, "I just got to figure out how to form habits, I got to form healthy habits." And they just couldn't do it. They had books on it, and they listened to podcasts about it. And they were like, "If I can just figure out how to develop these habits, then all be better." And then they got diagnosed, then that obsession with forming habits kind of went away. And a lot of that energy went instead to finding healthy ways to cope and healthy ways to manage things, some of which looked an awful lot like habits. But it became a less of this, "I just need to do this for 30 days, and then it'll be stuck in my mind." Nuh-uh, that's not how your mind works. Your mind doesn't have that sticky piece to it.

Baylee Hoey  31:48

I love that, yes, that is so true. Oh, the sticky piece - if only - that'd be so handy.  But that idea of trying to make habits, if you just do it enough that it'll stick around forever and you'll have a way of managing that's fine. Meanwhile, what can often be so important for people with ADHD is maybe finding rhythms and systems of working, but also kind of just attuning to what already might be working for you that you've maybe been fighting against. There can be a lot of things where, when you don't know what's going on, and you feel "That's not how other people do things. I should/need to be able to do it the way that I see other people doing it." You might fight against things where, certain ways of being might come more naturally to you. And so there can be this process of giving some permission to pay attention to what feels more natural to me, what actually is easier? Or like, how do I remove obstacles in my life? Where maybe some other people can manage those obstacles just fine. But maybe those need to get tossed out of the way for you. But then also the idea, even if I do find certain systems of working if even if I do find certain rhythms that come naturally for me, if you have ADHD, those things are probably gonna quit on you at some point. Maybe in a couple of weeks, maybe in a couple months. But if you find a way where "Oh my gosh, this is efficient. This is working for me. It's moving." One day, it's as if it breaks or something. And it's devastating. But it's real. And so that's that part of, again, addressing shame doesn't get rid of the very real struggle. Experiencing the loss of a system that was working for you is kind of scary. And it can be really painful and maybe disorienting of, "Oh gosh, that was working for me. And I kind of oriented my life around that. Shoot, I gotta figure out something new or kind of be in a place where maybe doesn't work for me for a while. Maybe it will later." That's stressful. But the idea of these long term habits where, once you get them built, they're stuck. And they'll they'll be consistent with you forever. Nope.

Tyson Conner  34:07

You mentioned loss a second ago, and I was thinking about that, thinking about these stories that we can tell ourselves and that people with ADHD, or executive dysfunction, can internalize. And how like, coming to realize the things that you're carrying around can cause a fair amount of loss. It sounds like or experience of grief, of, "Oh, man, I've been trying really hard and I thought that what's wrong was me but, no, I haven't been what's wrong this whole time. And, man, I lost 30 years of my life trying to get myself to fit into a box that would never fit me." And I'm also hearing in what you're describing, the importance of being realistic and being ready to be impacted by this again. And to know that you'll find solutions that will work well enough, long enough. And eventually, you'll have to find new ones. And that change, that reaction, it's not something that you're going to find a fix for. I'm thinking about somebody who I know who was dealing with some issues like this, and we were talking about it. And one of the things that we talked about was - if the plan that you're making relies on you becoming a fundamentally different person for it to work, maybe that's not the best place to put your energy. And that was a kind of a playful thing to say. But there was some grief connected to it. Because so many of this person's plans were actually built on the idea that, "Well I'll just be better." And that's not what it's about. It's not about being better. It's about managing the reality of what you're working with.

Baylee Hoey  36:06

Yeah. But so much of that does have to do with, in a way, kind of letting go of  some fantasies that were maybe really containing or you found hopeful. Well, I would imagine those are kind of a double edged sword, right, hopefully, but also, limiting you and what you actually get to accomplish or how realistic you can be. It feels that the aspect of being realistic and the grief that comes along with that, before it, after it, involved in it, all the time. That pairing is really important. The grief of the big things, right? Those big realizations of time lost, or how you could have been living, how you could have been working with yourself, whatever. But then also of the idea that, "I have this magical fix. Maybe if I just did X, Y, or Z, everything would change, I wouldn't have this difficulty anymore." Versus facing the reality of, "Oh, this is part of how my brain works." That's hard.

Tyson Conner  37:09

Yeah. And I can see how working through some of those feelings with a therapist, especially one who's a little bit informed about neurodiversity, in particular, might be really helpful. Because it's helpful to have someone who's able to be with you to grieve some of those expectations of what life was like, and being informed about neurodiversity might help them from thinking, or agreeing with some of the things that you're grieving. "Yeah, you know, you can fix yourself, you really can." Well, wait, no, no, not helpful.

Baylee Hoey  37:47

I think that's a really, really good point. Yes. Because, yeah, some people when they're not as informed, whether it'd be a therapist, or again, like other people in your life, if they don't know about these sorts of things, they might very unintentionally, repeat those things that have wounded you, over life or reinforced messages that you're trying to deconstruct. Which can be really hard, I would say that's important, too.

Tyson Conner  38:13

Yeah. So if someone's listening to this and is thinking, "Okay, this sounds like me," we've talked about executive functions. We've talked about what that dysfunction can look like, this sounds familiar. They're listening to our conversation about grief, and maybe they're tearing up right now. And now they're thinking, "Okay, but what do I do? If I've accepted - that's the first step - I've accepted that this is who I am, this is the brain I have." What do you recommend next?

Baylee Hoey  38:46

I would say - this is gonna sound dumb - but alongside that recommendation of 'talk to a therapist about this stuff to get into it deeper,- we have a whole article on our blog about TikTok and how that can work with ADHD stuff. And in that blog, you'll find that I say, maybe it's not the best for self diagnosis. But I will turn around right now and say it is awesome for ideas. Awesome for ideas of breaking out of maybe a lot of the rules that you've placed on how you function in your day, how you envision "normal people" or whatever to function in their day, the limitations that you might place on yourself, where you don't let yourself find more creative ways of working with yourself. Creative accommodations, those kinds of things. I would say, TikTok and Reddit have awesome ideas for just breaking open the mold of how you can help yourself and your day. And so I mean, maybe TikTok isn't the exact recommendation, but just considering how you can break the mold, how you can break those rules and be more creative and how you care for yourself. That's not just limited by the 'shoulds' or by the shame.

Tyson Conner  39:57

Yeah, taking a step or two away from TikTok specifically, what I'm hearing you say more broadly, is trying to be creative about what adapting could look like. And communities where other people have already started some of this work can be really helpful. We have talked before on this podcast about how Dr. Google says, we all have cancer and Dr. TikTok says we're all autistic, right? For diagnosis, it can be a little too general. But for community, for connection, for understanding, for relatable memes, there's lots of places on the internet, hashtags on Twitter, or Tumblr, or subreddits, or TikTok trends - I don't know, I'm not on TikTok so I don't know what those are called - spaces where there are other people who have done the work of accepting, who aren't going to try to fix you, but are going to offer, "Hey, here's the thing that works for me, maybe it'll work for you, too." Sounds like that can be helpful, not just for the practicality of having a skill, or an adaptation, but also to feel a little bit less alone.

Baylee Hoey  41:12

Yes, absolutely. To be able to connect with those people where you go, "Oh, my gosh, you get it." Other people might never have that understanding of something feeling so impossible when you actually want to do something. And then you go on TikTok, and someone is, "Oh, yeah, I know exactly what you're talking about." So relieving, so satisfying. You just go "Oh, thank God," but also to be able to see those ideas that people come up with and hold them with open hands. It's so individual and so personal. And like we already covered, if that thing does work for you for a second, it might not for long, and that can be very discouraging. But also just knowing that it can maybe help again, with that rhythm of, alrighty, this is going to ebb and flow, it's going to come in waves. But as I maybe gather resources, and people around me - whether it's through online platforms, or, you know, gathering around your little other neurodivergent friends, or support groups, or things like that - there can be so many other ways of finding both connection and that creativity you need to be able to cope and manage.

Tyson Conner  42:16

Yeah. Awesome. Baylee thank you for coming on to this podcast. This has been a fascinating conversation. And hopefully, the first of many. I feel like this could open the door to a lot of other topics that our Listeners could be interested in. Listener, if you are interested in it, feel free to let us know, shoot us an email or something. Before we go, do you have anything you'd like to plug?

Baylee Hoey  42:45

I would say, I mean I already pluged it earlier, because I'm loving it - check out our blog. We have articles on a whole host of different topics. But we are also kind of rolling out more ADHD focused ones as well. I believe we already have one published that I mentioned about TikTok. And so yeah, check it out.

Tyson Conner  43:06

Yeah. And this episode will likely come out in May. So probably like three or four more. Awesome. And are you writing all of those?

Baylee Hoey  43:16

You know what? I don't know. I've written several of them. Actually, we already have some on ADHD that have been published by others.

Tyson Conner  43:23

Cool. Do you have any experiment or further learning that you'd recommend for our listeners, if they want to have some experience of what we've talked about? Or are just curious and want to learn more? 

Baylee Hoey  43:34

I would say reflect on how breaking the rules, right, "breaking the rules" of those daily functioning aspects might help you find more workable ways of caring for yourself that aren't so burdened by shame, or by shoulds. But start getting creative and just try stuff out.

Tyson Conner  43:54

Yeah, just notice the ways that the rules that we follow might not be realistic to the minds that we have. That sounds like fun. And do you have recommendations for specific books, YouTube videos, anything like that, if people just want to learn more, they are curious about this. 

Baylee Hoey  44:14

You know what, actually, there is one book that comes to mind. It's called the Neurodivergent Workbook, and it's something that can actually be really great as an adaptation of DBT skills, but in a way that's much more friendly, right. Neurodivergent friendly, and can also really involve sensory needs. And so it's awesome. And I do not remember who wrote it, but it's really great. I love it.

Tyson Conner  44:43

I oftentimes rerecord these sections, there's a chance this might not even be in the episode. And if it is, Listener, oops, you caught me talking about behind the scenes stuff again. And we'll have a link to that in the show notes with proper citation and then the author and who knows, maybe my voice will come in with a very different audio quality right now with the author's name. Let's pause and wait for that. Sonny Jane Wise. Lovely, thank you, Tyson haha. Dr. Hoey, thank you so much for coming in today. This has been a lovely conversation. 

Baylee Hoey  45:21

Tyson, thank you so much for having me.

Tyson Conner  45:22

I'll see you again soon. Special thanks to Dr. Baylee Hoey. Dr. Hoey can be found at Relational Psych. Links to one of the blog posts that Dr. Hoey mentioned are in the shownotes as well as a link to a full freee - I'm pretty sure legal - pdf of the neurodivergent friendly workbook of DBT skills, which Dr. Hoey mentioned earlier in this episode. The Relational Psych Podcast is a production of Relational Psych, a mental health clinic providing depth oriented psychotherapy and psychological testing in person in Seattle and virtually throughout Washington state. If you are interested in psychotherapy or psychological testing for yourself or a family member, links to our contact information are in the show notes. If you're a psychotherapist and would like to be a guest on the show or a listener with a suggestion for someone you'd like us to interview, you can contact me at The Relational Psych podcast is hosted and produced by me, Tyson Conner, Carly Claney is our executive producer with technical support by Sam Claney and Ally Raye. Our music is by Ben Lewis. We love you buddy.

Further Learning: 

The Neurodivergent Friendly Workbook of DBT Skills by Sunny Jane Wise

ADHD, Executive Functioning, and Shame by Dr. Baylee Hoey

ADHD, Anxiety, and Depression by Dr. Baylee Hoey