Ep. 25 | Ted Leavitt – ADHD: Now Playing In A Person Near You | Pt. 1
- Why we lie
- EEFB (Event, Explanation, Feeling, Behaviour)
- Problem behaviours vs mental health problems
- Symptoms of ADHD
In this episode, Family Therapist Ted Leavitt describes his diagnosis of ADHD as a discovery that changed everything, including his personal perspectives and professional practice. For the last decade, in addition to his counselling work, Ted focuses now on removing distinctions between problem behaviour and mental health problems. His work and study support the understanding that people, “Do well if they can.”
Ted LeavittTed Leavitt is an author, an addiction counsellor, a youth and family therapist and a specialist in ADHD: attention deficit and hyperactivity disorder. His work is built upon years of study, practice and personal experience.
Diagnosed with ADHD in his thirties, Ted came to see himself and his clients through new eyes. In his work with both clients and medical professionals, he highlights the challenge of distinguishing between problem behaviors and mental health problems.
Ted Leavitt: Official Website
Ted Leavitt: LinkedIn Profile
(PDF) ADHD Medical Checklist
Transcript: Episode 25 | ADHD: Now Playing In A Person Near You | Pt. 1
Rachel Cram – Ted thank you so much for being in the studio today.
Ted Leavitt – Glad to be here.
Rachel Cram – I am so interested for this conversation, partly because I think I will learn a lot as well. In preparation for this interview I listened to your TEDx talk, which is fabulous.
Ted Leavitt – Thank you.
Rachel Cram – And I actually have a lot of ADHD that runs through my family as well so I’m here as a learner.
Ted Leavitt – Welcome.
Rachel Cram – Welcome to the club.
Ted Leavitt – Welcome to the club. Yeah
Rachel Cram – It’s a beautiful club.
Ted Leavitt – Yes it is.
Rachel Cram – I’m going to start today with the question that we typically open with in our interviews. Aristotle stated, “Give me a child at 7 and I will show you the adult.” So Ted, is there a story or an experience from your childhood that has shaped the man that you are today?
Ted Leavitt – Yeah, I mean there’s so many stories right. I’m a storyteller and so I remember all sorts of things. But it’s interesting that the quote talks about the age of seven because the story that rises to the top for me, I was probably seven or eight, I think was in Grade 2 and there was this little girl that moved into our school and she was just odd. I mean as a 7 year old you can’t articulate but she would just sit a lot of the time staring, either staring at you, through you, at nothing. She sort of had her mouth hanging open. She had a runny nose a lot of the time. And I was drawn to her. She looked like she needed a friend. So I said to my mom, “I’m going to try and be a friend to this girl.” So I tried really hard. I talked to her. I tried to include her and ask her questions and I got nothing.
And I remember one time seeing her in town with her dad and I just got this weird vibe. And I just I had this feeling something not good was happening there. And then they moved and I never saw her or heard from her again.
And I always felt kind of haunted by that, especially as I got older and learned about the world and things that happen in the world. And I thought, “Man, that poor little girl was all by herself and nobody was helping her.” And I don’t know if she ever did get help. I don’t know if she had some developmental difficulties. I’m sure there was some trauma going on there. So that’s kind of me. I was always the person to notice that person in the room.
I think that probably shaped me, those kinds of experiences. Seeing people that were hurting and wanting them to not hurt. That’s essentially how I ended up doing what I’m doing. I realized, “Oh okay. I see that this is kind of where I’m supposed to be; working with those people.” And I say those people I mean we’re all those people at times right. Where we’re the person sitting on the edge of the room. So I would say that’s probably the one that stands out the most for me.
Rachel Cram – Thanks for describing that. It’s amazing how early compassion, or empathy, manifests itself and that it led you to this career. Now you started off as an addiction counselor, is that correct? That was your first career in the area of counseling. Were there any big takeaways? I know you shifted, and we’ll get into that. Were there any experiences or understandings that you gained through that particular form of counseling?
Ted Leavitt – Oh yeah. Like so many so many. It was such a good place to learn on the job. One that served me really well over the years has been to not take lying personally.
Rachel Cram – Lying from the client?
Ted Leavitt – Lying from the client or your child or whoever. So I was working as the intake worker. I ran the group for the guys in their first two weeks and this guy came to me one evening and he said, “Oh my grandma’s dying. She’s in the hospital. She was my caregiver growing up. I would just feel terrible if she died without me having a chance to say goodbye to her. So I need to discharge from the program early and go in to see her.”
I said, “Okay, that sounds like a legit reason to do it.” So we bought him a bus ticket and took him down to the bus stop and dropped him off.
When I got back to the treatment center a couple of clients pulled me aside and said, “No, his grandma’s not dying. He wants to use drugs.” and I always hated being lied to. Which is ironic given how much I lied to other people as a kid.
So I was like, “What!” I was ready to get in the van and drive back down there to take the ticket back. How dare you take advantage of my sympathy. And then I realized, he didn’t pick that story because he thought I was stupid enough to believe it. Which was always a trigger for me. People thinking that I was dumb. I just realized, OK people lie because that’s what they know how to do.
Their brain has told them that is your best strategy in this scenario. So let’s do it. And I learned to not take it personally. And sometimes when they knew that I knew that they were lying but didn’t really care that they were lying, they would feel safe enough to open up a bit more. They would then tell me the truth. Because often when you say to kids, “Oh, if you do the thing that you shouldn’t do, that’s one thing but if you lie about it that’s when I’m gonna be mad.” But if I’m not even mad then, it becomes very safe to tell you the truth.
Music #1 – 8:02
Rachel Cram – Well I think what you’re describing is the complexity of people and, I think related to this, in your work you’ve been looking into the difference between problem behaviors and mental health problems. I’m wondering as you reflect on stories like this what are you discovering about that difference, or lack of difference?
Ted Leavitt – Well that is a source of frustration for me I would say; sitting in meetings with people who in my opinion ought to know better, who just cannot stop themselves from delineating mental health problems from behavior problems.
Rachel Cram – Are you talking about therapists or are you talking about clients here?
Ted Leavitt – Therapists
Rachel Cram – OK
Ted Leavitt – Therapists, psychiatrists, mental health professionals, people whose job it is to know the difference saying, “We don’t have enough beds in the child and adolescent psych unit because we have all these behavior kids coming in.” And me saying, “Well, behavior problems are mental health problems.” and then they say “Yeah, I know, but when they’re not.”
I said, “but they are always.”
Rachel Cram – Well and this comes back to teachers and schools too right. There’s a lot of conversations right now about all the behavior problems that are in the schools and I think this reflects directly on that conversation as well. And your attitude towards that very much affects how you relate to that individual.
Ted Leavitt – Absolutely. Yeah. So a lot of the presentations that I do, I start with this slide that says EEFB.
Rachel Cram – EEFB? That’s an acronym?
Ted Leavitt – Yeah. So, there’s an event that happens. We have an explanation for the event. Which gives rise to a feeling about the event. Which gives rise to a behavioral response to the event.
Rachel Cram – Event, explaining, feeling, behavior.
Ted Leavitt – So you have a child who’s saying, “No!” when it’s time to work on math. “No it’s stupid!”
If your explanation is that this is a power struggle; then my feeling, I feel like this person is trying to take power from me. Which gives rise to either a fight or flight response.
If my explanation of this behavior is that this child feels overwhelmed, insecure, afraid, I would hope that my feeling would be more compassionate and my behavioral response would reflect that
Rachel Cram – Which are mental health concerns, right?
Ted Leavitt – Right. So I think part of the hang up is, “What does mental illness mean? Right. And people think of that person mumbling to themselves walking down the street or suicidal depression, but it’s a spectrum just like physical health. There’s nobody who’s in perfect physical condition and why can’t the same be true with our mental health. We all slide up and down that spectrum day to day, based on things that happen. And it comes back to, kids do well if they can.
So if a person is having a behavior problem, I always say, “Nobody in their right mind does that. Nobody wants to do badly. Nobody wants to get in trouble.”
And I’m kind of a stickler for words. One of them will say, “Well, he likes to argue about everything.” Or, “He wants to make other people annoyed.”
Really? Does he want to, or is he feeling compelled to do that due to some unresolved thing that’s going on in his life.
Rachel Cram – It’s a perception of choice. I think right? Of feeling that there is a choice that somebody is making. As opposed to it is beyond choice, like the child saying that math is stupid, its a reflex to something internal or external. it’s an unconscious choice.
Ted Leavitt – Right. And that’s what neuroscience research has shown over and over, is that our default setting is reflex. And that makes people uncomfortable I think, because then how can I blame other people for stuff? So now my power is given up if I recognize that we’re all reflexive creatures.
Rachel Cram – For better or for worse, we all make unconscious choices
Ted Leavitt – Yeah, Now that’s our default setting. Through mindful practice you can learn to recognize your reflexes and override them. So we’re not doomed to stay that way.
Rachel Cram – But that takes a lot of conscious choice and practice.
Ted Leavitt – It does right. And often it takes a lot of painful experiences to wake us up to the reality that maybe we’re not quite as in control as we thought we were.
Rachel Cram – Now, before we keep going forward, I’m wondering if we can back up a little bit. You mentioned the trigger for you of people thinking you were dumb. And your book Teddy Hit Me, which is a great title by the way,
Ted Leavitt – Thank you.
Rachel Cram – covers reasons for this, and the confirmed discovery of your own mental health challenges when you were in your thirties. I’m wondering if we can look at that because I think often when you are a therapist or when you’re working with people, the more that you can personally relate the more effective you can be.
Ted Leavitt – 100 percent.
Rachel Cram – Can you tell me about that experience? What happened for you that brought that to your attention in your 30s? What was the journey?
Ted Leavitt – So in terms of the diagnosis?
Rachel Cram – Yeah, what made you be diagnosed at 30? And what did that do for you as an adult? How did that change how that shift? How did that change things for you? Or did it?
Ted Leavitt – Oh yeah, it changed my life entirely.
Rachel Cram – How so? You were at a work conference on mental health I believe?
Ted Leavitt – Yes. So, it was with Dr. Gabor Mate who wrote Scattered Minds and he had just written a book called In the Realm of Hungry Ghosts about addiction.
And so it was all about attachment trauma and brain development and the need for comfort. And I was like, “Oh my goodness, this explains everything!”
So I loved everything that he was saying. So of course I bought all of his books. And one of them was Scattered Minds, a book about ADD is what he called it when it was written. And I thought, “Oh, I think a lot of my clients probably deal with this. Maybe it’s a good way to get to know them.”
And so I started reading it and from the first pages I was like, “What the heck! This is my life!” Like there were lines in there that are things I’ve said many many times to other people.
Rachel Cram – What would be an example of that?
Ted Leavitt – So my wife one time, I was kind of like storming around the house, and she said, “You need to figure out what is stressing you out.”
I said, “I know what is stressing me out. I’m stressing me out but I can’t get away from me is the problem.” And that’s one of the things he talks about. Being terrified of being left alone with your own mind. And he talks about reading a book in the bank lineup because he can’t stand being alone with his own thoughts. It’s almost a visceral experience. What you could describe as impatience would not fully capture the lived experience of standing in a lineup that you can’t make go faster but you have to be in. You have an itch that cannot be scratched.
Rachel Cram – And did you think everybody felt like that? Or had you not really thought about it in detail?
Ted Leavitt – I hadn’t ever really thought about it. I mean nobody had ever attached any kind of a label to me except depression, and that was just like a one time comment when I was about 18/19 years old. When they said it, I was like, “Oh, that would actually explain a lot.” And they weren’t wrong, but the underlying source still wasn’t there.
Rachel Cram – So you’re reading this book and you’re thinking, “Oh my goodness, this relates to me.”
Ted Leavitt – Yeah. So I’m like, “This is me!” So I went to my mom and I said, “Hey, you’ve got to check this out. Like, this explains everything!” And of course, in a very ADHD way, I kept lending the book out to people before I actually finished reading it because I was so excited about what I was reading. I was like, “You’ve got to check this out!”
And my mom called me about a week later and she said, “Is it okay if I put a little pencil mark in the margin next to things that I can relate to or that makes sense?”
I said, “Sure.”
She said, “I was writing out lines that I liked. Then I realized I’m basically writing the whole book. So it’s probably better if I just make a little dot?”
And I was like, “See, was I right? Was I wrong?”
So back then I was very antimedication. I was like, “Oh you don’t need medication. Just learn to think differently, and plan, and all that kind of stuff. But that didn’t make any difference for me.
A big part of the treatment for ADHD is knowing what that is. Like, “Oh that’s why I do all that stuff, or don’t do all that stuff.” So that was a huge boom right off the top. Just understanding that.
Rachel Cram – What is the ‘that’? Like, when you say you understand that’s why I don’t do this, that’s why I don’t do that. What did that book tell you was the reason for that?
Ted Leavitt – Not enough dopamine in the prefrontal cortex of my brain. It actually had nothing to do with my character or my desire or will or any of that stuff that I had always been attached to. Laziness. Those kinds of things, which later became very apparent when I started to take the medication.
So what pushed me to actually be officially diagnosed was a client who had been through the treatment center many many times. He was in my colleague’s group at the time and just a classic case of ADHD. Legs bouncing all the time; talking all the time. He knew all the answers to all the questions. He could write out the plan with his eyes closed. But he could not follow through on any of it and he could not stay clean for more than a month. He would come in for three months in the program. Leave. Relapsed almost right away. Come back. Do it again.
And so his last time through, the counselor and I were pretty good friends and we’re talking a lot about my ADHD realizations, and he’s like, “Huh, I wonder if that’s what’s going on with him?” And so we were actually able to get him to a psychiatrist who prescribed Dexedrine for him, ADHD medication, and, totally different guy. He graduated and stayed clean and stayed clean. And you know, last I heard he had been seven years, and this is a guy who couldn’t get 30 days.
Rachel Cram – So what that medication was giving him was the dopamine hit to his brain that he needed.
Ted Leavitt – Yeah. That he kept finding in crystal meth.
Rachel Cram – Ted do you have a general statistic of the population of how many people are affected by ADHD? I know that’s a very broad term right now. It’s a big spectrum term. But do you have numbers? Stats?
Ted Leavitt – It’s incredible how widely varied prevalence estimates are for ADHD. I’ve never seen one that rates it at higher than 10 percent, but prevalence estimates are always difficult because it’s based on people seeking help.
Rachel Cram – So many didn’t make it into the stats.
Ted Leavitt – Right. So I tend to think that maybe all of those prevalence estimates are underestimates.
Rachel Cram – I asked that because in schools right now we’re hearing so much about the behavior problems, as we talked about before. And I think something resonates within us to know, to feel, it’s not always a choice. That it is perhaps a mental health problem. But then when you look at your child for example, or your husband in your wife’s case, you think, “I don’t want to attribute a mental health problem to this person because that doesn’t fit the stereotype of what I think. But there’s so much self-esteem, there’s so much potential, there’s so much capability that’s lost with not being aware of the necessity of a dopamine hit to our brain. Can you walk us through your growing up? What was school like for you?
Ted Leavitt – So, it’s kind of like an athlete who’s naturally athletic. They can get by on their talent but when they get with other people who are also athletic who work hard, then they kind of end up on the bench. So that was me in elementary school. I could kind of wing it. I was very creative. I didn’t get in a ton of trouble. My report cards were always, you know, “Ted could do a lot better if he would apply himself. He could be a great student if he would only be more organized.”
A lot of last minute projects with my dad was helping me finish. A lot of frustration, you know, foot in the mouth, saying the worst thing you could say, “Oh man! Why did I say that?” Those kinds of moments. But I had lots of friends and I was pretty well liked. And then when I was going to grade eight there was a big uptick in what’s required of a student in terms of self-directedness, self organization, self-regulation essentially.
Rachel Cram – So high school requires that?
Ted Leavitt – Yeah. In elementary school, not so much.
And so I’d really dropped off, and was doing really badly in school. But nobody really thought anything of it because they could see that I was the smart kid. So I must just be lazy or not working hard. Or I was really depressed. And so that persisted till the end of grade 12. Essentially this underachievement.
Rachel Cram – So what sort of things would you report card say? What were your teachers saying about you?
Ted Leavitt – Was a lot of the same stuff. “Not organized. Not handing stuff in. Not paying attention. Not applying himself; the classic one that ninety nine percent of ADHD people have on their report cards. “If they applied themselves or were less social…” that kind of stuff.
Rachel Cram – And what were you thinking about yourself at that stage? Do you remember that?
Ted Leavitt – Yeah, I just thought I was an idiot; an inevitable disappointment I guess. Not in myself, because I didn’t really have expectations for myself. I didn’t really think beyond the next day. A lot of people say, “I’m hardest on myself,” or “I’m disappointing myself.” I never felt like that because I didn’t have expectations for myself.
Rachel Cram – That’s such a sad outlook on yourself. You talk about there being symptoms of ADHD and symptoms because of ADHD. Is that kind of self image a symptom?
Ted Leavitt – Yeah
Rachel Cram – Can you give the distinctions for each? What are symptoms of ADHD?
Ted Leavitt – So things like, getting bored really easily, even by things that were once interesting. Starting really strong and kind of fading away. More big picture and not so much detail oriented. So, I’m just sort of paraphrasing the checklist right.
Rachel Cram – Maybe we can put a link to that checklist, or the list itself on our website.
Ted Leavitt – Yeah.
Rachel Cram – So, what are other symptoms of ADHD?
Ted Leavitt – Fidgetiness. A difficult time staying seated; although with adults, for the most part we’ve learned to stay in our seat. So I’ll ask them, “How often do you feel like getting up?”
OK, so we check that box. A very specific kind of memory difficulty in what’s called ‘working memory,’ which is remembering what you’re supposed to be doing. So if you’re doing a task and you’re pulled away from it, can you go back to where you left and pick up where you left off? You know, “I need you to do A B and C.” They can maybe remember ‘A’ but the rest of it kind of gets blurry.
Difficulty learning from mistakes. So a lot of repeated mistakes. “Why do we keep having this conversation? kind of stuff. “Emotional. Up and down mood swings. We also tend to hyper focus on things that naturally produce dopamine in our brain. We do have a chronically low level of dopamine, which is a reward chemical. But our brain also doesn’t regulate it very well and so when something comes along that produces dopamine you get locked into it and sort of laser tractor beam focus.
Rachel Cram – What would be examples of that?
Ted Leavitt – So as a musician I had a little studio in my house and I would say to my wife, “Oh, it’s 11:00 at night. I’m just going to go down to my studio really quickly and just work on this chorus. There’s just one thing I just have to record really quickly.”
And then she’d come down at 4 o’clock in the morning and say, “You have to be up in three hours. Do you think maybe you should come to bed?”
“Oh! What time is it?” It’s like no time had gone by. I felt refreshed as anything.You just get so engrossed in it that there is no world around you, whether it’s reading books or playing video games or kids building lego. And that’s one of the things actually that interferes with diagnosis sometimes, is that they’ll say, “Well you can play video games. You can focus on playing video games or..”
Rachel Cram – Because that’s giving the dopamine hit.
Ted Leavitt – Right. But that’s where we come back to this idea of choice, right. They think, “Well you can pay attention when you want to.” It’s not about wanting to. It’s about whatever the activity is eliciting that from me, not me deciding to give it to the activity. And so those are the main symptoms; the signs,
Rachel Cram – Like the external signs? The symptoms that are more obvious to other people?
Ted Leavitt – Yeah, which is like the bouncing leg and the interrupting all the time and difficulty waiting for your turn. And then there’s symptoms which are more internal. So, a lot of racing thoughts and obsessive thinking. When I was diagnosed the psychiatrist said a lot of my symptoms were subjective. And at first I thought he meant, a matter of opinion, but then he meant only I experienced them because they’re not obvious to the outside world. Which would explain a lot of why it took so long.
Rachel Cram – So these are symptoms of ADHD. Before we look at symptoms because of ADHD, can I just ask you, you talked about getting bored, even with activities that were really interesting to you. When you’re bored, is that because you have actually lost interest or is it because you can’t maintain the interest?
Ted Leavitt – I guess for me those are two different feelings. So Dopamine’s role, one of its many roles in your body, is a reward chemical. And so, if you have a chronically low level of it then things that are rewarding for other people, let’s say nine out of ten for you, are five out of 10. And so I use the phrase, it doesn’t hit the spot. So there are lots of things that I am interested in and I want to try and learn about. But when I do them, it’s underwhelming. But I am genuinely interested in them. So that’s probably what you called boredom right. Is that things just don’t do it for me.
Rachel Cram – So you don’t continue to pursue.
Ted Leavitt – Right. There’s no payoff for it.
Rachel Cram – So it appears probably like you’re starting a lot of things but not completing them
Ted Leavitt – Right. And when you start, you’re all in. Like,“You know what? I’m going to play the violin!” And you watch a thousand videos on teaching yourself violin. You do all this research on buying violins. You pick up the violin and you can’t make a note. And you’re like, “Ahh, forget it. But you know what? Mandolin! That’s what I need. I need a mandolin. It’s closer to a guitar.” So you switch.
So, it’s hard to say you’re not interested or you’re not motivated but there just isn’t a payoff for that interest and motivation and so things kind of fade out quickly. Now lack of focus, that can play a role too because a lot of times something like playing the violin or learning to draw requires persistence and follow through before you get the payoff. And if you don’t have the ability to stick with it, you don’t get the payoff. Even if there was a payoff at the end of the end of the rainbow, you don’t get to the end of the rainbow, so you never get to really experience it.
Which leads to a lot of learned helplessness. Like, what’s the point in trying to do something because it’s probably just going to disappoint you anyway.
End part one
Roy Salmond – We are going to pause here in this conversation between Rachel and ADHD Counselor and Family Therapist Ted Leavitt – but there is more to come. The rest of the interview will be our next release. Part 2!