Mastering ADHD Management: The Essential Role Of Effective Systems


May 9, 2024

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I am beyond excited to share with you an extraordinary journey into the world of ADHD, featuring a special expert guest on our blog today, Dr. Sarah Bren. As a licensed clinical psychologist, Dr. Bren brings her extensive expertise in psychodynamic and relationship-based therapies, along with behavioral methods such as CBT and DBT, and mindfulness techniques. Her decade-long experience spans a variety of clinical settings including hospital inpatient and outpatient clinics, college counseling centers, and now her own group practice in New York.

In today’s post, Dr. Bren unpacks the complexities of ADHD and offers insightful strategies that promise to enlighten us all. The knowledge she shares has not only expanded my understanding but also highlighted the incredible impact that well-structured systems can have on supporting moms and families. This is knowledge I am thrilled to have in my arsenal at Chelsijo.co, ready to support anyone who crosses my path.

So, without further ado, let’s delve into the enlightening discussion with Dr. Sarah Bren. Prepare to be blown away by the depth of insight and the transformative potential of truly understanding ADHD.

Listen Below For The Entire Episode On The Systemize Your Life Podcast

Exploring Dr. Sarah Bren’s Holistic Approach To Family And Mental Health

From my insightful conversation with Dr. Sarah Bren, I gleaned a deeper understanding of her extensive work as a clinical psychologist. Dr. Bren runs a group practice in Westchester, New York, where she and her team provide comprehensive support for families at various stages—from expecting parents to young adults. She has a particular passion for parenting support, dedicating much of her practice to helping families navigate the challenges of raising young children, including support for both moms and dads.

Dr. Bren also hosts her own podcast—a platform where she delves into the critical intersection of child development, child mental health, and parental mental health. She firmly believes that these elements are deeply interconnected and essential to each other, a perspective that enriches the discussions on her show. During our engaging discussion, it was clear how Dr. Bren’s work is shaping the lives of many, offering a holistic approach to family and mental health support.

Managing ADHD: Dr. Bren’s Personal And Professional Insights

During our conversation, Dr. Sarah Bren shared more about her personal life, revealing her own experiences as a working mother of two. Juggling her professional responsibilities with a bustling life outside of work, Dr. Bren also manages her own ADHD. This personal challenge deeply informs her professional practice, as she specializes in working with families and parents dealing with ADHD.

Dr. Bren emphasized how crucial, yet challenging, it is to establish and maintain effective systems when living with ADHD. She expressed a genuine appreciation for the strategies discussed on my podcast, highlighting how vital these systems are for managing daily life and responsibilities when ADHD is a factor. Her insights underscore the importance of tailored support and understanding in both personal and professional realms, creating a deeper connection with her patients and our listeners alike.

Enhancing ADHD Management Through Effective Systems And Self-Prioritization

In our discussion, I addressed a question I frequently encounter: “Will your systems work for me? I have ADHD, and nothing has ever worked for me.” The answer isn’t straightforward, as it depends on various factors. However, one thing I can affirm with certainty is that systems do help, especially for those managing ADHD. That’s exactly what we’re focusing on today—how systems can significantly impact someone with ADHD.

In the context of my company and the philosophy we advocate, there’s a strong emphasis on the importance of self-prioritization, particularly for moms who often place themselves last. This self-neglect isn’t just a minor oversight; it’s a pervasive issue that can diminish a mother’s ability to care for herself and, by extension, her family. By adopting effective systems, moms can break this cycle, reclaim their time and bandwidth, and prevent the detrimental effects of constant self-sacrifice. This shift not only improves their own well-being but also enhances their ability to care for others more effectively.

The Crucial Intersection Of Parental And Child Health

In our conversation, I resonated deeply with Dr. Bren’s perspective on the critical intersection of parental and child health. It’s a belief I share—that you cannot truly support children without also supporting their parents. This connection underscores the necessity of holistic family health, encompassing mental, emotional, and physical well-being.

It’s clear that our cultural understanding often overlooks the importance of family health—the molecular, fundamental DNA that holds families together. As a society, we need to re-emphasize the significance of this foundational health, ensuring that parents have the resources and systems in place to not only care for themselves but to foster a nurturing environment for their children. This shift is crucial for the development of healthy, well-adjusted families.

“It’s a belief I share—that you cannot truly support children without also supporting their parents.”

Debunking ADHD Myths: Understanding Attention Regulation Challenges

Dr. Sarah Bren shared some enlightening insights about common misconceptions surrounding ADHD. She explained that contrary to popular belief, ADHD isn’t just about a lack of attention, despite the misleading name ‘Attention Deficit Hyperactivity Disorder.’ In fact, it’s not a deficit in attention per se, but rather a challenge in regulating attention.

Dr. Bren pointed out that individuals with ADHD can indeed focus intensely—sometimes even more so than those without the condition. They might be able to play video games for hours or practice a sport like baseball with unwavering concentration. The real issue lies in the ability to control and regulate where and how long that focus is directed. This explanation helps clarify the nature of ADHD and underscores the complexity of managing it effectively.

Dr. Bren further elaborated on the challenges of attention regulation in individuals with ADHD. She noted that people with ADHD might sometimes hyper-focus on activities that are not particularly beneficial or necessary, while struggling to engage with tasks that are important but less stimulating. This discrepancy in focus isn’t a matter of choice or lack of effort; rather, it’s how the ADHD brain operates.

The Neurochemistry Of ADHD: Navigating Focus And Neurotransmitter Challenges

She explained that the brain of someone with ADHD performs a sort of “algorithmic decision-making” in the background, determining what captures their attention. This process is largely automatic and not fully within the individual’s control, making the management of focus a significant challenge for those with the condition. This insight helps demystify some of the behaviors associated with ADHD and emphasizes the neurological underpinnings of attention regulation difficulties.

Dr. Bren highlighted the frustration often experienced by individuals with ADHD and those around them, stemming from a common misunderstanding about the control they have over their focus. She explained that this isn’t simply about choice or preference; it involves complex neurochemical processes.

A key neurotransmitter involved in this process is norepinephrine, which plays a crucial role in regulating attention and sustaining focus. In ADHD brains, norepinephrine is not produced in the same way or amount as it is in non-ADHD brains. This difference affects how the brain assesses and responds to tasks. If a task appears too challenging, or conversely, too boring and simple, the brain might decide not to produce enough norepinephrine to engage with it effectively.

Dr. Bren likened this selective focus to the story of Goldilocks and the Three Bears, where the task needs to be “just right”—interesting, stimulating, and suitably challenging without being overwhelmingly difficult—in order for the ADHD brain to engage. This ‘sweet spot’ is where individuals with ADHD can achieve focus, demonstrating that the right conditions can significantly enhance their ability to concentrate and perform tasks.

Executive Functioning Coaching For ADHD

Dr. Bren pointed out that everyday tasks, particularly those that are mundane and routine, often pose significant challenges for individuals with ADHD. The ADHD brain struggles to engage with these activities because they lack novelty, excitement, or a rewarding aspect—key elements that typically stimulate focus and interest. This difficulty with the mundane aspects of daily life is a core issue for many with ADHD, as these tasks fail to activate the neurological ‘rewards’ needed to capture and sustain their attention.

Dr. Bren addressed the complex challenge of making mundane tasks engaging for individuals with ADHD, emphasizing the importance of replicating excitement in everyday activities. One effective method employed in addressing this issue is executive functioning coaching. This technique focuses on developing the skills located in the prefrontal cortex—often referred to as the “thinking brain”—which tend to be underdeveloped in individuals with ADHD. These skills include planning, organizing, and sequencing tasks.

Executive functioning coaching can be likened to physical therapy for the brain, where these cognitive “muscles” are trained and strengthened. A key strategy used in this coaching is “scaffolding,” which involves creating an external framework or structure that individuals can follow. This scaffold supports the individual as they learn and apply these skills, gradually leading them towards independence in managing tasks. As their abilities improve, the supports are slowly removed, enabling them to achieve tasks on their own more consistently. This process not only helps in handling daily tasks but also builds confidence and competence in their executive functions.

Building Independence: Executive Functioning Coaching For Everyday Organization

Dr. Bren elaborated on the practical applications of executive functioning coaching, using the example of someone who struggles with organizing their space, such as a cluttered desk. This scenario typically presents a challenge for individuals with ADHD who may feel overwhelmed and unsure about where to start. By introducing a simple, clear framework or system for tidying a desk, these individuals can experience a sense of achievement and clarity. This success can then act as a stepping stone, empowering them to apply the same framework to other areas of their life, such as organizing a closet or sorting out the refrigerator.

The principle behind executive function coaching is to build these essential skills gradually, starting with manageable tasks that can foster confidence and self-efficacy. While the coaching often includes basic life skills and can extend to academic or professional areas, its core aim is to enhance the individual’s capacity to plan, organize, and execute tasks across various aspects of their life. This scaffolding approach not only helps individuals with ADHD manage their immediate environment but also equips them with the tools to extend these skills further, enhancing their independence and competence in managing day-to-day activities.

Enhancing Focus In ADHD: The Power Of Task Pairing

Dr. Bren discussed an innovative approach to engage the ADHD brain in tasks that are typically seen as uninteresting or mundane. The challenge lies in triggering the brain’s interest mechanism, which is crucial for maintaining focus and motivation. Dr. Bren suggests a strategy she employs both personally and in her coaching: the pairing of tasks. By associating a less desirable task with one that is more engaging or enjoyable, individuals with ADHD can better manage to sustain their attention.

For example, if someone finds it tedious to organize their paperwork but enjoys listening to music, they might pair these activities together. This strategy leverages the more enjoyable activity to increase the production of norepinephrine, a neurotransmitter essential for focus and attention, making the overall experience more palatable and engaging. This technique of creating pairings can significantly enhance the ability to complete necessary but unappealing tasks by anchoring them to more stimulating experiences.

 Harnessing Personal Motivators For ADHD Management

In our discussion, I shared how personal motivators like music and certain physical cues significantly enhance my productivity. For me, one of the biggest boosts comes from music and wearing my running sneakers. There’s something about the combination of good tunes and being in my athletic gear that puts me in the right mindset to tackle household chores energetically.

This approach isn’t just limited to my own tasks. I’ve noticed it works wonders with my kids too. When faced with a task they’re not enthusiastic about, turning on their favorite music transforms their attitude entirely. It’s fascinating to see how these small triggers can change the dynamics of a task from tedious to enjoyable, not just for me but for my children as well. This practical application of pairing motivating elements with less desirable activities helps make daily responsibilities more engaging and manageable.

Crafting Intentional Lives Amidst Digital Distractions

In our conversation, I touched on the universal challenge of habit formation and the pervasive nature of certain addictions, like our collective dependency on screens and social media. These habits affect everyone, irrespective of personal or professional backgrounds, and play a significant role in shaping our daily lives and interactions.

The journey towards living more intentionally—towards that ‘next level’ of existence we each aspire to, which might look different for everyone—requires a conscious effort to break old habits and establish new ones. This isn’t just about striving to function at a high level; it’s about aligning our daily practices with the life we truly want to lead. It involves a deep commitment to understanding our behaviors and meticulously crafting the habits that support our goals and values. Everyone has their unique struggles and aspirations in this process, but the key is to remain steadfast and proactive in making these essential life changes.

Navigating Dopamine Dynamics

In our dialogue, I explored the concept of dopamine rewards and how they influence behavior, especially in individuals with ADHD. The feeling of accomplishment from completing a task, like doing the dishes, results in a dopamine release, which contributes to a sense of satisfaction and pleasure. However, in today’s digital age, our brains are bombarded with much larger dopamine surges from activities like scrolling through social media, making the smaller dopamine hits from everyday tasks seem less significant.

For someone like me, recognizing and appreciating these smaller accomplishments is crucial. I actively train myself to cherish the satisfaction that comes from completing mundane tasks, despite the competing high-intensity stimuli from our digital devices. This practice involves a conscious effort to ‘lean into’ the feeling of accomplishment, anticipating the pleasure that comes with seeing a task through to completion. It’s about rewiring our perceptions and responses to ensure that even the simplest activities can still provide a meaningful boost to our well-being. This approach is particularly important for individuals with ADHD, who may struggle more with finding motivation in day-to-day tasks due to their brain chemistry.

Rewiring Our Perceptions: The Impact Of Modern Preferences On Daily Enjoyment

Dr. Sarah Bren illustrated a compelling metaphor during our conversation to explain how our modern preferences and exposures can desensitize us to simpler pleasures. She compared the experience of eating a strawberry Starburst to eating an actual strawberry. If one regularly indulges in the intense, sugary flavor of Starburst, a natural strawberry might seem underwhelming by comparison. This phenomenon, she explained, extends beyond taste to our daily activities and choices.

Dr. Bren related this to how we consume media. For instance, the rapid and stimulating succession of YouTube videos can condition us to expect constant, high levels of engagement. As a result, when faced with content that demands more patience and focus, like a documentary, it might fail to hold our attention, feeling dull in contrast. This effect is not exclusive to those with ADHD; it’s a universal human experience where our ‘taste buds’ for daily experiences can become skewed by excessively stimulating or sensational inputs. This discussion highlights the importance of mindful consumption and finding value in the ‘strawberries of life’—the simpler, perhaps less immediately thrilling experiences that can offer deeper satisfaction and enrichment.

Navigating the Impact of Technology

Dr. Bren delved deeper into the broader societal impacts of technology on our expectations and satisfaction levels. She discussed how the fast pace of modern life and the immediate gratification provided by technology are effectively rewiring our brains. This transformation impacts everyone, not just those with ADHD. 

The convenience of technology, while integral to our daily lives, often diminishes our appreciation for the effort traditionally involved in achieving results. For example, the simplicity of clicking a button to purchase an item, which then arrives the next day, bypasses the traditional wait and effort associated with shopping. This shift towards instant gratification extends beyond technology to almost all aspects of modern life, reducing the patience required and expected in many situations.

Dr. Bren emphasized that these changes are universal, affecting all individuals regardless of neurological differences. The challenge now lies in balancing the benefits of technology with the need to maintain and foster an appreciation for effort, patience, and the more gradual rewards that life has to offer.

Navigating ADHD In Relationships

Dr. Bren explained the additional challenges faced by individuals with ADHD, especially when it comes to executive functioning skills such as impulse inhibition (“hitting the brakes”) and initiating action (“hitting the gas”). For those with ADHD, controlling impulses can be exceptionally difficult when an activity is highly rewarding. Conversely, initiating action can be arduous when an activity lacks appeal. This dynamic can be even more pronounced than in individuals without ADHD, making everyday tasks and responsibilities disproportionately challenging.

The impact of these challenges extends beyond the individual to affect their relationships and family dynamics. In households where one partner has ADHD and the other does not, it can create a complex “dance” of interaction. For example, a person with ADHD might struggle to activate and begin tasks, which can lead to frustration in a partner who does not share the same challenges. This frustration, in turn, might exacerbate the difficulties for the person with ADHD, not only because of their intrinsic executive functioning struggles but also due to the added pressure and judgment from their partner. 

This situation often leads to a cycle where the non-ADHD partner’s impatience makes the ADHD partner’s task initiation even less appealing, compounding the difficulty of overcoming their executive functioning deficits. This interplay highlights the need for understanding and support within relationships where ADHD is present, emphasizing that the frustrations and challenges are not one-sided but affect the family unit as a whole.

Navigating Parent-Child Dynamics With ADHD

Dr. Bren discussed the intricate dynamics that can arise between parents and children, particularly when the child has ADHD. This situation often involves a parent who, understandably, expects their child to perform tasks that they have successfully completed in the past. However, due to the fluctuating nature of motivation and focus in children with ADHD, they may find themselves unable to perform the same tasks consistently, especially under pressure or when lacking immediate interest.

In these moments, a parent’s natural expectations can come across as overly demanding to the child, leading to tension and frustration on both sides. This results in a “tricky dance” where the parent pushes for action and the child resists due to a lack of motivation or a difficulty in initiating tasks. This cycle can exacerbate stress within the family, highlighting the need for understanding and adapted communication strategies that consider the unique challenges faced by children with ADHD. These strategies can help in mitigating the frustration and fostering a more supportive and effective parent-child interaction.

Insights Into Parenting And Neurodevelopmental Challenges

Dr. Bren elaborated on her work with families, emphasizing the importance of educating parents about the neuropsychology of ADHD and other developmental, neurological, or psychological conditions affecting their children. This education is crucial for parents to understand what behaviors and capabilities are developmentally appropriate for their child, which tasks might be challenging, and how to appropriately push and expand their child’s abilities without overwhelming them.

One key aspect of Dr. Bren’s approach involves teaching parents how to identify and support the optimal conditions under which their child learns best. This includes strategies for stretching a child’s capacity to build new skills while ensuring they remain regulated and focused. Regulation is particularly important because learning new skills is nearly impossible when a child is dysregulated. Given that ADHD is fundamentally a disorder of regulation, helping children manage their focus and stay engaged is vital.

Dr. Bren also highlighted the role of the prefrontal cortex, the area of the brain associated with executive functions such as planning, decision-making, and moderating social behavior. Keeping this part of the brain engaged is essential, even though it naturally faces challenges in children with ADHD. When the prefrontal cortex goes “offline,” children struggle significantly more with tasks requiring focus and self-regulation. Therefore, maintaining engagement in this critical brain area, despite its inherent difficulties, is key to managing ADHD effectively.

The Role Of Parental Self-Regulation

Dr. Bren emphasized the complexity involved in helping parents understand the unique challenges their child faces, particularly when these challenges interact with the parents’ own reactions and emotional responses. She pointed out that this interplay can often create a cyclical dynamic that complicates the situation further, making it imperative for parents to also learn self-regulation techniques.

Reflecting on the broader context, Dr. Bren noted that many parents today may not possess the necessary skills for effective self-regulation, partly because such knowledge was not widely disseminated or understood in previous generations. The insights we currently have about the brain, ADHD, and child development are relatively recent developments in the fields of neuroscience, psychology, and child development. Dr. Bren acknowledged that much of what is known today was not part of her education in graduate school but was learned subsequently through ongoing research and advances in the field.

This situation underscores the importance of current parents being proactive in educating themselves about these advancements. Understanding the brain’s workings and the specifics of ADHD can profoundly impact their ability to support their child’s development effectively and manage their own responses in a way that fosters a healthier family dynamic.

Unveiling The ADHD Journey: Navigating Transitions And Evolving Coping Strategies

Dr. Bren shared a personal account of her journey with ADHD, highlighting how her diagnosis led to a deep dive into understanding and managing the condition. After being diagnosed, she sought the expertise of a psychiatrist and an ADHD coach, and devoted herself to learning extensively about ADHD and brain function.

This intense focus on ADHD arose partly from a need to “hack” her own brain. Like many high-functioning individuals with ADHD, Dr. Bryn had developed various systems and strategies throughout her academic career that compensated for her challenges. These systems proved effective during her time in high school, college, and even graduate school. However, the transition to motherhood and entrepreneurship brought new challenges that her existing compensatory strategies could not withstand. 

Faced with the complexities of managing a household and running businesses, the strategies that once helped maintain her productivity began to falter. This realization prompted Dr. Bren to seek new, more robust systems capable of handling the increased demands of her life. Her experience underscores the evolving nature of coping strategies for ADHD, highlighting the need for continuous adaptation and learning to effectively manage the condition in various life stages.

Harnessing The Power Of Systems

Dr. Bren emphatically emphasized the necessity of implementing systems for individuals with ADHD, describing them as not just helpful, but critical. She explained that the prefrontal cortex, which naturally functions as a system builder, might be compromised in those with ADHD. This impairment necessitates the creation of external systems to compensate for deficits in internal system management.

Dr. Bren pointed out that everyone operates within some form of system; the effectiveness of these systems, however, can vary significantly. For individuals with ADHD, whose ability to organize, plan, initiate, and inhibit distractions may be impaired, external systems become essential tools. These systems not only support day-to-day functioning but also serve as scaffolding for developing stronger executive functioning skills over time.

Wrapping Up The Conversation

The key, according to Dr. Bren, is not just to have systems but to ensure they are effective and tailored to enhance functioning in those areas where the ADHD brain may lack efficiency. By starting with robust external systems, individuals with ADHD can gradually build and strengthen their internal capacities, significantly improving their ability to manage their tasks and responsibilities effectively.

As you start this journey, I’m excited to hear your experiences and insights. Share them within our vibrant Facebook community or come over and visit me on Instagram. And remember that we would LOVE to see you inside of Systemize Your Life as a VIP student!

Until next time….


Frequently Asked Questions

I want to learn more about supporting myself and others with ADHD. Where can I do that?

Check out some other similar blog posts that can be helpful like: Time Blocking To Reduce Stress and Anxiety or 5 Ways to Shift Your Mindset to Finally Get Organized.


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