The Freeze-Shame Loop, Therapy Speak, and "Everyone Has ADHD": February Mailbag

Hello and welcome to Being Well. I'm Forrest Hansen. If you're new to the podcast, thanks for joining us today. And if you've listened before, welcome back. I'm joined today, as is frequently the case, by clinical psychologist Rick Hansen. Dad, how are you doing today? I'm good, Forrest, and I'm always happy to be here with you. Same, same. Really happy to be here with you today. This is going to be our first mailbag episode of 2026. If you have a question that you would like to hear answered on the podcast, the best way to do that is by signing up for our Patreon. I normally ask our patrons first when we're going to do a mailbag episode. It's patreon.com slash beingwellpodcast. But you can also send an email to contact at beingwellpodcast.com. And before we get into it, I also wanted to give you a quick reminder about one of Rick's online courses. It's titled Rewire Your Anxious Brain. It started on January 24th, but you can still sign up for it and get plenty of value out of it. It's 12 weeks long. It's a brand new offering from Rick this year, and so far we've gotten really positive reviews on that. So you can learn more at rickhansen.com slash anxious and get an additional 10% off with the coupon code BWP10. That's the letters BWP and then the number 10. So okay, our first question today, really interesting questions all around on this mailbag episode. You were just telling me before we started recording, Dad, how kind of thought provoking these have been for you. So the first question that we had, I tend to move into a free state in response to conflict. And I really appreciated your episode on the topic. I've become more aware of this tendency. But now when I notice I'm in a free state, but still can't do anything about it, it creates an extra layer of helplessness and shame. These feelings seem to make it even harder to do anything about the free state itself. Is this normal? Am I missing something? And what can I do about it? What did you think about this, Dad? I thought a lot about it. For one, I thought about the creatures outside my window in our home, the squirrel, the lizards. You have a very active backyard. You're right on the edge of open space. It's like Dr. Doolittle. You got a bird feeder. There's a family of quail that come down. It's really something. Oh, I've seen foxes, turkeys, and deer walking through our backyard, coyotes. When they're threatened, for one, they're constantly scanning. And second, when they're threatened, threatened, they freeze. It's normal. It's natural. It's adaptive for them to do that. So that's my way in here. I also think about the structure, the fundamental structure of practice, being with and working with. And paradoxically, one of the fastest ways to unfreeze a freeze state is to be with the freeze as it is. In other words, allow it, open to it, accept it, understand it, appreciate its adaptive function for you, have compassion for how you acquired tendencies to freeze, really, really helpful. That's the being with side. And then, of course, there's the working with side. And I think there's a place for making sure we're not being too tilted toward either being with or working with. I think this questioner may be trying to jump into the working with phase before paying appropriate dues, bowing in the direction of being with. On the other hand, I think sometimes people get, frankly, glib and dogmatic about just be with it, just accept everything. Well, yeah, but what you're in is not that great for you and you know it. So there's also the working with part of things. So I'll kind of pause there and get your take too. Well, it's funny because often when we do these episodes, I've written out quite a bit of information on a sheet and I send you the sheet that includes the thinking that I've already done on the topic just to kind of, you know, stimulate whatever we end up talking about. This time around, just to try something else out, I just sent you the questions. I didn't want to like bias you with my pre-existing thinking because I was like, okay, it'll lead to more diverse opinions between the two of us. And of course, you ended up just like saying all the things that I had on my sheet over here, which was fantastic. So I appreciate that. And, you know, I am your kid after all, I guess. So essentially, I would just echo everything that you said to maybe like layer a little bit here. Transmission flows in both directions. It does, it does. Hey, maybe I've also influenced you a little bit over time. Who knows? Well, I am your dad, you know. Yeah, yeah. I would hope that that is the case a little bit. I think that would be healthy for both of us. Yeah, I think first thing I would say is just the bit about animals, and this is a normal adaptive state, is really important for people. The idea that like I'm bad because I freeze is just a fundamental misunderstanding of what's going on here. You are not bad because you freeze freezing as normal. You're an awesome vertebrate. You're a good animal. Good job. Yeah, congratulations. And this is a coping state that is actually really helpful under a lot of different circumstances. And for most people, they move into these behaviors because they really helped them out once upon a time. So we want to kind of have a little reframe around freeze bad to, oh, okay, this is what's happening right now. There's a little bit of kind of cognitive diffusion in it. We're getting a little space around the feeling, hopefully. Then from there, I would totally agree with you, Dad, about that being with versus working with. And I think it's helpful for people to appreciate with nervous system response stuff that it's really difficult most of the time to do something about the state when you're in the state. You know, when you're angry, it's really hard to do something big picture about working with your anger. When you're freezing, it's really hard to do something about working with your freeze response. We do most of that kind of after the event through reflection or thinking about it or creating a plan for the future. Something that's really been shown to help people are essentially what are called like various forms of intervention response plans. They have different names for things. But it's essentially visualizing what you're going to do the next time that something happens. So you say, okay, the next time that I notice that I'm in this state, I will fill in the blank. Being able to say something like, okay, I'm noticing that this is what's happening right now. okay, I'm noticing that I'm starting to experience some self-criticism about it. Because that's really what's happening is that shame and the like, these are forms of self-criticism. Okay, this is coming up. And then over time, we can start to actually work with the self-criticism or the feelings of shame themselves. You remind me of something that I learned a jillion years ago, back in the dawn of time, about interpersonal rapport. And I'll swing back here. and what I'm saying also might be relevant to a couple of the other questions that will be coming down soon. Imagine that there's a kind of an intensity scale from zero to 10, or imagine similar kinds of scales related to certain types of feelings. Well, if you're with someone who is at a seven on an intensity scale, and you're trying to draw them down because for some reason it's not appropriate in a work setting or whatever it might be. If you interact with them at a two, the distance is too great. You're out of rapport and you won't be close enough to kind of draw them in your direction. If you, on the other hand, interact with them at maybe a five or even a six of intensity, a little bit less than where they are, then there's kind of room for them to come into rapport with you or to some sort of sympathetic vibration, co-regulation, whatever, and then you can draw them into your state. Similarly, in terms of rapport with ourselves, just like you said, if you're gripped in the middle of anger to drop into Dalai Lama levels of inner peace right on the spot, no, no. But maybe you could move from rage to being really mad to being merely irritated and then exasperated and then eyebrows rising, you know, step by step by step. Similarly around freezing, maybe the thing to do is to start with owning the freeze, claiming it. Paradoxically, again, that's a really useful technique to name it. I am choosing to say to yourself, I am choosing to be frozen right now. The naming of it in that way And the claiming of responsibility for it, claiming of agency over it or causality over it can actually start to help you budge from it. So you start by owning it. And then if you're interested in going further, look for very small steps in the moment, like just moving your body a little bit. Or even if your body remains still, making yourself think about different things inside your mind, like remembering something that you like. You're doing something, but it's small. but it's small enough to be real to gradually start moving you out. So I would say that part. And then for this person in general, I would wonder, okay, onstage when we're triggered in the moment, it's tough, but what are you doing offstage? What are you doing when you're not frozen to increase various traits inside you or decrease other traits so that the next time a similar trigger occurs, you're not going to be so frozen by it. Like, for example, offstage, can you build up your sense of being strong, of being determined, having moxie, you know, in a good sense, being a bit of a badass in your own way? You know, can you grow that offstage so that you have that more hardwired within you the next time that trigger occurs? There's a part of me when I first read this question that wondered if this could be a good form of pain. Pain is an impetus for action and change in different kinds of ways. So the value of awareness sometimes is that it draws our attention to the parts of ourself or the parts of our life, the aspects of our nature that aren't doing good things for us. I think of my own examples with this around my own tendencies, particularly socially, and shame is a social emotion, where I had a real tendency to be corrective, fault-finding, kind of excessively critical, sometimes excessively technical, really top-down in terms of my interactions with other people. As I became increasingly aware of this, I did experience some shame related to it. That shame was a difficult emotion, but it also had a utility function for me. It made me go, okay, I don't want to be ashamed of my behavior, so guess what? I should change my behavior in some kind of meaningful way. In general, sometimes, yeah, we feel a certain amount of suffering related to something that we're doing that we don't want to be doing anymore. And then that suffering can nudge us into having a different kind of relationship with it. But that messy middle, where we first become aware of some kind of tendency that we have, can be really painful for people and learning how to deal with it. So you don't get just like blown out and overwhelmed by it. And then that stops you from doing anything about it is a complicated part of the process. I I just wonder how you think about that in general, Dad, as somebody who's walked a lot of people through this kind of thing? First, I find it so interesting that you're going here. It's a little edgy because, yeah, I'm not sure if I want to be like, shame as a utilitarian function. You should feel it. That's not really the message I'm trying to give here, but I hope you take my meaning. Oh, I think it's a good move. It's counterintuitive to go in that direction. More of a reflection. I feel deeply embedded in a kind of learning model. with regard to this sort of thing. I mean, I feel ultimately embedded in a mystery model. Okay, inside that, whether you're a squirrel or a lizard or a human being, we're faced with challenges and opportunities. And as long as we're in this body, in this life, there's a value in coping and healing and growing and awakening. So I rested in that values frame. Then to me, there's a value in being with things well and working with things well. We can become increasingly competent and enacted in both of those. And just as with any other domain of life, like how you make your spaghetti sauce, we can evaluate in terms of values, evaluation, how are we doing? How are you doing with being with feeling frozen? How are you doing with working with feeling frozen? And you can evaluate, you can observe in reference to values, how you're doing. And I think there's a place for that broadly. Then the question is, what skillful means? And what is the sweet spot around motivation? To what extent is a little bit of wincing around realizing that you've either become or been kind of too much of a slacker around being with or too much of a highly pressured go-getter around working with. You know, there's a place for realizing that, and maybe there's a place for a little bit of wince or, you know, okay, harump, harump, giddy-yup with yourself. But more than that, I don't want to impose on myself, that's for sure. So I ask myself, what's the minimal useful dose of pain to help myself in this life? And I think on the whole, pain is way overrated as a motivator because it carries with it a lot of collateral damage. And I think it's highly useful to find other motivators besides pain and to not overdose the necessary amount of pain to get you to be motivated. What do you think about all that? I think that in theory, you're right on. And I totally agree with you. I too would love it if somebody experienced the minimal necessary dose of pain. In practice, I'm not sure if there is such a thing as the minimal necessary dose of pain. And I think that we just get the pain we get. And we do our best to kind of reduce it to that minimal level if we can. I guess that's how I would kind of say it back to you. But I think that spiritually we're very aligned here in terms of how we think about it. I totally agree that I have a very complicated relationship with just what you'll hear people say about like, oh, you need to feel the pain to get the gain. Or like, oh, you know, we teach kids how to do something by exposing them to the consequences of their actions. All of these different kind of pain-motivated learning models, which we know from behaviorism are effective, at least in the short term. But as you've written a lot about that, they come with a lot of consequences for people's real life experience. So when you start talking about this, I do think that you kind of start to wander into that material a little bit about like, what is the learning value of pain at all? And I think it's really complicated. So I let us down a little bit of a rabbit hole here with regards to this question, but I do think it is interesting. Like, how motivational is that moment of going, ah, shit, I messed up. You know, we evolve these emotions for reasons. So I guess that's my kind of take on the whole thing. This is a deep question about pain or pleasure as motivators, broadly. And I'm using pleasure in a very broad sense, eudaimonically as well as a form of fulfillment. For some people, they have not felt the pain sufficiently. They haven't really let it land that when they yell at their partner or get all stony and cold or their kids, that it has a huge impact. They don't really let it land that they're having an impact on another person morally or otherwise. And so there's a place for them to open to greater pain about that. Or I can think of turning points in my own life and a couple of them that took the form really of me realizing that I was completely messing up in some area and I needed to change my way and I needed to feel it. I needed to look at that face in the mirror that was hung over, let's say, and go, no, I never want to go here again. You know, there's a place we're hitting bottom. I think that's true on the one hand. On the other hand, I think about people also who they really do experience the pain, but neurologically, it just doesn't budge them. They actually need something that's attracting them to a better way of being. They kind of trapped in what called in complex systems theory a basin of attraction And they know it sucks there It kind of like the autobiography in five chapters that you might be familiar with I think from AA or some other place They're in the pit. It's very painful. And they know they're in the pit, and they're fully open to the pain of being in the pit, but that knowing doesn't get them out of the pit. They're stuck in that basin of attraction. They need to develop other attractor basins that are much more positive that draw them in that direction. And I think that's actually really an important thing to recognize. People have been facing, have been feeling the pain and they're kind of stuck. Well, you need a different motivational system. I don't even know how that would work neurologically. I think that's a great study. Yeah, I think that like moving toward aspect of this is a great part of it. And it can also be a great way through shame and self-criticism. So I think it's cool that we're ending this question by talking about this aspect of it. Because self-criticism typically comes from some kind of an internalized should. Like, I should be able to not be in the freeze response right now is essentially what this person is telling themselves. Like, I should have access to something else. And one of the ways to kind of work with that is some version of like, okay, what feels good to me? What would I rather be moving toward, not just what am I moving away from? Maybe that's something for this person to consider when they're doing that kind of next time I would like to fill in the blank. Like, what's the thing that they're moving toward that has some kind of a positive motivation associated with it? What's the reward that they would get from being able to do that? Would that feel good to them? Would it feel nice? All the things that we talk about on the podcast fairly regularly. I feel pretty complete on that one, Dad. Is there anything else you want to mention here at the end? Yeah, quick point. Pain freezes us. So it's interesting that this is a person who would like to become more unfrozen. And yet when we are on the receiving end of criticism, what do we tend to do? We tend to freeze. So the method of criticizing oneself for being frozen perpetuates the problem that one is criticizing. So that's a word to the wise here. Yeah, it's something to be careful about for sure. And it makes sense how these two things really feed each other. Yeah. We'll be back to the show in just a minute, but first a word from our sponsors. Really great bedding is one of those things that you don't fully appreciate until you sleep on it. That was my experience with quince. The softness, the weight, the quality of the materials, it's the kind of difference that you feel immediately, and then you notice more with every night. European linen that gets softer with every wash, organic cotton sheets that feel luxurious, breathable bamboo that stays cool all night. I know for a fact that I'm old now, because I actually know what a duvet is. Like Quince's clothing, their bedding is half the cost of similar brands, and they can manage this because they work directly with top artisans and pass the savings on to us by cutting out the middleman. I've been sleeping on Quince's bedding for a few years now. They've been a sponsor for the show for a while, and I love it. 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During arguments with my wife of 10 years, I try to start with joining. but it is impossible for my wife not to notice that I usually already have a nuanced or thought through understanding of the current issue. We've both been to therapy, including couples therapy, but I've been at it longer and am deeper into self-help-y material than she is. When we argue or try to repair, I've often already journaled, talked to my therapist, and thought things through, and my wife has mentioned that she feels less than or patronized to when, after listening and joining and exploring, I give what feels to her like an ordered, multi-paragraph thesis in response to the thoughts that she's currently struggling to put into words. I'm exaggerating my competency a little bit here, but this is what she tells me it feels like. I do try my best to join with an open mind and not a fully baked solution, and I don't think I have the full, correct, or objective answer to any of our problems. But I have done more thinking through of these issues, and I have more access to the therapy jargon, and I've thought through the thing under the thing of the argument. Your podcast is great, and he gave some additional I'll really appreciate your podcast for helping, teaching me these things. Therapy is great. Introspection is great. But when there's an imbalance in the relationship along these lines, it can become a new hurdle to overcome. How can I better handle differing levels of therapeutic experience in a relationship? And what's your advice to a couple where one person is farther along on therapy work than the other? For context, the questioner's male. And he also mentioned that what he's pushing back on or arguing with a lot of the time with his wife is her heavy self-criticism, that she gets very self-critical about whatever it is that they're exploring, and he tries to do something about it, and it goes poorly. What do you think about this, Dad? Ideally, of course, it makes me think about my own life and marriage. Sure. Duh. I have some personal experience with many of the things that this guy's speaking to, Yeah. It also makes me think of gender, of course. And to play with this a little bit, usually when I hear 80% of what's in this story, the gender roles are reversed. It's the woman who's saying that her male partner is a good guy. Not very psychoeducated. Yeah. She's read all the books. She can't get him even. therapy for years. I can't even get them in the door. It's a very common story. Yeah, yeah, yeah. Right. On and on and on. So that's interesting. It draws me into reflecting on any domain in which there's an asymmetry. And it is interesting that the domains in which we tend to get particularly prickly are the ones that are very close to our innermost being. So your mom knows much more than I do about physical health. So when she comments on You know, a donut or something I'm eating. I don't like it, but I know she knows more than I do. On the other hand, boy, if I comment on her psychology, oh, that's a pretty tender topic because it's so close to home. So there's that part of it too. Then I really wonder in a deeper way, what's the script here? What's the interesting script in which maybe, I don't know, Is the wife trying to draw him in to forms of help, which she then resists? Flip the other way. Why is he trying to help her? That seems like the line when it's crossed that gets him into trouble here. What would happen if he didn't share his multiple paragraphs of analysis? What would happen if truly he rested much more in a kind of don't know? attitude. What would happen if his focus was on potentially kind of giving up about her changing in this particular regard, even if it's one that creates pain for herself, self-criticism, and kind of gave up and stepped back? What would that be like for him? And how might that actually make more room in the relationship? So those are some entry-level reflections. How about you? I like the entry-level reflections. I also think it's great that this person is trying. Clearly, they've put a lot of effort into this. Yeah. And it's painful to feel like your efforts are making something worse in a way. And I also feel some empathy for the questioner because I think that there are ways in which I've fallen into similar patterns, particularly in terms of having a kind of top-down approach to relationships at times, and needing to learn what start by joining actually means, as opposed to how I might be applying it in a given moment. So the point of all of the things that this person has named, therapy, developing more knowledge, introspection, all of that, is to improve your relationships. If they're not improving your relationships, it's because they're either not the right tool for the job, or because you're applying them kind of unskillfully. So these things are means to ends. And sometimes when people get into the hobby of self-help, it can be easy to kind of lose sight of that, I think. So having some fluency with psychological ideas and actual developed relational skill are two distinct things. You can know what joining is as a concept and really try to apply it and still be bad at it. You can understand attachment theory and still make your partner feel really unsafe. reading more books about marriage does not inherently mean you're going to be more pleasant to be married to. And again, I feel like this is something I did for a long time, where I had this kind of cognitive understanding of things without actually the developed tools to apply them. And through that lens, this is how I would read this situation. I think this guy's kind of misdiagnosed the problem. I think the issue is not that they have different levels of knowledge about therapy. It's that his partner doesn't feel felt by him, and that she's experiencing a power imbalance, at least in part because they're making the power imbalance fairly apparent through the way that they're talking to their partner. They're talking to her in a way where it's like, okay, you came to me with all of this sound and I have now distilled it down into this really beautiful three paragraph response. And then she's like, okay, I guess I have nothing to say then, right? You've already figured it out for us. There's no relationship. There's no flow. There's no back and forth. There's no sitting in it with somebody. I'd be very curious if he's tried to include her in his own personal development process? Is he interested in talking about these ideas that he's journaling about with her? Is he including her in his own process in therapy? Are the topics that come up around the dinner table relational in nature, or are they discursive? Is this a broader example of bigger patterns inside of their relationship, where he tends to be the one who is the one who knows, and she feels like she has to go and appeal to the great sage? What's going on with all of that? So this is all stuff that I'd be very interested in exploring if I were talking to this guy on just a human-friendly level, let alone more of a coaching relationship or something like that. Because they can all be parts of the mix, and they can all explain what's actually creating this experience where, on the one hand, he feels like he's got all these great ideas, and his partner is just never moving into action around them. I assume that's his experience. That's the typical experience with this kind of thing. And on the other hand, she feels like he's kind of not really listening to her and isn't really that interested in why she feels the way that she feels. And he's always just kind of trying to solve her problem. I really appreciated what you said there about power imbalance. I would wonder about making sure that there are times in which she is helping him, at least as much as he has helped her. Yeah. In which he's troubled about something and she's counseling him or helping him see or being the knower. And he's the learner, part one. Part two, I do wonder about situations in which, frankly, person A is genuinely more skillful psychologically inside their own mind. And let's say genuinely has, you know, developed certain traits more fully than the other person. There really is a difference, Just as in there's a difference when you see people on a sports team. We get a lot of questions from people, to your point here, Dad, about relationships that are unbalanced in this way. It's something people really experience. Yeah, it's a very common question. Yeah. And then what do you do if person B, who's, let's say, maybe less developed in some regards, keeps talking about a personal issue? And person A, who's, let's say, farther along in certain regards, is genuinely trying to be helpful and genuinely is offering things that would be helpful if person B really took them up. Except you start to observe over time that person B is truly not yet motivated to apply them or to make significant efforts inside their own mind. They're not yet motivated to do that. What does person A do then? And I think that's a deep question. And sometimes in couples, the issue is so fundamental that person B's lack of motivation to really work with it, to really make efforts. We can't control where we are, but we have a lot of control over the efforts we make, whether it's externally directed or internally directed. And we're responsible. We're responsible for the efforts we actually do make. So what do you do if you're A and you realize that your partner B has a particular quality, let's say being highly self-critical, like in this example that is consequential in your relationship and maybe even consequential for your children, your family, or maybe you look down the road and you can see that it would be consequential. And then what do you do? That's a challenging one. And I want a foreground that that is a real situation. I totally understand what you're saying here, Dad. The one thing I want to jump in and just say that I think is important inside of this question is that it's not that the wife in this example is not interested or doing it or engaged. They've both been to couples therapy together. There's just this kind of over and over recitation of I'm further down the path. This is more my hobby. I know more about this stuff. And that could be totally true. But there is something in how that story is being told that I think I'm responding to here that is is raising my yellow if not red flat yeah uh there's just a point there's just extending it to a different sort of example i think i appreciate the generosity or something because it's possible that i'm not being generous enough um but uh you know i just there's there's some some tone to this text that i'm kind of going huh and you know this could be my own kind of sensitivities to it because i've got some experience wielding knowledge as a cudgel so hey, if we want to really look at it that way, maybe that's why this is the part of the question that I'm kind of responding to. Also, just my experience in general with more top-down people who get into this kind of stuff is when they learn the material, they kind of become robo-husband for a minute. Ah, yes, I see that you are experiencing self-criticism. That must be so difficult for you. That might work during an analysis, but that's not really what your partner is really looking for in a moment of conflict And just from a practical technical what does joining actually look like standpoint It something to be aware of I don know anything else you would like to kind of put on here as a layer dad or just as a, you know, you've seen this couple walk into your office, to your point. I was that couple, you know, going back to my time in my 20s in which I was in a relationship in which I was the teacher and the knower. And then after about four or five months of that, I was in a meeting with this person and I looked at her and I realized that she had grown tremendously in the last four or five months and I was still the same guy. And I thought, wow, I got the booby prize of being right and superior. And she got the real golden prize of healing and growth during that time. So yeah, I've been that guy. I'll leave it at this point. It's a good therapeutic technique in general to ask yourself, what would I be like if I didn't have this problem? Or what would we be like as a couple if we did not have this dynamic? What would replace it? And maybe what function is being served by this dynamic that we would have to face if we no longer had that dynamic? I think that's great, Dad. And maybe one final actual piece of advice here, in this whole thing. There is a fundamental difference between being in this kind of an interaction with another person and leading with descriptive jargon about what's happening and actually joining emotionally, including through vulnerable sharing of your own experience. So option A, I think that this is your protective part showing up because this reminds you of your dad. Option B, I'm freaking out right now because I'm worried that we're just not going to find our way through this. Or I feel kind of frustrated right now because I feel like I say this stuff and it never actually makes anything feel better. Ah, and that's an experience we're both going through. I'm frustrated about it. You're frustrated that I'm saying this stuff. This is the experience that we're in together. That second option is just going to get you so much further down the road, one way or the other, because it's going to be really revealing either way. Either they meet you in it in a productive way, or it's another, you know, plate onto the pile of plates where you go, eh, maybe this one's not for me. All right, let's move on to our third question, which, oh boy, is a big one. It seems to me, I love starting a question with that phrase, it seems to be, that ADHD is on the rise. I see it in my partner and in my colleagues at work who seem unable to focus or get things done by a deadline. What is contributing to this? How does a person's screen use play a part in this, if at all? How about the social videos these days with their jump cuts and short snippets of information? What does the research say about our brain's ability to pay attention and stay focused? I would love to use this question as an opportunity to help people learn how to think about a statement like, everyone has ADHD now, or something like that. One of these common, often repeated phrases that you'll bump into on social media for a little bit of background data, Dad, before you go into whatever your take was on this, just to kind of get us on the same page here. First, ADHD is estimated to affect about 5% of the population, but last year in the United States, researchers reported that more than 11% of children had received an ADHD diagnosis. So there clearly was some meaningful gap between the number of kids who were being diagnosed at that moment of time and our general idea of the rate of ADHD in the population as a whole. So what do you think about this stuff, Dad? I think a lot about it. And I'm going to try to be succinct. Think about four fundamental characteristics and the ways in which the population varies in each one of these characteristics. Distractability, stimulation seeking, impulsivity, and emotional dysregulation. Think about those four attributes. And then think about population of six-year-olds. And to some extent, it's relevant to do this a little bit by gender. There is a normal distribution along all four of those dimensions. Fairly arbitrarily, the powers that be declare that from about the 95th percentile onward for each one of them, there is something that is called a disorder. My own view about it is that no, there's simply a normal variation in four major temperamental attributes. And in fact, people at the very high end, let's say of distractibility, impulsivity, stimulation seeking, and or emotional dysregulation, were actually useful to have in small hunter gatherer bands, which is in part why those attributes psychologically were not selected out during the intense selective pressures of Stone Age life. Today, though, we call it a disorder, which I think is a terrible mistake. There is often an issue of fit between a child or an adult who's at the 99th percentile on impulsivity or stimulation seeking and environments that pull for highly regulated, controlled, contained, plain vanilla kind of person. But that's not a pathology located inside them. It's an issue of it, part one. Part two, those four attributes, the sourcing of them has a lot of loading on temperament and biology, and to some extent can be innate at birth. Additionally, in terms of nurture, to grow up in a very dysregulated environment, that can shape a person in a certain way so that by the time they're 15 or 45, they are more impulsive or emotionally dysregulated, dysregulatable, than they were, let's say, constitutionally at birth. Additionally, we have modern life and the ways in which it trains attention. It is really true that within a certain range, depending on your constitutional temperament, your distractibility, impulsivity, stimulation-seeking, and emotional dysregulation can be trained to one extent or another, for better or worse. The questioner is getting at the for worse side of it, particularly around attentional control and stimulation seeking, distractibility and stimulation seeking. And it is really true that if you start training children at a young age on a heavy diet of highly rewarding shifts of attention to one thing or another and another, that tends to train the stimmostat, as it were, deep in the subcortex of the brain and the basal ganglia to get habituated to a certain diet of incoming stimuli. So anything less than that can feel terribly, terribly boring. and deflating and dispiriting. So then you have someone who has a really hard time just sitting quietly and listening for long periods to something or sitting quietly and kind of watching a movie from the 1980s, let alone the 1930s, you know, that it just feels so slow. And so I do think that there is something here that's cultural and we're doing a vast experiment on the human brain and psyche, which is now being really accelerated by AI in new kinds of ways. And yeah, and then what do we do about it? Well, I do think that attention is highly trainable. Research does show that. And people, in my view, as kind of a value, really should have autonomy with regard to their attention. Well, I think that's good advice at the end there, Dan, and a good take on a complicated territory. I'm going to give a little bit of my own take on it here that includes some information and some research and some numbers, but like you were saying, this is difficult stuff to study. So an important distinction to just start with at the top is this question of, is what you're noticing in people, like if a five-year-old or something is exposed to vertical videos swiping through TikTok and they become more distractible, is that the same thing as having what we describe as ADHD? This is a really interesting question, actually, because ADHD is highly heritable. There's a major study, it was a twin study in 2019, that put the heritability rate of ADHD at about roughly 80%. So what this means is that it's similar to autism spectrum, bipolar, and schizophrenia, which are generally considered some of the most heritable mental health conditions out there. What this means is that not that if a parent has ADHD, their kid is 80% likely to have ADHD, by the way, that's not what that means. It means that of the aspects that lead to somebody having ADHD, roughly 80% of them are heritable in nature. And there are a lot of similar complexities to diagnosing autism. Is the number of kids with ADHD or autism increasing? Or are we just getting much better at identifying ADHD and autism when it does present? Or are standards for diagnosis going down? And one of those is absolutely true. Our standards for diagnosis are going down in a very documented way. There's a box score approach to diagnosis. So what this means is that in the DSM, they'll give like nine criteria for having a certain type of ADHD. And you need to click a certain number of those boxes in order for you to be diagnosed. The DSM-5 dropped the criteria from six of nine to five of nine in adults. So children still need six, but those lowered standards in adults mean that there are more adults getting diagnosed with ADHD. Because if you still have five of these traits, by the time that you hit 23 or 35 or 76, well, that's more of an indicator that you haven't essentially aged out of this, that this is kind of characteristic to you, right? The pandemic in general led to a radical increase in reported mental health issues, which led to many more people getting evaluated, which led to more diagnoses. Now, does that mean the overall rate of diagnosis went up? Or were we just getting more representative sample? Was there something about the pandemic where, hello, it was a collective event we went through that could very understandably lead to a rise in mental health diagnoses for people. There's also an argument here that the world has become a lot more complicated, and the kinds of things that we're being pushed toward are just really bad for somebody who has ADHD. If you think about the nature of staring at a screen all day long, that's going to be particularly like playing into the worst impulses of the ADHD brain, right? Or it's going to be really pulled toward that immediate, easy supply of dopamine. I think about Elizabeth. Elizabeth's had to really work on her TikTok consumption habit. She has ADHD, and it's very easy for her to just get really sucked into it for extended periods of time. So this all kind of suggests to me that the idea that screen time causes what we think of as ADHD is probably a little bit of an overstatement. But screen addiction and reliance can have symptoms that look a lot like ADHD. And the big increase in screens is probably bad for people who have ADHD. And you're right. If you're trained on these from a really young age, you kind of end up in the same spot. So really, what's the difference? And the what's the difference is that treatment options might vary, depending on whether or not you have like genetic, quote unquote, ADHD versus the non-heritable version. like you've just been trained in these kind of attentional issues from a young age. What do you think about anything that I've said there, Dad? I'm suspicious of my own memories on the one hand, but I will just say that my sense of the capacity of people to just plop and settle and be content with very little incoming, I think it's on the decline sure yeah yeah no I would agree with that and this might sound like a bit of a pedantic distinction that I'm making between what you're describing dad and ADHD as a diagnosable condition that's for sure but I think that people often use this psychological terminology in just way too broad a way good point referring to somebody as being distractible and they haven't trained the muscle of attention is distinct from having ADHD. Yep. And that's the distinction that I'm drawing in this. And it's very typical in this kind of a question. Oh, you know, everyone has ADHD. Kids these days with their ADHD and their purple hair and their autism diagnoses and it's just getting out of control. And a lot of this is because we're seeing different sets of behaviors that present in a similar way, but that doesn't actually mean that the condition is present. So I'm not a doctor as the constant caveat I give on the show, but that's just my experience bumping into this material. What do you think about what I said about autonomy and being the master in your own house with regard to hungers, appetites? Big thumbs up is my general take. I also think that that is obviously really individual in terms of the amount of influence that somebody has over that and the tools that they have at their disposal, Elizabeth needed to go on Adderall. That was the tool. That was the game changer for her. And that was how she exercised her agency, was hauling herself through the process that got her to Adderall. Oh, I wear contact lenses. I've exercised a lot of agency there. Yeah, exactly. That's how you exercise your agency. Totally. It's really okay to use these kinds of functional changes. And the reason that I say that is because I think that sometimes people can get like almost moral and dogmatizing about like, oh, you should just be able to control your attention, kiddo. And I just don't really buy into that very much. That's good. All right. How about the next one? Okay. All right. I think we got time for one more here. Let's do one more. Back to the show after a quick break. Now, back to the show. I have a question about working with a therapist. I think this is a great question for you, Dad. I recently started with a very experienced therapist. They've been working for over 30 years. In our first session, she was quite direct. I presented a situation, and she definitely didn't take my side in it. Some of what she said feels true and insightful. And if I'm messing something up, I definitely want to know. At the same time, I also felt threatened and, frankly, kind of offended, especially given that this was our first meeting and there wasn't really much of a relationship yet. In the past, I've worked with therapists who were very non-directive and shared little of their own perspective, which frankly was also frustrating. I was seeking clarity and advice, not just a lot of reflection. My question is about therapist directness. How does one know when to lean into a very direct approach and just work with the discomfort that I might be experiencing versus recognizing that the style might not be a good fit for me as a person and looking for another therapist? Such an interesting question. Great question. My first headline would be something like, be curious about what's the sweet spot, the Goldilocks place, in which there is both a directness and an explicitness that gives you something to work with, whether it's an insight about yourself or some actions you might be able to take. What's the balance of that, while also feeling that the therapist you're interacting with is not being controlling and also not sort of preventing you from coming to your own realizations because they just want to, you know, lay their infinite wisdom on you? What's the balance of those two together? And a key question to that would be, what's your second session with this therapist like? When you go back to that person, can you be real with them about your experience of the first session and in a collaborative way, explore style and balance points and kind of see what the therapist does. Clearly, from a skills standpoint, there would be a question if we were observing this session and then debriefing it we watch it through the one mirror let say and then we all just talk about it later Maybe we film it and we stop start You know, we were all to do that. Would we say that the therapist was really skillful? How would we evaluate the skillfulness of the therapist? Clearly, in a first session, she did something that you, the client, found fairly alarming. Hmm, is that skillful? On the other hand, maybe the therapist, when you really rewind the tape, made some pretty gentle observations, kind of tentatively and diffidently, and you, the client, overreacted to them. That was really about your material, not that the therapist did anything unskillful. So I think that's really useful to ask yourself because it makes a difference. If you think that this is a therapist who has been in the game too long and is getting kind of jaded and just being a little too quick and too caught up with her own infinite wisdom, well, that's not very skillful. And maybe you would want to find a therapist who was experienced but would be one notch more in rapport with you. On the other hand, if you rewind and you reflect and you go, she was actually fine, maybe a little quick, and I need to give her more feedback about myself, but there's a lot here I like, and I want to try to create a productive partnership, then that would take you down a different pathway. Totally agree with you. I think a lot of this is about what happens in session two. Do you go in the door and do you feel like you can be honest with her? For starters, I think that feeling of, do I think I can be honest with that person is about both of you. It's a little bit about you and your tendency, like how direct are you as a person yourself, but some of it's about her. Has she created an environment where you feel like you can be honest with her in return. I think it's noteworthy that all of the people who I've talked to on the show who have been clinicians that we think of as like great clinicians, all have a kind of directness to them. I think of Terry Real, super direct. His whole style is like maximum directness. Sue Johnson, I mean, she had a real directness about her, I would say, in her style. And she kind of had to, given the work that she was doing at the time that she was doing it. Dr. Jacob Palm, he was direct enough with me to be like, I didn't like the question you asked me. You know, that's pretty direct. And I would be talking with him again soon, and I'm really looking forward to that. So, you know, I think that this model of the purely receptive container is great and can be a big part of therapy. But I think it's striking that essentially everyone I can think of who's like a well-known great therapist is like fairly direct in their nature. I get a little squirmy about that because— Oh, okay, great. Carl Rogers, famously non-directive. That's one of your favorites. These are guys, so— We talked about this. Totally. Yeah. So I wonder what clients of mine might say over the years, and I'm not asking for the feedback. I tend to think, on the one hand, my nature, you know me as a person. You are very solutions-oriented as a person. Yeah. Yeah. I tend to be that way on the one hand. On the other hand, I just, I guess I really believe in listening. I think that's where you got to start. I think you got to start with report. Yeah. That's my personal. Not knowing and slowing down and being really aware of the asymmetry of power. And so for me, I would say there's some chartreuse flags, if not yellow or orange, about this therapist. How could the therapist know enough in just a first session to be strong about something, this or that, as reported here? Now, we don't know. We haven't watched the film of the session. Yeah, we don't exactly know. But I guess for me, there's something also sacred about a frame in which the client is seen as the active agent of their own change. And so if you, with good intent even, jump in a lot as a therapist, you're disrupting that frame. You're moving into it. You're crowding out the client from the cockpit. You're moving into the cockpit yourself. You're in the chair with your hand on the joystick. Not so good. and even more subtly, I am improvement oriented and I'm interested in the values of the client being fulfilled. People are in my office typically because they want something to be better in their life and so I'm very aligned with them about that as an end that is a lot, I think, best served by taking your time and really listening and not jumping to conclusions and having a hunch that it's more complicated than it might seem at first. I totally agree with you, and I get where you're coming from with it as well. I think that this gets a little bit to the episode that we did recently on the attention economy and that idea of when you have a hammer, everything looks like a nail. There were some things in the email that this person sent where it felt like the clinician had a real view about certain kinds of relationships or certain ways that people should interact with each other. And I do think that sometimes you just feel like you're talking to somebody who has seen you in their office so many times that they're no longer relating to you as an individual. They're relating to you as an archetype. And I don't know if I want to be related to as an archetype. I want to be related to as a person. And I think that as a clinician, you also have to be kind of sensitive to that, where you're not just immediately lumping somebody. To some extent, like I did in one of the previous questions when we were talking about the imbalance of power, and I was saying, oh, I feel like I've talked to a version of this guy at various points in the past. I've been a version of this guy at various points in the past. You can learn from that while not having it be the complete way that you think about another person. And just being sensitive to that I think is important. We're getting at how we are with other people in general. For me, there's something really important about a tender touch, to realize that behind the eyes of the other person and behind their veils and shields, in every person is a really tender being, vulnerable. Inside me, inside oneself, is that same tender, vulnerable being. And it's easy to lose touch with it through our distractions and attentions to the more superficial outer layers, the sleeve, sleeves plural, wrapped around the core. And especially in a therapy context, I think it's so important to rest in an ongoing felt knowing of the tender vulnerability of the person you're speaking with. especially, especially if there's an asymmetry of power in the situation. I think these were really interesting questions, Dad. I loved getting through them. I thought this was a really good one. And I always like talking about this stuff with you in general because you have the clinical experience and you're able to layer that on top of everything that I'm kind of thinking about. And sometimes it feels like we're very similar in things and sometimes it feels like we've got enough difference to make it interesting. If people do have questions that they would like to have answered on a future episode of the podcast, again, it's contact at beingwellpodcast.com. You can also sign up for the Patreon. It's always great to talk with you on this. Yeah, always, Forrest. I had a great time talking with Rick today, and we answered questions about the freeze response, different levels of psychoeducation in a relationship, dealing with a therapist who is very direct, and then a question about ADHD, modern culture's screen use, and whether screens could create more ADHD. I thought this was a particularly interesting episode of the mailbag. These were very deep questions. And to say one more time, if you want to have a question answered on the show, you can reach us at contact at beingwellpodcast.com. So we started with a question about the freeze response. This was somebody who was experiencing a good amount of shame and self-criticism. And the first thing that Rick started with was appreciating how the freeze response is a stress response. And the stress responses are kind of baked into us. They are a mother nature's blueprint for what we are supposed to do in response to threat. The reason that we have them is to keep ourselves safe. And so you doing something to keep yourself safe is not inherently a bad thing. It doesn't mean that you're a bad person if you can't immediately move yourself out of the freeze response and into something else. So just loading that in to start with can maybe help somebody deal with some of the shame and self-criticism. Because inside of shame, a lot of the time is an implicit, I should. I should be able to fill in the blank. And if we're able to change that to, it's really normal for my body to have this kind of response. It's really hard to do something about this. It doesn't mean that there's something wrong with me if this is something that I do. We're often able to build a much more functional relationship with the stress responses. We also talked about developing more self-compassion, doing some work, as Rick said, off the field. So when we're not actively experiencing the freeze response, what can we do with emotional processing or preparing for the future? I talked about creating a kind of intention plan. So in the future, when this thing happens, I will fill in the blank. Those are all tools that can help a person out. And as part of this conversation, we also talked a bit about the role of pain in personal development. You know, for a lot of us, we have a moment where we become aware of something, some fact about ourselves, some tendency that we have, some behavior, whatever it is. And it kind of hurts, you know, that self-awareness stings because I just came back from a dance event. I was watching videos of myself dancing and I was like, ah, man, I don't know. I was seeing myself do a lot of things that I didn't feel great about. And that's a natural part of any kind of personal development process, whether you're learning how to dance or you're learning how to deal with the freeze response, right? And Rick had a really good framing and question about this. What is the minimal amount of pain that you need to get some gain? Yeah, maybe pain is motivating, but also pain's bad for us in a lot of ways. We don't want to experience pain. And most people experience a lot more pain than they need to in terms of the second darts that they're adding to things. So it's not just that natural, normal pain of, oh, I want to be able to do something and I can't do it yet. It's all of the self-criticism and shame and so on that we layer on top of it. The second question was, at least on the surface, about different levels of psychoeducation inside of a relationship. I took the question in a slightly different direction. It felt to me from the tone of the question that there maybe were some things being missed in the relationship between these two people. One person was more cognitive and top-down and had done a lot of self-help work. And their partner had, sure, been to couples counseling and things like that with them. But they didn't really appraise her as being as thoughtful about these things. And so when they entered a conversation about some issue they were having, he was prepared with his three-point plan and multi-paragraph explanation. And she was kind of working through the feelings actively and in the moment. And understandably, that created a real sense of power imbalance between the two of them. And there were kind of two sides to this coin. And Rick emphasized how you want to be with somebody who has a learning curve, right? You want to be with somebody who is really interested in these things, who does care about growth and improvement over time, not just in a hobbyist, they're reading the books and just kind of bowing to the altar of self-help in America or something like that. That's not really so important. It's a much more fundamental question of, does this person learn from their experiences? Are they interested in being a little bit better tomorrow than they are today. But the other half of this question is really more about process. Inside of the process that this person had with their partner, inside of their repair conversations, was he really listening? Was he really involving her in it? Was he being constantly set up as the one who knew the answer? And did this create an uncomfortable power dynamic between them? Did she become self-conscious about how she communicates because she's entering into these conversations from this fundamentally one-down position? Was he using his knowledge as a tool for joining and connecting and actually solving a problem? Or was it a way to feel like he knew more and to kind of insulate himself from her criticisms? Bottom line, real repair means that people are in it together. She needs to feel like an equal. She needs to feel included in the individual work that you're doing. Are you asking her about the things that you're exploring on your own? Are you interested in her take? All of that, Is this real collaborative emotional vulnerability, or are you just kind of like moving through the checklist of today I must start by joining, and then I will reflect to her what I hear inside of her communication, and then I'm going to talk about how her protective behaviors are showing, you know, and so on. Like, this is not how real relationships work. Third question was about the seeming rise in ADHD and how people have become more distractible and, like, you know, they can't pay attention to things, they can't deliver the goods in some kind of a timely way or hit deadlines, and what's going on with all of that? Rick started by talking about the broader context of ADHD and the idea of it as a problem of fit between a certain kind of brain and our modern environments. And he talked about how, hey, if you have a brain that's constantly bombarded by different kinds of stimulation, it's easy for it to start to get used to that level of stimulation. And so when that level of stimulation falls away, it can become a lot harder for the brain to concentrate. As a not perfect analogy, I sleep with a fan on in the room. I'm used to having a little background noise. If there's no noise at all, that actually feels a little bit uncomfortable. It feels like, you know, and I actually have a hard time sleeping. So in much the same way, somebody who's used to that baseline level of stimulation starts to feel pretty uncomfortable when they're not getting it anymore. And yeah, if your brain is trained on movies from 2025 and you go back to watch a movie from 1930, it's probably going to feel really slow to you. So yes, there is all of that cultural stuff going on, but there's a lot of other complicated stuff in the mix. Rates of diagnosis, changes to diagnostic criteria. Is the rate of ADHD going up or are we just getting better at noticing it? has the massive increase in mental healthy conversations and knowledge of therapeutic lingo and all of that stuff, which we're at least partially responsible for, like we definitely play a part in that system. We do this kind of a mental health podcast. Is that the same thing as the actual underlying rate of an ADHD brain increasing over time? And what I ended up landing on is, well, I'm not sure if screens really cause ADHD in the way that we think of heritable ADHD. I doubt that that's what's happening. And then the descendants of that person would suddenly have a greater increased chance of like an ADHD brain. I don't know about that one. I'm not a doctor, but I sort of doubt it. But screens could definitely increase the rate that we are perceiving ADHD at, in part because they create some ADHD-ish behaviors out of people. Final question was about working with a therapist who was very directive in nature. And Rick emphasized two aspects to this. The first thing that he talked about was his own personal value that he places on being a receptive container for the client and how he thought that there were some things in the question that raised, you know, maybe a little bit of a yellowish flag for him. And he talked about the really important starting point of rapport and connection and feeling like you're on the same team, feeling like you're really heard by your therapist, you're treated as an individual, all of that good stuff. And then also Rick is a problem solver by his nature. He is a get in there, let's try to find a solution, let's make things a little bit different tomorrow than they were yesterday. And good therapy balances these two things. And importantly, do you feel like you can have a conversation with your therapist about that balance and be a kind of active agent in the process of therapy? If you feel like you can walk into session two and talk to your therapist about this, you're probably in good shape. If you feel like you can't, that's a little bit more of a red flag. I hope you enjoyed today's episode of the podcast. I want to give you one more quick reminder about Rick's online course, Rewire Your Anxious Brain. You can learn more about it at rickhansen.com slash anxious and get an additional 10% off with the coupon code BWP10. If you made it this far and you haven't subscribed to the podcast yet, if you could take a moment to subscribe, it would really help us out. If you're listening on Spotify or Apple, you can leave a rating and a positive review of the podcast. If you're watching on YouTube, you can subscribe, hit the like button, leave a comment, all of those good things, we really appreciate it. So until next time, thanks for listening, and we'll talk to you soon.