Connection comes in all shapes, sizes, and flavors. My daughter is about to graduate from nursing school and she shared a writing assignment with me that powerfully illustrates the power of connection even when connection appears unwanted. She wrote the following:

“Abraham Lincoln once said “I don’t like that man, I must get to know him better.” Never in a million years did I think I would find that statement truer then on an Oncology floor during my second medical surgical rotation at a large Boston Medical Center. Mike (not his real name) was a middle aged man, with a life I immediately deemed as average. He was married, had three children, and worked as a laborer. Mike was receiving chemotherapy for spinal cancer he had believed was in remission and he did not want a student nurse.

After begging my instructor to change my assignment, many unsuccessful attempts to engage Mike in conversation, and nearly getting my head bitten off when I gave him an injection, I finally used the oldest trick in the book and gave him a foot rub. He slowly dropped the “tough guy act” and started to tell me how angry he was that he was back in the same bed, with the same illness tugging at him. Mike longed for a chance to once again do the simply things, like watch his son playing football. I sat quietly and just listened.

The next week when I returned he had taken a turn for the worse and was very confused, but amazingly remembered me. I spent all my free time during that shift sitting next to him and he told me I had surprised him. A few hours later, he was placed on comfort measures only and died after a brief time. After his death, his family told me that he had spoken all about the student nurse that he didn’t like who ended up being his greatest caregiver in the hospital.”

Laura learned a great deal from her time with Mike. She learned not to be discouraged by seeing someone’s anger and defenses. She came to see that underneath it all, Mike, just like all of us, had a soft and tender need to be cared for, loved, heard, understood, and held. Laura had a life-changing experience with the power of connection.

Consider for a moment what type of connection others may need from you, AND, what connection you may need from others. Don’t be afraid to ask for connection. We all need it…we all require it! Why then, do so many of us sit alone with our suffering? Why do we worry so much about “burdening” others? Why do we think it’s up to us to figure out everything for ourselves? Maybe it’s time to put our fears aside and ask others to listen to us, be patient with us, hold us, and comfort us. That is how we become a part of something larger than ourselves.

Best,
Walter

“Instant connection! Our teenage daughter had been professionally diagnosed with ADHD at a young age and had been struggling with self esteem and anxiety for years. We met with many different professionals, had team meetings with educational consultants, neuropsychologists, teachers and tutors. They all said that this child was carrying around too much stress and absolutely needed to have someone to talk with, who could help her with this heavy burden. This was easier said than done, she simply did not connect with anyone until she met Walter. He has been an invaluable resource to our daughter and our family ever since.”
Parent of an ADHD Child

Walter Sherburne, Psychotherapist
walter@sherburnecounseling.com
www.sherburnecounseling.com
978-470-HOPE

This might be a fun puzzle if it weren’t so crucial that you find a way to get started changing your approach. One of the common side effects of procrastination is that people in your life lose trust in you and get angry. As you well know, this is usually matched by your own anger at yourself. But this pressure usually doesn’t translate into motivation to get started.

If life were a sport and you were critiquing yourself for missing critical shots because you didn’t keep your eye on the ball, I’d be pointing out that your focus on past mistakes is taking your attention away from the current situation, taking your “eye” off the ball again. Drop the self-critique, get a bit of help with your technique and try again.

The best hitters in baseball look for, and can see, the stitching on the ball as it comes at them at up to a hundred miles an hour. They know that they need to look for this detail to pull their attention to the ball; just looking in the direction of the ball doesn’t allow them to see the tiny changes in directions that they need to see in order to connect with the pitch. Golfers watch the dimples on the ball as it sits on the tee.

To get started on a project, focus on the details of getting started. What project will you start? Schedule it in your calendar. What small, discreet aspect of the project will you do? Define it and plan on doing just that much. What exactly will your next action on the project be? Write it out very simply as a task.

Think about teeing up the project – choose which one you’re going to work on.  Keep your head down, your eye on the ball and hit it just well enough to move it down the course and keep it in the fairway – do a small piece of it.  Now you’re ready for the next shot – concentrate on the new swing no matter whether you’re in the rough or on the course.

For you baseball fans, what you’re looking for is a single, not a home run; don’t over reach. Just connect with the pitch. Basketball aficionados, take one step and move the ball down the court. Every foot closer to the basket increases the odds of a score. Tennis players, make a solid smooth hit and get the ball across the net and into the court. Now set up for the next shot.

What do you need to get done? Right now schedule a time to work on it, and resolve to treat it like an important meeting. What is the first little step to getting the project started or moving it ahead? Write it down on your task list.

Procrastination can be head faked that easily.

Contact Jay Livingston

On the brain maps of some patients we can see regions of the cortex that are suppressed. Interviews with these patients reveal patterns of rumination, one track thinking and automatic responding to people and situations. When suppression is released, or when these regions begin to show greater variability, via relaxation therapy or neurofeedback for example, awareness increases, and there is greater cooperation and less resistance to new ideas. At this point the brain is more flexible and better able to benefit from mindfulness training.

Many of my clients who have ADD have exasperated spouses who are upset with them about starting too many projects and finishing too few, interrupting mid sentence, being late, losing keys, cell phone, etc.… I’m sure you can add to this list.

When I suggest the option of couple’s coaching to them, they’re surprised. Couple’s coaching is a relatively new offering for couples struggling with the affects of ADD or ADHD in the family. Couples’ coaching has similarities to, but is quite different from couples counseling, marriage counseling, and psychotherapy.

A traditional coach will work with you or your spouse. A couple’s coach works with you and your spouse. This person is not a life coach, and may or may not be an ADD implementation coach. Couples’ coaches that I recommend have a deep knowledge of relationships, ADD and ADHD, and some training in family work.

Many issues that couples contend with are completely unrelated to ADD. Expectations, communication styles, different ways of figuring things out, needs for intimacy and connection, and money can all create challenges to smooth and comfortable relating. Then there are the ADD-related issues like disorganization, losing focus, clutter, a different sense of time, starting and not completing tasks, impulsive communication and/or decision making… You get the idea.

Partners (non-ADD or less ADD) may contact the coach because they are frustrated or annoyed. People struggling with ADD symptoms may also initiate the call because they really want to please their partners, are trying very hard to make things work better, don’t want to have conflicts, and want to make positive lasting changes.

Coaching can be helpful for both newlyweds and couples who have been together 25 (or 45) years.

At Cerulli and Associates, we have a variety of professionals, including a couple’s coach; Jay Livingston does executive coaching and ADHD coaching, alongside his skillful couples coaching. He and I work closely, sometimes seeing couples together. I’ve found this blending of skills and approaches to work really well for certain couples.

You’ve probably heard of the study where almost all drivers rated their driving as better than most other drivers, a clearly unrealistic self-evaluation. Although I’m pretty sure my skills do put me in the top tier of drivers. 

Clearly, we sometimes don’t do a good job of evaluating ourselves.

When studies ask self-evaluation questions a second time, after a moment’s pause, the answers are a more realistic assessment. How good are you at estimating time? “Excellent?” How excellent? “Oh, the “pretty ok when I’m paying attention” kind of excellent.”

This information may be particularly important for those with ADHD who have a tendency toward impulsiveness and over-optimistic projections. Think of quickly answering a question about when you will be home with “Half an hour!” After a minute of slowing down and working it out, you might agree that the most likely correct answer would be an hour or more.

By waiting you’ve allowed yourself time to tap into your ability to compute details and mathematically figure out answer to questions, and you’ve allowed your intuitive side time to process unconscious information and experiences you have stored.

“Can you take on this new project?” If you answer “Sure!” without a pause to allow realistic concerns to bubble up, you’re trying to function at your best by using only part of your ability. It is clearly in our long-term interest to pause long enough to give our brains time to bring their full potential to bear on our response.

I’d suggest you pause, breathe, say, “Let me check my schedule and task list.” Do anything to allow your full intelligence and experience time to evaluate your answer.

Jay Livingston

What you need to know about Intuniv:
• A long-acting, once daily medication for ADHD
• Non-stimulant, not a controlled substance. Unlike stimulants, your doctor can put refills on this prescription.
• Approved for children and adolescents
• Helps with core ADHD symptoms (Hyperactivity, Impulsivity, Inattention) as well as the associated features of behavioral dysregulation, oppositional symptoms, emotional reactivity, or being “out of control”.
• Has a different mechanism of action in the brain than stimulants
• Doses range from 1-4 milligrams per day
• Clinical benefit is seen within 1-2 weeks of starting Intuniv
• Intuniv may be safely used either by itself or in addition to taking other medications to treat ADHD
• Tablets cannot be crushed, broken, or chewed
• Side effects may include sedation, fatigue, headaches, stomach aches, or decreases in blood pressure

Families often ask me what is the “best” medication for ADHD?

My answer:
There is no one-size-fits-all medication approach for ADHD. Response depends on many factors including individual symptoms, medical history, body chemistry, family history, co-existing conditions, and even the patient’s daily schedule.

Talk to your doctor to find the right medication for you or your child. It should be a collaborative process between the patient and the treating team. And don’t be surprised if it takes a few months to find what works well with the least side effects. This is very normal. The good news is that 70-75% of people do respond to ADHD medications with minimal side effects, so there is much hope you will find “the best”!

          Aside from the physical strength, endurance and clear thinking required to haul this barrel; it all came down to the leadership to make it happen. The winning team, as determined by the Green Beret instructor, was the group leader who put his ego aside to listen to his team, construct the most efficient harness and motivate his team to pull the weight. The winning team’s leader took into account all members’ suggestions. As time was precious, each member made suggestions built upon the previous contributor. It was up to the leader to pull the ideas together, commend those who offered suggestions, assign roles and supervise the execution of a plan. The leader of the successful team made all members of the team feel valued, whether their ideas were used or not. This process of mindful listening kept spirits high and was key to mobilizing the strenuous follow through effort to haul that barrel to the finish line.    

There is perhaps no human emotion more paralyzing than shame, greater even than fear itself. Unfortunately, many of the people who walk into my office are consumed with an overwhelming sense of personal shame. The reasons are as varied as the people themselves.
• I have not succeeded in school because I am too lazy.
• I was victimized as a child and I believe I should have done something to stop it from happening.
• I gamble because it’s the only way I can imagine finding financial freedom, but when I lose, it only makes things worse.
• I don’t speak to my wife the way I should.
• I don’t trust other people.

For one such shame-filled client, I put a sign up in my office which reads:
Attention: You have just entered a shame-free zone
The wording of this sign is purposeful since I believe that therapeutic progress cannot be made if one is mired in that sense of shame. The coat of shame needs to be taken off and left at the door before the real work can be done.
It is important to define the type of shame I am referring to. When we mess up, whether it’s joking with someone in an insensitive manner, or something more egregious, embarrassment assists us in the process of recognizing our mistakes, taking responsibility for them and then making amends for our transgressions. Shame, on the other hand, is a toxic belief that we are unworthy, loveless or unredeemable. “Toxic shame feels much worse than guilt. With guilt, you’ve done something wrong; but you can repair that - you can do something about it. With toxic shame there’s something wrong with you and there’s nothing you can do about it; you are inadequate and defective.”                                                                                                                                                                                                               (Leo Booth/John Bradshaw)

Toxic shame seems to condemn us to an existence of self-loathing, endless emotional pain or existing in a state of numbness to the world around us. Shame anesthetizes us to the possibilities of growth and relationship with others. Shame binds us and holds us captive, no different than a prison cell. It is the toxic shame that we need to recognize as destructive and unhelpful if we ever hope to find peace and connection.
There is always a reason why we do the things we do. The fact that we blame ourselves or see ourselves as defective is a construct that most often other people gave us. Take my examples above.
• I have not succeeded in school because I am too lazy.
o If, like many of my clients you have ADHD, you weren’t organically designed to be immediately successful in a classroom. If teachers and parents keep telling you that you just need to work a little harder, what option did you have other than to blame yourself and feel shame?
• I was victimized as a child and I believe I should have done something to stop it from happening.
o This is common reaction of children who have been abused. Adults have the power. It is their responsibility to keep a child safe; not the child’s, and yet most victims take on the burden of trying to figure out how they could have prevented the abuse.
• I gamble because it’s the only way I can imagine finding financial freedom, but when I lose, it only makes things worse.
o When we find ourselves in this type of financial bind, it is easy to understand how desperation drives us toward unlikely hopes about how we can be delivered from our anxiety and fear. Most people don’t confront overwhelming challenges with rational thoughts. And while it is normal to wish financial woes away by gambling, it virtually never works. These are times to ask others for help and ideas about how to move forward to resolve the dilemmas.
• I don’t speak to my wife the way I should.
o While there are many reasons why this may be true, there is usually some environmental factor which fuels this difficulty. If we lacked role models, for example, on how to speak with a spouse, or we struggle with a low self-appraisal, intimate communication with others is never easy.
• I don’t trust other people.
o Trust is something we learn from our parents and other important people in our early years. If adults proved to be untrustworthy, why would we trust anyone? In my experience, most individuals with this type of history have a “wish/fear” related to intimate connections with others. They both long for intimacy and, given the dominant, fearful expectations held tightly within, they reject it. The promise of intimacy and unconditional love is experienced as nothing more than a shallow or empty gesture. The recipient of such an offering, in order to keep themselves safe from the harm of disappointment, believes that they must reject the overture and assume it is not real. They remain “safe” but alone, isolated and shame-filled that they cannot obtain that which they crave.

All of these situations involve people who are simply doing what they were programmed to do, or are responding to painful situations the way most of us would. Why then, is it appropriate to feel guilt and shame for doing what makes sense? I don’t like it when I see people misunderstand their capabilities, or blame themselves for being victimized, or utilizing flawed strategies to make things better, or keeping a distance between themselves and others, but I understand it. I don’t judge it, rather, I attempt to help those “afflicted” with shame understand where it came from and how to put it down! If there is “fault” to be assessed, usually the fault sits with someone or something else. And when people are caught up in shame and guilt, they almost always fall back on the very behaviors and attitudes that keep them in distress or alone.

Once freed from the shame, individuals can then utilize all of their cognitive energies to managing their lives more effectively. No one deserves to sit with crippling and paralyzing shame. Shame doesn’t move people forward, it merely keeps them held back from experiencing life in its fullest form. While we all need to learn from our mistakes, we all too deserve to live an existence free of toxic shame.

Walter Sherburne, LICSW
68 Park Street
Andover, MA 01810
617-797-8739
walter@sherburnecounseling.com

I find myself more and more interested in stand-up desks as a way to counteract the effects of sitting long hours. When I get time to reply to emails or work at my computer, it feels like a great time to be on my feet, moving and maybe even burning a few calories.

So, as I have been perusing the web exploring stand-up desk options. I discovered a company that makes stand-up desks for students that has a “U” shaped metal rod to rest a foot on, and the rod swings. The kids report that it helps them manage their energy and even stay out of trouble – sometimes. I love the idea and have always provided something similar for my clients, many of whom have ADHD.

Every chair in my therapy room has at least one fidget object near it, soft stress balls, clear plastic magic wands with floating confetti inside, coasters, pillows and foot rests are the current selection. Clients find wonderful things to do with these items as they work off enough energy to sit and talk with me. The balls are constantly flying from hand to hand or being thrown in the air and caught one-handed in a continual game of catch, squeezed to a pulp.

The magic wands get twirled between fingers, rolled between hands, stared at with hypnotic attention as the confetti floats languidly down only to have the wand flipped on its end sending the confetti floating down once more, or beat like a drum stick, with an occasionally desperate rhythm, against clients’ legs.

Pillows get hugged, folded, punched and prodded. Coasters are slid, balanced on end, tossed and tapped. Foot rests are pushed and pulled. An observer of my sessions would be hard pressed to find a moment of complete inactivity during the 60 to 90 minute sessions.

One client told me that he knew I understood ADHD the minute he saw the “toys.”

Szifra (Shifra) Birke

Contact me

He appropriately asked them why they weren’t going back to the original therapist. Mary answered most simply, “We talked a lot about how our parents’ marriages affect us, and shared our feelings, but we never really understood what we should do when we were in the middle of a blow-up.”

Their physician hesitated, and then asked, “I can refer you to a couples coach. You should each expect to be challenged to change your own behavior and learn new ways to communicate. It’s all very practical and focused on your present situations and behaviors, but it can be too direct if what you really want is to have someone sympathize with you.”

Both said they wanted to try it and he gave them a referral to me. Boy were they surprised at the first meeting when I told them, “I don’t want to hear your story. I just wanted us to start with one of the conversations that you find it hard to have. We’ll use the conversation to take a look at your individual conversational strengths and weaknesses, and come up with new strategies.”

They started talking with each other about how they wanted to parent their children and almost immediately Mary started blaming Ken for not being consistent. I stopped the conversation and asked her what she was trying to accomplish.

This simple question opened up an explanation of her feelings, but once we had briefly reviewed them I suggested we start the conversation again and this time we got a bit further before Ken calmly explained that Mary didn’t respect him or his parenting style.

Once again I stopped the conversation and told Ken that I heard that was how he felt, but it was presented as an assumption about Mary that might just be his creative story and have little to do with what Mary really felt. I encouraged him to check it out.

This conversation went on for the hour and a half we had scheduled and in their summary both Ken and Mary were more accepting of their role in conversational failures and motivated to clear things up. I gave them things to try at home and we wrapped up.

Couples Coaching is about changing current behaviors so that an individual can get what they want out of a relationship. It focuses more on effective and lasting change, and learning through actions, then on supportive empathy. It isn’t right for every couple, but can be powerful for highly motivated couples.

If you’re interested in having your questions answered about Couples Coaching, contact me or phone me at 978-446-9600.

Jay Livingston