The ADHD Therapy Experience with Dr. Sharon Saline
Sharon Saline returns to talk about the ADHD therapy experience — what to expect, what to look for, and what to watch out for as you seek support for your ADHD!
Have you ever tried talk therapy? It can be intimidating, learning to open yourself up to a stranger, but with the right therapist, it doesn’t have to be uncomfortable for long. We’re continuing our series on ADHD interventions with Dr. Sharon Saline, psychologist and ADHD specialist. She joins to talk to you, the therapy novice, about what you can expect from therapy, what you should expect from your relationship with your therapist, and how you can make the therapy relationship thrive in support of your ADHD.
New in ’22
About Sharon Saline, Psy.D.
Sharon Saline, Psy.D. has focused her work on ADHD, anxiety, learning differences, and mental health challenges and their impact on school and family dynamics for over 30 years. Her unique perspective, a sibling of a child who wrestled with untreated ADHD, combined with decades of academic excellence and clinical experience, assists her in guiding families as they navigate from the confusing maze of diagnoses and conflict to successful interventions and connections. Dr. Saline funnels this expertise into her book, What Your ADHD Child Wishes You Knew: Working Together to Empower Kids for Success in School and Life. Heralded as an invaluable resource, her book is the recipient of two awards: Best Book Awards winner by American Book Fest and the Gold Medal from Moms’ Choice Awards. She recently published The ADHD Solution Deck: 50 Strategies to Help Kids Learn, Reduce Stress & Improve Family Connections.
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Pete Wright: Hello, everybody, and welcome to Taking Control: The ADHD podcast on TruStory FM. I’m Pete Wright.
Nikki Kinzer: Wow.
Pete Wright: Here on live 95 right here with Nikki Kinzer.
Nikki Kinzer: That is a fancy introduction.
Pete Wright: How are you doing, Nikki Kinzer?
Nikki Kinzer: I’m doing great.
Pete Wright: Can I tell you why I’m exuberant?
Nikki Kinzer: I’m doing really well.
Pete Wright: Can I tell you why I’m excited?
Nikki Kinzer: Yes, please.
Pete Wright: Because Nano Nano is over.
Nikki Kinzer: Nano Nano.
Pete Wright: Yep.
Nikki Kinzer: How did you do?
Pete Wright: Well, okay. So do you remember what my starting goal was?
Nikki Kinzer: Well, originally for you, it was the 50,000.
Pete Wright: 50,000 and a finished story.
Nikki Kinzer: Yes.
Pete Wright: Yeah. So where did we end up? I ended up with a total word count of, I don’t remember exactly 52,500 something or other change and I finished two days early. I crossed that line-
Nikki Kinzer: Wow.
Pete Wright: … on the 28th. Now the second one was a finished story and this is where there’ll be monsters here. I am so close, I can feel it, I can feel how close I am to the end of this ridiculous journey and I have to do it. So I’m still trying to write every day as I get to the end but these characters have a mind of their own. Every time I sit down-
Nikki Kinzer: Of course, they do.
Pete Wright: … I introduce something new and complex. NaNoWriMo is over. I did achieve the 50,000 in under 30 days and it was the easiest experience telling the story that I have ever had as long as I’ve been doing NaNoWriMo since 2002, whatever. It was enormously gratifying to actually finish it. A huge, huge, huge, massive, huge shout out to Ellie B. Ellie in the Discord community who’s my nanobody also finished and she had come from a behind moment. I think her last day she ended up with 7500 words. That’s an extraordinary lift to hit that in your last day and she’s got school and she’s a new mama and it’s just a lot.
Nikki Kinzer: Wow.
Pete Wright: So massive shout out to everybody who has been following along our journey in Discord. It’s been really fun and thank you for letting us wax on a little bit about our experience this year.
Nikki Kinzer: Okay, but wait, we’re not moving on yet. So you’re almost done. You’re almost finished. So what is the plan on getting that finish?
Pete Wright: Yeah. So my plan at this point is to finish by the end of this week. I would like to be done-
Nikki Kinzer: Oh, great.
Pete Wright: … by Friday midnight and I think I’m there because I’m not being terribly precious about the end of the book because this is the first draft, this is-
Nikki Kinzer: That’s right. Doesn’t have to be perfect.
Pete Wright: It doesn’t have to be perfect. But it does have to be finished so that I have something to work on.
Nikki Kinzer: Correct.
Pete Wright: And that has been a thing that’s gotten in the way for me in the past which is not finished and then I have nothing to edit. I have nothing to come back to in a month or something. So that’s my goal is to write. I think I can do it in 6000 words. I think that’s my plan.
Nikki Kinzer: And are you going to post this goal into Discord in the NaNo-NaNo-
Pete Wright: In the NaNo-NaNo chat.
Nikki Kinzer: … channel.
Pete Wright: Yes. NaNoWriMo 20… Okay, I will do that. I will post the goal in NaNoWriMo-
Nikki Kinzer: Yes, you’re going to post the goal-
Pete Wright: … [crosstalk 00:03:28].
Nikki Kinzer: … and then you’ll let us know-
Pete Wright: Friday night.
Nikki Kinzer: … what happens?
Pete Wright: Yes, that’s my plan.
Nikki Kinzer: Yeah. And if you’re not at the goal on Friday night, are you still going to post and let us know what’s going on?
Pete Wright: No, I’m going to hide from it-
Nikki Kinzer: Yeah, no.
Pete Wright: … like I normally do-
Nikki Kinzer: Yeah, we’re not hiding.
Pete Wright: I’m going to climb under my bed and just wait there until next year.
Nikki Kinzer: Gosh, I swear I think you can see into my brain because yeah, that’s exactly what I was hoping you would not say.
Pete Wright: Yes, no. I said it. I said it and that’s the truth. That’s the reality. I will hide from myself and mostly from you.
Nikki Kinzer: No. No hiding.
Pete Wright: So that’s good. No.
Nikki Kinzer: No. We’ll work with you. We’re going to make this happen for you.
Pete Wright: That’s the deal. So I’ve got a couple more days to wrap this up. I’m pretty excited about it. So that’s-
Nikki Kinzer: Good for you. Congratulations.
Pete Wright: … my only news. Thank you.
Nikki Kinzer: That’s exciting.
Pete Wright: Thank you. We are going to be talking to one of our very favorite people. Sharon Saline is back and she is a therapist and she’s following up on our conversation last week with Bill Dodson. We talked all about medication in the treatment of ADHD and this week, if you’ve never been in any sort of therapeutic experience, Sharon’s going to help us teach you what you can expect working as a client with your own brand new shiny therapist, and it’s really great. Before we do that, head over to takecontroladhd.com. You can get to know us a little bit better. You can listen to the show right there on the website, or of course, subscribe to the show or subscribe to the mailing list on the website and we’ll send you an email each time a new episode is released. You can connect with us on Twitter or Facebook @takecontroladhd. And if the show has ever touched you or helped you make a change in your life for the better, head over to patreon.com/theadhd podcast. Patreon is listener supported podcasting. It allows us to thrive with your direct support and it’s amazing. It is such an incredible gift that you supporting members give us to be able to focus more of our time and attention on this show and this community. We are working on all kinds of new and wonderful things. So if you have found that this show has served you in some way over the past of our understanding your relationship with ADHD and how you live your life with it and learn new strategies and incorporate new tools, we hope you’ll consider patreon.com/theadhd podcast to learn more and a very massive huge hug and thanks to Hilary Gill and [Soma Angelus 00:05:53] and Cory Fisher and John Foster and Allie Thompson and Stephanie Queen for joining us recently as brand new patrons and a very special thanks to [Anna Parika 00:06:03] and [Alison Kashmeric 00:06:03] for upgrading your support very recently. We so appreciate you, all of you, for joining the ADHD community, patreon.com/theadhdpodcast. All right, Nik, what do you got?
Nikki Kinzer: Well, first of all, I have to do another special shout out to John Foster because his patience is really, really good. He has really good patience.
Pete Wright: Yeah, he has been run through the tech support.
Nikki Kinzer: And understanding. Yes. Yes. He had purchased one of our online courses and it’s been very difficult for some reason on the backend to get him into this course which doesn’t happen.
Pete Wright: It’s a real mystery. It is a real mystery.
Nikki Kinzer: It is a real mystery and we’re still trying to figure it out. But I’ve apologized and I said, "Thank you for your patience," and he’s so kind because he comes back. He’s like, "No. No apologies. I get it. It’s okay." And just a really lovely response and I just have to express my gratitude because it could have easily gone the other way.
Pete Wright: Yeah.
Nikki Kinzer: What are you doing? Whatever. But it wasn’t like that. So I just want to say thank you. Thank you for your patience and grace.
Pete Wright: Perseverance.
Nikki Kinzer: Yes, yes. And we are going to figure it out.
Pete Wright: Oh, yeah.
Nikki Kinzer: Definitely.
Pete Wright: Yeah.
Nikki Kinzer: All right. But I have some other things to talk about. Whoa, and boy, do I ever.
Pete Wright: I know. You’ve got a lot.
Nikki Kinzer: I hope that people will bear with me because I do have a lot of exciting things to share that I’m going to be doing in 2022 and I want to talk about them on the podcast and I also want to make sure you know where to go if you have questions or you want additional information or you want to sign up. So new services and returning services that are happening in 2022. We, Pete Wright, and I hope you join me. You’re part of the we.
Pete Wright: Okay.
Nikki Kinzer: We are going to be holding an organizing challenge and it’s going to start January 1st and it’s going to go through January 31st and we’re going to play the game that you have taught us to play in the past.
Pete Wright: I taught you to play?
Nikki Kinzer: Yes.
Pete Wright: Very exciting.
Nikki Kinzer: Yes. It’s the purging game. So each day of the month, we’re going to let go of clutter. What we want to do is we are going to basically collect all of these items as we go through each day. So day one, you’re going to find one item to let go of and it’s just going to keep going so by the time you’re on day 15, you’re letting go of 15 items that day.
Pete Wright: New items-
Nikki Kinzer: But keep in mind-
Pete Wright: … every day. It’s a new item-
Nikki Kinzer: New items.
Pete Wright: … every day.
Nikki Kinzer: Yes. Imagine that by the end of the month, I don’t know what the math is, I’m sure you probably do but it’s a lot of stuff that’s been let go and you’ve done some really great work here. Right?
Pete Wright: Yes, yeah.
Nikki Kinzer: You’ve done this.
Pete Wright: It’s a lot.
Nikki Kinzer: You’ve done this several years.
Pete Wright: I’ve done it many years and in fact, it concerns me a little bit to pledge my participation because we’ve acquired new things but because we do this every year, our clutter stashes is lower than it’s been in a while.
Nikki Kinzer: Oh, you’ll find stuff.
Pete Wright: I know. I hope I find that many stuffs. It’s a lot of stuff that you’re giving away.
Nikki Kinzer: Paper. You could get rid of paper.
Pete Wright: I can, I can. I can get rid of paper.
Nikki Kinzer: Really, honestly. Because I thought the same thing because I’m going to be doing some organizing during the Christmas break. We take some time off. I’m definitely going to be doing this in December and I thought, "Well, what if I do everything in December?" And I’m thinking, "Really? Am I going to do everything in December?" Of course, I’m not. So I know even if you’re thinking you might not have enough, you’re going to have enough.
Pete Wright: Yeah, I’ll figure it out somehow.
Nikki Kinzer: So the whole thing that we want to do is we don’t want you to feel like you have to do this alone so we want to add some support for you, we want to add some structure to this process, and so that’s why we’re offering this game around this workshop in the month of January. So what’s going to happen is we are going to hold two organizing study halls over the weekend. You’re going to have two hours on Saturday to purge and two hours on Sunday. You are going to be working alongside myself. I don’t know if that is really a perk in this-
Pete Wright: Oh, no, you’re feeling a-
Nikki Kinzer: … because you get to see me.
Pete Wright: … little bit sassy to me right now, like a little bit troublesome.
Nikki Kinzer: Well, it was your idea to say, "Oh, Nikki, you should bring your laptop around so they can actually see you physically doing it too?"
Pete Wright: You’re getting me back for this now?
Nikki Kinzer: Yes.
Pete Wright: Oh, I see how this works.
Nikki Kinzer: Yes. I’m going to do at least one of the weekends and then I think that one of my assistants are going to help me too but I might be there both, I don’t know. But you’re going to get support no matter what. It’s going to be a hosted organizing study hall for two hours each of those days. And then we’re also going to offer, or I’m going to offer because I’m going to be answering the questions, weekly office hours. Tuesdays and Fridays at 8:00 AM Pacific or 11:00 AM Eastern, I’m going to be available for people to just drop in whenever you want and ask questions and I’m going to answer them about organizing. So if you’re stuck somewhere and you want to talk through something, come to the office hours and I’m going to help you. Or the other part of this that I think is really cool is we are opening up the Discord. We’re going to have a channel that is special for this organizing challenge and this is going to be for you to connect with others that are doing the challenge, sharing your updates, posting pictures, really just supporting one another because I know doing enough coaching groups in the past the information you can get from other ADHDers, it’s so valuable. Tips and tricks and things like that. Now, the cost of the workshop is only $75 for the entire month. So I want you to think about this for a second. $75 for the month, you’re getting 16 hours of organizing study halls. That’s 16 hours of organizing.
Pete Wright: Yeah, that’s a lot of organizing.
Nikki Kinzer: With a person, right?
Pete Wright: Yeah.
Nikki Kinzer: At least eight of those are going to be with me for sure. Eight hours of the opportunity to do the ask me anything and you’re going to get a Discord channel to keep you accountable and have some fun while you’re doing this.
Pete Wright: Yeah.
Nikki Kinzer: Now, the Discord channel will be available at no cost so if you still want to participate in this workshop, but you don’t necessarily feel like you need the guided piece that we’re offering, that’s fine. We still want you to be a part of this because our point is for you to clear the clutter and start the new year with more space but less stress.
Pete Wright: Oh, listen to you.
Nikki Kinzer: Does that sound like a-
Pete Wright: More space, less stress.
Nikki Kinzer: Right? I know. I should go on the info commercials.
Pete Wright: Yeah, put that on a shirt.
Nikki Kinzer: I know, right? The Discord channel is going to be free for everyone. And if you are interested in the more structured study halls and office hours, then it will be $75 for the month.
Pete Wright: Okay-
Nikki Kinzer: All right.
Pete Wright: … let me just tell you because to your point about the community and I think if you’re going to do it and you’re going to participate in the Discord channel, you’ve got to post your daily picture of the stuff that you’re-
Nikki Kinzer: I think that would be great.
Pete Wright: … getting rid of.
Nikki Kinzer: Yes.
Pete Wright: We’ve done it so many years now. But the only reason I can say that we have been successful every year is because we do it with a community of people. And in our case, we have a shared photo album that we add the daily picture to every single day. We’re looking at the stuff that other people are giving away or cluttering or decluttering or throwing away and we’re posting ours and it is so, so valuable because it’s really easy. It’s really easy to let it go-
Nikki Kinzer: Yes, it is.
Pete Wright: … and when you have that little motivator of get in the community, get in the study hall, create something to declutter your life, it keeps you moving. It keeps you moving.
Nikki Kinzer: Absolutely. And it’s a little bit of that accountability too. It gives you a reason to do it because you get to post your picture and that’s cool.
Pete Wright: It’s very cool.
Nikki Kinzer: And you’re going to have people really cheering you on so that’s awesome. Okay, next thing that is returning is GPS, and GPS is my guided planning sessions. So if you’re not sure what I’m really talking about here, what we do is on Mondays we plan. It’s a workshop. You’re planning the week ahead and on Thursday, we adjust that plan and then we look toward the weekend if you’re ready to move on past the week. What we do is we follow a process that I’ve put together and I teach this process during the first week and it’s where you learn how to plan, where to start, how to prioritize, how to match your to-do list with your calendar to get things done. What’s so awesome about it is that you’ve got the guidance of myself to help you but you’ve got other people that you’re doing this with too. Again, that community of being able to help each other out is so helpful. I have done this for the last year and it’s been such a success. I’m so excited about holding it again in 2022. To let you guys know, enrollment is open for the next GPS session. It will begin on January 10th. The enrollment deadline is January 5th. So if you want to be part of the next GPS, you’ll need to sign up before January 5th. That is GPS. I have one more.
Pete Wright: That’s it, there’s more. Okay.
Nikki Kinzer: I have one more-
Pete Wright: Excellent. One more.
Nikki Kinzer: … that I’m also really excited about.
Pete Wright: All right.
Nikki Kinzer: The third service that I’m really excited about talking to you about is the accountability groups. Now, this is something that I did a couple of years ago and I’m bringing it back because it is important and they’re really fun to do. There’s a need here for people to support each other and have some accountability to get some stuff done. I’m going to change it up just a little bit from what I did before so if you were actually a past member, you may see a little bit of change that I’m doing going forward. But what this group is about? The mission of this group is to help you get things done, it’s to help you get started on those projects that you’re avoiding, those things that are so hard to do and you feel so bad about them just moving over to the next week. This group is going to be really good for those folks who are struggling with this and they know that accountability works for them. Maybe you’re not quite sure if accountability works for you but let’s try it because it very well might. There’s a lot of magic in this. We have weekly sessions that we are going to meet. There’s going to be three different times that we can meet. You will have a primary session you’ll have like your session. However, if you can’t make your session for whatever reason, you can join one of the other two that week so you don’t miss it. We’re going to have hosted study halls, they’re going to be Wednesdays and Thursdays. We’re going to have a community board that’s going to be extremely active. I’m going to require a little bit more from the members than maybe I have in the past. I’m hoping that people… If you’re going to sign up for this, I definitely want you to be involved. This is not for the passive accountability person. We want you to really… Kind of like you were talking about with the organizing. Posting your picture every day, I want you to post every day-
Pete Wright: Yeah, right.
Nikki Kinzer: … of what’s going on.
Pete Wright: I think there’s something a little bit oxymoronic in the passive accountability person. If you’re ready for an accountability group, you should be ready for action.
Nikki Kinzer: Yes, and that’s exactly what I’m going to promote here. We’re also going to hold… I’m going to have a monthly workshop on a topic that is just around planning and that is just going to be for this accountability group. It’s not going out to the public. It’s not a webinar, it is for these groups and so that’s something extra that they can look forward to and hopefully, help them with getting stuff done. We also have a resource library that has a ton of information that you can go back to in between sessions, after the session. I’m going to stop there. There’s a lot more I can probably talk about with the accountability group but it is not starting until February. So right now what I’m doing is planting the seed, folks. I’m planting the seed that this is happening in February. You’re going to hear me talk more about it at the end of this year, but also in January. I’m going to talk more about it as well.
Pete Wright: Outstanding. All right. So that’s it? That’s all the thing. You’re done with all the announcement?
Nikki Kinzer: That’s it. Yeah. That’s all.
Pete Wright: All right. Why don’t we go over and talk to Dr. Sharon?
Nikki Kinzer: That sounds great.
Pete Wright: All right. Welcome to Sharon Saline. She’s a gracious repeat guest to us. She has been focusing on ADHD, anxiety, learning differences, and mental health challenges and their impact on school and family dynamics for over 30 years. Today, she’s going to help us understand what the experience looks like when starting therapy for the first time. If you haven’t checked out her book, What’s Your ADHD Child Wishes You Knew: Working Together to Empower Kids for Success in School and Life, it’s amazing. And last time she was here, she was talking to us about her now published ADHD Solution Deck, which I hope she will talk to us about a little bit later. Sharon, welcome back, friend.
Dr. Sharon Saline: Thank you so much for having me. It’s so great to be here and the minute I saw your faces on Zoom I was like, "Oh, so happy to see you guys again."
Pete Wright: Us too, for sure.
Nikki Kinzer: Yes, for sure. Thank you for your time and helping us understand a little bit about this therapy thing. Because this is what we’ve done in the last couple of weeks is we really have been trying to focus on different ways to treat and navigate through ADHD and therapy comes up as one of those pieces of puzzles, right? Or one of the pieces of the puzzle. But a lot of people who’ve never been to therapy maybe don’t really know what it is or would you go to therapy for your ADHD. Can you give us just a starting point of what that might look like in your own practice?
Dr. Sharon Saline: Of course. So we know that ADHD very rarely travels alone. It has friends. It has friends like anxiety, it has depression, learning disabilities, level one autism, bipolar disorder, substance abuse. All the things that people live with whether or not they have ADHD come along with ADHD. People come to therapy often for those what I call coexisting conditions more than they might necessarily come for, "I need help with my ADHD." Sometimes, people come for, "I’m not organized, I can’t get stuff done." "I don’t like myself," these are things that I see commonly with ADHD. I also see a lot of social anxiety. "I don’t have the relationships I would like." "I have trouble making friends." "Very sensitive to rejection." So all of those things are issues that humans live with and that people with ADHD have a higher proclivity of living with. And so the therapy is, for me, it’s a dance between cognitive behavioral interventions that are directed towards improving executive functioning skills and that insight oriented work. Who am I? How do I want to be perceived in the world? What do I like about myself? What could I just figure out that I like about myself? How can I be in relationships in a way that’s more rewarding to me and satisfying to the people around me?
Nikki Kinzer: That’s a lot to uncover, right? If I was your new client and I tell you, "I’ve got ADHD. I know I’m dealing with some depression. Definitely some anxiety and can give you lots of different examples of where that’s happening in my life." Where do you start? How do you start to unravel the pieces? Where do you focus?
Dr. Sharon Saline: Well, probably for me, I usually take a couple sessions. Obviously, I want to get to know you. And so you say, well, you’re coming here, you feel anxious, you feel depressed, you have ADHD. The question that I would ask is, "Why are you coming to therapy now? What’s happening now that’s brought you here to my office?" And then we unpack that a little bit. And then I want to get some information. When were you diagnosed? How do you feel about your diagnosis? What do you think some of your strengths are? What are some of your challenges? Do you notice there’s a pattern to your anxiety? Tell me more about your depression. What does it look like? What does it feel like? When do you notice those moments when you’re feeling most anxious or depressed? And what does depressed mean to you? That’s the thing that I really want to unpack, the meaning behind these labels. Okay, you have ADHD. What does that feel like to you? What kind of brain is it? Is it a foggy brain? Is it a fast brain? Is it a dreamy brain? Is it ADLs attention deficit look? There’s a squirrel brain. I want to unpack things and of course, that means getting a history. Are any of these things in your family? Because we know that with anxiety and depression, there’s a predisposition to it in families.
Pete Wright: The thing that brings you to therapy today question seems like it’s carrying an awful lot of weight.
Dr. Sharon Saline: [crosstalk 00:25:09].
Pete Wright: And when I talk to people about their experience about what are the things that actually push them to therapy, it always comes back to some sort of inflection point that defines their readiness for change, that whatever it is that they’ve been living through, they suddenly realize that the internal pain that comes from not knowing what therapy looks like and therefore it causes me stress and anxiety and fear to everything else in my life is worse than that pain and fear and uncertainty so I’m going to go ahead and move into therapy. I just wonder, from your perspective, what that inflection point, what being a witness to that inflection looks like for people living with ADHD who come to you for guidance and support.
Dr. Sharon Saline: That’s a really good question. And the word that comes to mind is suffering. How much are you suffering? In your daily life, where is that occurring? What is the impetus that’s made you decide, "You know what? I need to pivot. I need to change. I don’t like this anymore?" For some people, it’s a slow burn. It takes them a long time to get there. And for other people, it can just be like, just one day you wake up, you’ve stepped off the cliff, and you don’t want to go back. I think it really depends. Right now, I just was reading a statistic that there have been more emergency room visits due to anxiety and depression in the last year than ever recorded, particularly for young people.
Nikki Kinzer: Oh, I can see that, for sure, in my own environment, my own community. COVID has been really hard for those people. Yeah.
Dr. Sharon Saline: It’s hard for a lot of us and it’s not over. That’s part of-
Nikki Kinzer: It’s not over, yeah.
Dr. Sharon Saline: That’s one of the challenges. There are really two types of trauma. There’s single incident trauma which is a one-time thing. "I’m in a car accident and I need to deal with the resulting legacy of that car accident," whether, "It’s hard to drive again," or "I have physical ailments," or whatever it is. And then there’s complex trauma which is trauma that reoccurs over time and that can be physical abuse or sexual abuse or elder abuse. But it can also be the trauma of a thousand paper cuts, the trauma of racism, the trauma of homophobia, the trauma of living with ADHD and feeling like every day you’re missing something, you’re missing the mark, or you’re not measuring up or you don’t get it right. With COVID, it’s complex trauma because it changes and it morphs and it continues. We haven’t been able, as a world, and particularly as a country to get relief from it for any lasting amount of time.
Pete Wright: The complex trauma of COVID but also the complex trauma of ADHD, this is the proverbial straw on the camel’s back where every day you’re dealing with this and eventually, back to this impetus for change point, you realize that or you are intervened upon that you need some help, you need some support. Let’s talk just briefly then about what a new patient to therapy might expect.
Dr. Sharon Saline: For me, I call them clients even though I have my doctorate and that has to do with my perspective and how I was changed. I don’t want… I think that the dynamic of you being a patient and me being a doctor is super loaded and there’s an implicit assumption that I’m well and you’re not. [inaudible 00:29:07] neurotic and crazy as the next person. Talk to my kids, they’ll definitely affirm that. I want to present myself as I have expertise in this area but I’m also very human. I think that’s very healing to people who come to work with me because I’m not trying to show that I’m better or that I have all the answers or God forbid that I figured it all out because none of that is true. I just have a lot of experience, knowledge, study in the field of psychology, and being with people and helping you figure out where you’re going on your journey. I’m your guide. When people come to work with me, they better buckle up their seatbelt, because I am in your face. I’m very direct. I’m very direct.
Nikki Kinzer: I’m curious about that. How so? Give us an example of what that looks like.
Dr. Sharon Saline: There are different kinds of therapeutic styles. Some people are more passive. Some people are more active. I am an active therapist. Obviously, I’m listening, I’m paying attention but we are engaging in a conversation. I think that I’m witnessing my clients. Some people are much less active and they don’t share, they don’t reveal parts of themselves in ways. I tried to do that as thoughtfully as possible I’m very careful about when I disclose because it has an effect on my client. But I also feel like just being a blank wall is not who I am and it’s not who I’m going to be and I feel like particularly for people with ADHD, they need that kind of interaction, they need to feel like they’re being met where they are, that they’re understood, and that it’s okay for them to be exactly as they are.
Nikki Kinzer: I personally associate therapy a lot with CBT. I think of that. Cognitive behavior therapy. Tell us a little bit more about that. Why does that come to my mind when I think of therapy?
Dr. Sharon Saline: Aaron Beck, who just recently died and I actually had the pleasure of meeting one time, he was sort of the father of cognitive therapy. The reason that we think about cognitive therapy a lot in the United States when we think about therapy is because it’s very result oriented. You need to change how you’re thinking. It’s like, there’s a book once, Mind Over Mood. "I’m going to be able to change my thoughts and that’s going to change how I’m feeling." There are therapists who practice pure cognitive behavioral therapy. A lot of therapists practice a mix of different things whether it’s internal family systems or acceptance and commitment therapy or eye movement desensitization reprogramming, EMDR, somatic experiencing. Therapists in general, I think, are very oriented toward seeking knowledge and better ways to help people. And so many therapists practice a mix of different things and there are therapists who practice only CBT. It’s a particular way of being and often, those people tend to be in clinics, I think, more than in private practice.
Pete Wright: When you’re looking for a therapist, if you are looking for a relationship with somebody to support you, is there anything special about the work that you do with ADHD that might be important to consider looking for in person?
Dr. Sharon Saline: You do want someone who does work with a cognitive behavioral lens because people who come with ADHD are struggling with the challenges of daily living. They feel disorganized, they may not be able to plan or prioritize, they may have issues with emotional control, they may struggle with memory or motivation. So someone who you work with has to… If you have ADHD, you have to choose someone who actually really understands ADHD. I have a lot of people who come to work with me who have seen therapists who have some training in ADHD but that’s not actually what they know about. And so it’s hard for them to understand the difference between pathology and ADHD. There’s a lot of thinking about different kinds of diagnoses rather than seeing this as linked to having ADHD. That’s a very important distinction because my job isn’t to make you feel worse about yourself. My job is to help you own your ADHD and learn how to live with it as effectively as possible and to address the friends that it brings along and to learn how to manage those as well.
Nikki Kinzer: So I have an example of client. It’s a case story, I guess.
Dr. Sharon Saline: I love case stories.
Nikki Kinzer: Okay. That I’m curious to see what you would say.
Dr. Sharon Saline: Sure.
Nikki Kinzer: And I’ll be upfront. When this got brought up in the conversation I did ask about her therapist like has she talked to her therapist about this situation because as a coach, I felt like it was too much of a gray area for me to help her with. What the situation is, of course, with COVID for the last year and a half, two years, this person was supposed to be in a graduate program and it was supposed to be live and it’s a very artistic type of program. She feels really cheated out of the first year and rightfully so. She had to do everything online. It was very difficult. A lot of struggle. And now she’s in her second year, it’s coming to an end before she has to go do her student teaching and she’s feeling angry, she’s feeling bitterness. She’s very upset about how this is ending and how she’s just now starting to get what this was supposed to be. She talks about her ADHD, about how it really heightened the ADHD because then she was avoiding things, she was procrastinating on things, overwhelmed, really harsh on herself like very, very ashamed about things that she felt like she could have done differently. I’m curious. What you think about that? Because you can’t just say, "Oh, change your mindset." "Hey, everybody goes through it." You can’t, you can’t.
Pete Wright: Especially in the context of the trauma we’ve been talking about-
Nikki Kinzer: Yes, exactly.
Pete Wright: … the perils of accumulated trauma and resentment.
Nikki Kinzer: Right, right.
Dr. Sharon Saline: I would think that this actually is a therapeutic issue and the issue is grief.
Nikki Kinzer: Grief, yes.
Dr. Sharon Saline: And that’s something that we haven’t talked about yet today. But there’s a tremendous amount of grief that people are carrying. My daughter is 23 and she lost year and a half of college where she wasn’t on campus, somewhat by her choice. But COVID, really, really affected her in a negative way. Other people were more adaptable. But a lot of particularly emerging adults, people in their early to mid or even late 20s have had to make huge adjustments and given up things, the things that they thought were going to be a particular way and that’s very hard because it runs actually counter to that stage of development where there is a hopefulness about life and it’s unfolding and what your place in the world is going to be. It would make sense… I also hear like she’s a little bit of depression in that and depression, it’s very common. People say it’s hopelessness and helplessness. Of course, I hear that in what you’re saying. Both of those things. Those are clinical issues. Those are things that CBT would be good for with a combination of just being able to sit with the loss. And then there’s a narrative piece like what are you telling yourself about this experience, is there another time where you’ve experienced disappointment, how did that go, and is that legacy affecting what’s happening now at all.
Nikki Kinzer: I have to say I’m glad that I personally as a coach notice that too. I think, for coaches that are listening to this it’s important for us to know what is therapy and what is coaching. I think it’s a good thing that we talked about that.
Pete Wright: I think that brings up a really great question which is not just the difference between therapy and coaching, but what is the therapeutic experience good for as compared to and distinct from coaching and medication, kind of pivoting off of our conversation last week. They’re each useful for different things and work together. Can you comment on that?
Dr. Sharon Saline: This is the big question. This is the $94,000 question. In fact, last year at the International ADHD Conference, I was on a panel with Ari Tuckman, Elaine Taylor-Klaus, and Dulce Torres, and this was exactly the thing that we talked about, coaching versus therapy. they’re not necessarily in opposition to each other, they actually can work very well together. If the therapist is not someone who is well informed about ADHD and can do the kind of concrete practical, focused interventions that a coach can do. I think that medication is an important part of treatment for ADHD. Pills don’t teach the skills but pills make you available to learn the skills and retain them and so that can be very useful. It can help you lift the fog that you may feel or slow you down enough so that you can actually be paying attention and absorbing to what’s going on. I think they actually can work together. In my practice, I work with someone who was a college student at Smith and she had a coach to help her with her academic stuff basically to set up, planning, and prioritizing and calendaring the whole thing and that’s what they worked on. How are you going to plan for this paper? When are you going to do what? In our work, we were dealing with substance abuse, social anxiety, family issues. There was no way I could have done all that.
Pete Wright: Well, yeah. Let’s ask a coach when’s the last time you coach through substance abuse issues, Nik? No.
Nikki Kinzer: No, I don’t.
Pete Wright: Right.
Dr. Sharon Saline: There you go.
Nikki Kinzer: I don’t. But I do the planning and what do you need to do to prepare for this final. Yeah, yeah, absolutely.
Dr. Sharon Saline: And that was a beautiful marriage as far as I was concerned. And there was a psychiatrist also. The whole treatment came together. I was in touch with everyone and that’s the thing that I would also want to say to every people who are listening is if you have a psychiatrist and a therapist and a coach or a coach and a psychiatrist or therapist, you know what I’m saying, if you have any combination of those, give them release so they can talk to each other.
Nikki Kinzer: I agree.
Dr. Sharon Saline: It’s really important and it’s not like, "Oh, you’ll be talking about me when I’m not there." It’s actually, "Hey, this is what I’m working on. What are you working on? Is there anything that I could do that would support your work more effectively? This would help me with my work if you’d be willing to do that." I think that how lucky are you to have a few people working on your team to support you. It’s like your sag wagon moving toward that finish line, maybe that’s not the right image, but to be moving along as you’re on your-
Nikki Kinzer: Moving along.
Dr. Sharon Saline: … bike trip in Italy going from place to place biking together.
Pete Wright: I’ll take it.
Nikki Kinzer: I got to tell you too, as a coach, I think it’s really helpful to know where they’re at. Another example is I was talking to a psychiatrist who was working with the same client and I was concerned about working with her because I thought she was in a very deep depression and I wasn’t sure if she was able to… Coaching is so much more, well, not more, but it’s about action. It’s about what are you going to work on this week and I was really concerned that that was going to backfire on us. And so when I talked to the psychiatrist, it was so interesting to me because she said, "No, I actually really think it would be helpful for you to be able to sit with her and even if she just goes through her mail or even if she just does something to get her to do something even whatever that is that she wants to do, I think that’s going to help." I wouldn’t have known that if I hadn’t talked to her and really understood how we were helping her together. And so I agree, I think the more communication we have, we really can better help the person and support the person.
Dr. Sharon Saline: That’s great. I’m thinking back to a client I had a long time ago. Very successful professional woman who had trouble with sorting her mail and loves Staples. Went to Staples to either get accordion file or get four separate big files and she brought in a huge bag of mail and the file and that’s what we did. We just went through and then we were just processing while she was doing it, how she felt, why she felt bad about herself, how embarrassing it was to do it and it was very helpful because then we were able to create a system.
Nikki Kinzer: I think one of the greatest benefits of therapy and coaching is you have somebody you can talk to about your ADHD, your depression, anxiety, or a therapist and there is no judgment and it’s a safe place. I remember somebody telling me. "There’s nobody else I could talk to about my planner the way that I talk about my planner with you." I think that’s one of the wonderful things of connecting with another human is being able to have that safe place to talk about these things that maybe you don’t want to talk to your husband or your partner or whatever with because it’s not comfortable. I am curious. I have a couple of more questions and then… Well, actually, I have three more questions.
Dr. Sharon Saline: Ask away.
Nikki Kinzer: Yes. The first one I have is what happens when your therapist tells you, "I’m moving," or "I can’t see you, I’m retiring," something where they have to in the relationship for whatever reason and now you have to go and find a new therapist and one of your biggest fears is, "Oh, my gosh, I have to start all over."
Dr. Sharon Saline: Yes. In those situations, ideally, your therapist would give you some names of people and you would sign a release so that your current therapist could share some key points of your history and what you’ve been working on so that when you go to see the next person is like, "Ugh, it’s a completely blank slate," they have some idea of what’s going on. But you will have to tell your story, and while that seems burdensome and loathsome at the same time, there’s actually value in it because you may be telling your story differently now having been to therapy with that other person than you did when you told it the first time.
Pete Wright: That is such a great awareness.
Nikki Kinzer: That’s a really good point.
Pete Wright: I’m so glad you said that that way, right? That is amazing because you are the collected result of your experiences and that includes all your past therapy.
Dr. Sharon Saline: Yes.
Nikki Kinzer: Yeah.
Dr. Sharon Saline: I think that a lot of therapists… I think a lot of coaches think therapy is all about the past and coaching is all about the present. I don’t think that’s the case. I think coaching is about action, what are we going to do to get you to do X, Y, and Z. I think therapy is about so many things but a couple of them might be how is what’s happened in your past interfering with your ability to live fully in your present or to move into a future that is what you visualize. I think therapy is about being accountable for who you are in the present and talking through and being open to exploring whatever is happening with you emotionally, psychologically, spiritually that you want to change or shift so that you can move into action in a way that feels synchronized with who you are. And finally, I think that therapy is a lot about self-awareness and learning how to accept yourself as you are, warts and all. Really, that’s a life journey for all of us. I feel like that’s why we’re on the planet. And as you mature in adulthood, this becomes an important issue. Do you accept yourself as you are? How do you receive feedback, whether it’s positive or negative? What do you do with that feedback? How can you hear things without collapsing into a pile of negativity or rejection? All of these things are part of it. And so I think that there are a lot of places where therapy and coaching really dovetail nicely.
Nikki Kinzer: So a lot of the things that you just said, self-compassion is what comes to my mind. Having conversations with your clients around being okay, acceptance, what word is that come into play?
Dr. Sharon Saline: It’s more than just taking out the acceptance nail and hammering it.
Nikki Kinzer: Right.
Dr. Sharon Saline: It’s really about a kind of a dance that you do. For me, I feel like… I use humor and warmth and I do my best to express acceptance of where someone is. I think by the same token, I’m a little bit confrontational. I’m going to call you on your stuff. That’s my job. But I think that really people, particularly people with ADHD, are very hard on themselves. I haven’t met anybody in my 30 years of being a psychologist who has ADHD who doesn’t carry around some shame about who they are or how they are, and that shame really it can be debilitating in a lot of ways. Instead of working on the acceptance now, we might work on this shame or the sensitivity to rejection or a lack of self-confidence. Those come up in the news and actions of daily living. "I have to apply for a job," or "I have this girlfriend who isn’t treating me the way I would like to be treated." "I had an argument with my mother and I feel like she’s just really critical and then that just activates my own self-criticism." We want to look at all those things. I think that’s partially in a way particularly where internal family systems is so helpful because we’re looking at different parts of ourselves, the part of ourselves that’s self-critical, the part of ourselves that loves to do art, the part of ourselves that might be kind of goofy. They’re all there and it’s where we want to put our attention and how we want to talk to them and deal with them.
Nikki Kinzer: Okay, so I’m going to pivot back to my other two questions.
Dr. Sharon Saline: Excellent.
Nikki Kinzer: Is there an end to therapy?
Dr. Sharon Saline: Oh, that’s up to you.
Nikki Kinzer: Okay.
Dr. Sharon Saline: There are people I work with… I’m working with someone now and I went from seeing them every week to every other week and now every second session is canceled because of this, that and the other thing so that’s a message to me that they’re doing pretty well in a couple years and they’re ready to probably let go. They don’t want to let go because it’s scary to let go. But I also have someone I’m working with who I haven’t seen in 12 years who called and said, "I got a new job and I got married and I’d really like to come talk to you." So it depends. I think for me when the sessions are pretty much mostly about chitchat, then we’re done and I like to say, "Well, it’s not over," I like to say, "We’re going to press pause because you may want to circle back with me or someone else and that’s totally fine. But right now, I think you’re okay."
Nikki Kinzer: That’s a really good point. I like that. We can push pause because really it isn’t… Just with coaching too, it comes and goes. There’s times in your life where you might feel like everything’s really in place. But then you do, you get a new job, you get married, you lose a job, something happens, and then all of a sudden, it’s like, "Okay, I need that little extra structure and accountability," and so forth.
Dr. Sharon Saline: And it’s not that you’re okay, I want to just [inaudible 00:53:02], because it’s like you’re managing well on your own and you’ve now internalized our conversations and our work and you can use it on your own well enough. And when you need a tweak, it’s like you get your car serviced every whatever, six, nine, 12, 15 years, 12 months or 15 years, depending on who you are and how you do it, then that’s the same thing. People come back, "I need a little refresher," like okay.
Pete Wright: It’s training wheels thing, right?
Nikki Kinzer: [inaudible 00:53:40].
Pete Wright: It’s a training wheels thing.
Dr. Sharon Saline: Yeah, exactly.
Nikki Kinzer: Absolutely.
Pete Wright: We can take those off for a little while.
Dr. Sharon Saline: Sure.
Pete Wright: And if it feels like you took just one off and now you’re just riding in circles, you can always come back.
Nikki Kinzer: You can do that too. My last question, and thank you so much for bearing with us today, it is hard to find a therapist right now.
Dr. Sharon Saline: Oh, yeah.
Nikki Kinzer: They are in high demand and I-
Pete Wright: Nikki, do you feel a little guilty doing this show with Sharon when she could be working with someone who’s struggling to find an appointment right now? I feel just a little bit guilty.
Dr. Sharon Saline: No, no. This is my lunch hour so no [crosstalk 00:54:16].
Pete Wright: Okay. All right.
Nikki Kinzer: Okay, so no guilt.
Pete Wright: Everybody’s got to eat. Everybody’s got to eat.
Nikki Kinzer: That’s right. But it is really hard. I know this from personal experience. I have a 16-year-old and she was struggling, has ADHD and anxiety, eating disorder, all kinds of stuff going on. I can’t find a therapist in town that is open. Luckily, she connects with the school counselor.
Dr. Sharon Saline: That’s great.
Nikki Kinzer: We’ve been told from her doctor make sure she leans on her because it is so hard to find someone. I know that this isn’t just an Oregon problem. This is a problem everywhere. If you can’t find a therapist right now for whatever reason, what do you suggest people do? How can they still help themselves?
Dr. Sharon Saline: That’s a really great question. I’m all the way across the country here in Massachusetts and people can’t find therapists either. The first thing you want to do is get your name on waiting lists. Absolutely. And be persistent. Call once a month and say, "Hey, you have my name. I’m wondering if there’s been any change in status." That helps a lot. You might talk to your primary care provider, pediatrician, or nurse practitioner, or whoever you see as an adult and ask them if they could help you find someone because you’ve called this person would your primary care provider be willing to make call on your behalf. Right now, part of the problem is that therapists just are overwhelmed because of the demand but also, because I think that a lot of us feel like we can’t spend eight hours doing therapy online every day the way we might have been able to tolerate or do therapy… When I say tolerate because it takes a while to build up your ability to do that in person, it’s very different and it’s draining in a particular way. I know that for me I’m actually trying actively to shift to doing some, what I call, therapeutic coaching groups where they’re online. I’ve just recently decided that that would be more useful because I can reach more people. I’m only one person. I think that that’s something to look at also. Are there some groups available that would be helpful? I guess the main thing I want to say is don’t give up. I know it’s discouraging, but keep at it, keep calling people. The people who call me who email me, who say, "Please, do you have anything I need to be on your list." I have a long list but they’re in the field of my vision a little bit more than people who call once and then I don’t hear from them again.
Nikki Kinzer: Right.
Pete Wright: And I love that you said that about your therapy groups online. I know that is another part of sort of the evolution of practice that we’ve seen over the last 18 months, two years, and I think there might be just something to ask of yourself as a potential client to take advantage of groups even though you might have that in your head that the only thing that’s going to help you is one on one cognitive therapy.
Dr. Sharon Saline: Right. I think that’s really important. You yourself have to be flexible. There are a lot more group options online than there used to be and there’s also classes like mindfulness classes or… I know Kristin Neff’s organization does a lot of classes. And there are things for teens as well. It’s hard because one of the challenges is in child development, you need actually to be with people and see their faces and feel their connection. That’s part of what people need to really develop the skills to be sufficiently relational and satisfied and how they connect with people and that’s been challenging.
Nikki Kinzer: Whoo. Thank you so much for your… It’s so good to hear somebody talk about this that does it every day.
Dr. Sharon Saline: Yay.
Nikki Kinzer: Every day, and can help us understand it more. I really, really appreciate it.
Dr. Sharon Saline: You are most welcome and I want to just thank you for your thoughtful questions. I really appreciate talking with you. You’re both so curious and well informed. It’s always a pleasure. Thank you.
Nikki Kinzer: Oh, thank you.
Pete Wright: [inaudible 00:59:14]. Tell us about your latest projects.
Dr. Sharon Saline: My latest project-
Pete Wright: What does it look like when you’re not eating lunch on podcast?
Dr. Sharon Saline: I’m not eating lunch. I’m doing a bunch of writing articles. I have a webinar coming up for additude.com in January that I’m really excited about on perfectionism.
Nikki Kinzer: Ooh.
Dr. Sharon Saline: And I do a Facebook Live for ADDitude every Friday at 4:00. People come from all around the world. There are various topics. Check out my Facebook page at drsharonsaline.com or go to ADDitude Mag, their Facebook page. And sort of throwing around a few ideas for my next book and I’ve been doing a bunch of school consultation which I really enjoyed.
Nikki Kinzer: Oh, that’s wonderful. Wow.
Pete Wright: For those who don’t have the deck, you got to talk about the deck and [crosstalk 01:00:06].
Dr. Sharon Saline: Oh, my card deck.
Pete Wright: Yeah, yeah.
Dr. Sharon Saline: My card deck is really fun and it’s very useful because it’s my five Cs, self control, compassion, collaboration, consistency, and celebration in card deck form. There are five Cs and five suits and each card has a quote from a kid and perhaps a parent, a challenge, and a tool. You can work your way through the deck, you can say, "Ugh, I need some compassion today. I’m just going to pick a compassion card." Or you say, "Hey, things have been kind of down and out. I’m going to pick a celebration card." You can leave them in the bathroom so your kids can pick cards for themselves. You could play fun game somehow with them. It’s a really different way of getting the information.
Nikki Kinzer: Right.
Pete Wright: Well, it’s all lovely. We’ll put links to all of that stuff-
Dr. Sharon Saline: Thank you.
Pete Wright: … in the show notes.
Dr. Sharon Saline: Thank you.
Pete Wright: Sharon Saline, thank you. Truly, thank you so much for being here, for helping us and the community.
Dr. Sharon Saline: You’re welcome.
Pete Wright: We appreciate it.
Dr. Sharon Saline: My pleasure.
Pete Wright: And thank you everyone for downloading, listening to this very show. Thank you for your time and your attention. Don’t forget if you have something to contribute, got questions, you want to talk to the community, head over to the show talk channel in our Discord server and you can join us right there by becoming a supporting member at the deluxe level. On behalf of Nikki Kinzer and Dr. Sharon Saline, I am Pete Wright, and we’ll see you right back here next week on Taking Control: The ADHD Podcast.