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My approach to working with ADHD
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Psychotherapy for ADHD, in person and via Telehealth, based in Dupont Circle. Click the Free Consultation button to schedule with Dr. Levine.
My Approach to ADHD
I understand ADHD from the inside as well as the outside.
My approach to ADHD comes from my clinical training, and also from my own life. I was diagnosed with ADHD when I was six or seven, and it's something I've dealt with ever since. I know what it's like to sit down to answer a single email and, forty-five minutes later, realize you've watched a short YouTube documentary about medieval Europe, made toast, and sent your mom a long text about an upcoming vacation, and you still haven't answered the email. I know what it's like to understand exactly what needs doing, watch yourself put it off anyway, and finally get moving only when the anxiety of the deadline becomes unbearable.
I also know what follows: asking yourself, "Why does this keep happening, and why can't I seem to learn my lesson?" The painful understanding that your performance in so many areas never fully reflects your actual ability or intentions because you're unable to give yourself enough time to really do your best work, or organize the complexity of your ideas in a way that others will be able to understand. The shame and guilt that come with knowing that your difficulty with keeping commitments, showing up on time, and being responsive gives those you truly care about the impression that you don't. The confusion that comes with knowing that you can grasp complex ideas and accomplish genuinely impressive things academically and professionally, yet somehow you can't mail the birthday card that's been sitting on your counter for two weeks or pay that $15 overdue bill you keep getting emails about.
Effective ADHD treatment addresses both the practical and the psychological.
My approach to treating ADHD focuses on both the practical skills you need to reduce the difficulties that cause this kind of distress and the distress itself. Practical skills include things like strategies for reducing procrastination, increasing focus, organizational systems, systems for improving time management, techniques for addressing impulsivity, emotional dysregulation, and problems delaying gratification. There are many excellent executive functioning coaches and tutors who help with the concrete side of ADHD—skills, structures, routines, and systems—and some are exceptional at what they do. However, my training in clinical psychology allows me the ability to do that practical work alongside the emotional and psychological side. In my experience, these two elements of ADHD cannot be disentangled. We also focus on how ADHD may be shaping important parts of your life, like your sense of identity, your relationships, your values, and your mood. And we look at the reverse: how the rest of your psychological life affects your ADHD. For example, your sense of identity can make you more likely to procrastinate on certain tasks. Chronic feelings of guilt might make it harder to make a realistic weekly schedule because it feels impossible to say no to social invitations. Anxiety about decision-making might make it impossible for you to settle on a single to-do list app.
Effective ADHD treatment addresses co-occurring concerns.
In my view, a holistic approach to treating ADHD means paying attention to what else might be going on psychologically beyond just the symptoms of ADHD. For example, perfectionism, anxiety, and depression are all common among people with ADHD, and each can worsen executive functioning difficulties. A new calendar system won't do much if perfectionism is keeping you at your desk far longer than any system could realistically accommodate. Strategies to increase focus will fall flat if you're feeling foggy because of insomnia, disordered eating, or all-consuming relationship problems. Those concerns need attention too, and they're a natural part of the work we'd do together. I have experience treating most common mental health concerns, so I'll work with you to address whatever else is going on for you psychologically outside of your ADHD.
Therapy and medication work best in collaboration.
Many people ask whether I can prescribe medication. Since I am not a medical doctor (MD/DO) or nurse practitioner (NP), I am unable to prescribe medication. What I can do is help you prepare for conversations with your prescriber, advocate for your needs with them, develop strategies for taking your medication consistently, and assist you in keeping logs of symptoms and side effects that will be tremendously helpful for your prescriber as you work together to find the right medication for you. I have extensive experience working with psychiatrists, primary care doctors, and nurse practitioners across a wide range of clinical settings, and I consider that collaboration an important part of treatment. Whatever we do in therapy should complement what your prescriber is doing.