Adult ADHD is a strength that needs managing

I treat ADHD as a superpower. I say so in the first conversation, and most people look at me as if I have not been listening.

They have just spent twenty minutes telling me about the missed deadlines, the half-finished jobs, the row at home on Sunday and the email they have been avoiding since August. Strength is not the word they would have picked.

So I ask a different set of questions. When has your head worked better than anyone else's in the room? What can you do for six hours without looking up? Who rings you when something has gone wrong and needs sorting in the next ten minutes?

There is always an answer. Usually several.

The strengths are real, and they have running costs

The people I work with who have ADHD tend to be fast, inventive and very good in a crisis. They see connections other people miss. When something interests them they can go deeper and longer than seems reasonable. They are often the warmest person in the building, and the first to notice when someone else is struggling.

Every one of those has a cost attached when nobody has shown you how to run it.

The same focus that carries you through a problem for six hours will not switch on for a tax return. The speed that makes you good in a crisis makes an ordinary Tuesday feel like wading. The sensitivity that reads a room in seconds also reads one flat reply from your boss as proof you are about to be sacked.

Most of what people call the downsides of ADHD are its strengths, pointed at the wrong job or left running with no off switch.

That is the reframe, and it is more than a comfort. It changes what there is to work on. Nobody in front of me needs fixing. There is an engine here, and it needs someone who knows how to drive it.

What I work on

I start with the patterns that cost the most. For most adults it is the same three or four.

The dread before starting comes first. People describe sitting in front of a simple job for two hours, fully aware of what to do and unable to begin. By the time they reach me they have usually been called lazy for thirty years. What I see is a habit running below choice, laid down early and repeated daily, and that is the level I work at with clinical hypnotherapy.

Then the flood. A small criticism lands and the reaction is enormous, followed by the crash and the apology. I work on the reaction itself, so there is a gap between what was said and what your body does with it.

Then the boom and the bust. Three days of extraordinary output, then a week of running on empty and hating yourself for it. Managing the upside matters as much as the downside here. Hyperfocus is worth protecting, and it needs edges: a start, a stop, food, sleep.

And behind most of it, the old voice. "Try harder." "You are so bright, if only you applied yourself." People can often give me the exact classroom, the teacher's name and the colour of the carpet.

Where there is a specific memory still firing in the present like that, I use EMDR, a therapy that takes the charge out of a memory without your having to describe it in detail. The memory stays. The flinch that came with it goes quiet, and the voice loses a good deal of its authority.

Hyperfocus is worth protecting. It needs a start, a stop, food and sleep.

What changes

The first thing people tend to notice is small. They started something without the two-hour run-up. A sharp email arrived and the afternoon survived it.

Then the strengths start doing their proper job. The ideas get finished. The energy lasts the week, because it is no longer being spent on dread and recovery. Partners often notice before the person does, usually because the Sunday row did not happen.

None of this depends on where you are with a diagnosis or what you have decided about medication. Those are your calls, and I work with the pattern in front of me whichever way you have gone.

I do not make the ADHD go away, and I would not want to. The aim is better, healthier performance from a mind that was always capable of it: the speed, the focus and the feeling for people, working for you for a change.