← The Leading Edge in Emotionally Focused Therapy
The Leading Edge in Emotionally Focused Therapy
80. When ADHD Has a Role in the Bond: Special Guest Alexine Thompson-de Benoit
00:33:24
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- [00:00]
A
Man, have you ever wondered what about my clients that are neurodivergent or neurodiverse? Well, you know, people ask me in Ryan about that all the time and we didn't feel smart enough to answer it. So we have an expert here with us today to help answer your question.
- [00:17]
B
Welcome to the Leading Edge in Emotionally Focused Therapy with your hosts, Dr. James Hawkins and Dr. Ryan Raina. EFT is a dynamic model that humbles each, even the most seasoned therapist. Together, we want to come alongside you as you continually push the leading edge of your understanding and application of this wonderful model developed by Dr. Sue Johnson.
- [00:45]
A
Y', all, thank you. It's great to be back here today. And seriously, the question we've gotten, I've got it many times at trainings because so many people are affected by it. We're seeing so much on social media and then so you know, for, from an EFT perspective, what about when we are working with a couple where one identifies as neurodivergent or they're, they're even on the verge of just a new diagnosis or thinking about it. And I don't feel like I've been, you know, really adequate to be able to answer that question. So I am thankful to have my colleague and friend Alexine Thompson from Switzerland. She is a ISF trainer for the French speaking part of Switzerland to be able to be here. She's a marriage and family therapist herself. And so I'm so thankful, Alexine, for you being here and being willing to, to share on this topic. Thank you.
- [01:37]
C
Thank you for having me. It's a pleasure to be here.
- [01:40]
A
Yeah. So here we go. Let's just enter in with the big broad general question. How does EFT look different when one, or maybe both, and I'll let you break that down of the people in the relationship struggles with some type of. And I don't even know if I'm using the right language. So please correct me if I'm wrong. Alexine. Neurodivergence.
- [02:02]
C
It is a broad question. So and let me start by saying that when we talk about, when I talk about neurodivergence, my, my main focus is adhd. I do know a little bit about hypersensitivity, giftedness or autism, but my main focus has been adhd. But I think you can see you can have similar principles for all these diagnosis or these presentations. And the main thing I would say is that EFT doesn't look so much different, but you do have to take certain things into account and you have to sort of adjust the model just like when you work with trauma and you have to slow down and slice it thinner and maybe go back and forth between the two partners a little bit more often so that it's more digestible. So the main, the main thing I would say is you need to educate yourself and know about these diagnosis because you will have presentations, you will have things that will act as triggers, for example, in the relationship that are symptoms. And if you just do regular eft and you do these vulnerable enactments and, and change events and, and you don't realize there is a symptom that's not being treated, what is going to happen is that this, the, the work you do in session is going to be destroyed between the sessions because a symptom is going to reoccur and act as a trigger and you can do more damage. I think if you, if you ignore the diagnosis and you don't take that into account, you can do more damage by taking them deeper and then allowing them to fall from, from really high.
- [04:04]
A
Wow, I like that, I like that you said so many great, like just practical nuggets in that already. And some of them, I'm glad I, I have said them and I was scared. Like, am I saying that wrong? But I like that you said slow down, slice it thinner and make it more digestible. Yeah, yeah, I like that.
- [04:25]
C
Yeah. I mean, one of the things with adhd, for example, one of the, one of the symptoms is the difficulty, the inconsistency in attention. Right. And paying attention or being attentive. And so even in session you can see that sometimes with some clients where they can only focus for so long and then they lose track of what is being said. So one of the things I have to be sensitive when I have a non ADHD partner that does an enactment is make sure they don't go in too much details. They get to the point. It's very specific. I mean, we do that anyways. But you know, you have those clients that start opening up and it's beautiful. And in regular couple, I would say we, you let them go because it's beautiful. You let it happen. But when I have a non ADHD partner in acting and I have an ADHD partner listening, I've learned the hard way that I need to make sure the ADHD partner is present for the whole show, the whole enactment. Right. Because. And sometimes I need to interrupt and, or pause. I would say not interrupt, but pause and say, let me make sure that. I just want to make sure your partner can take that in can we pause here? I might do an enactment in several bits to make sure that there's somebody in front of them. That's one way that you adjust the model, that you adjust the tango. And I don't have to do that with all my ADHD impacted couples. Some. Some of them are fine, but if that's one of the symptoms that that happens, then it's important in session that you take that into account and that you honor the difficulty or the effort that it takes for a person to sit still and to listen for a long time.
- [06:33]
A
Wow. Alexine, thank you. You're just rolling up, I'm sorry, Nugget after nugget already. So I like that two frames you just shared were really three. It's one make sure that the ADHD partner is present. And so the way you handle that is you might pause and check in.
- [06:51]
C
Yeah.
- [06:52]
A
Like, you might say, hey, are you still with us? Like, I'm up or. Or something like what I've done before. It's, hey, just want to get your attention back for a moment. I'm about your partner's kind of in this sadness right now that they normally don't know how to share. I'm about to have them turn and share about that sadness with you. Do you think you can be with us for about the next five minutes?
- [07:11]
C
Exactly. Exactly. Yeah.
- [07:14]
A
Okay.
- [07:14]
C
Yeah.
- [07:15]
A
All right. And there was one more. I'm sorry, I forgot it was right at the end. I didn't get to write it down, but it was great. Your. Your help. I'll go. When I go back and listen, I'm like, that's a great nugget. Can I go back to another thing you said earlier that was. I didn't click on. You said maybe there might be different triggers that are symptoms. Yes, it may be triggers for the ADHD partner. Like, what are some of those triggers? Maybe that. Or I guess maybe that could be triggers for the non ADHD client. Such as.
- [07:44]
C
So what I've observed is that. And that is why. Another reason why it's so important to name the diet. So maybe just a few words about my practice. I have some experience, personal experience with adhd, let's put it that way, in my family. And then I started noticing in my couples things that looked very familiar. And so I started. And then because I had read some books and I had studied a little bit, I started asking questions to my couples and then suggesting that maybe have they ever wondered if one of them is struggling with adhd? And I've never been wrong. So Far really good. It's been confirmed each time except maybe once where they didn't, they didn't resonate with it and it didn't check. And what I've observed is that the non ADHD partner with complain about things like he or she forgets what I say. I send them to the store to buy five items and they come back with three. I, we've put it, I've told them there's this event and I've put it in the calendar, but they don't look the calendar, they don't look at the calendar and then the event gets forgotten. Or they never, yeah, they never remember. They always interrupt me. So all of these are like interrupting can be, can be the impulsivity. Right. Of, of we often say of ADHD people, people who have adhd, that they're like a Ferrari with bicycle brakes. So, so they don't have the breaks. They have a million thoughts going, an hour going into their minds and they just blurt them out sometimes because I got to tell you right now, this is important and there's no breaks accessible to them. And it's a real struggle. But the partner who receives that interruption can feel disrespected, can feel dismissed, can feel ignored, invisible, unheard.
- [09:58]
A
I'm not important enough.
- [10:00]
C
Then, then there you are. You're in the cycle, right? That, that's the trigger. If you forget everything I say to you, I'm going to start feeling unimportant. If you're disorganized and you keep losing stuff and then my stuff too, I feel disrespected and I feel like you don't. You take me for granted. So a lot of things around the household along the organization, the day to day organization, real struggles because it's a symptom of a difficulty with executive functioning or like you don't remember stuff I told you, you don't remember I told you yesterday. I told you, I told you an hour ago. Were you even listening? Right. And what you'll see is a partner that goes crazy and gets really, really mad and angry and frustrated and, and add someone who is really not doing it on purpose and, but they will start being perceived with as someone who has an intention of like not caring, of disrespecting, of forgetting.
- [11:11]
A
Wow.
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C
Right. So it's really, really important. Psycho education is really important. It does, it doesn't fix everything, but it makes a difference when you can realize, oh my goodness, this is what your brain is doing or this is what your brain is struggling with. It's like, if you don't have the brakes, then, yeah, of course you go really fast. And initially, the non ADHD partner can struggle to have any kind of empathy or understanding for that. They don't want to. They're just pissed, they're frustrated, they're angry, they're hurt. They have no patience for this because it seems so simple to them, to their neurotypical brain. So initially I, I kind of have to. I have to put myself in there and, and just. It goes through me. The empathy will go through me. The validation, the normalization, the psychoeducation. I will weave that into my empathic reflections to remind them this is, this is a real struggle.
- [12:23]
A
Wow. Wow. Thank you so much. Like, you just answered the question I was going to ask. So what do you do in these moments where you're kind of holding multiple perspectives? Because there's the neurotypical brain who's, like, taking this so personal that they're like, why. Why is this so difficult? Why am I not important? But then you're, as a therapist, especially you. You're, like, trying to hold space for. And you just answered the question. I was like, is she. Is, is she going to tell us? So is she going to tell us through, like, reframes? But you, like, you do it through an empathic reframe is how you do it?
- [12:55]
C
Yeah, yeah.
- [12:56]
A
What might that sound like?
- [12:58]
C
So, something like, something. So I always tell people in the, in the, in our trainings, which I do with my colleague Ben Knob, we always tell them, you know, psychoeducation is important, but we don't want it. We try to do it the eft way. So, so we, we sometimes we do it very directly and we give information about the symptoms in the brain and the executive functioning. But sometimes I like to weave that into my reflections. Something like it sounds like. So it sounds like when, when you see the anger in her eyes and that you hear the frustration in her voice, all your brain wants to do is distract with something more pleasant. This is really uncomfortable. This is really not stimulating. This is shutting you down. And you go somewhere else and you start thinking of something else that's more entertaining, that's more stimulating. Right. So what I've done there is. I've just talked about one of the symptoms. I've just talked about the dopamine stimulus, the seeking, the dopamine rush. Right, yeah. That the ADHD brain does. Because they don't. They struggle with that. They need more stimulation to feel the dopamine to produce dopamine.
- [14:24]
A
Yeah.
- [14:24]
C
So I'VE just talked about a symptom, but I've put it in a reflection. I've added it to my reflection.
- [14:30]
A
Yep. And what I like about it is you put it in a relational context.
- [14:35]
C
Yeah.
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A
It's not just lifeless. I want to be careful. It's important data no matter what. It's factual and it's true.
- [14:42]
C
Yeah.
- [14:42]
A
But it also has a different life and feeling in the relationship. So I'm like, yeah, of course your partner is important to you and what they say matters to you and you want to get it right. But in that moment though, I like how you said whether you see the anger or the tension your body where every. By the way you can normalize. Every human body wants to get away from it. However, your brain has even more gas as like the Ferrari to get out of here. But then it's even harder for you to hit the brakes and come back.
- [15:12]
C
Exactly. I love that. Wow, you're good, James. You're good at it.
- [15:17]
A
Well, you already know how to do it.
- [15:18]
C
Well.
- [15:19]
A
One, you're helping me like I wouldn't have. And you're right. Thank you for adding that. Psyched is maybe not our theory of change in eft, but psyched can bring a form of empathy because if we don't have that piece for. I want to go for the, not the, the neurotypical brain. If they don't have that, they're going to keep taking it personal. You don't care about me. I don't matter.
- [15:41]
C
Right.
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A
But that's a kind of like I want to be careful. It's a conclude. It's a, it's a, it's a meaning making that doesn't also understand what's happening in the brain and body of their partner that the partner probably wishes was different too.
- [15:57]
C
Exactly. Yeah. So that brings up the importance. There's two things that it brings up for me when I listen to you is we want to. It's also important to validate, of course, the non ADHD partner. And I'll say things like, it's mind boggling, isn't it? It seems so simple. It seems so easy to you. It's. It's like you don't even have to think about it. It's. It's such a simple thing to remember, a simple thing to do. It's mind boggling that it would be so hard for him or her to, to do that. And, and I get, I get how hurtful and how angry making that is.
- [16:40]
A
Wow.
- [16:41]
C
You always end up feeling let down, feeling forgotten and it's so painful and, you know, blah, blah, blah, like just really validating, giving them permission to feel what they're feeling. And then I might turn to the partner and one question I like to ask is, can you help your partner understand what it's like in your mind? What is like in your brain? Can we take a walk in your brain right now and can you let us see what it's like when you're trying to remember an information they gave you and there's a million things happening all at once and suddenly you've lost it, suddenly it's gone, suddenly you can't remember it. Can you, can you let them walk into your brain for a moment and let them see what it's like? And I, I personally find that, have found that very helpful to hear those stories because even for me, who knows about adhd, who knows the symptoms each time I hear about the struggle and how, yeah, how it's like I can't, you know, the hyperactivity of the mind, for example, we thought, we think about hyperactivity as someone who's always fidgeting and always needing to do a thousand things, but there's such a thing as the hyperactivity of the mind. When, when someone describes that to me, I'm like, oh my gosh. Oh my goodness. Wow, that must be so hard. That must be so exhausting. Right? And we forget. I forget because I'm. I don't have that brain. And it always brings empathy. It always triggers empathy in me. So by asking that question, I'm helping the non ADHD partner get a glimpse of the struggle. Right. And that's also important. That's also something that we eft is a beautiful model for that because it, it gives us tools to do that.
- [18:38]
A
Yeah. Wow. I know. I keep. This is helping. This is just helping make it so many parts of the process. Like, it's not just pursue withdrawal strategies. You're also having to be very intentional about neurotypical brain, neurodivergent brain, holding space for. And I love how actually as you model this, you're doing such a beautiful job of holding space, of validating both and not having to like attack or defend one or the other, that you can lean into the neurotypical brain and validate the pain and frustration that they have and the angry making that they're experiencing, while you also hold such great empathy for the neurodivergent brain. And I love that example of take me into your brain and like you're kind of taking a moment when the cycles Calm down enough maybe. And allowing the neurotypical brain to walk around in their partner's world to develop a felt sense of empathy for them.
- [19:36]
C
Yeah. Yeah. Wow.
- [19:39]
A
Can I ask one thing? So this is a fear I have and maybe you can help me. I get a little bit afraid of sometimes working with the neurotypical brain and inviting some of the pain and frustration that's happening for them. I'm not also wanting to bury the neurodivergent brain in shame and failure. Yeah, I want to get better, but I don't want to. I can't stay away from it. But like, how maybe what should I be considering to not do that to the neurodivergent brain?
- [20:14]
C
Yeah, I see exactly what you mean. I, I think. Well, first of all, anxiety and shame are, are almost always there in your divergent but at least ADHD partner. Sometimes they're well hidden. So I think I would wanna, before I dive too deep into the non ADHD partners or the non diverse, the neurotypical partners pain, I might want to make sure that I have brought awareness or brought, you know, the shame and the, the anxiety to light so that, so that it, it's held and then, and then, you know, it might, it might come up, it might get triggered. And I think that's why it's important to go back and forth more often and not stay for 20 minutes with somebody's pain and a lot of the neuro divergent person to, to just kind of drown into their shame. I think I like to say we titrate right back and forth, back and forth between the two and we slowly go deeper and deeper, but not like deep plunges like we can afford to do with some of our other couples.
- [21:41]
A
Wow, that was a great answer. Like the moment you started, I'm like, oh, she's right. So even for that one is just be. You're just being so clear and explicit in moments. And so because you know what's happening inside the neurodivergent brain or you have a good estimated, you know, educated guess of what's happening there. And I like that you said that. Let me make sure I say anxiety and shame is always present in the neurodivergent brain. That's a good. In that. What's that?
- [22:12]
C
In my experience, I mean, I, I can't speak. That's right. The whole planet.
- [22:16]
A
But that's fair. But I get why you say that though, because they know that there's moments and times that throughout their life they've had the experience of there's something that they're just not getting, and then they see the pain or devastation on the receiving end of themselves or disappointment or anger or.
- [22:38]
C
Yeah, yeah.
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A
And so you just make that a little bit explicit. So that way. I liked how you said so. That way you can give it compassion. You resource them before you invite the partner's vulnerability forward.
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C
I don't know if it's before. I think it's at the same time, I think initially it's kind of like, you know, from one brain to the next, maybe more frequently, so that you can uncover a little bit, but not too much, and then go check out how it's resonating on the other side, but not too much. And then.
- [23:14]
A
I like that.
- [23:15]
C
Right. Until. Until there's enough safety for you to stay longer in those places and for them to tolerate the shame and the. And the anxiety. But then again, every couple's different, so I can't see. I do that with all my couples. And I think it's all about attunement.
- [23:33]
A
Right, that's right. That's right.
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C
Yeah.
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A
I just love that you're giving us at least some. Some frames like we still doing the same EFT process. But I like that you and Ben have taken the time to think about some of the nuances and things that we can modify to do this in a compassionate and informed way.
- [23:52]
C
Yeah, absolutely. And. And I. I want to add this, though. If. If somebody has adhd, it's. Maybe it's a little different with autism, but with adhd, there are treatment pillars, like things that are important to. That you can do to improve your symptoms, to live a better life to be. To develop strategies. If somebody has ADHD and they're refusing to address that, it's tricky. It's going to be difficult because while I can be compassionate and empathic about your symptoms that are not your fault if you, if you choose not to address them, which you're the only one that can address them. I can't do that for you. I can't take your meds for. I'm seeking as a partner here, for example. Right. I can't take the meds for you or I can't develop the strategies and practice them for you. You're the only one that can do that. And when you don't, it has an impact on me. It hurts me. Me adds to my load because I have to then think about everything and I have to be the one that's organized and blah, blah, blah. So when you refuse to do that, then that. Then that hurts Then that's a, that can be an attachment injury or that can be.
- [25:15]
A
Yeah.
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C
That can deepen the wound and then it's hard to find compassion for that. Right. And so what I find is that often the person taking charge of their ADHD sends a clear message of you matter enough to me that I'm going to do all I can to, to manage this so that it has as little of an impact as possible on you, on us.
- [25:42]
A
Wow.
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C
And I'll benefit. I'll benefit from it too. Where, where I find that EFT struggles to work is when that, that piece is not owned. That piece is not. People don't, don't take charge or they drop, they drop from, drop out of treatment and.
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A
Yeah, yeah. Because that's a part of caregiving.
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C
Right, right, right. Exactly.
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A
Even them taking care of themselves.
- [26:12]
C
Exactly. And the same thing on the other end, like the non ADHD partner also has a responsibility to own their anger and the way they respond to the symptoms and the, and the, the ADHD manifestations.
- [26:27]
A
Yep. Wow. Thank you. That was. Man. Each time you do this, I love the way you're able to, like you said, go back and forth between the two brains.
- [26:38]
C
Yeah.
- [26:38]
A
And hold space like one. I love the way we've, you know, kind of evolved through this conversation today. It's in the process just be willing to kind of like, you know, go slower, slice it more digestible chunks of work going back and forth, almost regulating back and forth in between and resourcing both between. In the process really pushing that psyched piece in a compassionate attachment oriented way to help develop empathy for the neurodivergent brain. And then also being able to help the person who struggles with neurodivergence to see the impact of their partner. And then also in this, just once again, this end piece, like in, in the end, it's still going to be an uproar. It's still a battle for both partners, but also seeing how their choices impacts their partner and helping inform them to like, this is what it means now, knowing this diagnosis, having this awareness, how does caring for each other now what does it look like knowing this? And it could be, it could be the treatment pillars. What a great refrain.
- [27:50]
C
Yeah, yeah, yeah. And if I can add one more thing, I think grieving is also something that needs to be a part of the process. Right. Because you can't change that brain. You can help it function better, but you can't change that and grieving and celebrating. Because once you've grieved, once you've accepted okay, this is what we are living with. This is what we're dealing with. Let's make the most of it. Let's. Let's accept it and work around it. Like if my partner has diabetes or some kind of chronic disease and we have to change the whole way we eat and then we're going to do that as a team, we're going to do that. And yeah, we'll grieve. I don't know, eating our favorite foods maybe, or doing certain activities. But that doesn't mean we can't have a happy relationship. Right? There are so many things that we can still do. And ADHD comes with a lot of gifts, as does autism, hypersensitivity, giftedness. They come with a lot of gifts and a lot of superpowers, I'd like to call them. So those are difficult to access and celebrate when you're escalated, of course. And, and I think once you've grieved and accepted, then you can. There's space, right, to appreciate what is, what is beautiful about this.
- [29:24]
A
Wow, what a great. I'm glad you added that one more piece. And trust me, if you have one more piece, you can keep adding them. But what a great way. It feels like you just walked us through the whole EFT treatment map. Even there, it's hard for them to grieve and to celebrate when there's escalation. So you've got to be able to calm and soothe some of that through that short, intermittent work back and forth between both brains. Then maybe in stage two, you do drop down into some more kind of grief. And what does it mean to care and reach for each other in very hard places? And then maybe coming out into stage three, it's like now we can like grieve together, but also now we can celebrate now this new place that we have a new awareness of each other.
- [30:03]
C
Yeah, exactly. You got it.
- [30:05]
A
Wow. Alexine, thank you. This has been so informative. Like, man, I want to just encourage you all if you ever please. And we'll ask Alexine for her contact information, but like, if your community needs training on this, please contact her. And Ben, you've heard her here, she knows what she's talking about. Ben, I've never gotten to meet him and really know, but he works with Alex Scene. So I think they would be great for your community if you want maybe kind of, you know, consultation or supervision, please reach out to them. Alexine, maybe we'll put in the show notes too. But if people wanted to reach out to you, how could they contact you.
- [30:48]
C
So my email. Atomson.mftmail.com or yeah, I guess I'll give you my. The website, the EFT Switzerland website. We have a training coming up in October online in English. All right, that's us friendly in terms of schedule and we're going to work on CEUs as well and we'll be at the summit. So if you're at the summit, come to our workshop and yes, meet, meet us and introduce yourselves and we'd love to connect.
- [31:20]
A
Yeah, y' all right here. If you. If you've been saying, like, I want to be able to help these clients and these couples from an attachment based, compassionate perspective, go to that online training, come to the summit and meet Alexine in person. Alexine, thank you. This has been a great 30 minutes of a conversation to learn and I think I've been challenged to get better in my work here in this area. So thank you.
- [31:45]
C
Thank you, James. It was a pleasure.
- [31:47]
A
Oh, thank you so much. And to you all, thank you so much for listening. We really appreciate the work that you do as EFT therapists. And it's hard to hold space sometimes for multiple perspectives, not only just attachment strategies, but as Alexine has laid out for us, just even around some of these very hard diagnoses where there's one that's neurotypical, one that's neurodivergent, it's hard holding that space. But that's what we're called to do and that's what we do for our clients who are struggling and helping them find our way. So thank you so much for the hard work that you all do and we appreciate you as you continually push the leading edge of your learning and experience to help your clients push their leading edge. Thank you so much.
- [32:31]
B
Thank you for listening. We hope this experience helps you push the leading edge in your work to help people connect with themselves and with each other. Please subscribe to our podcast and leave us a five star review. You can contact us at pushtheleadingedgemail.com and you can follow us on our Facebook page at pushtheleadingedge. You can follow Ryan on Facebook at ryanrayna professional training and on his website ryanrenatraining.com youm can follow James on Facebook and Instagram ockhawklpc. You can also check out his website dochawklpc.com.