Russel Barkley on "prosthetics" in ADHD

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I found this very interesting:



I also caught this (emphases added):

http://www.russellbarkley.org/factsheets/adhd-facts.pdf

I can definitely say this in regard to my ability to organize my apartment and pack for the move I made last week. My apartment was chronically messy and disorganized. All these years of psychotherapy did nothing for it, even when I brought it up. All they gave were little tips here and there, but as Dr. Barkley asserts knowledge isn't the issue; rather, it's using that knowledge at the point of performance. No progress was made until I hired personal organizers to create the environment, to provide the prosthetics for doing. Psychotherapy was useless for this task. Not only that, but it's clear that I am going to need organizers again, because already I am becoming messy again.

I thought this was an important point that many mental health providers aren't aware of. They always seem to see something like CBT as the magic bullet for stuff like this, but I can say with Dr. Barkley that it doesn't work.

Is there supposed to be a video in the post? I think embedded youtube videos are not showing up here for me. Could someone post a link to it?

I remember Russell Barkley talking about how people with ADHD need help the same way a person in a wheelchair needs a ramp, because we have a literal physical disability, in our brains.

It makes me sick when people act like this is not a real disorder, like you can just try harder and it will all go away.

I've been a fan of Barkley since I first saw his videos a few years ago.
Changing my enironment, primarily divorcing my BPD first wife has made a huge difference.
I occasionally use methylphenidate for improved focus/motivation, but also find reward substitution helpful. Often leaving things to the last minute is still an option since I can usually get a lot done when under a deadline.

I forgot to mention B12 shots and high-dose supplements helped increase my frustration tolerance. My B12 serum level was barely over 200pmol/L before I started giving myself shots.

https://www.youtube.com/watch?v=_tpB-B8BXk0

Thank you for sharing this, beneficii!

ADHD symptoms is something I struggle with daily, along with the executive functions. There are so many things I'd like to learn and accomplish in life, but constantly struggle with lack of motivation, or getting distracted.

Maybe there are some helpful, practical tips I can glean from the video you shared.

I am an intrigued fan of Dr. Barkley--especially of that very video 9 months ago! ("This is how you treat ADHD based off science, Dr Russell Barkley part of 2012 Burnett Lecture"). His understanding of the underlying differences in ADHD brains and the varying implications is much more nuanced than most reporting, many in education, and even perhaps many mental health professionals.

The following video is similar, but spells it out even more succinctly for parents & teachers. One important crux is:
(4m10sec) "People with ADHD need more accountability, not no accountability... the problem is the delay, and all natural consequences of any importance are delayed."
--30 Essential Ideas you should know about ADHD, 5B ADHD is a disorder of self regulation https://youtu.be/yGOlNzaW7KA

15 years ago, in a new job, I remember telling myself, my wife, and my new boss something like "I just need more and direct accountability--more feedback." See, I had previously been left mostly to my own devices, which was fun & okay if I had discrete, identifiable tasks--or a project with a clear schedule and frequent oversight. For example, fixing one broken electronic board at a time till it passed testing.

But, I was unfocused and not effective in long-term, complicated, or open-ended projects--unless I was just the assistant following directions of an organized leader. (E.g. Student-Teacher, Grad Student-Advisor, Worker-Involved Manager.)

Flash forward 14yrs until last year, when I finally accepted a therapist's (and my wife's) opinion of an ADHD diagnosis. Dr. Barkley's viewpoint of the disorder requiring life-long, external accountability is an invaluable insight.

My father, a Marine veteran, highly energetic individual, and highly organized, was always telling me things like, "Take it one step at a time." "Break large tasks into smaller ones." Except for very trying situations, I usually dismissed his advice, namely because I erroneously thought that such tactics were "only for super big, super difficult jobs--not everyday life. "I shouldn't have to resort to daily lists, subtasks, small goals, etc. I should be able to follow my own mind, day-to-day." Or, I just didn't think my impulsive nature should/could submit to that kind of discipline.

I'm still struggling with what forms that external accountability can take, how much I can adopt myself vs. asking my wife, friends, coworkers, bosses, etc, to adopt. But, I've begun to accept that some form of daily and weekly lists, daily routines, periodic & planned check-ins for relationships, planned "me" time, etc., are going to need to be constants in my life.