by Ari Tuckman, PsyD, MBA

  • Why do people with ADHD have some struggles—but not others?
  • Why do some strategies work when others don’t?
  • Why are some treatments effective and others don’t touch the problem?

The answers to all these questions are grounded in an inability to consistently create a moment to pay attention to the right thing.

People with ADHD don’t always do what they know they should—or when they should.

They have trouble filtering both external and internal stimuli, so often they react to the “wrong” stimuli. For example, if they see an interesting magazine first, they just plain won’t see the bills to be paid sitting just one pile over. Their attention will be grabbed by the magazine and they will lose the thought, “I need to pay the bills now.”

It can look like bad judgment when they spend twenty minutes reading rather than paying bills—or in dozens of other examples through the day. But what really happens is that some less important stimuli have too big an impact on the ADHD person’s decision making. It isn’t bad judgment because they don’t stop long enough to judge. This is why those dreaded questions of “why did/didn’t you. . .” lead to such unconvincing answers like, “I don’t know. I just didn’t think of it,” which is actually pretty accurate. Their brains didn’t stop long enough to get a chance to think about it.

Russell Barkley’s response inhibition theory says that people with ADHD don’t have enough ability to hold back a response, to stop and think for a moment before acting. This is where people with ADHD run into trouble—they tend to leap without looking.

They make decisions without considering all the factors or weighing all the options. They’re pulled too strongly by some stimuli while ignoring or forgetting others. This sets them up to make less than optimal decisions. The irony is that they can easily see how they could have done things better if it is pointed out to them. The challenge for folks with ADHD is to take all the relevant information into account at the moment that they are deciding.

Because people with ADHD tend to be so vulnerable to external and internal stimuli, the strategies that help best are the ones that focus on increasing the strength of the desired stimuli or decreasing the strength of less desired stimuli, so that they are more likely to do the right thing in that moment.

For example, a beeping PDA tells a person that it is time to leave for a meeting. (This is the desired stimuli.) The noise is supposed to over-ride his attention to whatever else he was doing. (This is the less desired stimuli.) Medications (and possibly neurofeedback) help directly by increasing the brain’s ability to create that delay.

Admonitions to “just try harder” don’t work because they ignore the fundamental problem that people with ADHD have: trouble creating that moment of pause to try harder in.

This is where coaching comes in. The better you understand response inhibition, the better you will be able to create strategies that will help your clients more reliably do the right thing in the right moment. An effective coach will understand how the ADHD brain processes information and use that knowledge to help clients set themselves up for success. This is what separates coaching from generic advice-giving that just isn’t helpful. Coaches have more to offer because they understand ADHD more deeply.

About the author

Ari Tuckman, PsyD, MBA is a psychologist in private practice, specializing in diagnosing and treating children, teens, and adults with ADHD, anxiety, and depression. He has appeared on CNN, National Public Radio, and XM Radio and been quoted in The Washington Post. He is the current Vice President of the Attention Deficit Disorder Association. For more information about Dr. Tuckman and his clinical practice, you can check out his website at www.TuckmanPsych.com or email him at Ari@TuckmanPsych.com

This article is adapted from “More Attention, Less Deficit: Success Strategies for Adults with ADHD.” You can subscribe to Dr. Tuckman’s free podcast and learn more about both of his books at www.adultADHDbook.com.