It turns out that the demoralizing thoughts and beliefs that keep us from doing what we want to do can't stand up to the light of logic. As CBT reveals, they're distorted in certain characteristic ways:
- All-or-nothing thinking. You view everything as entirely good or entirely bad: If you don't do something perfectly, you've failed.
- Overgeneralization. You see a single negative event as part of a pattern: For example, you always forget to pay your bills.
- Mind reading. You think you know what people think about you or something you've done — and it's bad.
- Fortune telling. You are certain that things will turn out badly.
- Magnification and minimization. You exaggerate the significance of minor problems while trivializing your accomplishments.
- "Should" statements. You focus on how things should be, leading to severe self-criticism as well as feelings of resentment toward others.
- Personalization. You blame yourself for negative events and downplay the responsibility of others.
- Mental filtering. You see only the negative aspects of any experience.
- Emotional reasoning. You assume that your negative feelings reflect reality: Feeling bad about your job means "I'm doing badly and will probably get fired."
- Comparative thinking. You measure yourself against others and feel inferior, even though the comparison may be unrealistic.
Once you learn to recognize these distorted thoughts, you'll be able to replace them with realistic thinking.
"Understanding how you think is an effective start to making changes in your life," says J. Russell Ramsay, Ph.D., assistant professor of psychology at the University of Pennsylvania. "Changing thoughts and changing behavior work hand in hand. Widening your view of a situation makes it possible to expand the ways you can deal with it."
Undoing a Legacy of Failure
Drug therapy is effective at fixing the errant neurochemistry that underlies ADHD. But drugs are powerless to erase the legacy of bad feelings left by years of coping with ADHD.
"Adults with the disorder have had a tougher time in school, a tougher time in the workplace and in relationships," says Dr. Ramsay. "The end result of these frustrations is a negative view of themselves, the world, and their future. They're quicker to assume the negative, and this can magnify symptoms and interfere with problem-solving. People with ADHD avoid situations in which they've failed in the past, which keeps them from learning new skills."
CBT aims to bring these beliefs into the open and facilitate changing them.
Finding a Therapist
It's easy to find a CBT therapist, but it can be harder to find one who specializes in ADHD.
"My guess is that most cognitive therapists are generalists who don't have specific training in ADHD, but can apply its principles to the disorder," says Judith Beck, Ph.D., director of the Beck Institute for Cognitive Therapy and Research in Philadelphia.
When you interview a prospective therapist, ask about her training in CBT and experience in working with ADHD.
For the names of therapists who use cognitive-behavioral therapy, contact the Association for the Advancement of Behavior Therapy or the Academy for Cognitive Therapy.