ADHD and Sex: No Shame, No Blame

"Gina, sex is difficult for people with ADHD; it's tough to stay focused!" says a female Facebook friend, responding to my query on this topic.
What, you say, ADHD affects sex? Who knew? Yes, it's one of those areas, like sleep, where we often fail to connect the dots to ADHD symptoms. In fact, I open the chapter on sex in my book, Is It You, Me, or Adult A.D.D.?. with this quote:

Who knew so many women were begging their male partners for sex? It must be the world's best-kept secret. -- Rory

Later in the chapter, I write:

When ADHD does create significant sexual problems, it usually falls into two categories: The ADHD partner initiates sex all the time or almost never. Again, it seems, we encounter these pesky ADHD-related challenges in self-regulation and summoning motivation.

The truth is, ignorance about this critically important connection between ADHD and intimacy creates so much unnecessary hurt. Left with no other rational explanation for sexual difficulties, partners sometimes blame themselves—or each other. In a blog post on Sex and ADHD at Jeff's ADD Mind, the author first considers it as the “problem with no name” and finally “the problem that carries a lot of shame.”
Consider these comments I've collected over the years:

• “My wife is so easily distracted that boom, in the middle of a romantic interlude, she's suddenly talking about the cat! Talk about a mood killer."
• "Both my brother and I have ADHD, and what we've concluded is that thinking about sex is pretty exciting. But the reality? More often than not, boring. That's a hard thing for a guy to admit."
• “My husband, who was just diagnosed with ADHD, has always said I had to have sex with him twice daily in order for him to know that I love him. But we’re married 20 years now. I’m getting tired! In fact, I don’t it's about love at all. I think it's about self-medicating."
• "Our sex life is great! If only everything else in our life together was so easy."
• "If ADHD presents known challenges to 'self-regulation,' it makes sense that some of us could have a problem with regulation of intensity here along with everything else in life? My wife and I both have ADHD and are living proof of opposite ends of the ADHD spectrum when it comes to sex."

These quotes speak to just a few of the ways that ADHD might affect sexual intimacy. For the record, though, almost one in five ADHD Partner Surveyrespondents report having a great sex life. Moreover, many of them are in long-term partnerships that are challenging enough to send them scurrying to a support group. In fact, almost half say their ADHD partner is a skilled and considerate lover. I offer these findings not as scientific evidence but as a reminder that, as with most things ADHD, "your mileage may vary."
For those whose sex lives aren’t so sexy or lively, though, it might help to know that brain function can affect sexual expression. Though not in itself a solution, knowledge can at least relieve psychological pressures, hurt feelings, and unnecessary blame and shame on both sides. Moreover, knowledge paves the way to realistic problem solving.
Briefly, let's consider how these ADHD-related traits might pave a bumpy path to bliss:

Hyperactivity and Impulsivity
People with a high degree of hyperactivity or impulsivity might rush to start—either the relationship or sexual engagement—and quickly grow bored.

Distractability and Inattention
These two traits can generate challenges in getting the party started, paying attention to details, avoiding distractions (air-conditioning hum, scratchy sheets, dog barking, menacing thoughts of uncompleted chores) and maintaining interest through to, um, completion.

Low initiation and motivation
“My wife is always willing to have sex with me and seems to always enjoy it,” says Alex. “Yet, she never initiates. I’m sure this isn’t social or gender conditioning. She simply initiates very little in life and tends to respond to what's in front of her.”

Hypersensitivity to sensory stimulation
If you find a shirt label irritating, imagine how foreplay involving delicate areas might feel unnerving, if not downright irritating. It's called sensory integration disorder (also tactile defensiveness). Consider it a “filtering” problem within the nervous system.

Difficulties in cooperating and taking turns
Lovemaking is sometimes described as a dance that depends on following subtle back-and-forth cues. But what if you have trouble "transitioning" from one activity to the next or "sequencing" steps (that is, first comes this and then comes that, not vice versa)? This can create obstacles not only in your work life or at four-way stops but also in romantic pursuits.

The boredom factor
"Sex is boring," Bryan Hutchinson announces on his blog, AdderWorld. "We’d rather be doing something else while in the act of having sex, something more exciting, like, well, fantasizing about sex, putting together a good story about our sex life, and while we do that we miss out on something important: the reality of sex."

If any of these points resonate for you, know that there are strategies for overcoming their adverse impact on your relationship. For starters:

Adults with ADHD:
Learn about how ADHD symptoms might be affecting your experience of sexual intimacy. That way, you can avoid

• trying to hide the fact that your attention is wandering
• unfairly blaming your partner for your attention wandering
• deciding that you are an inept lover
• avoiding sex entirely without ever explaining why (but still feeling a certain amount of shame about it)

Next, be forthcoming with your partner about what's going on in your head. Otherwise, your behavior can lead your partner to feel sexual rejection, and that can be extremely destructive to a person's self-esteem, not to mention the relationship. It helps to be tactful, though. For example:

Don't say this: "For some reason, I just find debugging software code in my head (or, thinking about the half-yearly Nordstrom sale coming up, etc.) so much more compelling than having sex with you."

Say something like this: "Honey, you know I love being with you and want to please you, but I don't know what to do about this darn distractability. It hits when I least expect it—or want it. Will you work with me on finding some solutions that work for both of us?"

Partners of Adults with ADHD:
Don't make a difficult situation worse by translating your partner's ADHD-related bedroom issues into "You don't love me!" That line of thinking simply doesn't end well.

Both Partners:
1. Set aside time for intimacy
Consider this both a logistical strategy (schedule romantic weekends away or a weekly date night) and a mental one (leave your unfinished to-do list at the bedroom door).

2. Turn off the distractions
Robbie complains that her ex-husband was so distractible and hyperactive that he simply couldn't stay in bed long enough to have sex: “He was constantly jumping up to turn off distracting things—the lamp, the clock radio, the heater, and, eventually, me! I was very turned off!” Anticipate these ambient noises being a problem before getting started and counter them.

3, Learn all you can about evidence-based strategies for treating ADHD, including specialized therapy and medication.
Consider this closing paragraph from the chapter on Sex and ADHD in Is It You, Me, or Adult A.D.D.?:

ADHD Partner Survey respondents who reported an improved sex life after their ADHD partners started taking stimulant medication attributed the uptick to a better domestic life in general--co-parenting, employment, driving, managing finances, and the like. In other words, increased good will and cooperation outside the bedroom often translates into better intimacy -- and vice-versa.

http://adultadhdrelationships.blogspot.com

Five Strategies to Help Your Family Cope

by Paula L. Novash

TOO MANY DEMANDS AND UNREALISTIC EXPECTATIONS can make the holidays ho-ho-hum. The holiday season can be magical, filled with festive celebrations and special times with family and friends. But for many, it’s also a time of frantic activity. Fitting in extra tasks like shopping, decorating and entertaining as well as attending many social gatherings in just a few weeks can seem overwhelming. Here are five strategies to help put the joy back in the season.

Adults who are dealing with the challenges of AD/HD can feel even more pressure at holiday time.

“I often say that living with AD/HD is like being in the height of the holiday season all year round,” says Sari Solden, MS, LMFT, author of Women with Attention Deficit Disorder. People feel embarrassed when they can’t cope well, she continues. “We tend to have high expectations during the holidays, and if we can’t meet them, we feel like failures.”

And coping strategies may not be as effective when familiar routines are disrupted, says Arthur Robin, PhD, professor of psychiatry and behavioral neurosciences at the Wayne State University School of Medicine.

“The holidays tend to bring two major categories of stress for people with AD/HD: executive functioning deficits, when we have twenty-five things to do when we usually have ten, and interpersonal challenges, when we have to deal with people we may have limited contact with the rest of the year,” says Robin.

To cope with the stresses of the holidays, our experts suggest five strategies to get organized, relieve stress, and enjoy the holidays more.

1. Decide what works for you.

“One mistake we make is comparing ourselves to other people,” says psychotherapist Terry Matlen, MSW, author of Survival Tips for Women with AD/HD. “It’s important to focus on the things you do well and not feel you have to live up to some unrealistic standard.”

Matlen shares one of her own holiday stories. She once ordered a catered dinner for twelve and then left it in the trunk of her car on a balmy day. By that evening it was inedible.

“In the past I would have panicked,” she says. “But I called everyone and told them we were having a potluck smorgasbord of what we all had on hand. It turned out to be a great evening.”

2. Simplify.

Child psychiatrist James Van Haren and Beth Ann Hill, co-authors of The AD/HD Book, think you should consider relaxing your standards a little—or a lot. Instead of striving for elaborate decorations and gourmet meals, display one or two cherished ornaments. If you bake Grandma’s famous pecan pie, don’t worry if it’s a little lopsided.

“One of the most important things to remember is that you are helping your family form their own memories of the holidays with you,” Hill points out. “Do you really want them to remember how stressed you are?”

3. Have a plan.

To minimize holiday stress, Arthur Robin, MD, suggests that you “plan, plan and plan some more.” He says shopping early, making copious lists, scheduling time for tasks on paper or in a personal digital assistant (PDA), and deciding on a budget in advance makes tasks more manageable.

And try breaking chores down into manageable bites: Buy three presents a day online, visit a bookstore for multiple gifts, mail two packages.

4. Give yourself a break.

At holiday time it’s especially important to build in time for de-stressing activities: sufficient sleep; exercise; and calming rituals such as a yoga class, meditation, or taking a walk.

Our experts also recommend trying to anticipate situations that may be difficult and seeking support. Tell a coworker that you’d appreciate being able to circulate along with her at the company party, for instance, or volunteer to supervise the little cousins if joining in the group dinner preparation makes you feel overloaded.

5. Delegate tasks.

Delegate tasks when you can. Besides enlisting the help of family members, those in service industries consider it a gift to have your holiday business. You can have groceries delivered, presents wrapped, food prepared, and your home cleaned.

“I think of the holidays as an opportunity to reframe our expectations of ourselves,” says Matlen. “We may even help our neighbor with the perfectly decorated house to relax a little.”

http://www.chadd.org

Seasonal tips for anyone affected by AD/HD

by Karen Sampson, MA

THE RUN-UP TO THE HOLIDAYS IS IN FULL FORCE, offering everything from excitement to frenzy. For those whose homes are affected by AD/HD, it is often a time of both excitement and frenzy. For adults, couples, and families dealing with AD/HD, the holidays take some additional thought and planning—and a healthy dose of humor.

Each of us has an image of the “perfect” holiday in our minds. Many of us create undue stress in our lives by trying to achieve this image of perfection and end up missing out on the joy of the season. Instead, with a pad of paper, calendar and a realistic set of goals, we can plan and enjoy the holidays by following the advice of a CHADD member who wrote to us: “Change the expectations so the holiday works for you, not the other way around.”

So we dug into our archives in search of more gems like that. We found many ideas to make this holiday season flow more smoothly and become a pleasant experience in your home.

HOLIDAY POCKETBOOK

Many people affected by AD/HD have already heard the wisdom of budgeting and still struggle with it—especially during the holidays, with beautiful decorations and advertisements that all have the same goal of convincing you to part with more money. It seems that modern holiday celebrations are designed for overspending. But in a season meant to bring joy, overspending can lead to stress, difficulty keeping up with bills, and a host of other problems. So, seize the moment and consider the following tips to help control holiday spending, before the season gets the better of you.

1. Know yourself. It is important to understand how AD/HD affects your life in general and your spending behavior in particular. Develop a holiday spending plan, including in it how much you can spend on gifts, when sales will be held, and how many shopping days are left. On paydays, separate the money for gifts from the money for necessary expenses, and take care not to “borrow” from either pile. If needed, ask a friend to help you develop your spending plan. 2. Know your salesman. Merchandisers have expertise in getting people to spend money. Some adults with AD/HD may find these tactics particularly difficult to resist. Instead, shop early and with a circular in hand. Better yet, plan your shopping in advance, and create a detailed list you can stick to. Walk away from any high-pressured sale you encounter and practice the polite phrase, “Thank you, but not today,” for any insistent sales clerks trying to get you to buy something. You might find that a few “thinking missions” ahead of time—where debit and credit cards, checkbooks, and cash stay home—are helpful in deciding purchases and becoming familiar with store layouts and what merchants have to offer. If more than one store sells your holiday gifts, note the prices. Then you can add this new information to your shopping plan. 3. Know the consequences. Considering potential financial and interpersonal repercussions can motivate you to spend within limits. Buying something may make you happy now, but will it add to the joy of the season later? True peace and joy come from knowing the bills are paid, groceries are bought, and the family is together, and not necessarily from the newest toy, gadget, or really kickin’ boots. 4. Plan. You’ve combed the circulars and undertaken a few thinking missions. Your holiday budget is drawn. Now is the time to devise the shopping plan and work in its limits. It should also have a timeline that includes deadlines to keep you on pace and help you avoid the last-minute spending that usually results in overspending. Also, take into consideration holiday shopping crowds and whether you’ll be shopping alone, with a companion, or with a child. Choose stores and times that best fit your needs.

HOLIDAY TRAVEL

You have been on the ball and made your travel arrangements ahead of time, taking advantage of lower fares for advanced booking. You’ve also taken into account the best time of day or the season for you or your family members to travel. Now comes the actual journey. Traveling with AD/HD takes some planning beyond air flights and hotels.

For Yourself 1. Consider your daily needs and how they can be met while you’re on the road. How much do you rely on your planner or PDA? What about computers and email? Do you employ medication to control your AD/HD symptoms? Is there a particular morning coffee you crave or an evening snack? Take account of all of these things and plan your general day in advance, packing anything necessary for your day to run smoothly. 2. Check with your airline, hotel or travel agent to see if they can assist in meeting your needs. Ask for aisle seats if you know you’ll need to stand or walk a short distance for comfort. If you are carrying medication for AD/HD or other health concerns, check ahead of time for the proper way to pack them. Make sure you have any needed documentation or prescriptions with you, and always pack your medication in your carry-on bag. If you are traveling outside of the country, contact U.S. Customs for the proper way to carry your medications between countries. 3. When packing your carry-on bag, keep in mind your level of tolerance for inactivity. Bring appropriate diversions, including books, laptops, and MP3 players. For Your Partner If you are traveling with someone who is affected by AD/HD, you may need to be proactive in making your travel arrangements and packing. Many of the previous suggestions can apply, but also step back and offer guidance rather than doing it for your companion. Casual reminders rather than demands often go further in creating a pleasant experience. Plan ahead if you think a particular task or item will be missed, and help to avoid a problem. For Your Family Forethought goes into just about everything for parents, grandparents, and guardians traveling with children. 1. Just as adults need to check on medication concerns for themselves, they need to do the same for the children in their care, along with any necessary documentation of their children’s disabilities. Talk with the agent booking your travel, and ask about special accommodations or recommendations to make the trip more pleasant for all involved. 2. Always make sure medications are carried in their original containers, you have your medical insurance cards with you, and documentation or consent forms for emergencies. 3. When packing carry-on bags, make sure you have activities for the kids. Coloring and activity books are great for all ages; older children and teens may need a variety of books or magazines. Again, MP3 players can be useful, as can small game systems. The idea is to keep children occupied, especially when their attention can shift quickly. If necessary, talk with your child’s doctor for medication and behavior suggestions.

HOLIDAY BEHAVIOR

The amount of stimulation brought by holiday events—especially those that include crowds and seldom-seen family members—can easily become too much for adults and children affected by AD/HD. Parents and relatives can help children with AD/HD by understanding that the frenzy of the holiday season will affect their kids’ daily lives and by expressing some empathy for what they are going through. Adults can be equally kind to themselves or their spouses and partners by allowing “regrouping” time, quiet rooms, or graceful exits from the party.

Think ahead to social situations that may be difficult. Try to plan in advance a variety of “cooling off” activities that can help you or your loved one to gain control during these stressful times and make the event an enjoyable experience.

For Young Children • Turn on holiday music, and encourage children to dance to get their “wiggles” out. • Provide a special treat that your child needs to sit down to enjoy. • Roll up your little one’s sleeves, and let him splash in a sink with a bar of floating soap or bath toys. • Use a special CD or book for the holiday season as distractions when behavior starts to escalate. For Older Kids • Make “busy time” packets with stickers, coloring books, writing paper, crayons, pens and stickers. • Let children pack sack lunches and find different spots in the house or the neighborhood to have lunch. • Try art: Bring out the crayons, markers, and colored pencils, and let your child color in a special coloring book or use butcher paper to make a mural. Other possibilities include using modeling clay, gluing cotton balls together or on paper, or making chalk drawings on the sidewalk. • Record a favorite family TV show or find a special movie to play when quiet time is needed. For Adults • Plan ahead for how long you would like to remain at an event. • Offer to help out in areas that are more suited to your abilities, whether it’s the excitement of watching the kids or the calm of helping to do dishes. • Talk with the host or hostess ahead of time, and ask if there is a room available if you need a little bit of time away from the hubbub. • Be willing to politely intervene when you see your companion becoming stressed in the situation. You may realize it before he or she does.

HOLIDAY HOME

There’s no place like home, or so Dorothy told us. Getting ready for the holidays at home can test anyone’s patience. Some may find it difficult to start or stay on task. The first suggestion might be to offer to co-host holiday events with another family member, perhaps even at that person’s home. Otherwise, we have some suggestions.

1. Develop routines. Keeping in mind that CHADD doesn’t endorse products or websites, many CHADD members have shared their secret with us: FlyLady (flylady.net). The FlyLady (so named for her love of fly fishing) is all about “baby steps” and routines. She explains how to develop a routine to tackle the holiday season and the rest of the year. You design your own routine, with her guidance, to fit the needs of your life. Since routines are a great help to families and single adults dealing with the effects of AD/HD in their lives, FlyLady’s plans and control journals work well to help you get ready for the holidays and stay organized throughout the year. 2. Make a plan. The bigger the project, the more important the plan. Scout out your apartment or house, and note what needs the most work, what needs the least amount of work, and where the best hiding places for stuff might be (that includes cramming things under the bed, but only for quickly tidying up during the holidays.) 3. Set the timer. Once you have a plan, set the kitchen timer for five, ten or fifteen minutes—and attack the first room. Pick up, stuff away, clear out of sight. When that timer dings, reset it for the next room, whether the first is done or not. Repeat the picking up in the second room. Ding; move on to the third room. Set the timer again, grab something to drink or nibble and sit down and rest for the fourth round. Ding, and you’re back to the first room. Do this until each room is picked up, dusted, and vacuumed and any additional scrubbing is completed. Repeat this for as much time as you have available. Breaking it up over the course of a couple days or a week is a good thing, too. 4. Follow these handy tips. • Leave a second garbage bag at the bottom of the pail, under the current one. That way you have one handy in a pinch without having to hunt for it. • Keep no more than one extra of household supplies—laundry soap, paper towels, etc.—on hand. Don’t fill up your cupboards with more than you need, but make sure you have a back-up at the ready so you don’t lose your stride. • Keep all of your cleaning supplies together—a mop bucket makes a great container to stick everything in so that you can move from room to room quickly. 5. Since the best ideas often come from those who “walk the same walk,” here are ideas CHADD members have sent us. • Get out of having the celebration at your house. It saves on the cleaning and the prep time. Consider co-hosting family events at another relative’s house. • Limit the number of guests. Make it a small party—a dinner party of six is more manageable than one of twenty-six. Since this is a holiday season, make use of the time by having two small dinner parties with different guests or one intimate party and then making reservations for the larger group at a favorite restaurant. • Many grocery stores will prepare the entire holiday meal for you at a reasonable cost. Order ahead, pick it up, follow the store’s reheating instructions—and serve it in your own dishes!

HOLIDAY INGENUITY

Remember, humor and spontaneity go a long way during the stress of the holiday season. Allow yourself to be creative when faced with a challenge. Perhaps one of the most creative solutions we’ve heard came from a CHADD member who wrote that he once had a stack of newspapers piling up in the dining room for a couple of years. As company was coming rather soon, he struck upon a plan: He placed a board across the tops of the piles and draped a holiday tablecloth over it. The piles were successfully hidden, and the set-up “didn’t look bad, really.”

He added, with a touch of irony, that his newspaper-holiday table stayed in place for a few more holidays before finally making its way to the recycling bundles.

http://www.chadd.org

ADHD and the Holiday Season

seasonal tips for anyone affected by AD/HD

THE RUN-UP TO THE HOLIDAYS IS IN FULL FORCE, offering everything from excitement to frenzy. For those whose homes are affected by AD/HD, it is often a time of both excitement and frenzy. For adults, couples, and families dealing with AD/HD, the holidays take some additional thought and planning—and a healthy dose of humor.

Each of us has an image of the “perfect” holiday in our minds. Many of us create undue stress in our lives by trying to achieve this image of perfection and end up missing out on the joy of the season. Instead, with a pad of paper, calendar and a realistic set of goals, we can plan and enjoy the holidays by following the advice of a CHADD member who wrote to us: “Change the expectations so the holiday works for you, not the other way around.”

So we dug into our archives in search of more gems like that. We found many ideas to make this holiday season flow more smoothly and become a pleasant experience in your home.

HOLIDAY POCKETBOOK

Many people affected by AD/HD have already heard the wisdom of budgeting and still struggle with it—especially during the holidays, with beautiful decorations and advertisements that all have the same goal of convincing you to part with more money. It seems that modern holiday celebrations are designed for overspending. But in a season meant to bring joy, overspending can lead to stress, difficulty keeping up with bills, and a host of other problems. So, seize the moment and consider the following tips to help control holiday spending, before the season gets the better of you.

1. Know yourself. It is important to understand how AD/HD affects your life in general and your spending behavior in particular. Develop a holiday spending plan, including in it how much you can spend on gifts, when sales will be held, and how many shopping days are left. On paydays, separate the money for gifts from the money for necessary expenses, and take care not to “borrow” from either pile. If needed, ask a friend to help you develop your spending plan. 2. Know your salesman. Merchandisers have expertise in getting people to spend money. Some adults with AD/HD may find these tactics particularly difficult to resist. Instead, shop early and with a circular in hand. Better yet, plan your shopping in advance, and create a detailed list you can stick to. Walk away from any high-pressured sale you encounter and practice the polite phrase, “Thank you, but not today,” for any insistent sales clerks trying to get you to buy something. You might find that a few “thinking missions” ahead of time—where debit and credit cards, checkbooks, and cash stay home—are helpful in deciding purchases and becoming familiar with store layouts and what merchants have to offer. If more than one store sells your holiday gifts, note the prices. Then you can add this new information to your shopping plan. 3. Know the consequences. Considering potential financial and interpersonal repercussions can motivate you to spend within limits. Buying something may make you happy now, but will it add to the joy of the season later? True peace and joy come from knowing the bills are paid, groceries are bought, and the family is together, and not necessarily from the newest toy, gadget, or really kickin’ boots. 4. Plan. You’ve combed the circulars and undertaken a few thinking missions. Your holiday budget is drawn. Now is the time to devise the shopping plan and work in its limits. It should also have a timeline that includes deadlines to keep you on pace and help you avoid the last-minute spending that usually results in overspending. Also, take into consideration holiday shopping crowds and whether you’ll be shopping alone, with a companion, or with a child. Choose stores and times that best fit your needs.

HOLIDAY TRAVEL

You have been on the ball and made your travel arrangements ahead of time, taking advantage of lower fares for advanced booking. You’ve also taken into account the best time of day or the season for you or your family members to travel. Now comes the actual journey. Traveling with AD/HD takes some planning beyond air flights and hotels.

For Yourself 1. Consider your daily needs and how they can be met while you’re on the road. How much do you rely on your planner or PDA? What about computers and email? Do you employ medication to control your AD/HD symptoms? Is there a particular morning coffee you crave or an evening snack? Take account of all of these things and plan your general day in advance, packing anything necessary for your day to run smoothly. 2. Check with your airline, hotel or travel agent to see if they can assist in meeting your needs. Ask for aisle seats if you know you’ll need to stand or walk a short distance for comfort. If you are carrying medication for AD/HD or other health concerns, check ahead of time for the proper way to pack them. Make sure you have any needed documentation or prescriptions with you, and always pack your medication in your carry-on bag. If you are traveling outside of the country, contact U.S. Customs for the proper way to carry your medications between countries. 3. When packing your carry-on bag, keep in mind your level of tolerance for inactivity. Bring appropriate diversions, including books, laptops, and MP3 players. For Your Partner If you are traveling with someone who is affected by AD/HD, you may need to be proactive in making your travel arrangements and packing. Many of the previous suggestions can apply, but also step back and offer guidance rather than doing it for your companion. Casual reminders rather than demands often go further in creating a pleasant experience. Plan ahead if you think a particular task or item will be missed, and help to avoid a problem. For Your Family Forethought goes into just about everything for parents, grandparents, and guardians traveling with children. 1. Just as adults need to check on medication concerns for themselves, they need to do the same for the children in their care, along with any necessary documentation of their children’s disabilities. Talk with the agent booking your travel, and ask about special accommodations or recommendations to make the trip more pleasant for all involved. 2. Always make sure medications are carried in their original containers, you have your medical insurance cards with you, and documentation or consent forms for emergencies. 3. When packing carry-on bags, make sure you have activities for the kids. Coloring and activity books are great for all ages; older children and teens may need a variety of books or magazines. Again, MP3 players can be useful, as can small game systems. The idea is to keep children occupied, especially when their attention can shift quickly. If necessary, talk with your child’s doctor for medication and behavior suggestions.

HOLIDAY BEHAVIOR

The amount of stimulation brought by holiday events—especially those that include crowds and seldom-seen family members—can easily become too much for adults and children affected by AD/HD. Parents and relatives can help children with AD/HD by understanding that the frenzy of the holiday season will affect their kids’ daily lives and by expressing some empathy for what they are going through. Adults can be equally kind to themselves or their spouses and partners by allowing “regrouping” time, quiet rooms, or graceful exits from the party.

Think ahead to social situations that may be difficult. Try to plan in advance a variety of “cooling off” activities that can help you or your loved one to gain control during these stressful times and make the event an enjoyable experience.

For Young Children • Turn on holiday music, and encourage children to dance to get their “wiggles” out. • Provide a special treat that your child needs to sit down to enjoy. • Roll up your little one’s sleeves, and let him splash in a sink with a bar of floating soap or bath toys. • Use a special CD or book for the holiday season as distractions when behavior starts to escalate. For Older Kids • Make “busy time” packets with stickers, coloring books, writing paper, crayons, pens and stickers. • Let children pack sack lunches and find different spots in the house or the neighborhood to have lunch. • Try art: Bring out the crayons, markers, and colored pencils, and let your child color in a special coloring book or use butcher paper to make a mural. Other possibilities include using modeling clay, gluing cotton balls together or on paper, or making chalk drawings on the sidewalk. • Record a favorite family TV show or find a special movie to play when quiet time is needed. For Adults • Plan ahead for how long you would like to remain at an event. • Offer to help out in areas that are more suited to your abilities, whether it’s the excitement of watching the kids or the calm of helping to do dishes. • Talk with the host or hostess ahead of time, and ask if there is a room available if you need a little bit of time away from the hubbub. • Be willing to politely intervene when you see your companion becoming stressed in the situation. You may realize it before he or she does.

HOLIDAY HOME

There’s no place like home, or so Dorothy told us. Getting ready for the holidays at home can test anyone’s patience. Some may find it difficult to start or stay on task. The first suggestion might be to offer to co-host holiday events with another family member, perhaps even at that person’s home. Otherwise, we have some suggestions.

1. Develop routines. Keeping in mind that CHADD doesn’t endorse products or websites, many CHADD members have shared their secret with us: FlyLady (flylady.net). The FlyLady (so named for her love of fly fishing) is all about “baby steps” and routines. She explains how to develop a routine to tackle the holiday season and the rest of the year. You design your own routine, with her guidance, to fit the needs of your life. Since routines are a great help to families and single adults dealing with the effects of AD/HD in their lives, FlyLady’s plans and control journals work well to help you get ready for the holidays and stay organized throughout the year. 2. Make a plan. The bigger the project, the more important the plan. Scout out your apartment or house, and note what needs the most work, what needs the least amount of work, and where the best hiding places for stuff might be (that includes cramming things under the bed, but only for quickly tidying up during the holidays.) 3. Set the timer. Once you have a plan, set the kitchen timer for five, ten or fifteen minutes—and attack the first room. Pick up, stuff away, clear out of sight. When that timer dings, reset it for the next room, whether the first is done or not. Repeat the picking up in the second room. Ding; move on to the third room. Set the timer again, grab something to drink or nibble and sit down and rest for the fourth round. Ding, and you’re back to the first room. Do this until each room is picked up, dusted, and vacuumed and any additional scrubbing is completed. Repeat this for as much time as you have available. Breaking it up over the course of a couple days or a week is a good thing, too. 4. Follow these handy tips. • Leave a second garbage bag at the bottom of the pail, under the current one. That way you have one handy in a pinch without having to hunt for it. • Keep no more than one extra of household supplies—laundry soap, paper towels, etc.—on hand. Don’t fill up your cupboards with more than you need, but make sure you have a back-up at the ready so you don’t lose your stride. • Keep all of your cleaning supplies together—a mop bucket makes a great container to stick everything in so that you can move from room to room quickly. 5. Since the best ideas often come from those who “walk the same walk,” here are ideas CHADD members have sent us. • Get out of having the celebration at your house. It saves on the cleaning and the prep time. Consider co-hosting family events at another relative’s house. • Limit the number of guests. Make it a small party—a dinner party of six is more manageable than one of twenty-six. Since this is a holiday season, make use of the time by having two small dinner parties with different guests or one intimate party and then making reservations for the larger group at a favorite restaurant. • Many grocery stores will prepare the entire holiday meal for you at a reasonable cost. Order ahead, pick it up, follow the store’s reheating instructions—and serve it in your own dishes!

HOLIDAY INGENUITY

Remember, humor and spontaneity go a long way during the stress of the holiday season. Allow yourself to be creative when faced with a challenge. Perhaps one of the most creative solutions we’ve heard came from a CHADD member who wrote that he once had a stack of newspapers piling up in the dining room for a couple of years. As company was coming rather soon, he struck upon a plan: He placed a board across the tops of the piles and draped a holiday tablecloth over it. The piles were successfully hidden, and the set-up “didn’t look bad, really.”

He added, with a touch of irony, that his newspaper-holiday table stayed in place for a few more holidays before finally making its way to the recycling bundles.

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Roommates: Living Arrangements and ADHD

Karen Sampson, MA

AD/HD is known for throwing a wrench into the gears of a romantic relationship. With 42 percent of the U.S. adult population currently unmarried, however, it’s not just spouses and partners sharing space. Especially among younger adults, house-sharing arrangements

are going strong. And, of course, most college students share living space while they attend school. Living with a roommate while coping with AD/HD can provide many challenges and a handful of unique situations. Elbows are sure to bump when two people live closely together,

but when either one is affected by AD/HD, it can become very difficult. Forgetfulness, poor time management, frustration, and blame can begin to take a toll on the relationships between roommates. Here are some tips that can help.

Where to start

The first concern for many adults affected by AD/HD entering a roommate situation

is whether or not to disclose their diagnosis. Attention covered the topic of disclosure in the April 2009 issue. The decision to disclose, and how much information to disclose, is always a personal

decision. Offering information early on can help roommates develop effective communication. If you decide to disclose, offer information directly and answer your roommate’s questions simply. If he or she continues to be curious, suggest a few books that discuss adult AD/HD.

Working out the details

It’s important to be honest with yourself about your own home-management strengths and weaknesses and which among them are related to AD/HD. If you’re honest with yourself, you can be honest with your roommate when you sit down to divvy up household responsibilities.

Offer to take on areas that are your strengths and ask for help in areas

that are more difficult for you. Be sure to discuss money and bills (who pays for what, how rent is divided, is there a shared bank account for household needs and who handles the

statements?). Also discuss housecleaning, house maintenance, and other practical details of a shared home. Some housemates prefer to write out their agreement so there is no misunderstanding. Another idea is to hang a calendar somewhere in the shared living

space that you can mark with reminders about your agreements. This calendar can also keep track of events and dates for both roommates.

Communication

Communication is perhaps one of the most important aspects of sharing a home with anyone. Adults affected by AD/HD often struggle with social skills, which can make communication difficult when they live in close proximity with someone with whom they have

limited experience. It can help to practice active listening. One person in the conversation

listens to what the other says. Then the listener repeats what was said back to the first speaker. This is done until the first speaker’s message is clear. The speakers then reverse roles until each

side has been heard, and hopefully the situation is resolved. Another option is to handle some

discussions through email or instant messaging. This isn’t done to avoid the topic, but to be

clear and better understand the topic without heated discussion, in a space that allows

thoughtful consideration. Some people find instant messaging to be highly

stimulating and can better attend to the discussion if it’s on screen. It’s important to try to limit distractions and unnecessary stimuli when trying to have a conversation. Make an effort to turn off the TV and computer screens, turn down or turn off radios and other electronics that could grab your attention from your roommate as you talk.

Other tips for a harmonious shared home

Tackle concerns when they’re small; don’t wait for them to build up. They’re easier when small.

• Define “your space” and “my space” and stick to it.

• Keep your agreements. If you forget, apologize and do your best to fix the problem as soon as possible.

• Let your roommate know if there will be overnight guests, who they are, and how long they’re staying. Try to do so as far in advance as possible.

• Be friends with your roommate, but don’t worry if you’re not best friends. It’s important to have your own social circle and activities. For more information on social

skills, visit help4adhd. org, CHADD’s National Resource Center on

AD/HD, at and look up What We Know sheets 12 and 15, “A Guide to Organizing the Home and Office” (WWK12) and “Social Skills in Adults with AD/HD” (WWK15). ●

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Why Empathy Matters

by Robert Brooks, PhD

WHEN ASKED TO NAME the most important characteristics of a successful adult, I reply that there are several, but I always emphasize empathy. Being empathic means being able to place oneself inside the shoes of another person and to see the world through that person’s eyes. As my colleague Sam Goldstein and I have discussed in our books about resilience, empathy is one of the most vital skills in any relationship and is imbedded in the mindset of the successful person.

When I use the word "successful," I define it not in terms of income level or social status. While these may be important variables, I am more interested in contentment with one's life, in the ability to strive for excellence and not be derailed by mistakes, to relate comfortably with others, and to help others to feel special and appreciated.

Empathy implies that you consider how other people perceive situations, how they perceive you, and how they would describe you. If a person is lacking in empathy, he or she is likely to misread what is transpiring in a situation and misunderstand the intentions of others. It is not surprising that social scientist Daniel Goleman, author of Emotional Intelligence andSocial Intelligence, listed empathy as one of the main components of both of these intelligences.

Many individuals consider themselves empathic when, in fact, that is not the case. Achieving empathy requires diligence and thoughtfulness. Typically it is easier to be empathic toward people who agree with us or toward children who do what we request. Yet, if we truly want others to work cooperatively with us, we must consider their perspective as well as their perceptions of us. Therefore, the person striving to be empathic is guided chiefly by two questions:
In anything I say or do, what do I hope to accomplish? Many people are able to answer this question easily enough; it basically focuses on one's goals and/or objectives.
Am I saying or doing it in a way in which the other person will be most responsive to hearing and listening to me? I have witnessed countless examples of well-meaning parents, teachers, and businesspeople saying or doing things that actually work against their goals.

For instance, the parents of a temperamentally shy daughter (we now know that many youngsters are born shy or cautious) constantly implored her to make friends. Understandably, their goal was for her to develop friendships. Their anxiety led them to frequently ask her, "Did you speak with any kids in school today?" and "Did you invite anyone over to play?"

When this child was out with her parents and encountered people they knew, she would bashfully glance down. In prodding her to say hello, the parents barely disguised their anger and frustration. Of course, this actually increased her withdrawal. All of us want our children to be socially adept, but how would we feel if we were shy and were constantly chided, especially in front of others, to speak up and not be so shy?

A more empathic approach for these parents would be to tell their child privately, "I know that it isn't easy for you to say hello. A lot of kids have the same difficulty. But maybe together we can figure out what will begin to help, since many kids as they grow find it easier to say hello to others and learn what to say to their friends." A simple statement such as this, which contains a heavy dose of compassion and hope, can establish a foundation for a child to feel increasingly accepted. This allows a child, with the assistance of parents, to develop strategies for being less withdrawn and shy; it also promotes the notion that problems invite problem solving, which is an integral belief involved with becoming more resilient.

RECOGNIZING ROADBLOCKS TO EMPATHY

Some individuals have an easier time than others in developing empathy. But I believe it is a skill that can be nurtured, even in those children and adults who might be considered as having an “empathy deficit.” First, it may be helpful to examine the obstacles we may face as we take steps to improve this skill. Becoming aware of these obstacles will make them easier to manage.

A lack of models. If we grew up in a home where our communications were not validated and we were told how we should feel or not feel, it is more difficult to learn to take the perspective of another person. While having empathic parents does not guarantee that we will develop that quality, it is certainly an important factor.

I recall a family therapy meeting in which a teenage girl mentioned that she felt very depressed. Her mother responded, “But there’s no reason for it. We give you everything you need and we’re a loving family.” The mother meant to be reassuring, but her response led the girl to withdraw further. If the mother had shown more empathy in validating her daughter's words (such as, “I’m glad you could let us know how you feel; together we can try to figure out what would help you to feel less depressed”), I am certain her daughter would have been more responsive. The girl would also have been exposed to someone demonstrating empathy.

Being upset, angry, or disappointed in people. Individuals who are angry often say hurtful things to their children, their spouse, or others that they would not have said if they were less stressed and frustrated.

I was seeing a shy, socially immature seven-year-old boy in therapy when he received an invitation to a classmate’s birthday party—a rare event for him, so he was very excited. The party turned disastrous when several boys told him he didn’t belong. When his mother came to pick him up, she saw him seated by himself, looking withdrawn and sad. Her anxiety and frustration surged and she said, “No wonder you don’t have any friends, you always sit by yourself!” Immediately she wished to take back her words, especially as she saw her son’s tears. She cried as she described this situation to me. Her anxiety and disappointment had interfered with her capacity to empathize with her son's plight and offer the support he needed.

I’m right, you’re wrong! Some individuals have a reflex negative reaction toward anyone who has an opinion different from theirs. Their entire demeanor suggests that they are poised for attack. An intense need to be right can blind a person from seeing other perspectives. It is difficult to empathize with others when we are constantly defensive and unwilling to listen.

STRATEGIES FOR STRENGTHENING EMPATHIC SKILLS

Given these potential obstacles, what can we do to strengthen empathy? As Sam Goldstein and I highlight in The Power of Resilience, I believe that if we can keep these guidelines in focus and practice them regularly, we can achieve greater capacity for empathy.

Accept that empathy is a vital skill for successful relationships. This acceptance typically demands that we must be very clear about what empathy is and is not. Some people confuse being empathic with giving in or not being assertive. Empathy has nothing to do with giving in. One can be empathic and yet disagree with another person. One can be empathic and validate what another person is saying yet hold an entirely different view.

For instance, a student accused a teacher of not being fair when he had to serve detention for insulting other students. He had already received a warning. Rather than becoming defensive, the teacher said, “I know you think I’m not being fair. So, I think it’s important for us to review what led up to the detention, especially since I would not like to see it happen again, and I don’t want you to think I’m not being fair.” By first validating the student’s perception, the teacher created a climate in which this student was less defensive and more open to listening to the teacher’s point of view, resulting in the student eventually taking responsibility for his own behavior.

Try viewing yourself the way others view you. In my workshops I offer the following exercise as a way to strengthen empathic ability. If my talk is for teachers, for example, I ask them to use a few words to describe both a teacher they liked and a teacher they did not like when they were students. Then I ask a few questions:
If I interviewed your students and asked them to describe you, what words would you hope they use to describe you?
What words would they actually use?
How close are the two sets of words?
What changes can you make to help close the gap between how you hope to be described and how you actually are?

Parents and partners can try this exercise, too. It emphasizes that each and every interaction with others creates a perception of us, one that plays a large role in determining how comfortably and cooperatively they will relate to us.

Treat others as we would want to be treated. Ask yourself: When I say or do things with my child (partner, employee, patient), would I want anyone to say or do things to me in the same way?

I recall observing a young child spilling a glass of milk in a restaurant. His father slapped his hand and said, “What’s the matter with you? Use your brains!” I wondered how that father would have felt if he had spilled something and someone had slapped his hand and yelled at him. Would the father have learned anything or would he mainly be resentful?

Practice honest self-reflection. If we find ourselves constantly at odds with others, if our relationships are marked by anger and stress, if others tend to tune us out, then it is advantageous to engage in honest self-reflection.

A father with whom I was working regularly recited to his son a list of things that he thought needed improvement (e.g., homework being done on time, keeping a cleaner room, having better friends). His son’s behavior did not change. The father said, “He doesn’t listen to me!” I asked how he would feel if someone recited the same list to him night after night. It was as if a revelation struck this father: “I would probably do what my son does. Who wants to hear one negative thing after another?” Consequently, the father began to focus on things his son did well, striving to lessen comments that his son experienced as nagging. Their relationship improved noticeably.

Self-reflection can help us to appreciate what triggers our anger or disappointment, how we can speak with people so that they will listen to us even when we are frustrated with them, and how we would like others to treat us. In this process of self-reflection and honesty, we may require the support and insight of an objective person, perhaps a friend or relative with whom we feel comfortable.

If the obstacles persist, we should seek the guidance of a counselor or therapist. And remember, if you have struggled for years with problems pertaining to empathy, it may take a while to change. Don’t become discouraged. I believe very strongly that the benefits of being empathic and having satisfying personal and professional relationships warrant whatever time and energy are required to accomplish this goal.

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AD/HD and Empathy

In simple terms, empathy may be defined as the capacity to put oneself inside the shoes of other people and to see the world through their eyes. Empathic people:
are able to take the perspective of others even when they disagree.
attempt to understand how their words and deeds are experienced and how others would describe them.
reflect upon and take responsibility for their behavior.
are able to realistically assess and appreciate the “social scene.”

If one examines characteristics often associated with AD/HD, one can appreciate why many individuals with AD/HD struggle with empathy. It is difficult to assume the perspective of another person when we:
have trouble “reading” social cues.
are impulsive, frustrated, or moody.
quickly interpret the actions of others as withholding or unfair.
believe that others are not listening to us, especially if they don’t agree with our point of view.

An adult patient I saw for AD/HD treatment summed up his improved sense of empathy this way: “It wasn’t until I could slow down and realistically separate what I was feeling from the intention of others that I could become a more empathic person.”

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A psychologist on the faculty of Harvard Medical School, Robert Brooks, PhD, has a special interest in children and adults with AD/HD. He has lectured nationally and internationally and has written extensively about such topics as motivation, resilience, family relationships, school climate, and balancing our personal and professional lives. He has authored or coauthored fourteen books, including The Self-Esteem Teacher (Treehaus, 1991); he coauthored Raising Resilient Children(McGraw-Hill, 2001) and The Power of Resilience: Achieving Balance, Confidence, and Personal Strength in Your Life (McGraw-Hill, 2004) with Sam Goldstein, PhD. A former member of CHADD’s professional advisory board, Brooks has also received the CHADD Hall of Fame Award.

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