First things first

***While writing this post, I was reflecting on my sometimes resurfacing need to be an expert in the client’s problem area. When it comes to AD(H)D, that makes no sense, because I don’t have that expertise. Anyway, I believe that in the end the customer is always the real expert. That was once again proven here by this young man who put me on the right path, so that I could really mean something to him. And thereby improve his sense of control over his own life. It felt good, calm and cheerful to work like this.***

A tense young man sat down in the chair opposite me, his eyes wide, and looked at me intently. He immediately started speaking in a somewhat high-pitched voice, saying that he was mad at himself for blurting “the wrong things” to his friends. And also by not saying what he should have said to them, which upset him because he felt like he was too busy with himself when he was around other people. He was also angry with himself for spending a lot of time in his room without accomplishing anything.

Since he may have been correctly diagnosed with ADHD several years ago, we discussed how that might affect his self-esteem. I tried to comfort him by suggesting that as his brain developed, he would outgrow it. I started to feel a little uncomfortable, why did I want to reassure him and what was the use of that…

As I dug myself deeper into this hole, I asked some questions about when he first behaved like this and continued on how the ever-present squabble between his parents had increased his chances of moving up the AD(H)D dimension. He replied fiercely: “I’m not going to develop if I stay in my room and do nothing”.

When I thought about my attitude, I realized that the night before I had read Gabor Maté’s book on the causes and consequences of AD(H)D. It had set me on the wrong track… I caught myself and asked him, “What do you want to get out of this session?” He wanted to leave this particular session with “a clear plan of action”. A plan for what, I asked? “That was a very good question,” he said, pausing for a moment and searching inside for the answer.

The session had now really begun. As he told me, his first priority was to have enough income to live a normal life without borrowing any more. He needed me as a coach for that. We talked about his current situation, possible alternatives, which alternative to choose, how and when to perform this action. The role he assigned me was to face reality, to make him say what he already knew but wanted to avoid. Sometimes laughing, we began to discover his clever patterns of cognitive distortion and avoidance.

He calculated how much money he needed and how much he could earn. He concluded and summarized: “I have to find a part-time job to pay the costs of daily living. If I reduce my financial worries, my thinking and communication become clear again. And I can find out who I am and what I want with do my life.” As he formed his plan of action, seeing what he had been trying to avoid, his body straightened.

His voice deepened and I now saw a strong and promising young man, who clearly indicated the next steps he wanted to take. At the beginning of the session, I struck up a conversation with a somewhat confused young man with a high-pitched voice, who perhaps considered himself a loser. I now saw another person, a young adult looking me in the eye. When I noticed how straight his back was now, how neatly his short beard was trimmed, we both smiled. He had taken matters into his own hands again.

Excited, I was tempted to return to a more therapeutic approach to get even more results in this session. However, the young man now confidently ended the conversation and said, “You’re making the session too long again.” We both got up and laughed. The sound of a tram reminded us of the outside world. We both looked out the window and saw the busy 19th century Amsterdam street flooded with hurried cyclists.