‘Maybe the fear is that we are less than we think we are when the actuality is that we are much much more.’ Jon Kabat Zinn
In 2016, at a Thich Nhat Hanh Zen buddhist community (COI) family Mindfulness retreat in Stourbridge UK, I worked with families with Attention Deficit Hyperactivity Disorder (ADHD) diagnoses. My sons and I also all have ADHD and I wanted to share some reflections on mindfulness practice and how it relates to ADHD. I believe this is important at this present time because more and more people are being diagnosed with ADHD and being medicated away from who they are. Mindfulness offers all people affected both directly or indirectly an opportunity to find a realistic and long-term response to this.
ADHD makes life difficult for adults and children alike. It is a spectrum condition, like autism, thus many people may have some ADHD tendencies but not the full-blown condition. In someone who has ADHD the brain is wired differently and just because such people behave differently, they are not being difficult, rude or thoughtless; ADHD does not imply an IQ deficit, one can still be highly intelligent with severe ADHD.
Whether you are living with someone who has ADHD symptoms or are the diagnosed individual, or just perhaps likely to run up against someone with ADHD in your general life, (which is possibly most of us), this article may help you.
Not a developmental condition
One doesn’t grow out of it, but rather develops survival strategies. My sons and I were all diagnosed with ADHD in adulthood. Mindfulness and meditation practice became hugely influential and beneficial. It offered realisable solutions. I realise that many people struggle when taking up the practice of mindfulness, but it is even more challenging for someone with ADHD and they do have to be highly motivated to achieve this. I started my own practice about 20 years before diagnosis, in my late 30’snderly 40’s, and just found mindfulness and the Buddhist approach to life made sense of my struggles, all of them, not just the ADHD which at that time I did not even know about. I just thought I was weird. I was generally ok with that except when it seemed to sabotage my life again and again. For me there were many other factors involved too. I also got diagnosed with more or less life-long C-PTSD (complex post-traumatic stress disorder) resulting from my traumatic childhood, from parents who perhaps did not know how to control or manage a child with ADHD without recourse to increasing levels of ‘punishment’, and their own mental health issues. But once I learned to manage the PTSD, the ADHD was still there, as it apparently had always been.
Mindfulness has been shown to re-wire the brain over time ( David Austin, Sarah Lazar, Richard Davidson etc.) The interesting question is: can the brain be rewired where there are structural deficits such as those in ADHD. The answer researched thus far is probably yes, some of them at least, with many iterations and great effort. But there are limitations to this too, as more recent research by Sonuga-Barke et al. has shown. To understand how, one has to understand a little more about how ADHD manifests.
There are many features of ADHD which I shall address in turn to demonstrate how this mindfulness approach can work to ameliorate the additional difficulties and challenges that ADHD can present.
This is an ADHD spectrum behaviour sometimes leading to serious social and legal problems, but nearly always causing problems especially in childhood being seen as a discipline issue. Doing things and saying things without awareness of likely repercussions and implications. Consequences are just not on the ADHD radar and take a massive effort to understand and recognise. Impulsivity can also be part of their charm and strength, being spontaneous and generous, fun, lively and generally quite innovative, often being prepared to go where others are far too timid. The very nature of impulsivity can be challenging and I have found that this offers good opportunities to practice, i.e. don’t allow annoyance at superficial behaviours but look deeply into the intention behind it, which is often positively motivated. Mindfulness helps develop awareness of physical tensions and other symptoms of impulsivity and allow one to step in on one’s own body. It takes time for anybody to learn this skill but can really make a difference to the social competence and confidence of someone with ADHD. I am now aware of consequences most of the time and my son is gradually learning about them although still struggles to recognise what they might be and when they might arise. I found also the teaching on Karma and especially Thay’s (Thich Nhat Hanh’s) teaching of Inter-being really helped to make more sense of it all and enabled me to forgive my errors, and those of others, by recognising how important the motivation factor really is. What you do is far less important than why you do it. Someone with ADHD might not know this. They often do not have any access to the motivation behind their behaviours, it just comes as an impulse. How much responsibility can we attribute on this basis? Learning to stop for a moment, as often as possible, just allows you an insight into that motivation and (MAY??) allow you to make a choice rather than react, but with ADHD it is much harder.
Empathy and the rules of social relationships
Empathy and the rules of social relationships are rarely understood by people with ADHD in terms of both impacts on the person with ADHD themselves, and on those with whom they come into contact. Similarly to autism, ADHD often means being overwhelmed by crowds and struggling to understand and cope with social cues; these skills have to be learned. Often people with ADHD are forthright and literal, childlike, naive, rarely with malice intended. Their honesty and openness can be refreshing in contrast to some social rules which include various forms of dishonesty; you know where you stand and you can decide to go with it or to be offended - your choice. However they can also be quite devious as a coping mechanism to deal with what they might feel as their failures or abnormalities, and as an avoidance of the endless critical attitudes that come from other people. Mindful awareness and self-acceptance makes this all more manageable for both those with and those without but who are living with or relating to someone with ADHD, and helps to drop the need for negative survival skills like deviousness.
The most prominent feature of ADHD is also the most commonly understood challenge, that of very fragmented concentration on every-day things and, most of all, the educational sphere, hence the policy to drug diagnosed children into submission. But what is less well known is that the opposite is also true. Most people with ADHD can hyper-focus on things that grab their attention, and I mean really absorb and focus with an intensity that can appear obsessive. This has been the most successful role of mindfulness in my own life and what also eventually drew my son into the practice. Once you can recognise how much mindfulness will alleviate the problems of living with ADHD, it becomes an absolute must do approach to life. Once I recognised that for myself, and it had to be my own discovery no one could have told me, it became something I was able to work with eagerly. After all, mindfulness is the gradual development of focussed attention, but someone with ADHD will need many, many more iterations before it starts to have an effect. I always come back to the teaching of the student and the master to help keep me encouraged.
‘Master, master, my meditation practice is terrible, my attention is everywhere and I cannot sit still at all.’
‘This will pass’ says the master quietly.
A week later the student come and says ‘oh master you are so wise, now my meditation practice is so calm and I can sit still and peacefully through all the sessions’.
‘This will pass’ says the master quietly.
This simple teaching helped me to come through the struggles of sitting and being restless and unfocussed and helped me to relax with my own experience of sitting practice, however that is on any given day. It is not a competition, it is a goalless state, and ADHD might make it harder on one level but once you appreciate the goalless part of it you can be with it wholeheartedly, whatever arises. As Thich Nhat Hanh says ‘enjoy your practice’. I do not enjoy my sitting practice, but I have learned how to make the most of it and enjoyment has grown from that and exploring all the other ways in which one can develop a mindfulness practice. Now I love it.
People with ADHD have to be resilient to criticism and rejection; they attract lots. Mindful approaches to life make criticism less painful because you can convert criticism into useful feedback and learn how to recognise when the criticism is valid and when it is someone else’s problem with judgements, i.e. their projection onto you of their own personal agendas. It can be very helpful to understand why other people’s judgements may not be valid. They do not know or understand you fully. We often experience acute rejection dysphoria as part of our ADHD so this is an issue to explore through mindfulness too – it helped me.
This is more than not being able to wait for things to happen or to arrive, it becomes physical distress. Tests show clear preferences to take lesser rewards than face delay, even if delay means receiving more. The smaller reward is less challenging or disappointing than the distress and struggle to wait and be patient. It is not greed or snatching but seeking to avoid the tension created by waiting. Self-awareness arises from the practice of mindfulness and studying Thay’s interpretations of Buddha’s teachings in depth for their psychological content. This really helped me to understand how to challenge my own sense of permanent urgency and to use that as a place of relaxation, to notice when that kind of impulse was taking me over, to step back and breathe. It doesn’t mean it has all gone of course, far from it, but that I can work with it positively.
The hyperactivity part of ADHD, the need to keep moving, is a particular challenge of social expectations for children, even more for adults, creating the illusion of a badly controlled, naughty child. They are not. The physical backlash of suppressing the impetus to keep moving can be difficult to understand, the need to release the suppressed tension in the body can feel quite desperate and almost violent. My son when he started school aged nearly five, was told to sit down and he did. But then he got up again. This happened often and he was then shouted at regularly by his reception teacher, often right near his ear. Her had repetitive glue ear and perforated ear drums and this teacher often caused him considerable pain. I went to see her and she said she didn’t care as she was retiring at the end of the year. I regret not having followed that up more fully at the time but I was also struggling then and didn’t know how to. That teacher made my five yr. old son feel traumatised fearful and overwhelmed by the negativity of school.
Learning to work with the physical tension and the breath has helped me enormously although there are still times when sitting still for meditation is impossible. I have learned to use micro-movements — tiny rocking movements that help me to release the tension of physical inactivity. However, I often find my body has just moved of its own accord and I’ve learned not to be afraid of other people being irritated by that but for them to see that as their own mindfulness practice challenge. I often need to remind myself that I must be self-compassionate and not judge myself for what I still have to face but rather to recognise how incredibly hard it has been to get this far. And often nowadays when I sit, I am transported to wherever it is we all go in deep meditation, it does happen with perseverance.
My practice of mindfulness, in all its wonderful rich layers of teaching, has utterly transformed my experience of myself and the world around me so that it is ok to be me, to have ADHD qualities (not deficits- just differences) that can make me frustrating but also fun to be with, and to enjoy the present moments as they parade through. If I look back I can see the many skins I have shed on this journey and accept each one as part of that transition. This can apply to everyone. I can really enjoy my relationship with my son whose ADHD was once a massive and overwhelming challenge for me as a stressed out single parent. Both he and I have changed, grown and developed a deeper relationship and appreciation of each other as parent and adult son through this journey into the ADHD /mindful approach to life.
Emotional Hyper-arousal and Rejection Sensitivity
This is an extreme form of emotional sensitivity which literally has people in tears for so many mis-understandings. The rejection dimension I suspect comes from so much rejection and criticism based on other symptoms and creates a hypersensitivity in some people who also have a hypersensitive emotional network. Often people with ADHD just cannot suppress their emotions and indeed it would not be healthy for them to do this. It is probably the basis for my own PTSD during childhood, being punished so severely for something I could not control and being a very sensitive person as I also am. My own development of a mindfulness practice has enabled me to recognise when I am being oversensitive and mostly, but not always, be able to manage those reactions reasonably enough. The self-observation skills that mindfulness develops in us really helps to recognise that our own hypersensitivity may not be the real story — but nevertheless I am still very prone to those feelings. I can manage them positively nowadays too, which helps enormously, because the reactive dimension to this can backfire on me and does require those close to me to be very tolerant and understanding at times.
How mindfulness helps so much.
The challenges of ADHD are definitely assisted by mindfulness. Can you sit? Can you concentrate your mind at all or even start to slow it down? Can you learn to eat more slowly? Well yes you can but perhaps not as far or as quickly as someone who does not have ADHD. So don’t be hard on yourself if you struggle to eat slowly, and still finish first. And don’t accept the judgements of those who think they are better at their practice because they have eaten their meal more slowly. They have missed the point of mindfulness if they view you in this way. Accept that what you can achieve is good enough and will, like everyone else’s practice, improve over time, but perhaps at different rates. Another very powerful teaching comes to mind here which really helped me; that the form is not the thing itself, that having the external appearance of good mindfulness skills and intellectual understanding are not being mindful, they can in fact be very controlled and ego originated indeed. It is what comes from the heart that matters; the love of the practice, of this approach to life, of yourself exactly as you are, whilst knowing that this self is not fixed but will evolve over time, that is how I feel the dharma inside my own heart. I have met with many neurotypicals who have a good external appearance of mindfulness but it is more ego acting than heart commitment and that is not true mindfulness at all.
Watching the breath
Was this ever going to be a tough one for me? BUT watching the breath gets easier with determination, you cannot get a person with ADHD to concentrate unless you really grab their attention, then they will hyper-focus on learning and understanding everything they can about the practice. So it has got to come with bells on in the first place or else offer them something they really want for themselves. The latter came for me as I had struggled so much everywhere for my whole life, and believed myself a completely useless failure. It gave me hope and I hyper-focussed for over 2 decades on the teachings as Thay and other Buddhist or mindfulness teachers as they were presented to us. I still do in the right moments. But if not in the right moment, I can’t force it. It has to be when I am ready and receptive, then I practice like nothing else exists (it doesn’t, does it!).
What was a game changer for me though was that Thay said ‘enjoy your practice, do it but enjoy it.’ That gave me permission to develop my own approach to a form of practice which worked for me, but also which worked for my brand of ADHD / PTSD. I am still pretty traditional but I have worked out how to make it fit me rather than follow instructions that don’t help me at all and can even re-trigger my PTSD if I am not careful.
On the outside I can appear less than calm or slowing down, but there has been a vast transformation over time. Sitting continues as my greatest challenge but now I accept and manage the need to move; sometimes I go really deeply and sometimes not, just like the rest of you. Sometimes sitting is just endurance and I need to go for a fast walk or run afterwards to release the tension which builds up. But on the right day I can hyper-focus on my breath and stay still for ages, and I can’t plan which day it will be, ever. My favourite meditations are active ones: walking, gardening and manual chores. I was extremely grateful to the sister at Lower Hamlet who taught us how to walk mindfully and quickly at the same time. I’d done that for years but believed it wrong, the best I could manage but not ‘good enough’. Now I know I am doing my practice just like anyone else. I do also enjoy very slow mindful walking meditation practice when I am right for it. Right practice/ right time.
Finding what worked for me
This ws a process of trial and experimentation. One approach was creating a mantra, (a phrase one can repeat), out of the present moment focus was a great way of learning to concentrate when I needed to, along the lines of ‘this moment, this breath,’ repeated endlessly as I walk, and in time to my steps, or to my planting or weeding or laundry. The Plum village tradition also offers songs based on mindful teachings and I can sing these silently inside my own head when I need to stop and re-focus. There are so many ways it can be made more accessible for those with ADHD. Sometimes I just need to remind myself to be calm and take a single breath, and sometimes I need something stronger. Something more along the lines of impermanence ( this too will pass ) especially if I have been PTSD triggered, which at the point of writing still happens.
Non-judgement is one of the biggest challenges. We all judge without even realising it. Recognising the pervasive nature of my own self- judgement was very illuminating. Recognising how painful I find the judgement of others was another. Once I had unfrozen the PTSD it was so intensely painful that is physically hurt. Letting that go has resulted in reduced anxiety and the development of self-acceptance, a continual, iterative process. But I am now clear I will always have ADHD and I will always have to accept that what I can manage is enough.
Enjoy your mindfulness practice
One of Thay’s most important teachings for me was that you should enjoy your practice but that you should also put effort into it. There are many ways of practicing mindfulness from the heart and the more orthodox disciplinarian approach will almost certainly not work for someone with ADHD. It is just too much of a struggle. I believe you can teach mindfulness to anyone with ADHD but first find a way to make it an important thing in their life. Don’t judge how they practice; if it comes from the heart then it is good enough. The more physical forms of practice are almost certainly going to be easier to manage and enable you to feel that you are accomplishing something.
However don’t give up on sitting either.
I found that starting with very short ‘sits’ helped me to realise the benefits and to make progress. I started with ten breaths. If I could manage that then I could manage eleven and so on. I no longer need to count. I also found that I do sometimes enjoy my sitting practice but mostly just struggle with my bodily need for movement as a counter stimulation, BUT I did start to notice how much better I felt if I did a short sit in the mornings and a few more very short ones during the day. This was more manageable in a busy life too, and more likely to be adhered to for me. If I forgot one then I could do the next one without any self-punishing thoughts, and I always noticed if I had missed a whole day, I just felt more jumbled inside than usual. Even if you don’t know if someone has ADHD or not, but you find them a bit ‘busy’ in their practice, recognise that your judgements say more about you than they do about the person you are judging, even if iI’m grateful for my ADHD. It makes me who I am, and I am greatly loved by my husband for exactly who I am. It took me many decades to feel like that though. For far too long I felt the outcast, useless etc. Now I know that cannot be true because of the understanding I have of Interbeing. Let us celebrate ADHD through the practice of mindfulness, let us enjoy its wonderful positive qualities and help to re- educate a culture that sees it as a problem condition to be ‘cured’ by medication, when meditation and compassion is all that is really needed.
I’m grateful for my ADHD. It makes me who I am, and I am greatly loved by my husband for exactly who I am. It took me many decades to feel like that though. For far too long I felt the outcast, useless etc. Now I know that cannot be true because of the understanding I have of Interbeing. Let us celebrate ADHD through the practice of mindfulness, let us enjoy its wonderful positive qualities and help to re- educate a culture that sees it as a problem condition to be ‘cured’ by medication, when meditation and compassion is all that is really needed.f