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In 2016, I enrolled with the Institute of Psychosynthesis in London, and committed to the lengthy endeavour of counselling and psychotherapy training. This step was no mean feat because all my life I had lived with, and attempted to disguise, chronically impaired executive dysfunction, namely, attention deficit hyperactivity disorder (ADHD).

My MA thesis asked, ‘Is living from the self simply a question of balance?’ and focused on working psychotherapeutically with ADHD.¹ It also looked into what psychosynthesis could contribute to this field and set out essential considerations. The paper was recognised and awarded for its groundbreaking content and contributions to psychosynthesis theory and practice when working with this underrepresented neurodevelopmental condition.Ìý

PetrÅ«ska Clarkson describes the transpersonal relationship as ‘the timeless facet of the psychotherapeutic relationship, which is impossible to describe but refers to the spiritual dimension of the healing relationship’.² As psychospiritual practitioners, we might wonder how self, spirit and soul relate to someone suspecting they have or are diagnosed with ADHD. We do well to question what it means to work ethically and respectfully with neurodivergence while holding a psychospiritual context.Ìý

There are some elements to clarify first. For instance, what is meant by ‘success’ in therapy with ADHD? What does ‘healing’ refer to and what does it not? And, is it possible to apply these principles to anyone impeded by issues of impulse, overwhelm or compulsion, even if their experiences fall under the clinical threshold for ADHD?Ìý

In my thesis, I used the term ‘living from the self’ to convey a sense of being aligned with our spiritual nature, intuition and inner knowing. To live from this place is to be in congruence with our soulful inner values and integrity. From here, we can connect with humility and grace. Living with ADHD, a person can come to feel wrong and at fault in the world. The capacity to trust and appreciate your qualities can be diminished by the adaptations required for survival.Ìý

Where connection to the soul has been impacted by traumatic wounding and survival, it takes time and patience to renew this. Medication and techniques are hugely beneficial for ADHD; however, no external treatment can override the deep inner process of healing and reconciling the experience of the past.Ìý

Currently, ADHD is incurable. Finding the right treatment, and fostering a relationship with yourself alongside this, creates an environment where emotional regulation skills can be nurtured. This in turn supports personal responsibility to self and others.Ìý

Thresholds July 2024

In recent years, the media has been filled with information about neurodiversity, including ADHD, but what is often missing in these reports is the impact that it can have on a person’s sense of self and worthiness in the world. One of the most common comments I hear from those who go through the assessment process as an adult, is the deep well of grief experienced on receiving a diagnosis. This sense of loss often runs parallel with the relief of knowing that their struggle is due to a neurological disorder. The person mourns lost years and lost potential. They have to come to terms with having felt unseen, unheld and overwhelmed. This can lead to depression and rage.Ìý

To truly reclaim one’s potential, traumatic wounding must be tended to holistically, alongside the impact and reality of living with ADHD, even if the practitioner is not sure where these two meet or divide. The intersection referred to above is deeply personal to whomever we sit with. This can be a challenge for a practitioner who must resist the pull to diagnose or succumb to unconscious bias. The risk of falling into the transferential dynamic of re-enactment is great. Though this might naturally occur, if consciousness can be brought to it, there is potential for a reparative experience.Ìý

If the practitioner is willing to disclose their own part in the dynamics, they offer their client an incredible gift: the willingness to lay aside their preconceptions, and commit to the beginner’s mind. This honours their client and supports this process. Thomas Yeomans, who trained with the founder of psychosynthesis, Roberto Assagioli, states: ‘The therapist's presence… generates, or evokes, a field of spiritual energy which envelops client and therapist, and activates the client's connection to their own soul.’³Ìý

The individual’s unique experience of the divine creates an anchor within consciousness. A person’s faith in their renewed sense of self strengthens trust that they have a place and purpose in the world. From this anchored place, imbalance and balance can be recognised as part of the natural oscillation which facilitates personal growth and evolution, rather than viewed as a flaw. This can be seen in the bible verse: ‘Glory in our sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope.’ (Romans 5:3–5).Ìý

A client might seek therapy at any stage of their journey. They might be educated about the condition and have a diagnosis. They might arrive in despair, not knowing what ails them, but feel depleted after existing for decades in chaos and survival. They might express a yearning to finally feel at home within their being. At whatever place they arrive, it is imperative that they are met there, and that they are affirmed as this being a meeting of two experts: the therapist in their practice, and the client in their own experience. No one knows them better than they know themselves. Beginning explicitly from this place sparks the energy of trust. Together you are creating and tending to the container for therapy, and even these early interventions, when delivered sincerely, begin the work of soulful healing.Ìý

In this way, a psychospiritual context can be transformative in working with ADHD, and in dealing with the consequences of trying to live with an undiagnosed and misunderstood condition. I have witnessed how beneficial therapeutic support can be and have seen, too, the damage that can occur within therapy when the individual’s beliefs and lived experience are not met, acknowledged or treated with respect. This can also happen when therapist assumptions trigger the client. With ADHD, the reparative experience can be supported with knowledge of rejection sensitive dysphoria and amygdala hijack. These can be so overwhelming that the client may disappear, literally or figuratively.Ìý

The term, ADHD, though currently used, is not definitive in describing the reality of the condition. In my own experience, it wasn’t that I couldn’t pay attention but that focus encompasses everything; every sound, thought and sensation. With ADHD, impairment to executive functioning impacts the capacity to filter and direct attention consistently and appropriately. The onslaught of stimuli may trigger disassociation (zoning out). Alternatively, focus may close in on one thing at the expense of all else (hyperfocus).Ìý

The hyperactivity element, with my particular presentation, is mostly internalised; which invariably meant the cause, as in so many other cases, went under the radar. This is one reason for the historic underdiagnosis of ADHD, especially in women and girls. The kaleidoscope of characteristics appear in differing combinations, and shift depending on many external and internal factors. Research on the scale of these factors and their impacts is in its infancy.Ìý

Supporting clients as they begin to gather their loose ends within therapy requires the therapist to tolerate being with uncertainty in the room, while listening for the voice of self. Mirroring and affirming thus creates space for the client to tie things together in their own way. Jung writes that ‘personality can never develop unless the individual chooses his own way, consciously and with moral deliberation.’⁴ The therapeutic relationship provides containment and the space for unfolding which can take on a spiritual dimension. John Amedeo writes: ‘Our spiritual quest receives its grounding through intimate connections, and at the same time, the fertile stream of spiritual practice nourishes our relationships. A spiritual path invites attention… to our inner life in a way that inevitably connects us to what lives and breathes outside of ourselves.’^5Ìý

Since my teens, volunteering at my church’s Sunday school, I have wanted to work in psychotherapy. Twenty-five years later, diagnosed with ADHD and beginning the lifelong commitment to understanding and managing the condition, I felt grounded and resourced enoughÌýto take the step that my soul had longed for. I dedicated my thesis to my much younger self: that little girl who consistently fell through the gaps, but who despite it all, never gave up.

My own diagnosis wasn’t a label or a pass, but a conduit for deeper resonance with my spirit and lasting healing from a broken heart. ‘Healing’, when it comes to ADHD, is about tending to a soul wound. It is a journey of courage, compassion and acceptance. This is tender work and can ignite new faith in the future. For me, it has been about integrating all I had experienced and discovering I can live by what is most important to me.Ìý

Jack Kornfield writes: ‘you can’t fall off the path; it’s all the path’.⁶ And so here I am, at this place on my path, sharing my story with you. Though I write from the edge of vulnerability, I do so with conviction that everything leads to where we now find ourselves. For me, this has involved being prepared to answer the call from my spirit; and to go beyond the safe space of the known.Ìý

This also means celebrating my reflective and curious nature, and being open to messing up and learning, in my own uniquely quirky, truly human way. How else can I surrender to what is asked of me and be of service in the world?Ìý