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10 CEUs Treating Locking In & Blocking Out: ADHD Adults

Section 5
Conduct Problems with Young Adults

Question 5 | Test | Table of Contents | ADHD CEU Courses
Social Worker CEUs, Counselor CEUs, Psychologist CEs, MFT CEUs

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On the last track, we discussed the ADHD adult’s two types of controlling methods of coping with the ADHD diagnosis. These two types of controlling methods of coping were Manipulation and Blaming.

On this track, we will discuss the ADHD adult’s passive and aggressive methods of coping. On the first part of this track, we will discuss the passive methods of coping with the diagnosis. I have found that adults diagnosed with ADHD who cope with the diagnosis passively will usually have attitudes that are either "Who Cares?" or "Take Me or Leave Me." On the second part of this track, we will discuss the aggressive methods of coping with the ADHD diagnosis. In my experience, the aggressive methods of coping are Rebellion and Perfectionism. At the end of the track, we will outline the "Dissolving Resistance" technique to utilize with your perfectionist ADHD adult client.

2 Passive Methods of Coping
Tim, age 30, works as a cab driver. People tend to like him because he’s "easy-going" and "laid-back." Tim stated, "I usually don’t have problems with anyone because I don’t let anything get to me. Like if the boss asks me to work the graveyard shift – so what? I just accept it, and do it with a smile. I know someone has to do it, so I don’t mind if the boss asks me." However, Tim’s desire to be easy-going for everyone else has caused turmoil within him. Tim frequently suffers tension headaches, and has an ulcer that regularly flairs up.

Passive Method # 1 - "Who Cares?"
As you can see, Tim was an ADHD adult who was coping with his diagnosis passively with the "Who Cares?" attitude. The diagnosis has made Tim feel inadequate, and he often believes that he is a failure. To cope with these feelings, Tim approaches everything with the "Who Cares?" attitude that prevents others from seeing his disability. With the "Who Cares?" ADHD adult, the client does not acknowledge his or her faults. However, the "Take Me or Leave Me" ADHD adult which I will now describe usually does acknowledge his or her faults, as was the case with Stephanie.

Passive Method # 2 - "Take Me or Leave Me"
Stephanie, age 34 office manager, is the first to admit her faults and usually does so with humor, making herself the butt of her own jokes. In one session, Stephanie chuckled and stated, "I know I’m not perfect, and everyone else knows it, too. I’ve decided I’ll just be content with being perfectly imperfect."

As you know, many ADHD adults like Stephanie use humor to create a smoke screen that deflects criticism. While it may sound like this coping method of "Take Me or Leave Me" is an effective one, ADHD adults use this method may be hiding their fair share of problems. As you can see, Stephanie is willing to admit her faults, but she rarely does anything to improve those faults.

2 Aggressive Methods of Coping
Besides the passive coping methods of "Who Cares?" and "Take Me or Leave Me," some ADHD adults will use more aggressive coping methods. Cole, age 26, has carried the label "Punk" since he was in high school. Then, he had academic difficulties in school which caused most other kids to tease him. Cole began using hostile sarcasm to protect himself from criticism.

Cole stated, "People just made fun of me when I made an actual effort in school. I realized that if I started acting like I didn’t care about trying, I’d get more respect. People respect me more when I’m being bad than they do when I legitimately try to be good." Cole’s "bad boy" attitude has stuck with him since he dropped out of high school. His lack of respect for authorities, though, now gets directed at police officers over traffic violations instead of at teachers over classroom disruptions.

Aggressive Method # 1 - Rebellion
As you can see, Cole was using the first aggressive coping method of Rebellion. As you know, toughness projected in Rebellion creates a smoke screen to mask vulnerability. Cole’s hostile attitude intimidates others and keeps them from getting close. While this can be a solution for an ADHD adult who wants to protect him or herself from criticism, it’s a far cry from an effective coping method.

Aggressive Method # 2 - Perfectionism
Jean, age 20 college student, has known she has ADHD since she started high school. Throughout high school, Jean worked hard to keep other students from finding out about her diagnosis. Now that she is in college, Jean copes by being the best. Jean maintains a 3.9 GPA at her university and is actively involved in a variety of organizations.

However, her physical health is suffering. Jean rarely gets more than five hours of sleep a night, and frequently pulls all-nighters to get it all done. Despite her lack of time, Jean can’t bring herself to say "No" to anything.Jean stated, "I work so hard to keep people from knowing I have ADHD. I can’t say no to anything, like a service project, because then people would find out. Then they’d know I wasn’t normal."

Obviously, Jean doesn’t have a clear understanding of what normal is to begin with. Jean is coping with her diagnosis through the second of the aggressive coping methods, Perfectionism. I am stating that perfectionism is aggressive because Jean is actively doing something to cope with her diagnosis. She is trying to do everything perfectly. However, Jean has been a perfectionist for so long that she has inflated ideas about what is normal and what other people, who don’t have ADHD, can accomplish. Sound like a client of yours?

Three Steps in "Dissolving Resistance"
For Jean, it seemed to me that she would continue to use this aggressive coping technique until she came to accept her ADHD diagnosis. Do you agree? I asked Jean to use a simple technique that would help her be more at peace with her diagnosis. I suggested the "Dissolving Resistance" technique. As I explain how the three steps in the "Dissolving Resistance" technique work, think of your perfectionist client. Would he or she benefit from the "Dissolving Resistance" technique?

-- Step One - Let your Mind Wander
First, I asked Jean to give herself permission to let her mind wander.

-- Step Two - Talk Back
I stated, "Second, talk back to any fearful thoughts or feelings that well up in you." For many perfectionist ADHDers, as you know, resistant thoughts and feelings will often arise when they allow their minds to wander. I asked Jean to vocalize some of her resistant thoughts. She stated, "Stop dilly-dallying. You don’t have time to daydream. You need to work on that class project."
I then asked Jean to vocalize what she said in response to those resistant thoughts. Jean stated, "I’m just going to relax for a few minutes. I will get to work when I’m feeling rejuvenated."

-- Step Three - Daydream
For the third step, I explained to Jean that she should allow herself to daydream for a few minutes. I stated, "Although it is not a good idea to allow your imagination to take you too far from reality, a bit of escapism is not always a bad thing."

Do you have a client like Tim or Stephanie who is passively coping with his ADHD diagnosis with an attitude of "Who Cares?" or "Take Me or Leave Me"? Or maybe your client is coping more aggressively through Rebellion or Perfectionism, like Cole and Jean? Would your client benefit from the "Dissolving Resistance" technique?

On this track, we have discussed the ADHD adult’s passive and aggressive methods of coping. The passive methods of coping for an ADHD adult were the "Who Cares?" attitude and the "Take Me or Leave Me" attitude. The aggressive methods of coping for an ADHD adult were Rebellion and Perfectionism.

On the next track, we will discuss the Five Stages of Grief that ADHD adults experience after being diagnosed. These five stages are Anger, Denial, Bargaining, Depression, and Acceptance.

Peer-Reviewed Journal Article References:
Helseth, S. A., Waschbusch, D. A., Gnagy, E. M., Onyango, A. N., Burrows-MacLean, L., Fabiano, G. A., Coles, E. K., Chacko, A., Wymbs, B. T., Walker, K. S., Wymbs, F. A., Garefino, A., Massetti, G. M., Robb Mazzant, J., Hoffman, M. T., Waxmonsky, J. G., Nichols-Lopez, K., & Pelham, W. E., Jr. (2015). Effects of behavioral and pharmacological therapies on peer reinforcement of deviancy in children with ADHD-only, ADHD and conduct problems, and controls. Journal of Consulting and Clinical Psychology, 83(2), 280–292.

Lorber, M. F., & Slep, A. M. S. (2015). Are persistent early onset child conduct problems predicted by the trajectories and initial levels of discipline practices? Developmental Psychology, 51(8), 1048–1061.

Owens, E. B., & Hinshaw, S. P. (2016). Childhood conduct problems and young adult outcomes among women with childhood attention-deficit/hyperactivity disorder (ADHD). Journal of Abnormal Psychology, 125(2), 220–232. 

Perle, J. G., & Vasilevskis, G. (2021). Psychologists’ evidence-informed knowledge of attention-deficit/hyperactivity disorder (ADHD): Evaluating the domains of informational strength and areas for improvement. Professional Psychology: Research and Practice, 52(3), 213–225.

Stanton, K., Forbes, M. K., & Zimmerman, M. (2018). Distinct dimensions defining the Adult ADHD Self-Report Scale: Implications for assessing inattentive and hyperactive/impulsive symptoms. Psychological Assessment, 30(12), 1549–1559.

Walther, C. A. P., Pedersen, S. L., Gnagy, E., Pelham, W. E., & Molina, B. S. G. (2019). Specificity of expectancies prospectively predicting alcohol and marijuana use in adulthood in the Pittsburgh ADHD longitudinal study. Psychology of Addictive Behaviors, 33(2), 117–127.

What are the ADHD adult’s aggressive methods of coping with the ADHD diagnosis? To select and enter your answer go to Test


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