Attention Magazine Winter 2017

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IT’S BEEN A TERRIBLY BUSY TIME AT WORK FOR YOUR BEST FRIEND. You get a panicked call that it’s her husband’s birthday and she not only forgot to pick up the gift, she never made a dinner reservation. She says to you, I’m such an idiot. I always make a mess of everything. And what’s the first thing you reply? It’s fine, everyone makes mistakes, let me make a few calls and let’s find you someplace to go to dinner. You offer endless reassurance, care, and compassion.

Now imagine yourself in the same situation. Once again, you’ve forgotten a birthday and left planning to the last minute. What’s that voice in your own head saying? I’m such an idiot, I always make a mess of everything. Far too often, our lives are undermined and consumed by this harsh inner voice. We fail to give ourselves the benefit of the doubt we’d give our best friend. That self-critical, sometimes abusive perspective changes how we treat the world, and undermines our own resilience along the way.

Defining self-compassion

Kristin Neff, PhD, the foremost researcher on the benefits of self-compassion, describes it as being warm and understanding toward ourselves when we suffer, fail, or feel inadequate, rather than ignoring our pain or falling into self-criticism. Being self-compassionate means accepting that no one is perfect. When mistakes happen, amends can be made without as much self-judgment, anger, and blame.

Self-compassion is not new-age nonsense, running around saying “It’s all good, appreciate me for who I am.” It’s far subtler. We all have things to address in our lives, and there are times for apologies, correcting mistakes, and working toward self-improvement. We cannot always succeed, cannot always be perfect, and cannot always stay calm under stress. Self-compassion means treating ourselves no better or worse than we would our best friend along the way.

Dr. Neff’s research shows direct benefits to practicing self-compassion, notably a reduction in anxiety, depression, and stress. People also experience an increase in measures such as happiness, optimism, and social connectedness. Perfectionism and self-criticism are often falsely linked with motivation, as when we expect to be perfect, we tire ourselves out and give up more easily when we make mistakes. With self-compassion motivation improves; there is space to fall short, redirect, and therefore to persist longer. (Check out Dr. Neff’s TED Talk on self-compassion to hear more; see the link below.)

Self-compassion is also a more stable concept than self-esteem. Self-esteem is frequently tied to what other people think and to various external measures, like social standing or grades. There’s an aspect of social comparison, relying on being better than someone to feel successful and easily bleeding into traits such as narcissism and bullying. And since by definition everyone can’t be above average, we quite often set ourselves up for failure when depending on comparison for self-validation.

Self-compassion, on the other hand, relies on stable, realistic intentions. First, we build an acceptance of our own strengths and imperfections–like we’d see in our best friend. Second, we recognize that we are not unique in having difficulties. Everyone struggles sometimes, everyone screws up, everyone has stuff to work on. Third, we aim for awareness, seeing things as they are (I have ADHD which means some things are hard for me) without overidentifying with them (I forgot to make a dinner reservation so I must be a bad person).

Self-compassion is a more commonsense idea than it seems. When we cultivate a less abusive relationship with ourselves, we feel better and sustain motivation longer. We remain realistic, leave ourselves room for improvement, but do not sell ourselves short nearly as often.

The impact of ADHD on self-perception

ADHD potentially impacts anything and everything. It undermines executive function (EF), our fundamental life management skills. Because of that, it has been linked to everything from school and relationship difficulties to obesity and car accidents. But to paraphrase ADHD guru Russell Barkley, PhD, it’s a disorder of not doing what you know, not one of not knowing what to do. What’s the impact of living life that way, seeing exactly what ‘should’ be done and not getting there?

To manage ADHD requires acknowledging its full impact. Strong EF is required to manage everyday life. Anything can be harder with ADHD, from staying fit, to work, to getting out the door in the morning, to remembering to put a dollar under your child’s pillow for the tooth fairy. Motivation, self-esteem, and confidence suffer.

Resilience is our capacity to bounce back from adversity. It builds from various contributing factors, including strong relationships, a positive mindset, a sense of our own strengths (along with experiencing success), and concrete skills (executive function-based or otherwise) that allow us to overcome problems. Resilience is not a fixed, unchanging trait, but grows from all these experiences.

ADHD undermines resilience on all fronts. The skills to handle problems rely on executive function. The confidence to overcome difficulties stems from a positive attitude and past success, both of which can be affected by ADHD. Even strong relationships, which support resilience, can be influenced by ADHD. On the other hand, research suggests that the practice of self-compassion, addressing the impact of a negative self-view on our inner and outer lives, counters many of these effects.

That’s doesn’t mean people with ADHD aren’t resilient—because they most often are. It means that as difficult as life gets, there’s room to approach challenges with the same compassion you’d offer someone else. That’s a lot you’re dealing with, my friend; I see you are hurting, but well done. Addressing ADHD fully and returning to self-compassion allows anyone to remain at their best, resilient, and capable when hurdles arise.

Self-compassionate action

The idea of nonjudgmental awareness, core but not exclusive to mindfulness practice, means seeing life exactly as it is. The effect of ADHD on executive function is profound. Hiding from how it feels won’t help. But ADHD is a medical disorder, not anyone’s fault. Without judgment and self-recrimination, what’s the best step to take right now?

Coming back to compassion, how would you advise a close friend to deal with a chronic condition like ADHD? What is an honest reflection, without judgment, of what ADHD does to you? You’re doing great, stop giving yourself a hard time—but let’s figure out what you can do to make things better. Let go of the self-abuse, and then focus on concrete steps to take next.

How would you advise a friend to manage the effect ADHD has on people around her? It’s not your fault, but it’s time to go apologize. That’s rough, but stop giving yourself a hard time—say you’re sorry, and then let’s find a better way to handle your to-do list. What’s an honest reflection, without judgment, of the way ADHD impacts your relationships?

To overcome ADHD requires an accurate view of ADHD itself. Self-compassion doesn’t manage ADHD, but coupled to a comprehensive plan, it makes a huge difference. Seeing things clearly allows for a definitive, flexible long-term plan. Sticking to that plan takes effort. Effort requires resilience. And resilience builds from self-compassion.

Building self-compassion

Self-compassion is a complementary approach that may let every other part of ADHD care move forward. When things fall apart, it’s hard to make new plans and routines, stick with them, and adjust them. Resilient ADHD management requires being patient with missteps, gathering yourself, and starting forward again.

Here’s something to practice: Picture a difficult situation—or catch yourself when caught up in one. With each breath you take in, acknowledge whatever you are feeling. This is a challenging moment. Everyone has challenging moments. And then on each out breath, focus on whatever you’d wish for a friend, but this time for yourself. May I find peace, or happiness, or relief from my stress and suffering.

Don’t worry about the specific words, but focus on whatever feels most appropriate. Without forcing any particular feeling, practice letting go of judgment, wishing yourself whatever you would a loved one or friend. (A longer, guided compassion practice can be found at mindful.org.)

Give yourself credit for all you have accomplished with or without ADHD. Cutting yourself some slack doesn’t mean you’re perfect as you are. Although you are perfect as you are, because that’s how you are, like everyone, you have the capacity to improve. ADHD makes things difficult and there are choices to make about it that take time and effort. All of that is true, so allow yourself your flaws, focus on your strengths, and then take firm, compassionate steps toward bettering your life.

LEARN MORE

Kristin Neff, PhD | The Three Components of Self-Compassion

Mark Bertin, MD | Loving-Kindness (Compassion) Meditation; other guided practices are also available | http://www.mindful.org/mindfulness-meditation-guided-practices

Mark Bertin, MD, is a developmental behavioral pediatrician in private practice in Pleasantville, New York. He is an assistant professor of pediatrics at New York College of Medicine and an instructor at the Windward Teacher Training Institute. His books, The Family ADHD Solution (St. Martin’s Press, 2011) and Mindful Parenting for ADHD (New Harbinger, 2015) integrate mindfulness into evidence-based ADHD care. He regularly blogs for huffingtonpost.com, psychologytoday.com, and mindful.org. For more information, visit his website, developmentaldoctor.com.