← ADHD for Smart Ass Women with Tracy Otsuka
ADHD for Smart Ass Women with Tracy Otsuka
Ep. 364: *Encore*: The Doctor Who Changed the ADHD Conversation
01:04:55
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- [00:00]
A
Before we start, quick pause. Your ADHD brain is not broken. It just never came with a user's manual. So we are going to build one together. That's what our three days to fall in love with your ADHD brain is all about. We will start on January 6th, and you can sign up for free at tracyoutsuka.com ilovemybrain. Richard Branson. Michael Phelps, Justin Timberlake, James Carville. Wait a minute. Where are the women? Greta Gerwig, Lisa Ling, Audra McDonald, Simone Biles. That sounds like a list of highly successful titans in a variety of industries. They all have 88, but you don't hear much about that now, do you? You know what else you don't hear about are the 43% of people with ADHD who are in excellent mental health. Why aren't we talking about them and what they're doing right? I'm your host, Tracy Adsuka, and that's exactly what we do here. I'm a lawyer, not a doctor, a lifelong student, and now the author of my new book, ADHD for Smartass Women. I'm also a certified ADHD coach and the creator of youf ADHD Brain is a ok. A patented system that helps ADHD women just like you get unstuck and fall in love with their brilliant brains. Here we embrace our too muchness, and we focus on our strengths. My guests and I credit our ADHD for some of our greatest gifts. And to those who still think they're too much, too impulsive, too scattered, too disorganized, I say no one ever made a difference by being too little.
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B
Hello.
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A
I am your host, Tracie Atsuka. Merry Christmas. Happy Hanukkah, Happy Kwanzaa. Happy holidays. Thank you so much for joining me for another episode of ADHD for Smartass Women, especially during this busy time. My goal, you know, it is always to show you who you are and inspire you to be it. So thank you again for being here. Now, before we jump in, I want to tell you why this episode matters so much to me. This is an encore of my conversation with Dr. Edward Hallowell, and honestly, I think it's my favorite podcast episode I have ever recorded. Maybe this one and the one that I did with my son. I think the second one. You know, Ned didn't just come on my show. However, he also wrote the foreword to my book. And to this day, it is still one of the most generous, meaningful things that anyone has ever done for me. I don't take that lightly. I feel incredibly grateful that our paths crossed at all. And I'll be honest, every time I'm on Amazon and I see any new book about adhd, because, you know, when books are new, they get ranked a lot higher because of all of the buzz. So if I see an ADHD book ranked ahead of his, and that includes my own, by the way, I get a little upset. Because if you are looking for the person who started this whole conversation about ADHD as a different kind of brain, not something broken, not something to be shamed, but something that comes with, okay, some real challenges, but also real strengths, that person is Ned Hallowell. He has been fighting for a strength, focused understanding of adhd for over 40 years, long before it was popular, long before it was safe. And it matters that he does this work, not just as a clinician, but as someone who actually has an ADHD brain himself. Dyslexia, too. One of my favorite stories that he tells was when he realized for the first time that he had adhd. He was sitting in a lecture during a fellowship, I think it was at Harvard, and the professor doctor was describing adhd, but she was leaving out all the good parts. And as he listened, he recognized himself instantly. And he's talked about how the light came, like he could remember where he was exactly right with the light streaming through the window. And he was sitting there knowing two things at once. Oh, my gosh, this explains my life. And they don't fully understand what this really is yet. He could see how important this diagnosis was going to be long before the rest of the world caught up. And that's Ned. Deeply optimistic, incredibly grounded, of course, brilliant, and truly one of the kindest, most generous humans I know. And that doesn't just come from my own experience with him.
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B
I.
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A
Over the years, I've worked with many of his former patients, and I hear the same stories over and over again. He shows up, he listens, he cares, he helps. In that way, he's truly the ultimate model for what medicine can be at its very, very best. Look, I have not listened to this episode in years, but I just did, which is exactly why I felt the need to share it. Just thinking about it, it still makes me smile. I am so grateful that this conversation exists, and I'm really glad to share it with you. So whether this is your first time hearing it or your fifth, here is my encore conversation with the one and only Dr. Edward Hallowell. So we have two guest rules on this podcast. First rule, you have to have adhd. The second rule is, I only interview women after all our podcast is called ADHD for Smartass Women and there's so much out there already for boys and men. All that said, I am going to break rule number two today and I think you're going to agree that it's for a very good reason. In this episode, I am going to introduce you to the one and only Dr. Edward Halliwell. If you know anything at all about ADHD, you know his name as the leading authority in the field of ADHD. Dr. Hallowell is a board certified child and adult psychiatrist, a New York Times best selling author. He, along with Dr. John Ratey, wrote what I consider to be the bible of adhd. Driven to distraction. Now retired from the faculty of Harvard Medical School, Dr. Hallowell has been featured on 20 20, 60 Minutes, Oprah, PBS, CNN Today, Good Morning America, and in the New York Times, US Today, Newsweek, Time. I could go on and on, but I really had to truncate that list. He is a regular columnist for Attitude magazine and is also the host of his weekly podcast called Distraction. Dr. Hallowell is the founder of the Hallowell Centers in Boston, New York City, San Francisco, Palo Alto and Seattle. He lives in the Boston area with his wife and their three grown children. Welcome, Dr. Hallowell.
- [07:44]
B
Thank you so much for that introduction, Tracy. It makes me feel humbled.
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A
Well, I was wondering about that. Well, first of all, did I get it all right?
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B
Yes, yes, remarkably, you did. Often people don't get it right. And you did for someone who has adhd, that's, that's also impressive. Such attention to detail.
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A
Only when I speak.
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B
So you qualify for your first requirement to be on your show. I do have ADHD and throw in dyslexia as an added benefit.
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A
I know that. It's why I wanted you here especially. So when you hear all that, are you ever incredulous or are you kind of like, yeah, I knew that would happen all along.
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B
Oh my gosh, I'm so incredulous. In fact, I still have, you know, I'm 70, I just turned 71, which I can't believe.
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A
Happy birthday.
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B
But I still have a bit of what so many people with ADHD have, which is an imposter syndrome. You know, I think, did I write all those books? I know I did because the other day I, for a photograph, for a publicity photograph, I stacked them all up and held them in my arms and they're there. And I did. I sort of looked at them as If I'd begat 21 children. And I said, each, each One of you came from me, didn't you? And they all looked up at me and said, yes, we did. You know, this is a condition that is so full of paradox. It's so full of. On the one hand, you know, I've written these 21 books, and that's wonderful, but on the other hand, I can't quite believe I did it, you know, and because I'm just so accustomed to finding things in life difficult, but then magic happens and wonderful things happen. And that. I think that's a real common theme in life with adhd, the discovering that you can do things that you hadn't known you could over and over and over again.
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A
That is so encouraging because I know that I can certainly relate and I know that my women can also relate to that. So before I start peppering you with all kinds of questions about the book, because I just loved it so much, I just want you to know how personally grateful I am for you and your work. Like many mothers, you've probably heard the story a million times. I had no idea what ADHD was when my son Marcus was diagnosed at 12. And I really thought it meant you were stupid. It meant you were slow. And so I hired a local psychologist who was supposedly an expert in ADHD because I wanted to learn more. And she met with my son Marcus. And then she told my husband and me that privately, thank God, that he was far too well, now he knows that he was far too ambitious for his own good. And our job as his parents was to reduce his expectations so he wouldn't be disappointed in life.
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B
Oh, yeah. Oh, oh, oh. That just makes my hair hurt when I hear these kinds of. I hear them all the time, as I'm sure you do, too.
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A
Then I thought, okay, well, I got rid of her because I just knew, you know, I'm a eternal optimist. I make lemonade out of lemons. And I just knew there was. There was a different way.
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B
Yeah.
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A
Even when I went to the literature on adhd, I bought the books. It was so doom and gloom. And it wasn't until I found driven to distraction and your strength based approach. Well, you know what? Honestly, what gave me the most hope was learning that Both you and Dr. Rady have ADHD.
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B
Yeah, exactly. Exactly.
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A
I remember thinking, these are Harvard professors.
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B
I knew it.
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A
You can be wildly successful, not despite adhd, but maybe because of it. So I just wanted to say thank you so much. My son is now a freshman in his first semester at nyu. Tisch during COVID Excellent.
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B
Bravo. Bravo.
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A
So happy and he did so well. And that was after three high schools in four years.
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B
So there you go.
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A
Yeah, you changed his life. You changed my life because then I was diagnosed.
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B
Excellent, excellent.
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A
And you've also given me my purpose because now I get to change other women's lives. And I just, I feel honored to be able to tell you this in person. So thank you.
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B
Well, listen, I feel honored to hear it from you because, you know, your, the, the biggest undiagnosed group are adult women. And you're carrying on a campaign that, it's a, it's so one, It's a deliberate people, men and women, adults and children. But your target is adult women and to liberate them from the shackles that they have been clamped into for hundreds of years. I mean, you know, all the negative labels, loser, stupid, lazy, you know, morally deficient, blah, blah, blah, blah, blah, blah, blah. And to be able to come along like this marvelous fairy godmother and wave your wand and have those shackles break and have these wonderful women rise up from their, you know, enslavement and lay claim to the wonderful life they can have. Now, it doesn't happen overnight, but you're helping them. You're saying, look, these, these are mind forged manacles. You know, there's society forged, but they're also mind forged. And, and to break them, the starting point is to know that they're made of nothing but what you can destroy. And the possibilities are limitless. You know, you have, I don't mean to say it's not difficult. It is difficult. I tell folks I, I don't treat disabilities. I help people unwrap their gifts. But unwrapping these gifts is not as easy as unwrapping a present under the Christmas tree where you just tear it open. You know, it, it can, it can take an awful lot of time. But gosh, how much better you feel if you're saying to yourself, I'm unwrapping my gift as opposed to I'm treating my deficit disorder. You know, I mean, you know, it's just such a difference.
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A
Absolutely. Thank you. Before we get into your new book, the first question I ask every guest on this podcast is this one. And I'd love to hear your story. Tell me the circumstances around your own personal ADHD diagnoses.
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B
It's just. Dad, did you say, what number podcast is this? So you've asked this question.
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A
106.
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B
So I'm the 106th person guest. Wow, you must have collected quite a number of anecdotes. My, my own discovery of this condition was one of the great. That's the question, right? How did I find out about it?
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A
Yeah, yeah, yeah.
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B
Was one of the great. Aha. Moments of my life here. I'd gone through all my schooling. I knew all along that I had trouble reading. And in, in first grade I was just called a, a slow reader. And, and, but, and I'll tell you that story as well. So I knew I had what's now called dyslexia. And by the way, I ended up majoring in English at Harvard College while doing pre med and graduating with high honors. Now I've written 21 books, so you can hardly say the dyslexia impaired me with words. I mean, the. Again, another paradox. I'm an incredibly slow reader. My wife says I don't know how you know anything. It takes me so long to read, but I'm able to do quite a lot with it. So again, the paradox. You know, impaired but gifted. And you see that over and over again. So here I am, I've gone through school, high school, college, medical school. I'm doing a residency in psychiatry at a Harvard training program. Then I am doing a fellowship in child psychiatry. And In July of 1981, one of the first lectures I heard at the start of this fellowship in child psychiatry was by a neurologist the name of Elsie Freeman, a woman, fittingly enough for our theme today, who proceeded to describe this condition that was then called Attention Deficit disorder. The H was not added in yet. And as she described it going from the diagnostic manual, all the negative symptoms, I could see into that, that the description fit me to a T, only she was leaving out all the good parts. So it was, it was this massive epiphany, revelation. Call it what you will, but. But in that half hour, probably the most transformative, other than meeting my wife for the first time or having our babies, the most transformative, intellectually mind changing half hour of my life. Because I could see it. I could see it all right there in July, Boston, 1981. Sun coming in through the windows and I could see this dazzling vision. Boy, this thing is so much more important than most people know because it was like no big deal. Add that nobody'd ever heard of it. You know, it was a disability that children had and you know, stupid children at that, and a bunch of pain in the neck, little boys running around, getting into trouble. You know, they just needed a spanking. They didn't need a diagnosis. And, and it was just so thoroughly misunderstood. But I could See, right then, and it's been the story of my career, you know, expanding on that epiphany, expanding on that little grain that, that the wonderful Elsie Freeman, she didn't know what she was doing. She didn't know she was passing along to me so much more than the content of her lecture. But, but so that's how I found out about it. And you know, people often poo poo sort of stories of revelation, but it was, it was, it was on a par with. When I was 10 years old, I heard a voice in my head saying, you should become a psychiatrist. That's another story. That's also a true story. But that was just a moment. That was a. But this was a lecture and a process of revelation and discovery that's been continuing ever since. You know, I'm still learning about this condition, still learning how to manage it and tell others about it and spread the good news. You know, See, I see this as good news. The bad news is when you don't know about it. The bad news or the bad news is when you have a professional who's stirring you wrong like you encountered saying, oh, well, give up your, you know, you're nothing but a loser. You might as well, you know, work on the rock pile for the rest of your life. When you, when you discover that you have hidden talents that don't necessarily unwrap themselves, that school often doesn't notice and certainly doesn't do anything to encourage when you get that information, that's really good news because your life can only get better whether you get it at 6 years old or 60 years old. My oldest patient was 86 and the treatment changed his life. He was able to write the book he'd wanted to write his whole life long. So it's a long answer to your question, but that's how I found out about it. And I've been lucky enough to have been working with people who have it ever since. You know, I'm the happiest doctor, I'm the happiest doctor you'll ever find because I just deliver good news.
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A
Yeah, but this was 1981. I would think that everything that Elsie was talking about was negative. And how did you make this connection that that was you, when here you are, a Harvard educated doctor.
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B
First of all, I'm really impressed that you remembered her name was Elsie, because I only mentioned it once and I wrote it down. Well, good, good for you, good for you. But I'm very impressed with that. You are one smart cookie. Anyway. Yeah, she was only Talking about the negative, the deficit disorder. But I could see between the lines. I could see, you know, impulsivity was one of the cardinal symptoms. And, you know, it, it occurred to me right then and there, you know, what is creativity but impulsivity? Gone, right? Because you don't plan to have a creative idea. You don't say, it's 2 o', clock, time for my creative idea and lay it like an egg. No, no, Creative, creative ideas pop. They come unbidden, unplanned, in the shower in the morning, falling asleep at night, stuck in traffic, whatever, in the middle of a kiss, you know, suddenly, oh, my God, I just thought of this. And you're. The person you're kissing says, what happened? You say, I just had a new idea. So it's impulsive. It's impulsive. That's the upside of impulsivity is creativity. The downside is making wacko decisions and shooting from the hip and, you know, leaping before you look. So like everything in this strange, misunderstood condition, there's a positive side and a negative side. There's always the flips of the upside and the downside and, and the same thing with distractibility. You know, when she was talking, oh, these people are so distractible. Blah, blah, blah. Well, I ask you, what is curiosity but a form of distractibility? If you didn't care what was going on outside, you wouldn't look away from what you're doing to find out. If you didn't care what was going on in that petri dish, you wouldn't notice that it wasn't the same as when you left it. And you wouldn't discover penicillin. So, you know, we, yes, we can be, we can be drawn off track. But often that's a wonderful thing. Now, sometimes it's not, and you miss what's going on in the classroom and you fail the test. So, so, you know, like, like I say, like everything in this condition, there's a positive side and the negative side. But yeah, it was a blessing. And that I was able to sort of see that the medical model, the deficit disorder model, really only told half the story. An important part of the story, to be sure, you need to work on the downside. But my job as a, as a doctor working with people who have this is to maximize the upside and minimize the damage done by the downside. And there's, you know, there's always some negative parts to it and, and then, and then often the positive parts the person is not aware of, you know, and when I turn them onto that you know, women, I mean, so many women come in and they, they had been diagnosed with depression and anxiety, which is almost invariably what happens to a woman who has ADHD if she happens to go for help. The doctor will say, well, you're depressed and anxious and here's an ssri, see you later. When I'm meeting with them and I start talking to them about their aspirations and they sort of look down at the floor, well, I want at one point wanted to start a business, but I know I can't do that. I'm too disorganized and flighty and too anxious and too depressed and I'm not smart enough. And then I say, the fact is you're extremely smart. And they look up at me because they've, they're used to being BS'd and they sort of eyes narrow and they say, how do you know that you don't know me well enough? I say, well, I do. Your vocabulary, your appreciation of irony, even your ability to challenge me and ask me how do I know that those are all indicators of high intelligence and you're very smart. And then the tears will start coming down her cheeks because she's known all along she's very smart, but just nobody recognized it. So she pushed it aside and said, well, maybe they're all right, maybe I'm not very smart. But when I come along and offer just a little bit of proof that she is in fact, very smart, it activates that part of her that has known all along that she's smart but has given up on it. And all of a sudden she starts sitting up straighter, sparkle comes into her eyes, the tears subside and we begin to talk about, you know, the places she'll go to, the wonders she'll see. And this is not, you know, Hallmark baloney, this is real. I've seen this in my office thousands of times. And women particularly get overlooked because they're not disruptive, they're not hyperactive. In a classroom, they didn't get into trouble. They stare. The girl who sat in the back of the room staring out the window, twisting their hair and their finger, you know, looking at the specks of dust in the shaft of light coming in through the window and, and thinking long thoughts that have nothing to do with what's going on in the room. They get overlooked and they are dismissed as maybe not that bright or maybe not that motivated or sort of dull. And that's the sad part, because that begins to get woven into your self esteem system. And, and that's why it's so important that women become aware of this diagnosis that you don't have to be a history of being disruptive or hyperactive. Just the opposite. You can be the quiet daydreamer, what I call the Emily Dickinson kind of add Emily Dickinson for listeners who don't know it. She's probably America's greatest poet, and she lived a quiet life in, in Amherst, Massachusetts. And, and, but boy, oh boy, was her mind going a mile a minute. And, and that's, that's often the way it is for, for these women, whether they're again six years old or, or nine years old, which is what my daughter was when she was diagnosed, or 29 or 39 or 49. It's never too late to get the diagnosis. And if any of you are listening and hearing yourself in some of this, that's great news. That's great news. Don't let the negative thoughts swim in and undercut you. Don't let them saying, oh, well, it's not me, or I'm not that smart, or it's too late for me and I can't do it and people will laugh at me. No, no, no, don't let those negative thoughts circle you. Don't let those negative thoughts demotivate you or discourage you. That's why what you're doing, Tracy, is so wonderful, offering this podcast where people can get accurate information, but also encouraging information, because like I said earlier, this is a good news diagnosis. The bad news is when you don't know about it.
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A
So this is a perfect segue for this question I have had for a long time now. So, as I understand it, ADHD symptoms exist on a spectrum or a continuum, and that's also true for intelligence. So you can have some people with very high intelligence with adhd, and some people supposedly not so much. But I feel at this point, I've met thousands of ADHD women, and my observation is that every single one of them seems truly brilliant at something. Am I wrong? Is it just that I'm attracting a certain kind of woman with adhd or what have you seen?
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B
No, I think you're absolutely right. And that's what's so misleading about the word smart. Smart. You immediately have to ask, smart at what? Smart means nothing standing by itself. No one is smart at everything. People who are smart at math are stupid at fielding ground balls, say. And remember, all the range of human skills and capabilities goes well beyond a classroom. But yes, that's why I say to folks all the time, having this condition is a marker of talent. And it's my job to locate that talent because a lot of times the adults who come to see me, particularly the women, I'll say, what are you good at? They'll say, nothing, I'm not good at anything. One of my patients said her father used to say to her, you have no more sense than a jaybird. And that got into her and that, that defined her in her own eyes. And this woman was absolutely brilliant. She just wouldn't hear it because she hadn't gotten good grades in the sciences and math in school. So she wasn't particularly smart at science and math, but she was a gifted artist, a gifted writer, and more than that, gifted interpersonally. You know, she could make anyone smile, she could draw out anyone's story. I mean, these are all forms of intelligence. So I completely agree with you. It's just our job, those of us who work with these folks, to help them discover the areas of smartness, quote unquote, that they have buried, overlooked, or forgotten.
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A
Completely. And it's so much fun to do that. And I think you're so right. It's actually, it's not that difficult. And it happens pretty darn quickly.
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B
Exactly. Exactly. It's like picking low hanging fruit. Yeah.
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A
Okay, so over the holiday, I read the new book that you've just written with Dr. Rady, ADHD 2.0, new science and essential Strategies for Thriving With Distraction. Now I believe it's available tomorrow, Tuesday, January 12th. Is that true?
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B
Yeah, tomorrow is the publication date, but it can be ordered today.
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A
Perfect. Okay, so I just want you to know, as I said before, I absolutely loved it. It was really clear to me that ADHD 2.0 was written, actually written for an ADHD brain.
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B
Yes.
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A
So many times I will pick up a book about ADHD and I'll just know it was written by someone who doesn't really know what an ADHD brain feels like because it's 300 pages long, it's in nine point type, and there's these ridiculous one page paragraphs.
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B
Yep, yep, yep. Tracy, if I can interrupt you because you're putting your finger on something that distinguishes this book among all my other books, this is only 50,000 words. It is the shortest book I've written by far. And the book I handed in was 125,000 words. And the editor said this is just too long for people with adhd. So we proceeded to cut more than half of the book. And it was painful for me, but I'm so grateful to her because what, what you hold in your Hand is, is just meat, no fat. And, and, and someone with ADHD can read it pretty quickly. And I'm so glad to hear you say that. It is add friendly.
- [30:19]
A
Read it in a weekend and that was just a couple hours each day. I loved it. It was easy to read. It got to the point quickly and simply. The science was presented in an understandable way. And my favorite part of all the books you write is it's full of optimism, hope and positive emotion. So I will tell you, it is now my number one ADHD book recommendation. I feel like you literally wrote this book for those of us over here smartass women with adhd.
- [30:50]
B
Oh, I, I did. You know, the, the epigram to the book comes from a little children's story I wrote for my daughter when, when she was diagnosed at age 9. And it goes, no brain is the same. No brain is the best. Each brain finds its own special way. And that's sort of the, the life adventure that we're all on. ADHD or not.
- [31:15]
A
Right. So tell me, why this book? Why now? Because you've written a lot of books about ADHD, right?
- [31:22]
B
Right. Well, it had been since 2005, our last ADHD book came out. So it had been, you know, driven to distraction was 1994 and then delivered from distraction was 2005. So this is, you know, 15 years later. And a, a lot's happened in those 15 years in the field. And we also wanted to really consolidate, in very plain terms, the strength based approach and give the condition a new name, you know, because deficit disorder is just does horrible injustice. It's not a deficit of attention, it's an abundance of attention that we have. Our challenge is to control it. And I don't see it as a disorder, I see it as a trait. Can it be a disorder? Yes, it can. But can it be an asset? Yes, indeed it can. So we offer up as an alternative term, and I have no illusion that it'll be adopted by the dsm, but we offer it up as an alternative term for you to use in describing yourself. The acronym is vast and it is a vast terrain, but it stands for variable attention, stimulus trait. And attention and stimulus are sort of the two key elements to this condition. And they're variable. That's the third key element. And then it's a trait rather than a disorder. And if you manage it properly, it can become predominantly an asset. There's always going to be some downside to it, but you can minimize the downside and maximize the upside. And it gives you reason to celebrate, I'm part of a documentary that's being made by Nancy Armstrong and her husband Tim. Tim is the former CEO of AOL Yahoo. And he's got big time ADHD and so does his son. And they are personally funding this documentary that's based on the strength based approach. And we profile just a slew of very well known celebrities that everyone will recognize. And they're all saying, I have it, I have it, I have it, I have it. And then we walk along some prospective patients that we started with de novo and took them from diagnosis through treatment. So we follow them for a year. And our hope is that this will really go a long way toward undoing stigma. So we have ADHD 2.0 coming out tomorrow and then the documentary coming out in early March. And we hope that'll be a one, two punch to, to really knock the stuffing out of the deficit disorder model. But don't get me wrong, I'm not saying there isn't a downside to this. There's a terrible downside. It can undealt with, ruin your life. People with this condition can, you know, just live a life of horrible underachievement or miserable failure. Or at its worst, it's the prison population or the addicted population or the unemployed, the marginalized population, the alienated. So the suicide, depression, all that is higher in the world of this condition. But the part that that is, is accurate, truthful and so hopeful is if you get a handle on it, if you learn how to ride this bucking bronco, you can win races. You can. The, you can. There's a Nobel Prize. In this age of COVID the best test for Covid is called the PCR test, and that stands for the polymerase chain reaction. And the man who discovered that, Kerry Mullis, who's now passed away, won the Nobel Prize. And, and he had flaming adhd, used to go take penguins to the beach in California and he used to just do a wildly eccentric guy. And, and, and absolutely brilliant. And, and that's. You see that? And, and that's why it's such a shame for people to feel like they have to try to force themselves to be Joe or Jill normal. We're just not Joe or Jill normal. And, and we need to be confident enough or get enough support from folks like you to say, gosh, I don't care if I act like the neighbor, if I act like the Joneses, because that's not me. Nothing against my neighbor or the Joneses, but I want to talk to penguins, or I, I Want to, you know, eat my dinner under my bed or, you know, whatever odd habit you might happen to have. There's nothing wrong with it. As long as you don't hurt people, anything goes. And.
- [35:54]
A
And so boring as hell anyway.
- [35:58]
B
Right? Exactly. And boredom is our kryptonite. We just don't do boredom. You know, we are. The minute boredom sets in, we're off to something else, if not physically, then mentally.
- [36:10]
A
So in treating adhd, why do you think it is that focusing on constraints has been ignored for so long? I mean, you've been shouting about it, but many other experts aren't.
- [36:21]
B
Well, I think. I think part of the reason is it comes out of the medical model. And, you know, medicine is all about pathology. You don't go to the doctor because you feel so good. You know, you don't say, oh, I feel great today. I think I'll call my doctor. You know, you go to the doctor when you feel bad. And so medicine is all about pathology. And then the other reason is no one's going to fund research into an asset. Nobody's, you know, so if you want to get research money, you've got to play up how damaging the condition can be. And that's the point my wonderful colleague Russ Barkley makes. He says, ned, will you please stop talking about the positives, because we're not going to get any research money. Nobody's going to fund research into a gift or an asset, you know, and he makes a good point. So I think those are two reasons. The medical tradition is pathology and the. In order to get research money, you've got to prove that this can be, you know, disabling. And, and, and it can be. It's not hard to prove. Russ has done a very good job of that. But, But I'm just saying that's not the whole story. And the rest of the story needs to be told. So. So parents don't think, you know, they've been given a, you know, lower your ambition sentence for their children. And the. And these women, your audience can say, you know, there's a darn good chance I've got a lot more in me than I've unwrapped. There's a darn good chance that I couldn't fly, that I can be the person I envisioned when I was a little girl, daydreaming in fifth grade, that the only thing that stands between me and that is how I feel about myself and about possibility now. You can't snap your fingers. No, but that's another quality among us. Adders we're tenacious, we don't give up, we just don't give up. And you knock us down 10 times, we'll get up 11. And it's a wonderful quality, it's an amazing quality. But so many folks with ADD who don't know they have it are driving on square wheels. Well, it's hard to get very far on square wheels or they keep putting in the effort. Trying, trying, trying and you know, just getting the, the shopping done, the housework done, the kids dressed, the kids off to school. It's herculean how much effort they have to put in. And then if they happen to have a career as well, it's just, it's mind boggling. But they manage to get it done. But you know, the message I want them to know is, look, get the right help, get the right coach, get the right strategies, get the right medication. If, if that applies, your life can change. And that's another issue that people. Medication is such a negative press. Used properly, stimulant medication is a godsend. Used properly, it can be as life changing as eyeglasses. Is it the whole treatment? No, it's never the whole treatment. Education should always be part of the treatment. Coaching, lifestyle changes, you know, marry the right person, find the right job, you know, obvious stuff like that. And a lot of people with ADD are stuck in the wrong relationship or stuck in the wrong job or both. So there's a lot more to it than just taking medication. But if medication works for you and it works for about 80% of people, then it can make all the other non medication interventions so much easier to enact.
- [39:57]
A
Quick break. If you have ADHD and you've tried everything to make things work, listen closely. Adhd, well, you know, it's not a disorder. It's a different operating system and different brains need different strategies. In three days to fall in love with your ADHD brain, we talk about how your brain actually works, how ADHD shows up differently in women, and how to replace shame with pride. Then we build your ADHD user's manual together. One that fits you, supports confident decisions and quiets that ruminating brain. If you are ready to stop fighting your brain and start working with it, sign up for free@tracyotsuka.com Ilovemybrain we start on January 6th. Now let's go back to the episode. There are two acronyms that you use. Two new acronyms in ADHD 2.0. I hadn't heard of them before. One of them is TPN and one of them is dmn. Can you explain how these two networks interact and how we can use them possibly to benefit our ADHD brains?
- [41:15]
B
Absolutely. When you said tpn, my immediate this is the deep centers of the brain. Before I went to medical school, I did research in nutrition surgical patients at the old Boston City Hospital. And a lot of them were on what's called total parenteral nutrition, tpn. But that's not the TPN I talk about in the book. Don't worry. This is not a book.
- [41:38]
A
I don't think so.
- [41:40]
B
Surgical patients dying of malnutrition, tpn. The brain has, and this is wonderful new research from functional magnetic resonant resonance imaging. When you're doing a task, when you're frying an egg, when you're doing a crossword, when you're talking to another person like we're talking, different regions of your brain light up four different regions and in aggregate it's called a connectome. And the name of that connectome is the task Positive Network, the tpn. And your imagination is firing and you're creating, you're building your. Whether it's frying or conversing or constructing or planning or painting whatever it might happen to be, your imagination is engaged in a way that's constructive and positive and building. Well, when the task is finished, when the egg is fried, when the crossword is done, when we're finished our conversation, the TPN shuts down. The elements of that connectome go dark. The old thought was the brain kind of takes a rest like we all do when we're finished a task. Well, not the brain, no. In fact, when the TPN shuts down, the brain becomes more active than it had been before, as measured by glucose consumption and oxygen.
- [43:07]
A
Is that everyone's brain or just the adhd?
- [43:09]
B
Everyone's. Everyone's brain. But then what lights up is called the default mode network, the DMN or the demon. And I'll explain why. Now, in people with addiction and in some others who are have this trait, what happens is that the imagination starts feeding negative stuff. The DMN starts this. This stream of sludge of I suck. Life sucks. Nothing's going to work out. You're stupid, you're ugly, you're a failure. Your dreams are over. Kiss good, kiss happiness goodbye. Your marriage is over. Your husband is stupid, your kids are ugly, you're ugly. You know, just the litany of really bad stuff about yourself, about your life. And it just keeps on this ruminative, brooding, negative state. And the Person fixates on it. And why do they do that? Well, we like stimulation, we add years. And contentment is too bland. You don't say she was riveted in contentment, but you do say she was riveted in self loathing, in fear, anxiety, self hatred, you know, doom and gloom. That's riveting. It's horrible, it's punishing, it's torturous, but it's riveting. And so you sit there feeding the demon, feeding the DMN with your attention. With your attention. And the solution is not medication, it's not psychotherapy. It is simply don't feed the demon. Don't give it your attention. Cut off its oxygen supply, which is your attention. And as riveting as it is, you know, it's like irresistible. Like looking at the accident you pass on the highway. Well, do what happens on the highway. Drive past it. Stop feeding the demon, don't give it your attention. So do something else. Do something else. Dig a hole, call a friend, jump up and down, do 25 jumping jacks. Focus on your breathing. As long as you engage your attention in some other task that, that is interesting enough to take your imagination away from the negative, then you've, you've foiled the demon.
- [45:39]
A
So it's all about action.
- [45:40]
B
Yes, yes, yes, yes. And, and don't feel, don't mistake the creations of the demon for truth. That's what a lot of people do. They say, oh, yeah, you're right. I really am a total loser and I'm brave enough to face it. And I'll face it down and accept my horrible fate. It's your imagination. It's a disease of the imagination. And again, another paradox I've talked. This is a condition of endless paradoxes. When you're in the TPN Task Positive Network, what your greatest asset is, your greatest strength, your unique ability is your imagination. Well, when the DMN lights up, your greatest asset becomes your worst enemy, your imagination. And it conjures up all the horribleness that, you know, any creative person's imagination can conjure up. This has been one of the most tenacious problems that my patients bring to me. And, and one of the major reasons for writing this book was we really wanted to get the word out that you don't turn to medication to control this and don't try to argue it out with psychotherapy, because you can't. The DMN always wins. What you have to do is the simplest thing in the world is shut off your attention to it. It's hard to do. It's simple, but hard because it's very seductive. The DMN is very seductive. There's no better way to get someone's attention than to tell them they're stupid, ugly and boring. Oh, yeah, you're right. I really am. I'm a total loser. Particularly people with add. We are so, so ready to condemn ourselves and, and so ready. And it's just. It's just. Don't do it. Don't do it. Don't feed the negative version of who you are with your attention because it only lets it grow. Tell it to shut the bleep up and get on to something else. Doing jumping jacks, take a shower, call a friend, slap your face. Something that will get you. Snap you out of it. You know, the old ancient puritanical wisdom of a cold shower and a run around the block is in fact a very good idea if you can get yourself to do that. And you know, it's. It. It sounds so simple, but it's profoundly helpful. And, and of all the assets in, in this new book, it's one of the most practically useful if you can just get yourself to do it. Don't feed the demon. There are a few aphorisms I really, really, really love, and that's one of them. Once you understand what the demon is, don't feed the DM and don't give the demon your attention. Another one, by the way, is Never worry Alone.
- [48:31]
A
I love that one.
- [48:32]
B
Yeah, yeah, yeah. It's so important, you know, just never, ever worry alone. And, you know, bad stuff happens when you're worrying alone.
- [48:43]
A
So why is that so important specifically for our ADHD brains, not to worry alone?
- [48:50]
B
Because when you worry alone, the demon gets activated. Your imagination starts going toward the negative. And, you know, in isolation, that's when bad things happen. The demon gets activated. You're worrying alone. The demon just loves it. Ah, you're alone. And it's like a vulture. It's. It swoops in and just picks away at your carcass. But when you get someone else in the process, suddenly that worrying turns into problem solving. A good analogy illustration is imagine yourself in a dark warehouse, huge warehouse, alone. You get paranoid, you get terrified. But if you're in that dark warehouse with someone, you laugh, you don't feel scared at all, and you immediately start brainstorming. How do we get out of here? How do we turn on a light? Do you have a match? What have you? But when you're in that dark warehouse alone, then you envision every Terrible outcome. And you, you get down on the floor and take the fetal position. You know that that's what worrying alone does to us particularly imaginative people, which is the ADD population. We are cursed and blessed with an amazing imagination. And my job is to help people turn that imagination into more of a asset than a liability.
- [50:08]
A
That makes perfect sense. Even just being alone in the dark, sometimes my brain just goes off. And I've always been like that. And I think, do normal people think about these things? Like, I have to run for the light because I'm imagining all these things.
- [50:25]
B
Things. That's the price you pay for having such an imagination, you know? No, adult people don't. It's, it's why worriers. I'm a big worry. I wrote a book about worry because I'm a big warrior. I think people worry a lot. It's also a sign of talent because it takes a lot of smarts and creativity to dream up all the crap we worry about. You know, not very smart or creative people don't worry so much because they can't think of all the things that could go wrong.
- [50:57]
A
Wow. So about a year ago, I did a poll in our Facebook group because I just had this sense and I asked our women, do you feel that you have more of a need to live to your full potential and make a difference than your neurotypical friends? And it was a small survey. I mean, we have 22,000 women, maybe more than that in the group, and only 119 women responded, but 119 said yes and only 4 said no. I have noted, noticed in my practice, however, that we have a lot of women, they're midlife empty nesters and they're always working on that second or third act. We don't retire, we don't ride off into the sunset. They always seem to be like learning and collecting degrees and wanting to know more about themselves. Has that been your observation about ADHD people as well?
- [51:53]
B
Absolutely. And I think there's a reason for it. And it's not that we're so ambitious. It's that we have this imperative to grow things, to nurture things, to build things. In fact, I have a chapter in the book called Find the Right Difficulty. If we're not creating something, we're not happy. I mean, the reason I write so many books, it's not that I'm ambitious to write a lot of books. If I don't have a book going, I get depressed. Someone else, if they don't have a business, they're growing, they get Depressed. If they don't have a degree they're pursuing, they get depressed. It's not about ambition so much as it is an internal need, an absolute need to create. And another reason is ordinary life just doesn't do it for us. Our baseline pleasure is set lower than other people. This is a reason for addiction, by the way, as well. But in order to feel good about being alive, we need to pump up the volume. We need to create more intensity. Well, one wonderfully adaptive way of doing that is to have a creative outlet to write a book, to start a business, to plant a garden. And then you get the wonderful effect of. Of. Of doing that. And it really makes us. It makes us feel good. You know, that's what I mean by find the right difficult. Now, you can't just pick anything that's difficult, learning Chinese or something, you know, but it's. So it's got to be a difficult. A creative activity that both matters to you and is challenging. For me, it's writing, and I discovered it in 12th grade and I've been doing it ever since. For someone else, it might be knitting or it might be, you know, bench, scientist. It might be whatever. But find your right difficult. Find something that you can just invest in that will challenge you, that you'll never master completely. That'll be endlessly frustrating, like writing is for me. But it's endlessly frustrating in a very rewarding way. And that may again, that's another paradox. But it's true. And we need to have that expression. It. We're like cows. We need to be milked. We need to be milked. And, you know, if we don't get milked, you know, we don't feel right. I came up with that analogy from John Milton, the poet who wrote Paradise Lost. And at his end of his life, he was blind, and so he would compose in his mind. He was such a genius, he just composed it in his mind overnight. The next, you know, 100 verses of paradise Lost. And in the morning he would call his daughters and he would say, I need my milking. And so they would come and write down what he had composed in his mind overnight. And. And I think we, as a group, we need our milking and we need to find the right difficult. The right, you know, because a lot of people with this condition spend their whole lives trying to get good at what they're bad at. And, you know, for women, the women who just are never going to be good at housework, forget it. The goal is not smart. What the goal is not for housework.
- [55:05]
A
To me, no.
- [55:06]
B
Yeah. The goal is not to have a perfect house, it's to have a house that's well enough organized that you can live in it, you know, and so, you know, or a pocketbook that's well enough organized that you can find something when you need it. That's a far cry from being Martha Stewart. Give yourself a break. You know, and if you're not the, the world's greatest cook, so what? Order out. You know, I mean, you know, don't spend your life trying to get good at what you think society wants you to be good at. Follow your own talents and develop them. Get, get better at what you're good at. You know, when you're a kid, you have to try to get good at everything because you're just learning. But if you're an adult, you know, just, just develop your talents and, and hire out, delegate, whatever the stuff that you don't do. Well.
- [55:56]
A
So much of that though is socialized. Right. We have the sense of, we're women, these are the kinds of things we're supposed to be responsible for and if we're responsible, we need to do them well. But you're absolutely right.
- [56:06]
B
It's. Listen, my wife is mastering that. My wife, I'm 71 and she's 65 and she, I think she's now gotten to the place where she really doesn't care if the house doesn't look like it's all perfect. It's taken her 30 years to get there, but.
- [56:23]
A
Absolutely. So before I let you go, I have to ask you a couple questions that my women in my group asked, if I may.
- [56:32]
B
Yes.
- [56:32]
A
So Megan M. Asked, she said, as a medical student, I'm interested to know where Dr. Hallowell sees the field of ADHD research and treatment going.
- [56:43]
B
Oh, I think it's all going to head toward the strength based approach for sure. And the non medication interventions like in the book I talk about cerebellar stimulation. I think that's one of the most promising. So I think those two areas and, and you know, destigmatizing, you know, the whole, you know, I want people by the time I die to wish they had adhd. Right. You know, and run to their doctor.
- [57:08]
A
To get the diagnosis.
- [57:09]
B
Exactly, exactly, exactly. And come out skipping because at last they've been validated and they can, you know, contribute to the world what they know they have it in them to contribute to. And then I think we're going to find more and more non medication, whether it's exercise or Nutrition or brainwaves or, you know, more targeted, doable interventions. I think the day will come when medication is obsolete, but we're not there yet. And don't fear medication if you use it properly. Like I said earlier, it's a godsend.
- [57:42]
A
Thank you. So, Kelsey asks, do you have any thought on the relationship between introversion, extraversion and ADHD types? Do notable. Do notable inattentive ADHDers tend to be introverted rather than extroverted?
- [57:58]
B
In my experience, yes, but I have never tested that out. So what I'm saying may be complete baloney, but in my experience, yes. Now, I, contrary to what most people would think, am an intense introvert. And I am, you know, inattentive adhd. I've learned to compensate my introversion by being able to behave like an extrovert, which I need to do in my work. But I. I love nothing more than curling up in bed and watching TV and letting the world disappear, you know, so. So. So it is in my experience that inattentive and introversion go hand in hand.
- [58:41]
A
Okay, so, Dr. Hallowell, our Facebook group is called ADHD for Smartass Women. So you are not going to escape without a question about women and hormones. Yes, apparently. And remember, I'm a lawyer, not a doctor, so I may get this a little bit off, but if we simplify it, is it true that where our hormones are affects our estrogen levels, which affects then dopamine, which in turn affects our ADHD symptoms from, I guess, adolescence on through our lifespan? But there are still so few studies on women and hormones and adhd or the few studies that are out there are so small. And I think the thing that surprised me the most was that women generally, we haven't been included in ADHD studies because it's my understanding our hormone levels aren't static, which ultimately means that our symptoms aren't either. So it mucks up the ADHD studies. Is that true?
- [59:42]
B
Yeah, I think it is. And we really do need more studies. In fact, I'm thinking about doing one myself. I think we will get to the time where we adjust medication throughout the month based on your menstrual cycle and that we add estrogen for women in menopause as a standard part of prescribing stimulants that, you know, I think there's a. Much more than for men. There's. There's this menstrual variability, you know, and. And as well as the need for exogenous estrogen if you're in menopause. And I think A lot of so called medication failures. It's not that the stimulants didn't work, it's that they needed the extra estrogen.
- [60:25]
A
Got it.
- [60:26]
B
But you're right, it's a big topic. I have a close friend who's been working with. She's the woman. I don't know if you know, but I'm on TikTok and I have to.
- [60:35]
A
Tell you, your TikTok is fantastic.
- [60:38]
B
Oh, thank you so much.
- [60:40]
A
I was having trouble with the TPN and the double. I was really having trouble understanding that even after I read your book and I thought, well, I could go back and do that again or I could go look on his TikTok and you have it described in the TikTok and you make it so simple. It was basically go dig a hole or fry an egg. You're acting so it's fantastic. So I'm sorry I interrupted you.
- [61:00]
B
No, no, thank you. I'm so, I'm so glad that you related to the Tick Tocks. Yeah, they've had over 5 million views. It's been amazing. But I think the format fits, you know, the 62nd, 62nd clips. But anyway, the woman who has helped me do that is the one who really turned me on to this women hormones and whatnot because she's gone through menopause and she's found that her stimulants work much better when she gets an estrogen supplementation. So. And she's saying, she's saying we ought to do a study. So remember, there are people for whom no medication works. Like me. My medication is caffeine. And the thing that I think is probably most important of all the other vitamin C, vitamin Connect and you know, your Facebook mirror, I mean that's fantastic what you're doing. Your women tell them just by being a member of that and feeling that community, they are extending their lives. They're raising their performance level. It's so good. You know, I think it's the most important thing in life is connection. And what drives most of the problems in life is disconnection. Of course, during COVID it's made it more difficult, but it's not impossible. I mean, what we're doing, you and I feel like we've gotten to know each other. We haven't seen each other, we're just talking, but we're connecting. Absolutely.
- [62:21]
A
Well, I just can't thank you enough for spending time with us here today. It was truly an honor and a privilege.
- [62:27]
B
Well, the honor and privilege was all mine. And I can't thank you enough and your listeners and your readers. Traci, thank you.
- [62:34]
A
Thank you. Isn't he amazing? You know, listening back to this conversation, it reminded me why Dr. Edward Hallowell's voice still matters so much. Not just because of what he knows, but because of how he shows up with curiosity and optimism and respect for the complexity of the human brain. So much of the conversation around ADHD has focused on what's wrong, what needs to be fixed, what needs to be managed. And this episode, it's just such a reminder that there has always been another way to understand it, one that sees the challenges clearly but never loses sight of the strengths. If this episode resonated with you, I hope that you'll take a moment to reflect on your own brain with a little more generosity and maybe a little more pride and go buy his book adhd. It is brilliant, just like him. Thank you so much for being here. Thank you for listening, and thank you for helping keep this conversation alive. I will see you on, I think it's New Year's Eve. Okay, Bye. Bye. You've been listening to the ADHD hello for Smartass Women podcast. I'm your host, Tracy Otsuka. Join us at adhd for smart women.com where you can find more information on my new book, ADHD for Smartass Women. And my patented you'd ADHD brain is AOK system to help you get unstuck and fall in love with your brilliant brain. One last thought. Understanding ADHD really helps. But trusting your ADHD brain, well, that changes everything. And that's exactly what three days to fall in love with your ADHD brain is all about. It's free and you can sign up@tracyoutsuka.com Ilovemybrain we start on January 6th.