Speaker 1:
Well, hi, Mark. So glad that we get to talk to you today.

I'm, ADHD-ish. I call it ADD-ish is a big topic for me, both because I was diagnosed many years ago, but also because I've seen this all across my practice as a private family therapist. And then of course in my, you know, community, my membership communities, it shows up again and again. And what I love about this new book that you've just written is that it's fatigues. So tell us about the book, how it started, and then we'll, we'll jump off that platform to discuss some of the specifics.

Speaker 2:
I think even before we start talking specifically about teens, I guess I would just very briefly say it's really important to in understanding, you know, why it is, she's such a unique challenge for teens. It's important to recognize that ADHD itself has kind of long outgrown its name and really one of the most practical things to try to understand as an individual who has ADHD and certainly as a parent of a child with ADHD is the easiest way to understand it. Nowadays as a developmental delay of this very wide ranging skill set called executive function, which is kind of like our life management skills. So I sometimes shorthand that with parents, that if you can put the word management to it, it probably involves executive function. So we have to manage our attention and we have to manage her behavior, but we also have to manage time and we have to manage projects and we have to manage our emotions and we have to manage our health.

Speaker 2:
And all of that involves executive function, which is kind of like the brain CEO. So it's kind of like the organization and planning center of the brain includes things like long-term foresight and planning for the future and adapting our plans if they come apart. So is that maybe why in part you've come across it so much working as a family, you know, a family therapist, because it is certainly something I don't think you can ever work at work with ADHD, with kids in isolation of the fact that, you know, greatly impacts parents and families, but then, you know, if you wanted to focus more on what the new book, I don't think, you know, which is mindfulness and self-compassion for teen ADHD, hopefully addresses something. That's very challenging for teens in particular, because you can almost look at teen ADHD as kind of a particularly developmental a particular disconnect in child development, because it's typical for teens it's appropriate for teens that they're trying to obviously become more independent, to separate a little bit from their parent parents to, you know, figure out who they are and to be successful on their own.

Speaker 2:
And at the same time executive function, you know, ADHD is ADHD by impacting executive function, delays exact skills. So teens with ADHD on the one hand are emotionally ready to start defining themselves and become more independent. And on the other hand, their ADHD is probably directly impairing that ability. You know, it's a delay in independence almost for some teens. So, you know, helping teens understand that while still feeling strong and resilient and positive about themselves is really the bottom line of, of why we decided to try to write this book for teens themselves, which I've never done before writing, you know, there aren't that many books out there writing, you know, trying to help teens understand the situation because of the, obviously, you know, this is the mindfulness part of things. The better we can see any situation with clarity, you know, the better we can understand it with sort of honesty and purpose, you know, the better ability we'll have to handle it well.

Speaker 1:
Beautifully, beautifully said. And I'm so happy that you said that the label or the diagnosis has outgrown itself. That's why I use the “ish” after ADD, because I don't see it as a deficit. It's not that we don't have enough attention. It's a challenge in directing it or, or kind of harnessing it at times. And it's certainly not a disorder. I mean, I can look at my life and the elements of my life that were impacted by the fact that I have fallen. You know, I have these characteristics or have had them through my life and see so many positives, so many pluses, so many ways that it has greatly enhanced my life. So I don't see a disorder doing that so much. And, but I loved the idea of management that what you're really saying is, is just so elegant. It's that we have some challenges in managing whether it's focus, organization time, and certainly a teen who is still in the process of developing and growing a brain is going to in some areas, lag behind their peers. And I often say to parents, when you say to your youngster, especially a youngster who seems to have this, these, this constellation of characteristics, you're old enough to fill in the blank. You're 15, you're old enough to remember your lunch, your, you know, as soon as those words come out of your mouth, I would invite you to question that there is no universal kind of dictum that says at age 15, a human brain should be capable of X, Y, and Z, right?

Speaker 2:
Oh, totally. I think sometimes it takes a while for teens to understand: you just really look at it as a skillset. So you can easily have some people, very loosely estimate kids can have up to a third delay in some of these self-management skills.

Speaker 1:
Was about to say that very thing, that you take your 12 year old. And if you could recalibrate and think of them as eight or 15, think of them as 10.

Speaker 2:
And, the disconnect often can be that, you know, they're obviously like everybody else, they're going to have other things that they're particularly skilled and wonderful at so that they have some skills that they're more like a 15 or 16 year old and some skills that they're more like a nine or ten-year-old. My favorite one line summary, sometimes of trying to, like when I begin a talk on ADHD in schools is just remembering things like forgetfulness as in ADHD symptoms. So that's not anybody's fault. And at the same time, just punishing, you know, saying, less than supportive things to someone who's struggling with forgetful, punishing. I mean, by marking their grades down, I don't mean literally punishing them by, you know, getting them in trouble. I just mean punishing them by they're forgetful around their schoolwork.

Speaker 2:
So their grades are never what they should be, really isn't going to accomplish much unless we help them come up with a solution also because it's a symptom of ADHD and we can look at any symptom of ADHD is like you were alluding to, it's a skill set that's behind. So I often talk about it as in the short run, you just need like a safety net. You just need to come up with solutions that are gonna, you're not gonna teach someone a new skill over, you know, a few hours this week. So this week skills are what they are, and it's frustrating. And it doesn't mean they're right, but it just, I mean, it doesn't mean like it's something you're enjoying or it's positive, but it's difficult. And yet those are skills that are behind. And then over time you have to try to teach someone ways to you know, manage that difficulty or, or teach them some tools. That'll help them be less forgetful.

Speaker 1:
I love that you're including this idea of self compassion. It just touches me because we know that how we grow up greatly influences the imprint and patterns and beliefs we have about ourselves as we move into adulthood. And when we're compared with others or when the strategy that's typically used is shame, or as you said, punishment we internalize that and that can become the voice in our heads. So kind of intercepting that process or interrupting that potential narrative that a teen might move into college and adult life carrying in their head is so powerful. Can you say a little bit more about that, this idea of self-compassion?

Speaker 2:
Sure. I mean, I think there's several different components to it. I think about you know, one is, is that the experience of sort of really harsh self-criticism is something that is kind of universal to begin with. And we can touch on that a little bit. I'm just how, you know, we often misconnect, we think that inner self criticism and perfectionism is what gets us places when actually our inner worlds are a little more subtle than that. I mean, Kristin Neff's research really shows well that when we let go of self-criticism and let go of perfectionism and, and don't treat ourselves better than we would anybody else, you know, we choose, still treat ourselves realistically, but we learn to treat ourselves as well as we were treated any, anyone else, our ability to persist and plan and stay motivated, improve actually grows.

Speaker 2:
And so, you know, the foundation of self-compassion research, which I'll, I'll define the term self-compassionate in just a moment really shows that it helps anybody sustain their resilience and problem solving over time. The short version of self-compassion before I sort of talk about it as an actual practice is simply that we can learn to treat ourselves as well as we would treat like our closest friends or our own children. What's unique about ADHD. I think one of the best summaries of why this is so important to ADHD is Russell Barkley, who's kind of the guru in the field years ago, said that ADHD, isn't a disorder of not knowing what to do. It's a disorder of not doing what, every people with ADHD do frequently know exactly what they, you know, want to be doing.

Speaker 2:
I was talking about the word should before, but in a literal sense, what they should be doing in any situation, it's not like they're choosing to be impulsive or choosing to be forgetful. And there's this really intense impact, I think, to your inner world, to how you feel about yourself, to your self-confidence, that your self esteem to growing up in the, you know, sort of battling that all the time. And honestly, I don't ever want parents to feel like it's their fault. It's not even in the most loving, supportive, positive family, you could say everything perfectly. Whatever that means, I just said there is no perfect, but whatever that means, but, if you're an individual who's growing up and, always your grades are never quite what you're capable of because of your ADHD symptoms or your behaviors and quite what you want it to be, or ADHD has been increasingly linked to difficulties with health, you know, that begins to really impact your self image, which is enough of a reason to talk about self-compassion.

Speaker 2:
And yet there's another part to it, which is that a lot of learning to overcome and manage ADHD relies on resilience and persistence and seeing problems with clarity, all of which is really, really hard if you're overly caught up in self-criticism and self and poor self esteem. So the practice of self-compassion is one you know, we're touching on which, which you haven't referenced directly. We're touching on the whole, this sort of growing practice of mindfulness and in pediatrics mindfulness in life. You know, one of the things I always like leading with when I start talking about mindfulness is it's always meant to be practical and realistic. So even as I start talking about it, I always feel like that term self-compassion can feel kind of you know, new age-y and everything else, but it's really meant to be very accessible and realistic.

Speaker 2:
So like a lot of mindfulness practice, we're not trying to force ourselves to feel any different. We're just trying to see our situations with as much clarity as we can muster and then treat ourselves well while we're trying to handle whatever we're facing is really what it comes down to. And in life, most of us tend to, you know without a little effort stay caught up in kind of this reactivity and autopilot. And just sort of, if you, if you look at the inner critic, just sort of constantly harshing on ourselves, when we, you know, when we mess up our, in our world, you know, we're way nastier with ourselves than we would be to anybody else in life. So these practices are meant to try to shift that attitude, not because they suddenly, you know, cure ADD, it's more that by developing this tool set that helps us with resilience, you know, that will help us take care of everything else that needs taken care of.

Speaker 1:
I'm just having such a huge aha here to talking about this, because mindfulness is a, is a, for many people kind of a novel new idea. And I'm so, so happy that it's finding its way into mainstream and to schools and hospitals and treatments for PTSD and all, all over the place that we are learning that spending a little time or a lot of time if you have it, but at least a little time being present, whether it's going inside in a meditative practice, or it's just having strategies for staying in this moment, as opposed to propelling yourself into the future, or sort of, you know, rolling around in the past which can accelerate anxiety and pain and fear and hurt and sadness that staying present, or going inside and anchoring to something that's steady and stable, no matter what life is bringing is so incredibly powerful.

Speaker 1:
And I just realized I started meditating when I was 16 years old. I hadn't yet been diagnosed with ADHD that came decades later, but, you know, I had many of the characteristics and qualities in terms of the, you know, kind of the list. And yet I did pretty well. And I think in part, so many circumstances supported how I was as a learner, why I ended up going to a college that allowed me to customize an independent learning program and take in-person sort of hands-on programs and classes with mentors, as opposed to just having them all in, you know, sitting in a large classroom with a professor at the front of the room. But I wonder now how much that practice that I had at the time mitigated what might have been sort of a much more negative cloud following me around because of me, the tendency that we all have to compare ourselves to others as we grow.

Speaker 2:
It sounds like you were probably very fortunate to, you know, to find that that, that tool set really early, because I mean, one of the things I should mention, because it's one of the questions that gets asked quite often is, you know, how can someone with ADHD even practice mindfulness and and the answer is really if you actually understand if w you know, when you, when you really look at what the practice is there's nothing that says your mind is ever really going to be totally quiet, and your body can still be restless. Mindfulness is so anybody can really practice mindfulness. And when it comes to ADHD, like anything else in life, you know, whatever we're trying to navigate, what mindfulness means is trying to develop traits that let us see our moment to moment life with as much clarity as possible and, and relate to it with as much skill as possible.

Speaker 2:
So like you were alluding to, it means that quite often, for example, when things are going well, which is really important to bring our full awareness to those moments, if we're going to stay strong and resilient over time, but we're more caught up in stress and reactivity, you know, the, the positive stuff that might help us feel better and stronger just gets missed. You know, we're, we're having our morning cup of coffee and, you know, still dwelling on some problem from yesterday or where, you know, hanging out with our kids on a, you know, on a good day, but we're still, we're worried about, you know, we're just consumed by worries about their future. And then we just don't even enjoy those moments. And so on the one hand, you know, the idea of like, sort of be in the moment, you know, that's one of those things that you really want to like, look past the words to, you know, what does it actually mean?

Speaker 2:
You know, the moments, you know, you look at a moment, for example, that's really difficult. It's still gonna be difficult if you're practicing mindfulness most likely, but maybe you're not adding onto it, those projections 20 years into the future where your regrets or your ruminations, or all these other things that we do that complicate the moment, if a difficult moment happens, we want to be present mostly because that lets us see what needs to happen. And so, you know, when you, when you pull all that together, you know, people with ADHD are totally capable of practicing mindfulness. You just have done set, you know, an expectation of, you know, of this is how things are right now,.

Speaker 1:
Like to walk us through like a one-minute little practice so that people can have that little pause in their day.

Speaker 2:
Sure. So self-compassion practice itself is typically described as having three parts in the first one is mindfulness. You know, if we're really going to take care of ourselves we just have to see what's going on. And that's really what mindfulness means is just, you know, clarity and awareness. So as you're listening to this unless perhaps you're driving, but as you're listening to this, you can just pause wherever you are. And you can begin to notice for just a few seconds that there's a physical movement to your body that happens with each breath. So in this type of practice, we use the breath, not because we're trying to make anything in particular happen, but just because it is something we can pay attention to it's there. So letting go of any need to change anything, you can begin to bring your awareness to that little sense of movement, maybe labeling and breathing in and breathing out.

Speaker 2:
And what's pretty amazing is probably almost immediately you'll notice your mind gets busy and wanders off somewhere else again, and that's totally normal. That's totally fine. The most important moment is when you notice that without giving yourself a hard time, come back again to the next breath. If your mind stays really busy and you just notice one breath or maybe two, that's perfect, and then bringing your awareness back to our conversation today. And I really think that's quite an important reframe of mindfulness practice. I think it's really easy to quit on mindfulness practice. If you have a sort of perfectionistic view that your mind is going to be still, or that you're going to be calm all the time, it's more, just a big open sense that that kind of open sense of awareness is, could be something that allows you to acknowledge a problem or a knowledge, something that needs to change, or it really doesn't mean anything specific as much as just acknowledging it all, you know, not denying it, not running away from it. This is what's going on right now. And that's really the full scope of mindfulness.

Speaker 1:
This word comes to mind. I don't know why, but mercy, mercy toward ourselves toward the predicament of being a human being. Yeah.

Speaker 2:
That's yeah, so that's, that's a perfect transition into like the full self-compassion practice, which I know we were going to talk about today. So what does it mean to actually practice self-compassion and this is something that's certainly to me always been like, it's a good, it's a good thing to discuss anytime we're talking about mindfulness. And so Kristin Neff has developed this three-part practice. I'm about to describe, but if you're practicing mindfulness alone, a more traditional practice, just the breathing practice. So you can just reflect on how important self-compassion is to that practice, you know, because it's difficult to, no one could do it perfectly. And it's how often in life do you actually set out to do a task knowing you can't do it right. And it's just, you're going to get distracted. And the most important part of the practice often is then in that moment, you realize you lost track of your intentions, which is a metaphor for all of life.

Speaker 2:
You know, you lose track of your intentions. That happens. The most important thing is without giving yourself a hard time, just realigning yourself, coming back, you know, to the next breath in this case, but it could be anywhere in life, you catch yourself that way. And then the other two parts of the self-compassion practice. So it's, so you can consider self-compassion practice like another option for a type of meditation. So, you know, one type of meditation might be a breathing practice in self-compassion practice. There just a little bit more about our intentions that we add to the practice. So the second part of the practice, which can be really valuable for teens Dr. Neff called common humanity, which is really just a way of saying that when we start feeling miserable, when we start feeling down, we often start judging ourselves for that too.

Speaker 2:
There's often that sense of like, I'm the only one who ever, you know, fill in the blank. I'm the only parent whoever, you know, blew up and lost my temper. I'm the only person, whoever, you know, forgot to hand in my paper, even though obviously logically we know better. So the second part of the practice is adding a reminder to our breathing practice. So we're, so part of the, part of the practice is just that kind of open awareness. This is, you know, this is a challenging moment for me. And then you add to it, this sense of all people have these moments where all teens are, we, you know, whatever word comes to mind. And then, like you said about mercy that sense of mercy or kindness, the last part of the practice, often, I, you know, when I'm doing this practice, we time it to the breath.

Speaker 2:
So it's sort of on the, in breath, is that sense of open awareness. Like this is, this is life and everybody has moments like this. And then then on the out-breath, the focus is on a sense of kindness for yourself. So it might literally be thinking to yourself, not again, the subtlety here is we're not trying to force ourselves to feel anything we're just trying to remind yourselves of what's possible. And so it might be something like, you know, may I treat myself with kindness right now? Or may I stay strong and kind, or may I just, you know, feel at ease, whatever, whatever words sort of capture that perspective, you'd take towards a friend, you know, right now I'm feeling really self-critical, but may I just find some sense of mercy or kindness for myself? And so you can do that as a very short practice in the moment, like just in the middle of a challenging moment and you take three or four breaths of just may stay strong or may stay kind to myself or it can be part of a longer practice. And the subtlety little bit, like with all of these practices is always just recognizing we're not trying to tie ourselves in knots. You know, we're trying to develop a new perspective and develop traits that become intuitive over time. So, you know, we want to let go of any sense of, you know, striving to push ourselves to feel any differently than we actually feel. It's like setting a reminder for like I said, a moment ago, it's like creating a signpost for ourselves.

Speaker 1:
It's like little micro shifts. So that over time with this practice and, you know, I sometimes have sticky notes around my house just to help prompt me to remember if I'm trying to make a shift that, that feels significant, that, you know, I have one from John Kevin sins sessions that he did during the pandemic and be where your feet are, one of them. And another one was just this. And so, you know, I have that over the thermostat ways of remembering would you mind before we wrap up what a beautiful, beautiful conversation can you just summarize the three steps again that you talked about preferencing Dr. Neff's work?

Speaker 2:
Absolutely. so I'm Morgan and thank you for the opportunity to be here. So again, just to, just to put it in a broad perspective for a second, you know, this isn't meant to replace any other part of ADHD care. It can just be, you know, quite foundational support for all the rest of ADHD care and the three parts of the practice, if you want to start practicing over time. And there's a lot of places you can find it online are the first one is just practice is the practice of mindfulness. So the first part of the self-compassion practices is really developing that ability to see with clarity. What's actually going on sorry, sort of like you just said a moment ago, you know, be where your feet are and this is what's going on right now. And then the second part of the practice is really you know, reminding yourself, taking in the fact that everybody's struggles.

Speaker 2:
It's just part of life. You know, everyone struggles, everyone has their moments of difficulty. So the second part of the practice is which again can be a very powerful one for teens of just realizing you're not alone. And the third part of the practice is the more specifically the self-compassion part. So wishing for yourself in that moment what feels most appropriate? Like what, what would you wish for a close friend or loved one and trying to create a more balanced in her life by sort of developing that habit instead of staying caught up in whatever sense of inner criticism or harshness we've lived with up until now. Absolutely. Beautiful.

Speaker 1:
Dr. Burton, please tell people where they can find out more about your wonderful.

Speaker 2:
The easiest way to find me in all the different places, you know, like on like social media and everything is just through my website, which is all spelled out www.developmentaldoctor.com.

Speaker 1:
Any final thoughts, parting words that you'd like to share.

Speaker 2:
With, you know, ADHD isn't anybody, you know, it isn't anybody's fault. It can be quite a challenge obviously. And I think the more clarity we can bring in to managing it with a sense of compassion you know, we're able to allow anybody to thrive.

Speaker 1:
And then not only thrive. Yeah. I mean, thrive and use those qualities to, to really, you know, express who you are in the world and manifest your gifts and joys and passions. I am very grateful, even though it has been challenging for me at times, but with strategies and lots of help and support and learning, it has definitely become a positive element of my life. So. Right. Thank you. Thank you so much. And as a core to further conversations with you, Dr. Mark Bertin.

Speaker 2:
Well, thank you so much. I look forward to the next time we get to talk. susanstiffelman.com.