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Product details
File Size: 1405 KB
Print Length: 288 pages
Publisher: Jossey-Bass; 1 edition (February 3, 2014)
Publication Date: February 3, 2014
Sold by: Amazon Digital Services LLC
Language: English
ASIN: B00H7JE3HI
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I do academic coaching, ADHD coaching, and tutoring with students diagnosed with psychiatric disorders. About half the students I work with have had full psychoeducational evaluations that diagnosed them with ADHD. The case studies presented in this book remind me of a number of students I have worked with.One thing I greatly appreciate about the book is how well Dr Brown connects various comorbid conditions often seen in bright ADHD students with the emotional impacts they experience. As such, Dr Brown superbly captures the nuances of ADHD. While people with ADHD have many commonalities (which is the focus of most books on ADHD) not everyone with the condition has the same experience. Smart people with ADHD get stuck in particular ways and the best treatments are not always the same. The case studies in this book do a great job of emphasizing this. The book also does a great job of interweaving new and relevant research to shed light on various aspects of the ADHD experience.Another thing I really appreciate is how well the book addresses transitions. A particular interest of mine is how to best support ADHD students in their transition from elementary school to high school and then to college. This book offers beautiful examples of how these transition can be supported (it also does a great job of addressing transitions at later points in life!)I highly recommend this book to any ADHD teens and their parents as well as to adults with ADHD. I also suggest it to all professionals working with ADHD clients.
This book provided lots of examples of people with ADHD and how the classic treatment options don't address the extremely common comorbid problems. Its not particularly well written or fun to read. It is obvious that the author is a psychologist who happened to write a book, an author that happens to be a psychologist.This book assumes you already know a lot about the subject, and seems to be more of a guide to refer to and to supplement the knowledge of someone who already had a degree in the field. As a patient, it was still interesting, but ultimately not particularly helpful.
Ironically, while writing this book review, I often found myself feeling “smart but stuck.†This review was scheduled to be published last month but my inability to get started until the last minute got in the way. I believed writing this was important so I set earlier deadlines and forced myself to “work†on it (when I spent plenty of time staring at my blank screen — to the detriment of other obligations.) But that wasn’t enough in the moment — I just couldn’t force my brain to write sentences. And now that I’ve read this book, I understand exactly how that can so easily happen to someone with ADHD.Dr. Thomas E. Brown in his latest book, “Smart But Stuck,†explores the role of emotions in the ADHD experience. “Emotions — sometimes conscious, more often unconscious — serve to motivate cognitive activity that shapes a person’s experience and action. For those with ADHD, chronic problems with recognizing and responding to various emotions tend to be a primary factor in their difficulties with managing daily life.†And as Brown explains, being smart doesn’t provide shelter from these problems.The patients discussed in this book were all very bright but still became stuck in school, relationships or work. The high incidence of comorbid psychiatric conditions with ADHD is well documented, but the impact of emotions on ADHD is even more pervasive when considering those affected by subclinical manifestations or “shadow syndromes.†To anyone with ADHD, it is obvious emotions play a critical role in how ADHD symptoms manifest, yet very little has been written on the subject.This book appeals to a wide audience. The first chapter, entitled “ADHD in the Emotional Brainâ€, reviews our current understanding of the role of emotion in ADHD by drawing on clinicians’, researchers’, and neuroscientists’ latest research findings. Dr. Brown clearly explains the research without ever getting bogged down in technical language. In this very thorough yet very readable summary, he discusses topics including attentional bias, delayed rewards, the importance of context, executive functions, neurobiology and working memory. This sets the foundation for the remaining chapters where he illustrates and expands upon these topics through case studies.Much of the book is dedicated to exploring these issues through the personal stories of eleven of Dr. Brown’s patients. Says Brown, “One of my special interests over the years has been adolescents and adults who are especially bright; they have taught me that being smart is no protection from attention impairments. Not only is it possible for people with a high IQ to suffer from ADHD, but it’s likely they’ll suffer longer without adequate support or treatment because the people in their lives assume, quite mistakenly, that anyone who is really smart can’t suffer from ADHD.â€The patients in this book range from a 14 year-old high school student to a 50 year-old homemaker and mother. Six were college students, which is not surprising given Dr. Brown’s practice at Yale University. But as Brown explains, context is crucial in ADHD and each of the students struggled mightily with the major changes in context encountered as they respectively entered high school or college.Dr. Brown weaves patient’s stories with explanations of the specific challenges faced. Though they all fell under the umbrella of “Smart but Stuckâ€, Dr. Brown explains how he approached treating the unique problems of each patient differently. All challenging cases, they serve to illustrate how successful treatment is often the result of exploring and abandoning many approaches before finding one that works. These patients were not merely struggling; they were completely stuck and required a great deal of hard work to get them going again.ADHD is typically presented as a problem of cognition and the executive functions. When emotions are included in the list of symptoms, they are just one of a multitude of areas where problems with inhibition manifest and are dismissed as difficulty putting the brakes on. But as Brown points out, there are many instances where a problem might be better described as difficulty with the ignition system. The students described all invariably struggled with getting work done in classes that didn’t interest them. They were smart enough but they couldn’t get their brains activated to work when needed. Medication typically helped with this but therapy was also required to explore and resolve the conflicting motivations that consistently got in the way.Although each story is unique, there were many common threads. The patients were all very bright and had had many successes in their lives. However, their ADHD made universal success impossible and this inconsistency created many problems. Martin, a 23 year-old university student, belonged to Mensa but still struggled with his grades. His parent’s had even explored the possibility he might have ADHD when he was young, but the doctors all said he was too bright to have such a problem. To outsiders, this achievement gap often appears to be an issue of willpower and so, for these patients, the gap between expectation and performance results in embarrassment and shame. And for someone with ADHD, it is easy for an emotion such as shame to fill their minds and prevent them from seeing the larger picture, leading to further problems. Here we see examples where their pain drove them to substance abuse, escape through video games and avoidance.The role of working memory in problems with emotions was illustrated in several cases. Emotions are complicated, conflicting and nuanced, but with limited working memory, it can be difficult to experience more than one emotion at a time, let alone weigh two conflicting motives against each other. In these cases, Dr. Brown talks about the importance of external feedback from a trusted source to point out overlooked nuances or contradictions.Sarah, the 50-year-old housewife, who first experienced ADHD-like symptoms at menopause, discusses how a decrease in estrogen levels can cause executive function problems for some women who had never experienced them before. While she technically would not qualify for an ADHD diagnosis, it is interesting how many of the same approaches helped, including the use of stimulants. This is still a new area of research and I expect we’ll be hearing more about it in years to come.The stories were inspiring but also offered caveats. In most cases, the patients eventually became unstuck and were able to move ahead with their lives. Treatment was quite intense and ramifications included lost time, lost tuition money and a marriage that couldn’t be saved. One patient, Lois, whose severe ADHD problems had taken an enormous toll over time, was still struggling by the end of the chapter. I believe these stories taken together offer an encouraging but realistic picture.The last chapter summarizes the steps to help get unstuck — assessment, treatment and support. Finally, Brown talks about the importance of cultivating realistic hope. As he concludes, “With the right supports in place, many of those stuck with ADHD can develop realistic and sustainable hope can learn to survive — and even to thrive.†I found Brown presented a well-balanced view of his patients. He spoke of their weakness and struggles but also of their strengths and talents. As he told me when we spoke, “We all have this sort of illusion where we’re often told, particularly people who are smart, ‘You can do anything that you want to!’, but that’s just not how the brain operates.â€I better appreciate that I need a more realistic view of what I can and can’t do. I have a lifetime’s accumulation of all the things I’ve been told — and believed — I should be able to do, but looking back with this new knowledge, I can see why I struggled so often, seemingly inexplicably at the time. If I can incorporate these insights into my future plans, I have hope I’ll be able to avoid getting stuck quite so often.This is an important new book that shines light on the importance of considering the role of emotions when dealing with ADHD. This is not intended as a self-help book, but rather, is an exploration of the role of emotions through the use of story. The cases presented were all quite severe. I would like to have learned more about what might help people who weren’t stuck per se, but were still struggling to meet their own, and others’, expectations. I also would have liked to learn more about the impact of emotions on those who were diagnosed with ADHD much later in life. Any adult with ADHD or anyone who wants to learn more about ADHD would benefit from reading this book.
Dr. Brown is a clinician and Professor with Yale University who specializes in the treatment of people with attention and related disorders. He is an insightful, highly creative and patient healer. In Smart but Stuck Emotions in Teens and Adults with ADHD, he offers portraits of 11 people suffering because of an overlooked, underappreciated facet of the effects of ADD/ADHD: ADD/ADHD often contributes to and exacerbates emotional challenges, in particular with anxiety and depression, but also sociability, empathy and intimacy.Dr. Brown's subjects are limited: ages 15 - 50, all of them with very high IQs, and all of them also affected by other complications, for example unusually delayed physical growth, functioning in the autism spectrum, having hoarding disorder, and/or harmed by extreme circumstances like witnessing the unexpected death of a family member.I found this book of narrow value: I don't know how many readers will "see" themselves in it. But I would suggest that anyone with ADD/ADHD read it to try to see themselves : if any of the conversations feel familiar, that recognition might lead to successful new focuses for their treatment.Lauren Williams, Certified Professional Organizer(R), Owner, Casual Uncluttering LLC, Woodinville, WA, USA
A groundbreaking book that really takes a very fresh and insightful look at ADHD and how emotional regulation plays a huge part in it. Those overlooked by the old paradigm "ADHD as attention deficit" may recognize themselves in this very new interesting paradigm of "ADHD as attention surplus", i.e. inability to manage your emotions, interests, etc.
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