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Section 1
Cognitive Distortions in the Psychosocial Treatment of Adult ADHD

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In this section, we will discuss four closely linked problems that ADHD adults may have with switching gears and multi-tasking. These four problems are the One Channel Operational System, the Locking In and Blocking Out Phenomenon, the Defective Filter, and the "I Hate Details" Dynamic. Sound interesting?

Troy, age 31 diagnosed with ADHD, complained of his difficulty switching gears from one task to another, especially on the job. Troy stated, "I work at a psychiatric unit, where I share the responsibility for answering the phone. I have trouble switching gears fast enough to pick up the phone after a few rings. Usually, I don’t hear it ring at all! Other staff members resent that I don’t answer the phone. They think that I think I’m too good to do it. But they’re wrong! It’s just not as easy as it seems!"

4 Common Problems for ADHD Adults

Common Problem # 1 - One Channel Operational System
I explained to Troy that the first common problem I find in ADHD adults is the One Channel Operational System. I explained that the reason his fellow staff members held this grudge about answering the phone was that their minds operate on a different channel system than Troy’s.I stated, "Most people give everything the opportunity to grab their attention. It’s like they use a scan button on the radio to pick the channel that comes in clearest. When the signal for one channel fades, they easily switch to another channel."

As you know, for most adults with ADHD, the "scan button" doesn’t work as well. I explained this to Troy, stating, "Instead of pulling in the strongest signal, your mind is pulling in every channel, and you end up losing track of the station you were listening to." Troy protested, stating, "But I can usually pay attention to whatever it is I’m working on. I just can’t think to answer the damn phone when it rings!"

Common Problem # 2 - Locking In & Blocking Out Phenomenon
I explained to Troy that the One Channel Operational System is sometimes related to the second problem I find common in ADHD adults, the Locking In and Blocking Out Phenomenon. As you know, many ADHD adults can be overpersistent. I explained to Troy, "When ADHDers like you get locked into a task, they work hard to block out all those other channels that may be trying to come in. If you’re Locked In to a filing task at work, you’ll usually Block Out all other tasks, including the task of answering the phone."

Troy looked defeated, so I added, "The good news is, you can use it to your advantage. I’m willing to bet you file faster than most other staff members at the psychiatric unit." Troy smiled, chuckled, and answered, "Yeah, everyone else usually gets sidetracked. They’re impressed by my speed." I stated, "The bad news is, Locking In and Blocking Out can be counterproductive. You may be the fastest filer in the office, but that doesn’t solve the problem of the ringing phone if you’re the only person there to answer it."

As you know, ADHD in adults does not just cause problems with switching gears. For Joel, age 27, his ADHD caused problems with multi-tasking that were starting to threaten his marriage. A mechanic, Joel was usually able to focus on a car in his shop for hours but sometimes had trouble following conversations with his wife.

Joel stated, "Lots of times I’ll come home after work, and we’ll sit down to have dinner. She’ll be talking to me, but I’ll get distracted by the TV. The next thing I know, she’s yelling at me, saying things like ‘You’re not even listening to me! You just spent two hours working on some guy’s truck, so it’s obvious you can pay attention when you want to. Don’t even try to blame your ADHD!’ Then she cries. It’s not that I don’t want to pay attention to her, but I just can’t focus on her the way I focus on cars."

Common Problem # 3 - Defective Filter
In addition to the One Channel Operational System and the Locking In and Blocking Out Phenomena, the third problem for ADHD adults is a Defective Filter. Because of his familiarity with cars, I tried to explain Joel’s Defective Filter in terms of car parts. I stated, "Your brain works at peak efficiency when it can select what it needs to concentrate on and keep out other distractions. Your mind works like the oil filter in a car. Tell me, what happens if you have an old oil filter?"

Joel perked up and answered, "Well, you’ll get a lot of dirty bits and useless particles in your oil that runs through the engine. Clean oil makes the engine run a lot more efficiently." I stated, "The ADHD adult mind works a bit like an old oil filter. It doesn’t always keep the useless particles, like what you’re seeing on TV, out of your engine."

Joel stated, "That makes sense, I guess. But sometimes we’ll eat dinner with the TV off, and I still won’t always follow what she’s talking about. A couple of days ago, she bought a new brand of dog food. First, she had to tell me what we’ve been getting. Then she explained how she ran into her friend at the store, who recommended another kind of dog food. Right about then I stopped paying attention because she just gave all these stupid little details that don’t matter! She does that with everything she tells me, then wonders why I don’t listen anymore. I just want the big picture – that we’ve got new dog food – but by the time she gets to the end of her story, I have no idea what the point even was." Sound like a client of yours?

Common Problem # 4 - "I Hate Details" Dynamic
As you can see, Joel’s problem was the fourth common problem I have found in adults with ADHD, the "I Hate Details" Dynamic. I explained this dynamic to Joel, stating, "Your filter may be letting in too many bits of detail which keeps you from attending to them all. When you try to remember sequential details, you may lose the first detail before you can assimilate the second. This is probably why you can’t follow your wife’s long, drawn-out stories."

The Two-Step Asking for Clarification Technique
For Joel, I found the "Asking for Clarification" technique helpful. There are two steps to the "Asking for Clarification" technique. Listen as I explain how the two steps worked for Joel. First, I asked Joel to have a conversation with his wife. I stated, "When you start the conversation, just listen to what your wife Nora has to say." The second step is for the listener, Joel, to interrupt the speaker, his wife Nora, when he realizes his mind is wandering. I felt the "Asking for Clarification" technique appropriate for Joel since he stated, "My wife is really getting angry because she feels, as she puts it, ‘not heard.’"

I replied, "As soon as you realize you aren’t listening to Nora anymore, let her know." Joel asked, "How can I do that?" We brainstormed and role-played some statements which included "You know, Nora, my mind started to wander when that bee flew by and I lost track of what you were saying." Or  "I sort of blanked out for a minute. Could you repeat what you just said?" or "I know this is really important to you, but I sort of lost track. Can you repeat the sentence you just said?"

Do you have an ADHD client like Troy who struggles with the One Channel Operational System and the Locking In and Blocking Out Phenomena? Or is your ADHD client more like Joel, who faces problems with a Defective Filter and the "I Hate Details" Dynamic? Would your Troy or Joel benefit from the two-step "Asking for Clarification" technique of listening then interrupting when their mind starts to wander and ask for clarification?

In this section, we have discussed the four problems that ADHD adults may have with switching gears and multi-tasking. These four problems are the "One Channel Operational System," the "Locking In and Blocking Out" Phenomena, the "Defective Filter," and the "I Hate Details" Dynamic.

in the next section, we will discuss the problems ADHD adults face with intense feelings and distorted senses. I have found that there are three aspects to the ADHD adults difficulties with intense feelings and distorted senses. These three aspects are the Intense Emotional Roller Coaster, the Bottomless Pit of Needs and Desires, and the Time Tyrant.
Reviewed 2023

Peer-Reviewed Journal Article Reference:
Kofler, M. J., Soto, E. F., Fosco, W. D., Irwin, L. N., Wells, E. L., & Sarver, D. E. (2020). Working memory and information processing in ADHD: Evidence for directionality of effects. Neuropsychology, 34(2), 127–143.

Perle, J. G., & Vasilevskis, G. (2021). Psychologists’ evidence-informed knowledge of attention-deficit/hyperactivity disorder (ADHD): Evaluating the domains of informational strength and areas for improvement. Professional Psychology: Research and Practice, 52(3), 213–225.

Ramsay, J. R. (2017). The relevance of cognitive distortions in the psychosocial treatment of adult ADHD. Professional Psychology: Research and Practice, 48(1), 62–69.

Ramsay, J. R., & Rostain, A. L. (2016). Adult attention-deficit/hyperactivity disorder as an implementation problem: Clinical significance, underlying mechanisms, and psychosocial treatment. Practice Innovations, 1(1), 36–52.

Schultz, B. K., Evans, S. W., Langberg, J. M., & Schoemann, A. M. (2017). Outcomes for adolescents who comply with long-term psychosocial treatment for ADHD. Journal of Consulting and Clinical Psychology, 85(3), 250–261.

Stanton, K., Forbes, M. K., & Zimmerman, M. (2018). Distinct dimensions defining the Adult ADHD Self-Report Scale: Implications for assessing inattentive and hyperactive/impulsive symptoms. Psychological Assessment, 30(12), 1549–1559.

QUESTION 1
What are four challenges that ADHD adults may have? To select and enter your answer go to Test
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