Review of Smart But Stuck: Emotions In Teens And Adults With ADHD
Reviewed By Merri Rosenberg
Smart But Stuck: Emotions In Teens And Adults With ADHD
By Thomas E. Brown, PhD.
Published by Jossey-Bass: San Francisco, CA: 2014: 276 pp.
Most of the time, issues around ADHD (Attention Deficit Hyperactivity Disorder) focus on cognitive concerns, behavior problems and how the disorder affects executive function skills.
That focus, however justified, neglects the emotional component of ADHD, which has a significant impact on someone’s ability to perform appropriately in the classroom, on the job and in social situations.
“We must recognize the critical role of emotions, both positive and negative, in initiating and prioritizing tasks, sustaining or shifting interest and effort, holding thoughts in active memory, and choosing to engage in or avoid a task of situation,” the author writes.
And the author definitely has significant professional credibility to make his case. Thomas E. Brown, PhD, is a clinical psychologist and assistant clinical professor of psychiatry at Yale University School of Medicine, as well as the associate director of the Yale Clinic for Attention and Related Disorders.
Through a series of anecdotes, based on several representative patients, Dr. Brown explores ways in which ADHD interferes with smart, high-IQ people’s functioning. They can become easily overwhelmed by frustration, or anger, anxiety or boredom, and get derailed from tasks that need to be tackled. For some individuals with ADHD, an inability to even recognize these emotions can create additional hardships as they negotiate a complex and sometimes confusing world. Problems with recognizing emotions can result in social isolation from peers. When these emotions become too extreme, the behavior that results—for example, a teen with ADHD whose anger leads him to punch a hole in his bedroom or overturn a table in a classroom—can lead to harsh consequences and set up even more of a negative feedback loop.
In some situations, as Dr. Brown observes, “sometimes the working memory impairments of ADHD allow a momentary emotion to become too strong; the person is flooded with one emotion and unable to attend to other emotions, facts, and memories relevant to that immediate situation.”
When students leave the relatively protected, structure environment of high school for college, those with ADHD can be left adrift, struggling with difficult feelings of anxiety and isolation. Nor are adults immune. Some of the more intriguing chapters concern adults with ADHD, especially middle-aged women, whose anxiety, lack of concentration and distraction are often attributed to menopause, rather than ADHD.
There are remedies, including appropriate medication, talk therapy and finding the right support systems and accommodations to achieve success at school, on the job, and in personal relationships. It’s not easy, but the effort, Dr. Brown suggests, is worthwhile.
“Getting unstuck is a process that involves thoughtful assessment and effective treatment, usually with medication. In many cases, getting unstuck also requires an ongoing supportive counseling or psychotherapy relationship to address complex and often hidden emotions. With the right supports in place, many of those stuck by ADHD can develop realistic and sustainable hope and learn to survive—and even to thrive.”
This is a significant, and important resource, that belongs on the bookshelves of special education teachers and school psychologists.#