Client dialogue: Adhd and Trauma and Bears... oh my.

Introduction

What follows is a writing project I've been working on with a client. The thing that is missing from the vast majority of work written on psychotherapy is the voice of clients. It's understandable: there are the issues of consent and confidentiality. I, of course, regard these issues as sacrosanct, and everything you read in this and other work I will do with clients in the future has been sanctioned by those clients themselves. All identifying information will be scrubbed from these dialogues, though there are some details that are necessary. This first dialogue is an important example, because it is critically relevant to know the sex and the approximate age of this particular client to understand the weight of her story.

I have edited the original emails as little as possible, but I have taken some things out and cleaned up spelling errors for readability.

The Story of Josephine

In the dialogue below, the reader will find the story of Josephine. It is certainly not her entire story. Only she can tell her whole story. This is the latter part of her story, the part where she has come to understand an important truth about herself that though completely obvious retrospectively was unknown to her until July of this year (2025). The truth that was concealed from her for all these years is that she is a person with adhd.

Adhd is an official medical diagnosis, and it is important to have a diagnosis so that one can access all the supports that are available through medical channels. But adhd is much more than a diagnosis: it is a way of understanding the way one is in-the-world. This is why I have called my practice There Counselling: because until clients can locate where they are in space and time, it is impossible to understand the reasons why we do the things we do, and it is impossible to chart a considered course going forward, into the future.

I asked Josephine to work on this with me, because her story is representative of the experience many women have with respect to adhd: that is, their challenges manifest in different ways from their male counterparts, and they are not offered the same supports. And let's not beat around the bush with polite language here: women are simply not taken seriously by our medical systems. Josephine had gotten a myriad of diagnoses and prescribed a myriad of medications over 30 years, but not a single Doctor, Psychologist, Psychiatrist, or Counsellor had ever suggested that the challenges she was clearly having were the result of adhd. None... over 30 years.

I can't tell you the number of women I have seen in my practice who have similar stories to tell. The commonest story is women who are entering into perimenopause and find that they are unable to cope. Perimenopause is an incredibly challenging developmental transition in a woman's life, and it is wildly common that women who have found ways of dealing with their adhd across the span of their lives run out of resources when perimenopause is thrown on the pile of work: paid work, emotional work, domestic work, parenting, and all the other tasks that women do in a way that men simply don't.

It feels cruel to me that women in our society have to get to the brink of collapse before the medical system pays them proper heed. And even then... it so regularly get its wrong.

One of the other reasons I asked Josephine to participate in this dialogue is that she had such a positive experience with medication. She achieved a sense of calm and understanding of her self in the first week of taking first line adhd medication—stimulants—than she achieved in three decades of therapy. But I tell you this as a Counsellor: medication on its own is not a silver bullet or panacea. It is a bit overdetermined for me to think the following way, but... here we are: medication and therapy produce the best outcomes. As you'll read below, finding the right medication at the right dose can often be the very beginning of the journey.

My deepest gratitude to Josephine for her willingness to engage in this dialogue with me.

August 20 (me)

as i mentioned, i wanted to engage in a dialogue with you, because i think your case is a very important one, for a number of reasons:

• because you are a woman (and this is an example of the ways in which women are not given the proper attention vis a vis adhd)
  • you have been seen by Doctors, Psychiatrists, Psychologists, and Counsellors over a span of, if memory serves, 30 years, and not a single one of them clocked the fact that you are a person with adhd;
• because you are someone who has experienced trauma (and we are in a time when trauma always comes first. not only that, but we are in a time where it is a therapeutic given that trauma is at the root of all issues a person might experience, which seems to have been your experience);
• and because of how angry you are—rightfully so— at the whole of my discipline;
• and because of the immediate and obvious positive effect stimulant medication had on you, and that it had been withheld from you for all these years. and that you experienced that positive effect within hours of the first dose on the first day.

i'm not sure where to begin, but my first thought is to start with your anger at the discipline of psychology, particularly as someone who had been a proponent and an adherent to counselling for so long. what do you think? do you want to start with your justifiable anger as a starting place?

August 20 (Josephine)

Hi hart,

The fucked up thing is that a part of me feels like I inadvertently did something that hid my adhd from the professionals that I worked with, like somehow, it's my fault. On the other hand, I know that I approached our meeting in the same way as I did with other therapists, and you got it right away, so I couldn't have been that good at hiding who I am.

Then when I would go back to the psychiatrist, psychologists, trauma specialists, anger therapists (I've seen them all) and told them that this isn't doing anything for me, I'm doing ALL the work, I'm taking the pills that do nothing and in the meantime I'm self medicating with drugs like cocaine and alcohol and feeling better than taking the meds improperly prescribed to me, they would tell me that I'm not doing it right or I am not doing it at all.

Sounds dramatic, it is dramatic, and that's okay. I didn't give up, I just kept going back to therapy (adhd keeps us hyperfocused) because I wasn't going to accept that I was an introverted, empath, with severe anxiety that made me hyperactive and oversharing, sensitive to light and textures, or a mean bitch that was rigid and unforgiving with a volatile temper that couldn't be reasoned with, and I wasn't a fucking broken child either. I knew that THERE WAS SOMETHING ELSE going on, but had yet to find what it was after searching for 30-odd years.

August 21 (me)

There's a important therapist and thinker from the mid-20th century named Paul Watzlawick, who is best known for the following phrase: "you cannot not communicate." This is what comes to mind when I read what you wrote above, about your worry that you unknowingly hid your condition from the many psy-professionals that you saw over the years. But it doesn't matter whether you were hiding them or not—and I can say from own personal and therapeutic perspective that if you were attempting to hide parts of yourself, you were doing an extremely bad job :)—everything a person say or does is a way of communicating. I will say for my own part, that it was extremely clear, extremely quickly that there was a great likelihood of some neuro-deviancy in you. My challenge is trying to be patient with clients and find ways of telling them in a way they can receive it without pissing people off or alienating them. And even still... my recollection is that you weren't super enthused about my suggestion that adhd might be something at work in your case.

I'm not asking you to name names, but can you recall the number of doctors and psy-professionals (psychiatrists, psychologists, counsellors, etc.) you saw prior to getting assessed? You wrote in your previous message that you weren't angry, because you reserve that emotion for "people you care about" (which is a sick burn). But I am angry and ashamed and embarrassed by the neglectful "treatment" you received over three decades instead of the care you deserved from my supposedly learned colleagues. It is inexcusable that people like you have reached out for help time and again, spending your own money and time to try to effect change in your life and be met with the well worn tropes about trauma and mood and your inner child. And please don't misunderstand what I'm saying: journalling and meditation can be extremely helpful practices for a person with adhd. And trauma and adhd have a very special kind of relationship—though it is not the current "wisdom" offered by what I sarcastically call the Trauma Industrial Complex by the likes of Bessel Van der Kolk and Gabor Maté. But appropriate therapy can only start and progress if you know the starting position. 

If I can take a moment for a little self promotion, this is the reason why I named my new counselling practice There Counselling. It is not possible to make a lick of progress in your therapeutic work if you can't locate yourself in space and time. And this is exactly what you struggled with all those years: psy-professionals kept pointing to a spot called trauma or addiction or neurosis or even brokenness, and said to you: "There. That's your starting place. This is the name we use to describe people in your situation." But they were pointing to the wrong there. 

back to you...

August 21 (Josephine)

Hi,

Thank you for this. It feels very empowering to finally know where "THERE" is for me. From above:

And even still... my recollection is that you weren't super enthused about my suggestion that adhd might be something at work in your case.

Yeah, I told you I didn't like the label, and went away with my arms crossed, and in good adhd fashion, I wanted to know more about this 'bullshit', so I read your essays, and of course (you know where this is going) and Kill the meaning, Keep the name hit the nail on the head, and so I read everything that you wrote about adhd, went on Reddit and Googled everything to read about other peoples (women's) experiences being late diagnosed and HERE we are now.

So now back to the actual question that you asked: Including my family doctor that I saw when I was a child and a young teen, and before meeting you, my GP, whom I talked with about my mood swings (perimenopause). I have had 15 different professionals (one for about 10 years) and some for only 4-5 sessions, this includes a psychiatrist, psychologists, doctors, psychotherapists, and registered counsellors. This does not include you.

Starting Medication...

August 21 (me)

it's great to hear that you are feeling empowered from feel a sense of there-ness, or you can also think of it as the feeling of being home.

i'd love for you to share your experience of starting medication. i think it's a funny story that it took you all of two days after that meeting of ours for you to find a nurse practitioner to offer you a diagnosis and write you a prescription. but more importantly, i'd love for you to share with readers what you noticed when you started taking medication. there's a lot to that, i think: for example, the physical and emotional and cognitive experiences of being on stimulant medication. but i'm also interested in the process of looking back on your past. and i wonder if you would recount the story of being able to have a discussion about finances with your partner that didn't end up in anger and disconnection and hurt feelings on both sides. feel free to stretch out as much as you like to tell these stories and to describe the difference that being on the right medication makes.

August 25 (Josephine)

Hey,

I haven't forgotten... I'm just trying to articulate my feelings into words as it's a lot deeper than just "it's quiet and I'm a lot nicer". I'll work on this when I get home.

August 25 (me)

great. no rush. looking forward to reading it.

August 25 (me)

i realized that i missed an opportunity with respect to your last email to me when you wrote:

Hey,
I haven't forgotten... I'm just trying to articulate my feelings into words as it's a lot deeper than just "it's quiet and I'm a lot nicer". I'll work on this when I get home.

there's actually something very important in your message, that is... that you were finding it difficult to say something more substantial than "it's quiet and I'm a lot nicer," which, of course, is pretty important thing to be able to say in itself.

in the past, clients would ask me prior to starting medication, what they could expect or what it would be like. and i would try to give some sort of description of my own experience or the experience of other clients. but every time a client came in they would say some version of either:

• "that's not at all what i expected" or
• "is this how neurotypical people experience the world?"

so... i stopped. the way i now describe is to say the effects are extremely subtle, which i think is counterintuitive to what people think about this class of medication. i mean... we are talking about stimulant medications, and lots of people (including doctors who should know better) have a LOT of preconceived notions about these medications. it's not to say that stimulants don't have any side effects. they do... just like every other medication we put in our bodies. but those of us with adhd have a very different experience taking stimulants than the neuro-means. Neuro-mean folks take stimulants and they experience a surplus of stimulation. Neuro-deviants, like ourselves, take stimulants, and we feel things like calmness and quiet. we often feel an almost immediate capacity to make every day decisions that an hour prior we might have agonized over, but with the assistance of medication the decision is made quickly and without much if any emotional toll.

i'll stop there. does that offer some assistance in describing your experience as more than quiet and nicer? really think about your day-to-day, e.g. how to relate to your partner, to money, to disorder. think about the differences in the way that you navigate things that would otherwise cause irritation or anger. and think about the ways in which the past intrudes on your day-to-day in a different way than it did prior to starting medication. and one last one (but particularly important to me): how taking medication has caused you to relate differently to the future.

August 27 (Josephine)

*Warning* this is a ramble written over 2 days, some of it was written first thing in the morning before my meds kicked in order to recall how I used to feel...

I remember how offended I was when you mentioned that with the "right meds" things would be easier (or something like that) for me. I was able to accept that I was neuro-spicy, and different because that made all the sense in the world to me... but being told that the only way to "fix" me is to take medicine, which at the time felt like it could only mean that I was "sick"... What I realize now is that this world is not designed for brains like ours. I've worked harder than most people to arrive at where I am and I feel that I'm pretty successful in my life, (considering that I had some pretty big unknown shit going down in my brain)... I knew that I was different and felt so fucking broken (cue all the "professionals" I've seen).

Honestly, I was afraid of the meds making me numb or dumb or changing my personality, I thought that if they take away my 'superpower' who will I be? I'm still me, but without the intensity, stress and irritation.

You put it really well when I asked you what should I expect by taking meds and you said something like: "you'll still be able to see the one broken pixel but your hair won't be on fire about it."

My past experiences (trauma or however it rears its ugly head) are no longer in the front of my mind clouding my decision making process. I also noticed (something I was never aware of) that I no longer have fleeting insane thoughts like 'what would happen if I 'veered into traffic or drove off this bridge?' I don't have a death wish in the slightest but my brain would just throw in fucked up thoughts like that once in a while (like what the fuck!? And how that became such a part of my life that I didn't even think that it was abnormal...until it stopped, is beyond me.)

I was able to let go of control and compromise when talking with B about financial and relationship issues, even if I didn't agree. I no longer felt that compromising was going to hurt me in some way. I was finally able to see his side without feeling like he was out to somehow 'get one over' on me. I don't feel slighted or cheated and can speak rationally with a calm mind.

I'm able to communicate with other people in my family without my negative emotions getting in the way. I'm able to let go of things that I would normally latch on to and obsess over. Now I can focus on the important things and be productive.

Yesterday, I went on a packed Metro in Montreal during rush hour, squished, standing room only...and didn't get overwhelmed by the number of people and wasn't internally freaking out about people 'in my space' or 'touching' me... I'm able to go shopping and have much more patience now. In the past, I had absolutely no tolerance for slow walkers or people who are blissfully unaware aware of how much space they take up, and I'd come home exhausted from trying to control the 'rage' I felt.

Another thing, I wasn't apprehensive about being introduced to a friend of a friend where before, I'd be cringing waiting for my neuro-spicy brain to blurt out something obscure or share something irrelevant or become "jacob-two-two" and tell the same story twice in a span of a minute (that's my brain for you)...I was able to make small talk and act like a 'regular' person (whatever that means).

On another note, I miss B for the first time being away from him, I couldn't understand how people could miss someone unless they were 'gone forever' (and even then it was hard for me to fathom). For me, if the person was out of sight, they were out of mind. (I convinced myself that I must be, somehow, a self-centred asshole because I don't know anyone like this). I've been thinking about how it would be nice to share my experience here with him and have called everyday without him calling first. He is thrilled to bits with the "new" me.

I also didn't have (the urgent need) to unpack my luggage immediately and arrange things perfectly when I arrived. Shit... I didn't even make my bed! I'm less rigid, the same 'rules' don't feel like they apply any more because those were coping mechanisms to help organize my mind and the meds take away that need to be super organized to cope. A bit of chaos no longer drives me crazy.

I feel like I was living with a piece of me missing, my brain was never satisfied, I was chasing dopamine and trying to fulfil that emptiness with drinking alcohol. And so I went to addiction therapy (and was put on (meds) naltrexone to curb the physical 'craving' for alcohol) but replaced that missing part with food. Today, I don't crave any of that. It's like the missing puzzle piece finally fell into place... I'm not impaired, just clear, quiet and calm from the Vyvanse.

I'm still sensitive to light, textures, touch and sounds but my reaction to them isn't as dramatic or intense. I don't dwell on things that I have no control over. I can just let them go.

I'm still writing lists and using voice notes when people give directions as that part of me still needs systems in place.This is all still pretty new to me as I took my first dose on July 4th, and I haven't really taken the time (until you mentioned it) to even think about the future. I'm just enjoying my new brain in the present. Let me get back to you on that (important) part.

Neuro-Deviant. I like this, but for myself I think neuro-spicy suites my personality more. ;)

Noticing what's absent: the lack of macabre scenarios

August 27 (me)

so much to ask about and follow up on:

first, i'm very interested in your reflection on the sort of thoughts you had in the past but are not having after starting medication. how did you notice the absence? to be clear, i don't think they are crazy thoughts at all but are legitimate existential musings on life and death. the question isn't why do people have these sorts of thoughts, but rather why aren't people having them all the time?! after all, we know that getting into a car is the most dangerous thing most of us ever do on a regular basis. and yet... we do it without a second's thought. to my mind, your past fleeting thoughts are not at all about having a death wish but rather a legitimate question about a dangerous activity. but of course... our entire way of life is now predicated on this, relatively speaking, dangerous activity, so your ability to engage in it without spinning out into an existential nightmare is a good thing.

i thought what you wrote about the relationship to your past experiences was spot on! there are many folks who now claim that adhd is itself the result of trauma. this seems like complete nonsense to me. but your take on the relationship between adhd and trauma fits with my understanding: that is, in the absence of the right medication at the right dose, the past intrudes in ways that "cloud your decision making process." this is why i called my new practice There Counselling, and why i refer to the kind of work i do as there-apy instead of therapy: adhd can make it very challenging to know when and where your present there is.

for clarity, this is how it should be. if your traumas are with you as presently as they were when they occurred in childhood, then it would be crazy not to attend to them. the fact that these traumatic memories are no longer screaming in your ear means that you are better able to make decisions on behalf of the person you now are. and they also communicate to the child in you who was hurt that there is now a competent adult in charge who will take care of the child you once were—you!

i wanted to focus a bit on what you wrote about your relationship to finances and how that was a very challenging part of your relationship with B. you wrote:

I was able to let go of control and compromise when talking with B about financial and relationship issues, even if I didn't agree, I no longer felt that compromising was going to hurt me in some way. I was finally able to see his side without feeling like he was out to somehow 'get one over' on me. I don't feel slighted or cheated and can speak rationally with a calm mind.

it is my experience that everyone with adhd has at least one of what i call domains of scarcity. for some it is time. for some it is control. and for some it is money. i recall a couples' session with you and B where finances was the main topic, and... it was a tough session. you were unable to hear what your partner was trying to communicate. i mean... you were fierce about it. but what you wrote above gives such context to your feeling on that day, because if it was true that it felt to you on that day that someone was trying to hurt you or get one over on you, then... again... the way you reacted was not crazy or overblown. just like with the example of trauma above: if what was present for you was "i'm definitely going to get fucked in this deal like i have so many times before," then anger and defensiveness and rigidity were not crazy responses but a reasonable response to the stimulus as you experienced it. to use the language of There again: it seems like the medication has given you the wherewithal to recognize that even if you disagree with B, you no longer associate that with the feeling that he is prepared to hurt you.

one last question (for this round): how has your relationship to alcohol changed since starting medication?

being able to breathe is perhaps the most subtle but important reflection on the medication. what could be more important than changing the feeling of the thing we do 20 000 times per day?

August 29 (Josephine)

It was also apparent (after I thought back) when I stepped onto my flight going to Montreal, and of course last night, coming home that I always had issues stepping over the gap between the plane and the walkway, looking down between the crack, thinking that somehow, it would separate and I'd fall to the tarmac below; no such thought this time.

Here's a question for you about the adhd brain that's been bouncing around in my mind... Looking for your opinion from experience. Do you think that we may process trauma differently? Or hold on to things for longer due to hyperfocus or a version of RSD?

My adhd has always been here; the proof has become more and more obvious by speaking with my mum, that it appeared as a baby, as a toddler (before any trauma, unless you believe that trauma starts in the womb).

I sat with this for a bit:

for some it is time. for some it is control. and for some it is money.

Yeah, all 3 have been a thing for a long time for me. I still enjoy a drink or two but I can take it or leave it. I'm no longer 'chasing peace' by getting drunk, which was what the focus was during my addiction therapy. He was convinced that 'trauma' made all the 'noise' in my head (it should have been so fucking obvious that it was 'more' than that). And once again, "If you say it, you slay it" bullshit. I said (as so many times before) this isn't working, and I agreed to take the naltrexone, which didn't do anything except take away the craving for the alcohol (as I said previously).

The 'peacefulness' comes when the stimulant medication kicks in.

There's something else that I wanted to touch on that might sound weird... I want to go back and watch movies that struck myadhdbrain to re-watch them now to see if they 'hit' differently, for example, Inception (2010) - the concept of that movie fucked with my brain (not sure why), and I have a feeling that watching it now, medicated, it won't feel the same. It's like I want to re-experience the world with new glasses on.

I'm attaching a screenshot of a post from Reddit that spoke to me. There is a lot of bullshit and misconceptions on the internet about adhd; however, some of the real-life experiences shared on this particular forum, especially around 'imposter syndrome' and RSD, make sense to me.

August 29 (me - responding to the images above)

i talk to clients on a very regular basis whose doctors say this very thing to them. it sometimes make me shake with anger. part of the reason i want to do some writing projects with my clients is to find a way at getting this message out. 

there are many doctors and psychiatrists who believe that adhd is wildly overdiagnosed. these people are fucking dopes. just yesterday i spoke with a 60 year old client with a very long history of alcoholism. i asked them if they had ever had someone talk to them about adhd. they said no, though 10 years ago they did get diagnosed with bipolar disorder and medicated for it. but... it didn't work because they didn't have that condition. they have adhd, and because they were a succesful person (save for decades of heavy drinking), no one ever mentioned it until yesterday. 

Trauma and adhd

August 29 (me)

this is great!

i'm very appreciative of your participation in this. i think it's going to make an amazing resource for other folks.

i love that you are able to notice the absences, which is a tough thing to do. that is, you noticed the absence of your brain creating for you "macabre scenarios." this is a great phrase! but this is exactly the kind of thing that the uninhibited adhd brain does: it serves up ALL the possibilities to you as a way of keeping you safe. and in a way, this is exactly as it should be. it's just that because there is a lack of inhibition in those of us with adhd that the aspects of us that create these predictive scenarios come up with the extreme worst scenarios because these are the ones that we have to be most attentive to. the thing our adhd brains are not good at doing is marrying the likelihood of these things happening with the grimness of the scenario. if there's a one in a billion chance that you could fall off your bike and land in the St. Lawrence, that's not actually something you need to consider because even though it is a very bad outcome, the likelihood of it happening are vanishingly small. now that you're taking a stimulant medication, your brain is now capable of inhibiting the macabre scenario where you fall into the river. 

you ask the following question:

Here's a question for you about the adhd brain that's been bouncing around in my mind... Looking for your opinion from experience. Do you think that we may process trauma differently? Or hold on to things for longer due to hyperfocus or a version of RSD?

As I look back now, it feels like if I were properly diagnosed earlier, that maybe the fucking therapists would have stopped opening up old wounds, making me recant and re-live the trauma that I had (giving me more shit to hyper-focus on), and I would have been able to get ahead of all of it, much earlier. Instead of having my feelings, behaviour, and actions always blamed on trauma. My adhd has always been here; the proof has become more and more obvious by speaking with my mum, that it appeared as a baby, as a toddler (before any trauma, unless you believe that trauma starts in the womb).

this is an absolutely critical question. my answer is yes, we do process trauma differently, but i don't think it is due to hyperfocus or RSD. it's actually related to my response to your reflection on macabre scenarios above. Macabre scenarios are future projections of what could happen. you could possibly fall off your bike and fall into the river. but there's probably the same chance that you could have a brain aneurysm or be hit by a meteorite. all those things are possible, but so unlikely that it is important to disregard them (which you are now able to do and which is a great thing).

Traumas are similarly macabre scenarios from our past. And the reason trauma can have such a powerful effect on us, even decades after the traumatic event happened, is that it introduces to us the possibility that such a thing could happen again. and if such a thing could happen again, then it is for the safety of the person to keep on serving up the same macabre scenarios from the past as a warning going forward. and importantly, unlike the macabre scenarios that our brains simulate with respect to what could happen in the future, the macabre scenarios of the past are verifiably real: that is, they've already happened. and so... just like with your macabre predictions of terrible futures, experiencing your past traumas is a way that your body is trying to protect you going forward. it's just that... the protection mechanisms are not well calibrated to the dangers of the present (i.e. there) moment.

you also point out something critically important and very poorly understood by many of my colleagues: namely, that bringing up these macabre scenarios again and again strengthens their presence in our day to day rather than helping us to properly understand and categorize these experiences of the past. and this doubly true for those with adhd, because we have less capacity to inhibit these macabre scenarios from the past. they much more easily get "triggered" by phenomena in the present related to traumas of the past. for instance, if you, say, were a person with adhd and suffered physical abuse as a child from someone who hit you with a clothes hanger, then the shape or material or some other feature of a clothes hanger might "trigger" the memory of being hit as a child. there is a much thinner membrane between the past and the present for those of us with adhd.

Work and... Bears

August 31 (Josephine)

Look at me answering questions I didn't know I was answering...

Okay... fuck, another thing that I have been thinking about is work and adhd: for me as a person who had undiagnosed adhd for so long, I always had to be number one or in a specialized position, more advanced than my colleagues, more educated than the leadership team and driven to do better than everyone else, all the time, this was a symptom (superpower, or whatever) of my adhd... Now that I am medicated, I no longer feel the need to be like that anymore... Where do we go from here?

I always avoided promotions for a position where I would have to interact with humans in a personnel role, such as a manager or team lead, but now, I don't know, I'm a lot less rigid and 'nicer' and maybe, just maybe, I would be able to manage a team or do something like that?! I hit the salary ceiling a couple of years ago in my position and have been told that the only way up is to take a management role, etc....

Yeah, but I convinced the leadership team that there is no fucking way in hell that I would or could manage people, EVER, and to quit asking... Do we say "SURPRISE" and talk about our diagnosis (UGH), (honestly, the amount of 'broken pixels' I've found or my whacked out ways of doing shit they wouldn't be surprised in the least) or do we run away and get a new job?? Just kidding on the last part, but seriously! (not going to throw away what I have obviously). But I don't feel 'stuck' anymore, and it's because I'm medicated, for sure. After all, this is NEW.

I don't think that this type of situation would be unique to just me; meds change the way we feel and behave, so why wouldn't everything else start to change with it?!!

I'm not looking for any advice here (I'm sure I'll work it out), BUT I'm just curious if this is a thing, and again, where do we go from here?

Sept 1 (me)

this is an outstanding question.

and yes... this is definitely a thing. it's a positive thing in that it opens up possibilities to you that you actively shelved many years ago. but it is also, as you point out, NEW, and as such takes a fair amount of energy and personal resources to resolve.

here's the way i understand what you wrote: through the lens of lostness and there-ness. in the past, you've always needed to be number one in your professional endeavours. why? is it because you are egotistical? is it the result of feeling superior? is it the result of ambition? i think the answer to all three is no. i think the answer is that you experienced yourself as lost, existentially lost. you had a hard time in assessing your own performance or, in my language, knowing where you were, where your there is and was. and because of that sense of lostness, you could only guarantee your success by always (and i mean always) going full out. 

so now... you're no longer being chased by the bear. and this is a profoundly good thing. but it is also something—one more goddam thing—that we as people with adhd have to contend with. and this falls directly into the category i was asking about earlier, i.e. your relationship to the future. in the past, the bear was chasing you, and you were running for your life. i know that might sound dramatic, but i think that is fundamentally the experience that those of us with adhd have all day, every day for much of our lives. and... it's not a great way to live. it does, however, answer a lot of questions for us on a moment-by-moment basis, and it does make things quite clear.

that is, if you are being chased by a bear, you are in danger. danger is a very good way of getting your body moving, but it is not a very considered or mindful way of getting your body moving. all you know is that danger is behind you and that the way to remain safe is to outrun the others the bear is also chasing. but that leaves you constantly running at breakneck speed in whatever direction feels like the one the bear is least likely to take. this doesn't leave a lot of agency for you to make choices in your life. and it also leaves you in a constant state of panic and aggression. this is also the reason why alcohol might have played such an important role in your life: when you spend all day, every day, being chased by a bear, the systems in your body accept that you are constantly in danger, and your body doesn't know that at 5pm when you close your laptop that the danger is no longer present. but it feels bad to have your sympathetic nervous system running in turbo mode all day, so... ethanol to the rescue. 

but now, you realize that you are not being chased by a bear. you never were. and that can be a very unsettling realization. because you're not being chased by a bear, there's no reason for you to be tearing around the countryside with your hair on fire. you no longer have to compare yourself to your colleagues, because the danger that was present for you for all these years is now gone.

so... why run? why outpace your colleagues? why leave everything on the proverbial field each and every time? you are now able to stop and look around your environment. because you are no longer running for your life, you can stop and apprehend your situation. do you like it? is it good for you? does it serve you well? if the bear is no longer menacing you, what do you do know? or, your final line from your last email, "where do we go from here?"

this is the only question.

i hope what i am about to write doesn't infuriate you: but this is where therapy really begins. you are now, for maybe the first time in your life, in a position to make some considered decisions on behalf of the person you are and the person you wish to be (again... the future). when the bear is chasing you, these are not decisions you have to or get to or have the wherewithal to make. in the past, you've been running for your fucking life, and so... most decisions were made in the moment and for the preservation of your life. but now things are different: no bear. and since you're not running for your life, you have the opportunity to make decisions about how you will proceed. for the first time you get to ask "where do we go from here?" without the answer being "wherever the bear is not." 

this is the time where you get spend time understanding where your there is. and if you're not in the there that is right for you, you get to walk the path to that there. or... you get to make the there that is good for you.