Clinical Psychologist: How To Overcome ADHD Paralysis

1. 0:00 – 0:26

   Intro

   1. APAlex Partridge0:00

      Michaela, thank you so much for joining us.

   2. MTMichaela Thomas0:02

      Thank you for having me. It's exciting to be here.

   3. APAlex Partridge0:05

      I'm so pleased you're here. Uh, I think this is gonna be a really life-changing episode. Procrastination is one of my biggest problems. I've... So ashamed of my to-do list, it's as long as my forearm.

   4. MTMichaela Thomas0:17

      [laughs]

   5. APAlex Partridge0:17

      I've tripped over a suitcase that was from a holiday months ago, so I'm desperate [laughs]

   6. MTMichaela Thomas0:23

      [laughs]

   7. APAlex Partridge0:23

      ... for, for some help. But I guess to start with,

2. 0:26 – 6:01

   Why people with ADHD procrastinate

   1. APAlex Partridge0:26

      and this is super interesting, why do you think people with ADHD struggle with procrastination so much?

   2. MTMichaela Thomas0:34

      Well, it's kind of a bigger point of why the struggle with initiating anything. So we know that task initiation can be difficult 'cause it's part of our executive functioning, right? It's getting yourself organized to start something. It's finding the energy to start something. There's a lot of things that neurotypical people just get up and go, and sometimes that can be hard to even just get off the sofa to go and brush your teeth, 'cause that means you have to get off the sofa. So it's that inertia that can be. Like, we're almost, like, in stuckness, stuck mode, and you can't get going. So if you then have something that you have to do that is not even remotely interesting or fun or exciting or rewarding, like emptying your suitcase, why would you be bouncing off the sofa to do that? There's very little dopamine in doing that. Um, and when we have an interest-based nervous system, we wanna do things that are exciting and fun and novel and give us a challenge and... Or it's on urgency. Like, suddenly your partner is saying, "If you don't, if you don't open, open that suitcase and empty it immediately, I'm leaving you" [laughs]

   3. APAlex Partridge1:37

      [laughs]

   4. MTMichaela Thomas1:37

      And suddenly now you have to, or there's some negative consequence that will come, and then the urgency kicks in, and then the adrenaline kicks in, and then you might be able to get off the sofa. Now, I work a lot with helping people find motivation that isn't so adrenaline-fueled, that isn't so cortisol-based, 'cause it's quite stressful if you leave everything to the last minute. And don't get me wrong, I'm still ADHD myself, I leave things to the last minute. It's kind of how it works. But when you learn to work with your nervous system, when you work with motivation that's kinder and more compassionate, you can learn to do this and, and kind of gamify it and play with it in a fun way so that the procrastination doesn't turn into a m- a massive doom. Uh, and instead you can kind of, "Yeah, how can I make this more interesting and gamify that?" So I'm happy to get into more details about how you do that.

   5. APAlex Partridge2:24

      Typically, I leave it until the next holiday comes around, and then the urgency becomes now.

   6. MTMichaela Thomas2:31

      Yeah.

   7. APAlex Partridge2:32

      The, the... There's a contradiction though, right? Between, like, the impulsivity that we associate with ADHD, the wanting to do stuff now, and the procrastination that stops us from being able to, to do stuff now.

   8. MTMichaela Thomas2:45

      Yeah, absolutely, and that's, that's a paradox. That's weird, right? Like, why are you suddenly unable to, to stop yourself from doing something when you've not been able to get yourself going all day? Well, it's again coming back to interest. If you get an impulse you wanna do something, that's usually because it's a spark. Like, something has sort of sparked and got triggered that, "Oh, wow, that sounds fun," or, "I wanna do that," or you get a novel idea of something. So that's where you can then shift yourself out of the inertia quite quickly because you got the spark. You got something to get you going, a bit of dopamine. Whereas that suitcase that's been there so long, that's probably, like, part of the furniture by now, you don't even see it anymore, it blends into the background, that has no dopamine. That has no interest, and it's just a threat. Like, "You must do this because otherwise I'm a failure of a human being who can't unpack my stuff, and I'm... can't do adulting," and all of the self-criticism that comes in. Like, "Why can't I just empty the suitcase like normal people do?" Like, do you recognize any of those kind of thoughts that come in into your-

   9. APAlex Partridge3:45

      Oh, huge. Yeah. It makes you truly believe that you're lazy.

   10. MTMichaela Thomas3:47

       Yeah. No, you're not. You've just got an interest-based nervous system that's wired differently to other people's.

   11. APAlex Partridge3:54

       If we rewind just a tad, what's your specialty, your mission in the world of ADHD in general?

   12. MTMichaela Thomas4:01

       So as a clinical psychologist, I work with mental health and the overlap between that and neurodivergence. And with my specialism having been perfectionism for, like, 15 years, I noticed that a lot of the things that comes with perfectionism, like people-pleasing, stress, burnout, anxiety, low mood and depression, when you feel like you really haven't measured up, all the way down to low self-esteem and low confidence, all of that was also possible to see in undiagnosed ADHD women. So I started seeing through my ongoing therapy clients that there was something that wasn't quite explaining why they had repeated cycles of burnout, repeated episodes of anxiety, and they felt misunderstood. There was something else that wasn't just about the mental health. So my mission really is to identify these women and help them find a way to approach themselves with more compassion and kindness and self-acceptance. Because when we do that, we can actually unlock the things that we need to put in place in our lives to survive and live well with ADHD, and that's such a multi-pronged approach. There's so many things that we need to work on that is utterly overwhelming when you first start out. "Oh, no, I need to think about my sleep and my nutrition and my exercise and, and this..." There's a lot. And so my mission is to really help people give themselves that permission to unlock those things, to work on those things, to make them non-negotiable, medicinal even. Because if you think, "Oh, no, I don't need to prioritize this. I don't need to put myself first," you're not gonna really look after your ADHD, and the symptoms will be worse. So that's really the... what I'm trying to do. I'm really passionate about that compassion journey for those women and softening their self-criticism and shame that decades of not knowing that you are differently wired can do to you.

   13. APAlex Partridge5:54

       Perfectionism is such an interesting topic. I feel like it's something I struggle with, and it stops me from starting a lot of things-

   14. MTMichaela Thomas6:00

       Yeah

   15. APAlex Partridge6:00

       ... and it can lead to

3. 6:01 – 13:47

   The link between perfectionism and procrastination

   1. APAlex Partridge6:01

      procrastination. Is there a link that's deeper there between perfectionism and procrastination?

   2. MTMichaela Thomas6:07

      Yes, there is. And you might not remember this, but first time I met you at the Neurodiversity in Business, um, Conference a couple years ago-

   3. APAlex Partridge6:15

      Yeah

   4. MTMichaela Thomas6:15

      ... I asked a question about perfectionism, because you were talking about anxiety, and I was like, hang on a minute, there's definitely perfectionism underneath here. And at that point I was, you know, quite new to your work and whatnot. So I think there is a strong link between procrastination and perfectionism. But what's really important to think about, uh, correlation and not causality. So just because you are a perfectionist doesn't mean you always procrastinate, and just because you procrastinate doesn't mean you are a perfectionist. They just- there's overlap, right? And often that is because procrastination for perfectionism, uh, p- procrastination for a perfectionist isn't about laziness, it's about avoidance, and often it's avoidance of fear, the fear of failure, fear of not being good enough, fear of being judged, fear of other people noticing that you're not measuring up, fear of your own standards not being met, fear of past memories even of, of hearing from other people, like parents, siblings, coworkers, peers in school, that it wasn't good enough. So it's not that you're trying to avoid something and procrastinating starting that task because you are lazy, it's often because what if the end result isn't good enough. So I think of it as there are three stages where people really struggle when it comes to procrastination. It's getting started, continuing, and finishing, and not everyone struggles with the same thing. I'm sure you've heard of the whole like 80% or 95% issue of we're nearly there and I just can't get it over the finish line. That's a very different type of procrastination to the one that is about starting and getting going. So it's really difficult to say exactly this is how perfectionism feeds the procrastination 'cause it's so unique to what that individual's circumstances are. It really depends. So what we do when we work with this in therapy or coaching, you do a f- a functional analysis. You basically formulate what's going on, looking at patterns. What happens when you try to, uh, start something that's new or scary, or you've not done this before, or you're worried about failing? And then understanding what thoughts are going through your mind. What do you notice your, in your body? How does that feel? Um, and what is your behavior like? Like, getting really aware of those avoidance patterns, noticing it as it's happening, that is really powerful. So I can't get people with ADHD to no longer ever procrastinate. What I can do is to help them notice when they're in the middle of that, noticing it as it's emerging, as it's happening, and then soften that with a compassionate voice saying, "Of course I'm gonna wanna procrastinate that. This is really scary." I procrastinated looking at your, your questions for ages, and I even told you about that, saying, "Wow, there's a lot of questions in that email."

   5. APAlex Partridge9:02

      [laughs]

   6. MTMichaela Thomas9:03

      Um, let's see if I can break this down to myself. And I didn't procrastinate that because I was lazy, I procrastinated because it was scary. Does that make sense?

   7. APAlex Partridge9:11

      Yeah, totally. Yeah. I feel like the optics of procrastination can look like laziness-

   8. MTMichaela Thomas9:17

      Yeah

   9. APAlex Partridge9:17

      ... for someone who doesn't quite understand the complexities of what's going on inside their mind and what's causing that paralysis.

   10. MTMichaela Thomas9:23

       Yeah.

   11. APAlex Partridge9:24

       How do you think procrastination generally can look like from others, partners, bosses, friends?

   12. MTMichaela Thomas9:32

       Yeah. And I, I think you've, you've said it there that it's, it's often frowned upon. It's often seen in a negative light because people don't realize the agony, the analysis paralysis that's happening on the inside. They're just seeing the, the, the output, they're seeing the behavior not being done, they're seeing the box not being ticked. But if you're looking, you know, if you roll that back, it's often to do with overwhelm, it can be lack of clarity, uh, not knowing what I'm supposed to be doing, and then not daring to ask for clarification. So if we're thinking about something happening at work, and your boss is at you because you've not done this thing, but you don't even know what you're supposed to be doing and you're too scared to ask for clarification. So the procrastination is not a simple thing, and it's not everyone procrastinates in the same way, but it's we need to look underneath the surface. What's going on here? What is the function of that avoidance? Usually that avoidance helps you to not face one fear that is bigger than another fear. So of course you know you're gonna be late, or you know you're gonna, uh, be questioned, but that is still less scary than the prospect of trying to do the thing and the thing doesn't work and you get laughed at or, you know, have to face your own sort of incompetence. So it's, yeah, it's very, very fear-based. That's why a lot of pro- uh, perfectionists are also anxious, 'cause they're anxious and worried about not being good enough, about failing. So yeah, it's not an easy one to, to answer. Anyone's listening who feels like, "Well, I procrastinate loads," well, you might hear some aspects of what I'm saying on this episode that resonate and not others, and that's okay. Everyone's very unique in how they procrastinate.

   13. APAlex Partridge11:05

       I feel like it's totally exhausting, the overthinking that leads to the procrastination. You're o- like you said, para- a- analysis paralysis?

   14. MTMichaela Thomas11:14

       Mm-hmm.

   15. APAlex Partridge11:15

       Like, it, it's, it's so all-consuming and so exhausting. But the person who you're with, your partner, your boss, your friend, whatever, they don't see that.

   16. MTMichaela Thomas11:24

       No.

   17. APAlex Partridge11:24

       So it's must be really hard to explain why you could be potentially burnt out through the exhaustive process of overthinking, whereas the optics of what you're actually doing might just be lying on the sofa doom scrolling.

   18. MTMichaela Thomas11:36

       Yeah.

   19. APAlex Partridge11:36

       And you, you have to explain to your partner, "I'm so tired."

   20. MTMichaela Thomas11:39

       Mm.

   21. APAlex Partridge11:39

       But that can lead to conflict because your partner doesn't necessarily see that internal workload, the analysis paralysis that you're describing.

   22. MTMichaela Thomas11:49

       Yeah. And I guess you need to name it to tame it, so being more vocal about that. Um, as someone who does couples therapy as well as individual therapy, I see that a lot between partners, that they need to name and make, make the unconscious conscious so that what you see in your partner lying there on the sofa scrolling, you're like, "Ugh, why aren't they doing anything?" Or sometimes, uh, partners tell me that they can see their spouse just literally standing, staring, and you're like, "What, what are you doing?"And they're just in that paralysis, they cannot physically move. And being able to name that as much as you can with, with a partner, hopefully your partner is supportive, and just to say, "I'm actually really stuck. I don't know what I'm gonna wear tomorrow." Um, and being able to name that, knowing that a lot of us, uh, ADHDers, are verbal processors, so just having that sounding board. Uh, I do that with my husband all the time. Uh, he doesn't need to come up with any answers. Sometimes I just need to agonize [laughs] out loud and to say, like I did getting here to the studio, like, "Which, which route do I take?" And just having that acceptance and that compassion between the two partners that, "Actually, I, I need a bit of help with this," that's really difficult, 'cause that's vulnerable to say, "I'm really stuck. I need to probably sound this out. It's gonna take five minutes. Can you help me with that?" Rather than seeing you lie down for three hours and do nothing, and it leads to conflict, get ahead of that pain and say, "I can see where this is going. I can see I'm gonna agonize on this and go around in a, in a doom spiral. Can you help me, and can we sound it out?" Doesn't have to be more complicated than that. You save so much time and conflict and awareness. And if you are with a partner, I don't wanna be, like, fatalistic here, but if you're a partner, you... With a partner you can't do that with, you, you need to consider what's going on in your relationship, if they're that unsupportive that they can't let you talk it through for five minutes so you'll feel less agony inside you. And it's, again, making the invisible visible, sharing it with another person, and you feel less alone in having it as well.

4. 13:47 – 18:19

   The emotional toll of perfectionism

   1. APAlex Partridge13:47

      What's the emotional toll of someone who doesn't have a supportive partner, someone who really struggles w- with procrastination, perfectionism, to the point where they get exposed to so many comments, "You're lazy. Why can't you just start the task?" What does that do to their self-esteem?

   2. MTMichaela Thomas14:03

      I mean, it completely erodes it. I think the... You know, we know the statistic of receiving 20,000 negative comments by the age of 12. Um, and we think about my community of women who are late diagnosed, who didn't know they were ADHD, who got all these comments of, "You're too much," and, "You're not enough." That has been an i- internalized self-criticism. So we've taken the negative comments externally and brought them inwards, and we don't need people to be negative anymore. Even when everyone's positive, giving you appraisals that are wonderful, that inner critical voice is so loud that that will trump anything that other people say. And yet we are seeking that external validation, constantly looking for that approval to feel good enough on the inside. But it's not gonna be strong enough to override that inner critical voice, unless you work with softening and soothing that voice with compassion. So it's an inside job that takes a long time. It's been laid down over, often, decades, so we can't then expect that to just go away. Sorry if you listened to this podcast thinking, "If I listen to this episode, I'll magically be kind to myself." No, but you can start chipping away at it, slowly, gradually, doing little moments of checking in with yourself and just saying, "Well, no wonder that I'm really worried about that. No wonder I'm agonizing about how to get to the studio on time," or, "No wonder I don't wanna unpack my suitcase." So that, that phrase, "No wonder that," is a really lovely little one just to say. You don't have to do anything else with what you find. It's just a little permission piece of compassion that, "Wow, this is really hard. It is hard for me. I'm differently wired, and I agonize over small decisions." You know, it's, it's a known fact that we bring, bring calm to the chaos. We can do extraordinary things under pressure. We... You know, some of my clients are working in the emergency services, where they run towards danger, where everyone [laughs] else is running away from it. We know we can bring calm to chaos, and so we will bring chaos to calm, and utterly overthink what outfit you're gonna wear for an ADHD Chatter podcast recording. Um, I've not overthought the questions and the answers I'm gonna give you today, but I agonized over what I was we- what I was gonna wear. That's, that's kind of how it is, right? We can sit in the complexity, while we struggle with the simplicity, and that is a big thing to understand when you procrastinate. The, "Oh, well, no wonder that I'm gonna procrastinate this, because I don't have clarity and it feels overwhelming. It's a long list, and it... Can I break it down somehow?" I think you talk about the-

   3. APAlex Partridge16:32

      Mm-hmm

   4. MTMichaela Thomas16:32

      ... turning the iceberg into ice cubes. Um, how can I do that? How can I make it simpler? And then I'm less overwhelmed by it, and I can start, 'cause then you can do... Well, maybe can I even put it into crushed ice. Can I do one little ice chip and then, you know, take one sock out of that suitcase? And that's it. Done. And then eventually you chipped away at it, and all the socks are emptied, and you're done. So giving yourself the permission to do it differently to how other people do it. Maybe you can't ever in your life empty a suitcase all in one go. So be it. Can you chip away at it? 'Cause if you're not approaching that with compassion and acceptance, you will battle against it, and the suitcase will be there forever after, haunting you, laughing at you. Whereas you think, "Actually, I'm gonna do this my way, my ADHD way. I'm gonna gamify it," or, "I'm gonna listen to one song at a time. I'm gonna empty as much as I can in my favorite song that's four minutes," or whatever, those kind of things, that you can play with it. And the acceptance piece is saying like, "Yeah, okay, other people don't need to do that, and so be it. That's fine."

   5. APAlex Partridge17:35

      So much good advice there, and it's so important, as you said, to take those ice cubes sometimes, and have no shame if you need to really crush those down into-

   6. MTMichaela Thomas17:44

      Mm

   7. APAlex Partridge17:44

      ... crushed ice.

   8. MTMichaela Thomas17:45

      Mm-hmm.

   9. APAlex Partridge17:45

      Sending an email can be such a daunting task for me, and some days... And I have to give myself grace and say just turning on my laptop is a piece of crushed ice sometimes. Opening up the web browser is another one.

   10. MTMichaela Thomas17:57

       Yeah.

   11. APAlex Partridge17:57

       And eventually I get the momentum that gets me writing the email and, and clicking the send.

   12. MTMichaela Thomas18:02

       Yeah.

   13. APAlex Partridge18:03

       Many people are listening to this podcast after years and years of feeling misunderstood, being called lazy, and not understanding why. And during that time, maybe they've been diagnosed, wrongly or rightly, with an anxiety disorder-

   14. MTMichaela Thomas18:18

       Mm

   15. APAlex Partridge18:18

       ... depression.

5. 18:19 – 20:56

   Can perfectionism cause depression

   1. APAlex Partridge18:19

      Can-P- perfectionism, procrastination, can that cause anxiety and depression?

   2. MTMichaela Thomas18:26

      Yes, it can. It, it's almost like two different cycles are going on. So when... If you have perfectionist standards, uh, or very high standards, perfectionism isn't a clinical diagnosis as such. It's not a mental health diagnosis you can get from your, uh, from your therapist or a doctor. It's, it's an umbrella term that houses a lot of things sitting underneath it, everything from, um, disordered eating or eating disorders. Uh, it's very common in anorexia nervosa. Um, things like panic disorder, social anxiety, so all of the anxiety disorders can sit under that umbrella as well, being fueled by perfectionism. OCD and perfectionism strongly overlap. So there's, there's a lot of that anxiety that is often about your nervous system, your, your threat system is really on high alert, looking out for danger, that you're not gonna be good enough, you're gonna fail, and that can take various forms, like having a panic attack before you're supposed to do something that requires a lot of performance because it might not be good enough, right? So now we're building that up. Or it might be social anxiety fueled by perfectionism, where you feel like everyone's gonna judge you, and again, you will never be good enough, and people will laugh at you, and you feel humiliated. So perfectionism can fuel all of these different areas, but it's not a diagnosis in itself. It's what we call trans-diagnostic, running across those. So if you think about it, it's almost like one side of it is anxiety, and the other one is depression. So the anxiety is almost like the future-based bit where you think, "Maybe you won't be good enough. What if I'll fail? What if, what if, what if?" And that builds up into stress and pressure, obviously, in your nervous system, whereas the depression side is, "Ah, I knew it. I failed. Nobody liked it. It wasn't good enough. I'll go home after here, after here and, like, agonize and be like, 'Oh, he's nodding his head a lot, but he probably hated it.'" You know, that's the kind of the self-criticism and the shame that fuels the depressive side when you think it's a fact, "I knew it. I didn't reach my standard." And that's how both anxiety and depression fit in with perfectionism, because it depends on where it lies in time, and we know that those who have high levels of self-criticism and shame don't necessarily benefit to the same extent of, say, CBT, cognitive behavioral therapy, for depression or anxiety. They are more likely to benefit from compassion focus therapy or acceptance and commitment therapy because they address shame and self-criticism.

6. 20:56 – 22:07

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   1. APAlex Partridge20:56

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7. 22:07 – 26:22

   The 3 circles of emotion

   1. APAlex Partridge22:07

      You mentioned a fascinating theory off camera-

   2. MTMichaela Thomas22:09

      Mm-hmm

   3. APAlex Partridge22:09

      ... about the 3 circles of emotion. Could you elaborate again?

   4. MTMichaela Thomas22:13

      Yeah. So in compassion focus therapy, the, the founder of that theory, Paul Gilbert, he talks about 3 circles of emotion, and I think they are really important to know when you're thinking about why perfectionism happens, why we are high-striving. So there's three parts to it, threat, drive, and soothing, and the threat system, we need that for survival. That is where we feel a sense of adrenaline and cortisol, and that's where we protect ourselves from danger. So it's about safety, safety from harm, and for anyone who's listening who has ever had an experience of RS- RSD, your threat system gets activated when someone says something and you think, "They hate me now," um, when you've made a mistake, when you've had a negative comment, your threat system comes alive. Um, and that is the thing that can help you mobilize to take yourself into safety quite quickly. Need that to survive, otherwise you would cross the street and be run over. Not good. We also have the drive system, which is a sense of joy, excitement, vitality. That's the thing that we get, that way we get dopamine. We can get that sense of high. Too much of the drive might make you manic. Not enough of the drive might make you depressed. So a sweet spot there where you have enough dopamine, enough of that excitement. And lastly, the soothing system, which is where we feel a sense of being at ease, safe, at peace. It's our rest and digest. That's the parasympathetic nervous system where you feel like, "I am calm and connected, rest and digested." Now, the really interesting thing with these three models is that in perfectionists, we see the motivation for them striving for things, getting the next accolade, doing the next big achievement, reaching the next goal, is not driven by the drive system solely, which is the system that gets us to do stuff and get things done. It is driven by threat-infused drive, so wanting to do something because otherwise you might feel bad about yourself or you might feel ashamed, so that's a threat coming in there. Or hitting the next goal, getting that next promotion, because otherwise you might worry that your parents are gonna think you're not good enough.That's not the same as, "I want this promotion 'cause I can really see how much I would enjoy that next job, and how much I would en- enjoy that role, and the change I can make." That's driven by pure drive, and we know that when you do something that's driven by that threat-infused drive, the fear of failure, fear of success even, you're much more likely to go into burnout, because you're pushing yourself beyond your limits, and you're overdoing it, and you're not listening to your body's signals that you need to slow down or stop because you just need to do the next thing, which is very common in ADHD and perfectionism, that you're constantly pursuing the next thing without getting any satisfaction for having hit that goal, and at the end, you have all the accolades but still feel empty on the inside.

   5. APAlex Partridge25:09

      So there can be a fear of letting someone down.

   6. MTMichaela Thomas25:12

      Mm-hmm.

   7. APAlex Partridge25:12

      Fear of being triggered, like the pain of RSD can be a motivation.

   8. MTMichaela Thomas25:17

      Yeah.

   9. APAlex Partridge25:19

      What if you fear letting someone down, but there's so many moving parts, there's an overwhelm that stops you getting over the start line, keeps you in procrastination? Can that create quite an internal turmoil for that person?

   10. MTMichaela Thomas25:32

       Absolutely, 'cause that overwhelm means that you then don't take any action, 'cause you've already expended all your energy on being overwhelmed in, you know, burning calories in your mind by just obsessing, uh, and agonizing, that you then don't have any energy, energy left to do the action. That means you're not pr- making any progress. And often we see that perfectionists are so keen on hitting a certain level that they then don't take actually the steps that makes them have progress. It's all or nothing. So if I can't do it perfectly, then why not... But not... Why bother? You know, my clients would say stuff like, "I can't meditate 'cause once I've missed one day on Headspace-

   11. APAlex Partridge26:10

       Mm

   12. MTMichaela Thomas26:10

       ... I've broken my run streak, and then there's no point." Or if they can't meal plan for six weeks, they won't plan what they're gonna eat tomorrow, because that's not... It's all or nothing. If I can't do it fully and perfectly and brilliant, then I won't try.

8. 26:22 – 29:33

   ADHD procrastination VS Autistic procrastination

   1. APAlex Partridge26:23

      What about the differences between autism and ADHD? Is there a difference in how perfectionism shows up in those two categories?

   2. MTMichaela Thomas26:30

      Yeah, a little bit, but as we've discussed, uh, before as well, and you've had brilliant guests on the show talking about AuDHD, um, there's such an overlap as well. There's obviously a lot of people who are autistic who are also ADHD, and vice versa. But the autistic side of perfectionism is a lot about control and preventing anxiety, having certainty, wanting to feel like things are predictable. So then that type of perfectionism can be seen in anorexia, when someone is controlling their, you know, controlling their body weight or body size or food intake when everything e- else around them is unpredictable. That can give them a sense of calm and control. Whereas the ADHD side of perfectionism is, can be much more about the, the RSD, or having had so many comments in the past for being messy or being late, and being everything but perfect, actually, that they then work really hard to try to keep that under wraps and not showing people what a mess they are underneath it. I even... Actually, one of my most popular episodes I recorded on my own podcast is called You Can Be A Hot Mess And Still Be A Perfectionist. Because a lot of people say to me, "But, but I'm not perfect. I'm, like, I'm terrible. Like, my house is a tip. I, I'm always late. Like, h- how can I be a perfectionist when I'm clearly, like, chaos on legs?" And that's not what perfection- perfectionism is. It's not about the end result, it's about s- striving and the journey towards that, that you never feel satisfied w- w- with what you've done, and you would always question, "How could that have been b- been better?" in a self-critical way, not in a growth way. Um, so yeah, it's exhausting, and then striving for perfect that way makes you vulnerable for burnout.

   3. APAlex Partridge28:09

      I suppose the perfectionist might appear perfect, or even productive from outsiders, but internally, their home, like you said, could be chaotic, because it's too much to manage both their internal world and their outward appearance?

   4. MTMichaela Thomas28:26

      Yeah, especially for women who are late diagnosed when they become parents, because before that, they could maybe work really hard in a senior job, and work extra hours to perfect emails or read things, and perfecting their slides to make sure everything is neat, and then they could do that. But then the week you have kids, then there's no rest on the weekend. You can't just crash into your weekend because you've overworked in the week. Suddenly, you have to... Something's gotta go, and then there's a lot more chaos. Kids bring mess. They are not tidy creatures, as I speak from experience. Um, then that's where that equation no longer works, and then you add perimenopause on top of that. So a woman who has kids, who might also be neurodivergent, who's got a senior role, and she's got high standards for how she should parent, how she should be at work, how she should be as a partner, and thinking, "Oh, never mind, I also have to do my recycling, and do my f- my face to not get wrinkles," and all the pressures, the patriarchal pressure of perfection on women today, it is just a perfect storm, pun intended, and that leads then to burnout.

9. 29:33 – 31:21

   The hidden cost of perfectionism

   1. APAlex Partridge29:33

      What's the cost of perfectionism? If something's gotta give, what, what do we see gives? What's the cost?

   2. MTMichaela Thomas29:40

      Sanity.

   3. APAlex Partridge29:41

      [laughs]

   4. MTMichaela Thomas29:42

      Yeah, inner peace. Um, but also physically. What we see as markers of, of especially women that I support, that they've gone beyond their own body's boundaries, is that everything from hair falling out to their gut being in, in disorder, um, skin issues, autoimmune conditions, all the things that we also know is related often with neurodivergence. When you are not respecting your body's natural resources, how much energy you've got to your disposal, if you use up all your spoons, to use spoon theory, you will pay the price for that. So there could be things like feeling really exhausted, having frequent, uh, inflammation in the body, frequent infections, picking up cold after cold 'cause you're never resting properly. You're never getting a chance for your body to reset and recover and come back into the soothing. You're constantly operating in the threat and the drive to get more stuff done. As you said, on your to-do list that is longer than you are, that's probably a perfectionistic part to that as well, is setting ourselves really unrealistic long to-do lists that is just inhuman for us to-To even manage to complete them. So high pressures, unrealistic standards for yourself, and never letting yourself recover and rest and have downtime and really appreciate what you've done and be proud of that. So that is what the drive system looks like when it's fueled by soothing, when we're actually kinder to ourselves. Then you can do that. You can hit the accolades, you can do all the aspiring brave, proud things that you wanna do in the, in the world to create impact, but with less impact on yourself.

10. 31:21 – 33:06

    The reality of ADHD burnout

    1. APAlex Partridge31:21

       How bad, how severe can burnout get? If someone does just keep striving for perfection, they might even have entered burnout, but they're not aware of it, they just keep pushing forward. How, how bad can that look like?

    2. MTMichaela Thomas31:35

       Well, there's the, when the, the kind of engine has come to a full stop, when you are unable to get out of bed, when we might have a, you know, an acute depressive episode, uh, the physical exhaustion is, is there. You can't take care of your kids anymore. You can't... You just need to sleep. You just want to rest. And that's when we have had, you know, proper chronic fatigue coming, and that can lead to chronic pain. Um, but I see a lot, lot more of kind of a, a, an over-functioning version of that. So they are still going, but underneath the surface they have like a perpetual sense of doom or a low-grade level of anxiety. And so they say to themselves, "But I've not hit the wall. I can still get up in the morning." And that's almost like a treacherous place to be, 'cause then they're still performing their duties, they're still doing the thing, but not giving themselves, uh, any rest. And I've had women who would even sort of like wish that they would break a, break a leg or something so they would have a reason to rest and not... and, and be able to say to their partner, "Oh, I can't, I can't parent, so you're gonna have to do it now." 'Cause then they would get the full permission that they don't give themselves to properly stop. And I think it's really scary that it has to come to that ultimatum of being ejected out of the car-

    3. APAlex Partridge32:47

       Mm-hmm

    4. MTMichaela Thomas32:47

       ... kind of thing. And hence why I talk about pause, purpose, and play. You need to pause before you come to a full stop, 'cause some of that damage cannot be reversed, and it can take years to recover from that kind of proper fatigued episode of burnout. So why not try to be kinder to yourself before that

11. 33:06 – 38:23

    Michaela’s ADHD item

    1. MTMichaela Thomas33:06

       happens?

    2. APAlex Partridge33:06

       I wanna move on to my favorite part of the show-

    3. MTMichaela Thomas33:09

       Mm-hmm

    4. APAlex Partridge33:09

       ... which is the ADHD item section.

    5. MTMichaela Thomas33:11

       Mm-hmm.

    6. APAlex Partridge33:12

       Every week I ask my guest to bring in an item that most represents ADHD, and your item has been patiently waiting underneath this cloth-

    7. MTMichaela Thomas33:19

       [laughs]

    8. APAlex Partridge33:19

       And I'm going to reveal it now.

    9. MTMichaela Thomas33:24

       Wee.

    10. APAlex Partridge33:24

        Wee. That is two sloths.

    11. MTMichaela Thomas33:27

        Yes.

    12. APAlex Partridge33:28

        Why? [laughs]

    13. MTMichaela Thomas33:29

        So one is mine.

    14. APAlex Partridge33:31

        Okay.

    15. MTMichaela Thomas33:31

        And they are sloths because when I asked my nine-year-old son what to bring as an item for today, he said, "Clearly you need to talk about sloth mode." So sloth mode is what I lovingly call it when we need to slow down. Again, I talked about the three systems, so s- sloth mode comes into the soothing mode. When you do it intentionally, slowing down in a way that works for your busy brain and busy body, then you start to rest and recover and you start to calm down, and that soothing system actively down regulates threat. So the oxytocin we get from being in soothing, so give this a little cuddle.

    16. APAlex Partridge34:08

        Yeah, very s- cozy.

    17. MTMichaela Thomas34:10

        It's very cozy, and it's weighted. For anyone who's not watching but actually just listening, this is a, a cuddly toy that is a sloth, and it has beads in it, sort of wheat beads that you put in the microwave. And I love it because it's something tangible to hold on my lap to remind me to slow down, and because there's a bit of a weight to it, it can be quite grounding. And even when I meditate, I sometimes need to move something, like stroke my thighs or rub my two thumbs together, and sitting with the little sloth, I can sort of hold onto those little cute little paws, and it's a physical reminder that I need to slow down. So it sits on my bed-

    18. APAlex Partridge34:50

        [laughs]

    19. MTMichaela Thomas34:50

        ... or it sits, sits on the, uh, um, sofa or whatever. And it's also s- a conversation starter for my kids to, to, to understand that after we've done something stretchy, when you have reached an achievement or done something really hard, you need to allow yourself that permission to, to sloth mode on, basically, because otherwise we don't have that recovery. It's okay for the body to handle stress, and we know that ADHD is basically perpetual stress responses.

    20. APAlex Partridge35:18

        Yeah. [laughs]

    21. MTMichaela Thomas35:19

        So we need to have a way to just bring that slowing down o- uh, on a little bit. So sloth for me represents that if I don't intentionally bring it on, I'm gonna crash into it, and then that's where the paralysis comes in.

    22. APAlex Partridge35:34

        Mm.

    23. MTMichaela Thomas35:34

        That's the procrastination that you get as a bit of a hyper-focus hangover. If you've been working hours and hours on end without taking a break, not going to the toilet, neglecting your physical needs, hard relate for a lot of people listening, I'm sure, then you tend to have that energy depletion for the next day. You probably don't do very much the next day because you've burned through the cylinders. Doing little bits of slothing here and there means that you avoid that uneven performance and you're a little bit more paced by saying, "Right. Now, for instance, today I'm doing a big podcast. Tomorrow I'm doing a lot less in my workday than I would normally," because it's, it's that reaction to counterbalance the big stretchy thing without getting overstretched. So that's why there's a little sloth here as my item. So I think of that as one of the many faces of ADHD, and I've been working on a little book of compassion for ADHD where I want to illustrate some of these faces. So sloth is one of them, and raccoon is another. As you can see, I've got raccoons on my dress.

    24. APAlex Partridge36:35

        Yes.

    25. MTMichaela Thomas36:36

        That's the very sort of the-

    26. APAlex Partridge36:37

        [laughs]

    27. MTMichaela Thomas36:37

        ... cheeky, hyperactive, little rebellious part of ADHD.But there's also the meerkat, uh, which has that frantic, curious, anxious, nervous energy, has to be like, "What's going on? What was that?" And when I had my own ADHD assessment done, my sister gave information about, you know, supporting information about what I was like as a child, and she said, "Michaela has basically two modes, uh, meerkat and sloth." And it stuck with me since then, so I credit my sister for that idea for the book. Um, I just need a publisher for it now.

    28. APAlex Partridge37:09

        [laughs]

    29. MTMichaela Thomas37:09

        Hint, hint. Hint, hint. Um, so yeah, that- that's it, sort of how I'm thinking about upregulating your energy or downregulating your energy. If you are in sloth mode, then can I borrow a little bit of the meerkat energy? What would, what would stimulate you? What would get you going? Is it listening to some upbeat music that would make you a little bit more raccoony or meerkatty? And it's like knowing that with awareness, where am I at? How much energy have I got? What's my battery like? Do I need to go up or do I need to go down? That's probably the biggest question I teach my clients, of to having that compassion for yourself, the permission piece, and the self-awareness, the self-acceptance to say, "I don't have much capacity. I need to go into sloth," or, "I have actually quite a lot of capacity. I can flurry through the house like a little raccoon." Um, and just being okay with that, that it's gonna fluctuate from day to day, and especially for the women I support, from week to week-

    30. APAlex Partridge38:01

        Mm-hmm
12. 38:23 – 42:27

    Audience questions

    1. MTMichaela Thomas38:23

       Yeah.

    2. APAlex Partridge38:23

       I'm gonna move on to the audience question, which is called the washing machine of woes, because my item is a washing machine because I always leave my clothes in the machine after the cycle finishes, and I always ask the guest, do you do that?

    3. MTMichaela Thomas38:37

       Yes.

    4. APAlex Partridge38:37

       Yes.

    5. MTMichaela Thomas38:38

       And then you have to do the rinse and spin-

    6. APAlex Partridge38:39

       Yeah, exactly

    7. MTMichaela Thomas38:40

       ... uh, all the time.

    8. APAlex Partridge38:41

       Yeah. Gosh.

    9. MTMichaela Thomas38:41

       But now I use timers a bit more to try to remember it. Also, my washing machine plays The Trout. [laughs] The, uh, the song, that little music piece from La Forelli, I think? It's a classical instrument.

    10. APAlex Partridge38:52

        How does that work? That reminds you-

    11. MTMichaela Thomas38:53

        It j- it just makes more of a noise when it's finished-

    12. APAlex Partridge38:56

        Oh, okay

    13. MTMichaela Thomas38:56

        ... because it plays that for quite a while.

    14. APAlex Partridge38:57

        Right.

    15. MTMichaela Thomas38:57

        I'm like, "Oh, yes." But often it's that surrendering acceptance piece of that it's gonna be a rinse and spin kind of day today. That's okay.

    16. APAlex Partridge39:05

        I have been using the Tiimo app, which is what reminds me-

    17. MTMichaela Thomas39:07

        Yes

    18. APAlex Partridge39:07

        ... to empty the washing machine. Um, this week, Michaela, someone has written in and asked, "My daughter is AuDHD," that's dual diagnosis of autism and ADHD. "She's a total perfectionist at school, and just from her room, I can tell how every detail matters, but how do I know this is just a healthy perfectionism, and not something that might turn into OCD?"

    19. MTMichaela Thomas39:33

        Again, this is where I give that standard psychologist answer of, well, it depends.

    20. APAlex Partridge39:37

        Yeah. [laughs]

    21. MTMichaela Thomas39:37

        And it depends on how functional it is. It depends how much distress it causes, um, because we have to understand that the autistic side of, of that, of the AuDHD, might need that control, need that certainty. So it can actually be quite a kind thing for that parent to think, "Actually, can I help you keep that in order? Is that really important?" Because the ADHD side is probably gonna want to sabotage that and ruin the, the structure and the order because it's gonna create mess, and so hence we have that internal paradox, the, the internal struggle. It's like two people rowing a boat in opposite directions.

    22. APAlex Partridge40:12

        Mm.

    23. MTMichaela Thomas40:13

        Unhelpful, right? But perfectionism, in order for us to suss out if it's unhelpful, we have to see, is it causing distress? Is that making them really, really anxious? Um, is it getting in the way of living a meaningful life? Like for instance, can this person not have friends over unless the h- unless the home, the room is in a, you know, spotless condition? Maybe that's something they need to work on together. You know, what's an agreeable standard, uh, so that maybe they can have the richness of having friends over. Or if they get really distressed of it being out of order after the friends have gone. Like, when is it accommodating for the autism, and when is it needing treatment for OCD? It's really difficult to say. It's depends on, on the intensity of that reaction, on the frequency of that reaction, how often does it happen, and the duration of that reaction. Does it last for ages, and then that's ruined her whole weekend, et cetera, when something is out of place? So it's difficult because the, the field is divided on how to support autistic people with anxiety. Some say treating it with, say, um, hierarchies to helping you to kind of tolerate more and more anxiety, and others would say the most compassionate thing to do is to try to help them avoid the anxiety. So I guess it's difficult to give an exact answer, what do you do to support your child? But listening, talk with your child, try to be curious, not furious. Um, there is something here that gives her a sense of safety, control, and peace, and are there other things that can give her that that isn't about tidying, uh, so there can be some flexibility introduced around what order she has in her room? So watch it. Keep an eye on it. And if you're concerned, obv- OCD obviously is a mental health condition that needs treatment. It's also part of being neurodivergent. So, um, yeah, seek out consultation with your doctor or a therapist if you're concerned about your child. But try to be kind and compassionate, and be curious about what's going on. Sometimes kids will do that when there's something else going on that's got nothing to do with that room, because they feel so out of control with something in school. Maybe there's bullying or teasing or feeling w- other types of anxieties,

13. 42:27 – 44:04

    A letter to my younger self

    1. MTMichaela Thomas42:27

       and they influence what they can influence, like their home environment and space. So yeah.

    2. APAlex Partridge42:33

       Fascinating. Truly helpful. Thank you very much. Just finally, I'm gonna deliver you a letter-

    3. MTMichaela Thomas42:39

       Mm-hmm

    4. APAlex Partridge42:39

       ... that was written by the previous guest, where they wrote a letter to their younger self. There we go. And if you could kindly read that letter out.

    5. MTMichaela Thomas42:49

       I will do, and I'm gonna do this in the way that we do when we do compassion-focused exercises, doing these things, where we're gonna really think about slowing it down. So I'm gonna ask you to take a couple of deep breaths with me as well, so we can activate our soothing system, because whoever wrote this, um, hopefully listening, and it will be more powerful if we read at a slower tone of, uh, tone of voice and pace, and I'm gonna really bring in some warmth into this. So take a deep breath into your nose if you can. [inhales] And slowly sigh it out through your mouth. [exhales] Okay. To my younger self, always continue to be kind and helpful. It is who you are, and it's something that develops into a career you love. Be the solution focus, and provide that support, but just look after yourself and your emotions too. You are still human. It's beautiful.

    6. APAlex Partridge43:51

       It's really nice. And I could kindly ask you at the end to write a letter to your younger self. Thank you on behalf of everyone listening, watching. Thank you so much.

    7. MTMichaela Thomas44:00

       Thank you for having me. It's been absolutely fantastic. [upbeat music]

Episode duration: 44:05