How Cognitive Restructuring Reframes Failure and Erases ADHD Self-Doubt
Low self-esteem and lack of confidence plague many adults with ADHD. Cognitive restructuring, a primary technique used in cognitive behavioral therapy (CBT), encourages a different perspective on your “problems” that can free you from harsh and inaccurate self-judgments.
“I am a failure.”
“I can’t even do the simplest things.”
“Any normal person would be able to do this.”
These are some of the statements I hear from clients diagnosed with ADHD. To help them see themselves the way I see them — and to notice all the ways in which they are successful — I use a therapy technique called cognitive restructuring.
What is Cognitive Restructuring?
Cognitive restructuring is one of the primary techniques used in cognitive behavioral therapy (CBT). The premise of CBT is that our thoughts and beliefs influence our feelings, which in turn influence our behavior. So if we think crappy things about ourselves, we will feel crappy and be less able to do the things necessary to live well with ADHD. Cognitive restructuring is a fancy way of saying, “Change the way you think.”
How do you change the way you think? You can try choosing to believe the opposite of your negative thoughts: I am successful. I can do anything I set my mind to. I am normal. Affirmations like these have their place in your positive-thinking repertoire, but there’s likely to be a part of you that says, “Yeah, right.”
Cognitive Restructuring Tip #1: Seek Out a Different Perspective
One way to change the way you think is to actively seek out a different perspective. What is another way of looking at it? A guy I met at a party said to me, “Everyone has issues. Everyone.” Of course, I argued with him (we with ADHD are pretty good at arguing any point). But I couldn’t meet his challenge to name one person who is without issues. This is now one of my mantras when I’m feeling down on myself. I feel less alone, less of a victim.
You can also use evidence gathering, another staple of CBT. Think about all those times when you were successful, when you didn’t fail. The more examples you come up with, the more you will be able to start to believe that it isn’t true that you fail at everything. You can believe you are successful some of the time.
Cognitive Restructuring Tip #2: Use Metaphor
Using metaphor in cognitive behavioral therapy is an approach I’m especially fond of — and it is effective for my clients. CBT founder Aaron T. Beck, M.D., championed the use of metaphor early on. He saw it as a powerful way to generate alternative ways of thinking. A metaphor applies a concept we understand to something harder to grasp, in a vivid, catchy way. A good metaphor is paradigm altering; you can’t un-see it once you’ve seen it.
To be therapeutically effective, you want the metaphor to be strength-based. You could equate ADHD to quicksand, but that’s likely to keep you stuck. You want the metaphor to suggest a new, positive way of thinking about the situation.
Edward Hallowell, M.D., a leading authority on ADHD and co-author of the best-selling Driven to Distraction, likens ADHD to having a race-car brain and bicycle brakes. He explains to his newly diagnosed patients that their brain is very powerful and capable of winning races (doing well in life). But they have bicycle brakes, so they can’t slow down very well; they are impulsive on many fronts. He describes himself as a brake specialist.
Cognitive Restructuring Tip #3: Reframe Distractions
I like to share the “paperweight metaphor” with my clients. Imagine you and a colleague decide to go to the park and get some work done. You each go to a picnic table and spread out your papers (there are no electronics in this metaphor). You arrange them in neat stacks. You look over and notice that your colleague has done the same. But she puts a paperweight on each of her stacks.
Paperweights, brilliant! But you don’t have any paperweights. The wind blows and your papers fly away. Your colleague looks up for a moment, smiles at the breeze, and gets right back to work, her papers safely secured. You have to track down your papers. You finally gather them up, lay them out, and start to work again. And the wind blows again and you’re back to chasing papers, because you don’t have any paperweights.
You and your colleague are equally smart, equally talented, equally capable. She gets more done because she isn’t affected by the wind (distractions). You are not “less than” just because you weren’t given paperweights at birth like 95 percent of the population.
Cognitive Restructuring Tip #4: Make Sure Your “On” Switch Isn’t Turned “Off”
Another metaphor I like to use with clients with ADHD is the circuit and the switch. Everyone, neurotypical or not, can be compared to a simple electrical circuit. Current runs through the circuit and powers equipment such as a light bulb. Everyone’s circuit has a switch in this metaphor. Turn on the switch and the light comes on. Turn off the switch and the light goes out. The current in people with ADHD is just as strong as anyone’s, and our light just as bright. But our switch is not reliable. It turns itself off when we get distracted or overwhelmed and our light goes out.
We have to keep an eye on the switch and be ready to turn it back on. That means we have to use our coping strategies without fail. Structure, good sleep, diet, exercise — those are the things that keep the switch on. It seems unfair that some people have more reliable switches. But it’s just the switch. There’s nothing wrong with our basic circuitry. That’s the point I want my clients to get.
With metaphor, we can move from “It’s a given that I’m (insert negative belief here)” to the ability to challenge that assumption and generate hope. We can make sense of the problem. We come out of that dark place of feeling alone and misunderstood. There’s a sense of “Ah, that’s a thing.”
Another good thing about metaphors in therapy is that they help clients remember what was said in the session. Information is more likely to be remembered if it’s accompanied by vivid imagery.
Some clients use metaphors to help the therapist fully understand their experience. They can be used to describe a feeling, a thought, or a belief that may be too complex to describe in simple sentences. This shared understanding leads to improved rapport and therapeutic alliance. Metaphors that come from the client are more likely to resonate with them, so I encourage them to do it.
Sometimes in sessions I find the client and I will pass a metaphor back and forth, each expanding on it as we gain clarity. We use it as shorthand: “What happened to your switch?” “What do you want to use as a paperweight?” or “Yeah, there go my bicycle brakes again.” The ADHD community feels misunderstood. Shared metaphor lets them know they are understood, accepted, and valued.
Cognitive Restructuring and ADHD: Next Steps
- Download: Everything You Need to Know About CBT
- Learn: How CBT Dismantles ADHD Negativity
- Read: Putting a Stop to Negative Thoughts
Beth Main, LCPC, BCC, is an ADHD coach, therapist, and founder of ADHDSolutions.net. She specializes in using a cognitive-behavioral approach to helping people with ADHD overcome their challenges and achieve success.
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