EP 2:11: ADHD and Chemsex Addiction with Daniel

Hey y'all, this week we are going to touch on a highly debated and I think probably very misunderstood topic, and that is ADHD, and especially how it relates to chemsex addiction. Honestly, I haven't met a meth user yet who has not said to me that they have ADHD. I have some opinions about that, which you will hear in this episode. Today's discussion only barely scrapes the surface when it comes to this topic. And there is definitely a gap in the research as far as I can tell when it comes to how neurodiversity affects chemsex users. But I do believe that when we work to alter ADHD-type behaviors, we make our recovery stronger. And I do believe that there are people who are living better lives because of prescribed Adderall. And I also believe many people will be better living better lives without it. There is a vast amount of gray area on this topic. When it comes down to, for me, is treating everyone with respect and providing a safe space like my guest Daniel is doing with his psychotherapy practice. For men who have sex with men, that is the key to healing and recovery— a safe, unconditional space. And above all that, the causes and the cures for ADHD can be debated till we're all blue in the face. That may never end, but if this discussion today helps one person feel less shame around their behaviors and habits and be able to step forward and ask for help, then we've done our job. And if this discussion brings more empathy and understanding to the table, like it did for me, then we've done our job as well. I hope you enjoyed this episode, and I would expect many more podcasts on this subject in the future. The Aftermath Podcast is an outreach tool to help men who have sex with men break free from the addictive patterns associated with chemsex, otherwise known as crystal meth or Tina. I'm your host, Dr. Dallas Bragg, a former crystal meth user, now recovery coach. Here you will find a repository of tools and resources intended to eradicate the epidemic that is plaguing our MSM community. M population. Please note that the views expressed on this podcast are not to be taken as medical advice. Also, we will be talking about drugs and sex, so if you feel triggered to use, stop listening and contact your local emergency system and/or your support network. Let's go. Welcome back to the Aftermath Podcast. So, so, so grateful that you're here. So grateful that you are tuning in and listening. And we have a lot of new listeners, which I'm very excited about because I can tell by my story, which is episode 1 of our podcast, keeps getting a bunch of views. So it's about 1,000 people have viewed my story now. So I really appreciate that. And I love getting new listeners to the podcast because, you know, we are probably the only— well, not probably. If you go searching, we are the only podcast serving this niche topic. So I really would like you to help me help it grow and getting the right hands. So rate and review the podcast if you possibly can, please. If you've already done that, then please just share it, share it word of mouth, share it through email, share it on your social media, do something to get the algorithm saying, hey, people like this, so it can get out to more people. The ones who need to read it. Um, I'm very grateful again that you are listening and tuning in and that continuing to grow. We had our record number of downloads last month, and so we continue to see that happening. So, uh, don't forget that we have a supplemental study guide with each episode. That supplemental study guide is posted on my website, drdallasbragg.com, under blog, or you can get it straight to your email by subscribing to my website. in my mailing list, because if you do subscribe, you also get on Mondays a newsletter that's also a workable study guide with journal prompts, with reflective questions, all kinds of actionable exercises. And it goes— there's a different topic each week. This week was perfectionism and how that influences meth use. So if you're interested, go to drdallasbragg.com and sign up for my mailing list. We have a free Facebook community, the Aftermath Podcast. Um, you can— on that, in that community, I usually say, hey, I'm doing this podcast today, you have any questions? Or hey, what's the topic you want to hear on the podcast? So you get a say in actually what the— what we focus on here. Um, we also support one another and we have different types of activities and questions on that. So if you are still on Facebook— I guess not many people are— but if you are still on Facebook, join our Facebook community. And don't forget, you can watch this podcast through YouTube, the Aftermath Podcast. If you do Type it in. Make sure you do not let it autocorrect to after math, or you will not find me. So it's after myth. Ah, so I have a note for all that. So I got it all down. So I'm don't forget anything. All right. So today I am so excited to have another repeat offender on the podcast. Repeat guest Daniel.

If only you knew. Yeah.

Daniel. Gilsen.

Gilsen. Gilsen. Yeah, yeah.

Oh my God, it's not even hard to say. It's not even hard to say.

But Daniel is unusual though.

Yeah, yeah, yeah. Um, Daniel is an organizational psychologist, executive coach, psychodynamic psychotherapist, an addiction and recovery specialist. He is also my supervisor at Controlling Chemsex. By the way, I haven't mentioned it, uh, lately, but Controlling Chemsex is out of the UK. You can find them on online, or you can find them on Instagram, other social media outlets. But if you are having difficulties with chemsex, you can apply at Controlling Chemsex, get on the waiting list, and you can get free keyworking sessions, as they call them, or we can call them coaching sessions in the US. But you can see someone about 8 times. I volunteer for Controlling Chemsex as one of the keyworkers, and Daniel is my Supervisor. And I will take— I will come to Daniel and I will learn every single time, uh, what I, what I'm missing, because I, I see what my blind spots are, um, every time that we meet. And so I also want to say, Daniel is— if you are looking for a psychotherapist who knows chemsex, this is the man to go to. We're going to put all of his information in the show notes, but you can link to his website, um, and anybody in the world can see you, right? Right.

Yeah, absolutely. Yeah, I operate virtually. So, yeah, so I've got consulting rooms here in London, but, you know, global. Yeah, the world's— in fact, I once, I mean, here we are doing it here, but I've delivered workshops with people. I once delivered a workshop in New York with a colleague in Sydney and it's just, well, I'm showing my age, aren't I? But yeah, virtually works, I guess, is the short answer to that question.

Yeah. Yeah, yeah, because, you know, as a recovery coach, I see myself in the center between treatment, recovery coaching, and then psychotherapy. So I try to get these guys away from the substance long enough so they can be therapized. And I get a lot of guys coming to me who tried therapy and the therapist didn't understand chemsex at all, um, and they didn't feel comfortable sharing. But you have a vast, deep knowledge, and I would say if you are looking for psychotherapy Daniel's your man. Please, please go to his website. It'll be in the show notes. Today we're talking about ADHD, which is a topic I get asked a ton of questions about. As you all know, I am not a therapist. I do not claim to be a therapist. And the views expressed by me today are not Daniel's because I have sometimes very strong opinions about ADHD. I I, um, get asked about this quite often, often enough that I wanted to do a podcast. I've been searching for someone and then all of a sudden, Daniel, you, you had your, your announcement of your practice and in there it said you specialize in ADHD. And so I was like, wow, this would be perfect. Um, but anyway, I want you to introduce yourself too, if you'd like.

Yeah, sure. Thank you.

Tell us more about you.

Yeah. I mean, I wouldn't say specializing. I don't, I think specializing is the wrong phrase, but I, what I, what I say and the only, the only, the only promise I make, and it's not even a promise. promise, as I say, that I have helped people. I've helped people with ADHD and autistic spectrum, um, presentations or diagnoses develop a greater degree of comfort with themselves and, and the world and some flexibility in their thinking. And I think, and I think that's, that, that's the extent of the promise. And, and I'd love to know what your strong views are on ADHD. That might be a really useful way for us to get into the conversation, actually.

Yeah.

To the extent you feel safe to share them, but Sure. Yeah, I do. And thank you. Thank you. Thank you for the plug on psychotherapy. And I think the difference, the difference, you know, I was just reflecting on this recently, is I think if you see somebody for recovery, the focus is on recovery, they talk about the substances or the behaviors, and it's your focus is on recovery. And they can't really do psychotherapy because they haven't had the training. On the other hand, if you see a psychotherapist, and you mentioned that you've got an issue with, with, with, with substances or behaviors, they will often say they can't see you for psychotherapy. And And I think the difference that I can offer is, you can really be wherever you, wherever you are on the journey. And I'm happy to see you. As long as you can show up to a session sober, then you can sort of do the work. It is worth saying, though, that it'll take longer. I say this on my website that, you know, people, people ask me the question, I'm still, I'm still struggling with the substance, can I do psychotherapy? And my answer is, yes, you can. But it's the results are going to, it's going to be slower. And, and I think it's worth saying, it's worth saying that. So I kind of am more open than most psychotherapists to seeing people that have got addiction issues, because I know actually psychotherapy can, can help you get the issues under control, even if it's not a very black and white programmatic kind of conversation about the addiction. The process of sort of developing self-awareness and self-knowledge that comes from psychotherapy can be very supportive in recovery. But my background is, as you say, my background is in, is in finance. So I used to work in investment banking. I spent a couple of decades working in investment banking and then in corporates, big companies like Tesco, which is our Walmart, and IHG, which is the hotel company that owns Intercontinental Hotels and Holiday Inns. So even though that's, those are US brands, it's a British company. And then retrained as an organizational psychologist and then as a psychodynamic psychotherapist at the Tavistock Center, which is sort of the spiritual home of Sigmund Freud in the UK. Um, and, and now work as a coach and a therapist. So that's me very briefly.

Thank you. Thank you. Thank you. Thank you. Yeah. So I just want to, I'd like to be very 101, 101 with everything, um, because I'm not a— again, I, I say this all the time— I'm not a therapist, I'm not a clinician, right? So a lot of what I say is my anecdotal opinion.

Yeah.

I haven't— I have an opinion about everything, um, but I just wanted to very basic, very basically, for anyone who may not know what ADHD stands for, attention deficit hyperactivity disorder, right? I'm reading this from a text, a chapter in a textbook that I have pulled up here, but it's characterized by symptoms of inattention and/or hyperactivity and impulsivity, right? So according to this chapter, it's frequently represented in substance use disorder patients. Yes. The estimates of the prevalence of ADHD vary between 14% and 23% in substance use disorder populations.

Wow.

And it says because they have shared genetic background. So there's a shared genetic background between substance use disorder and ADHD is what they're, they're saying. But like you said, on the other hand, there's a lot of people— and one of my favorite people in the world is Dr. Gabor Maté, who leans more into it's not a genetic background that causes ADHD, it's behavioral, and it's what happens in your formative years, um, especially around attachment disorder, right? Like, yeah, he's big on, you know, this is not genetic. This is how— this is like nature versus nurture kind of, kind of thing. Um, and so my— the way that I'm seeing things, I lean more toward that. Um, I lean more toward there was, you know, that there's— it's a learned behavior. Um, and maybe it doesn't matter, you know what, like maybe it doesn't matter if it was learned or it's genetic, you still have it, right? Um, but what I see, what the, the problem that I see with it, I guess we could just start here, is I see people embracing it as their identity and just casting all, everything on the fact that I, it's my ADHD, right? Like, yeah, not, not replying to texts or giving into that craving, or the way that I, you know, like popping off at somebody and not thinking about it, uh, being depressed. Everything revolves around, it's my ADHD, it's my ADHD. And to me, it becomes— you, you become at your recovery from a victim standpoint and something to blame instead of taking full responsibility. So, but That's controversial, I know. So that's kind of, that's very light, but that's how it is.

All right. Well, there's a lot to unpick there. So I might ask you to sort of bring me back on track because I'm probably going to get lost. And maybe that's my ADHD. Let's get lost.

Let's get lost. It's your ADHD.

Yeah, exactly. And I don't mean to laugh at it. I'm pretty sure I don't have ADHD. But I certainly, you know, the thing about ADHD and all mental health conditions or diagnoses is that they're all spectrum situations. I don't even want to use the word disorders. So, you know, there's normal functioning, whatever normal is, and then there is abnormal or problematic functioning. And it's all about more or less than. And we will all move through phases of more or less than. And actually, I was just, before I came on though, I was reading an article in the New York Times, which is really an interesting one, and if it's useful, I'll— I'll find a link for people, um, that talks about people, you know, it can be situ— there can be a situational element to ADHD. But going back to the nature versus nurture argument, I think what, what I would say to that is in all, in all things psychological, there seems to be reasonable evidence that, that everything has an element of, of biological or genetic disposition and an element of, um, environmental. So note the nurture piece. And every— and it's— and it seems to be about how you know, who you were born interacts with how you were raised that creates character, personality, whatever you want, putting, putting the labels aside altogether. And so I think the most likely, and not being a neuroscientist or having any medical qualifications apart from a psychotherapeutic qualification, which is all about the subjective rather than the objective, I think what is, is likely is that you may be born with a certain a different way of sort of tolerating intrusion. So it might be that you are particularly sensitive to light or sound or temperature or whatever it is, or that you're particularly— it's— you have a higher need for care or a lower sort of intolerance of being left alone or whatever it might be. There'll be biological factors that will result in um, your experience of the environment being different. And at that point, it's then what you make, how you survive in that environment. So it might— it isn't— it isn't— it's, it's the— it's what nature gives you, and then it's a little bit about what environment provides you, and then it's a little bit about what you do with it. And I think it— that the most— probably the most important thing to hold in mind is that there's— I think there's a very— shame is a very active element of the ADHD experience. And, and when people sort of want to push toward it being something that's fixed, it's, it's a diagnosis, it's biological. What they're trying to say is don't be ashamed of who you are. And I think that's a very, very helpful voice to have, you know, in your mind as you're, as you're grappling with ADHD and in the world as it's adapting to it. Um, but there's no judgment, you know, it isn't that you had a bad parent, but it might be that you had a particular set of needs that your parent wasn't able to notice, recognize, or respond to for whatever reason. So there's no blame and there's no guilt. It was what it was. It's a question of you got to where you got to, you are where you are in the world. You know, you function the way that you function. What can you, you know, what's, what's your capacity to evolve through that, to change that, to, to, um, to develop a greater degree of flexibility, a different relationship with yourself? Because I think a lot of the issue with ADHD as you get into adulthood isn't just that it's difficult to sort of manage your life. It's what you think about that. And so I was talking to an ADHD, a friend of mine, a friend and colleague, psychotherapy colleague of mine who's in her 50s yesterday about her ADHD. She was diagnosed just a few years ago and she gave me enormous insights into just how difficult certain things are for her. But one example she gave that was really interesting is she said, it's really difficult for me to get out of the house. And I had no idea. I meet her for lunch and she's always late and it never occurred. I mean, I roll my eyes and think she's late again. But she explains to me that she can't find her keys. And then, you know, the self-talk comes in. I mean, I've done it again.

I'm a complete idiot.

I can't believe I've screwed this up again. And so it's not the fact that the keys are missing, it's what she's telling herself about the missing keys and the disabling that that does to her capacity to, you know, in a calm emotional and psychological state, look for the keys. That becomes the problem. So very, very long answer to a long question, to be sure.

Now, I love— no, no, no, I love this. This last part I'm picking up on is that We— there's so many people self-diagnosing also, right? Like, anybody I've ever had as a client tells me they have ADHD, right? Um, and maybe they all do, you know, it is prevalent, right? It's, it's co-occurring often, you know, like, like all the studies I'm seeing.

It absolutely is. There's very good evidence of that. Yes.

Yeah, like, I, I see all the studies and I'm seeing like treatment centers are now starting to, starting to get into this and treat ADHD as part of the treatment for addiction, right? But what I think you're saying is really important in— if you lose your keys a lot, that doesn't mean you have ADHD, right?

Right.

But it's how you respond to that. I lose my keys all the time, right? Like, I have to say audibly every time I leave my house, keys, wallet, phone. Like, I have to say it out loud or I will walk out without one of them, you know. But I, I don't berate myself over it at all. I make a joke about it, you know, a lot of times. But I have adapted to it also, you know.

Yeah.

By saying I do have to— I can't think it either. It's got to be out loud for me. Um, and so I, so I, I'm not saying that I, I, I don't know what I'm saying there besides I think that we have to be careful about what we label and what we think is bad or failings in our character. You know, if we lose things a lot or if we forget things a lot or if we are late, I think that's an important note there.

Yeah.

The other thing—

let me give you a counterpoint. Sorry, go on. The counterpoint is if you spend your life And, and I think this is the experience of a lot of people that have ADHD or more severe ADHD. If you spend your life constantly feeling like you're a screw-up and, and, and the shame that comes from that, and then somebody comes along and says, oh, it's ADHD, or you, you get self-diagnosed on Instagram, which by the way happened to me, and I'm pretty sure I'm not ADHD, but Instagram wants you to be ADHD so it can then sell you the cure. It really does. And that's something we can, we can talk about later. Yeah.

Yeah.

It's, it, it's, it's a resting place. It's a refuge. It's a retreat. It's a, it's a, ah, you know, it's this, this life has felt exhausting. I can give myself a break. And I don't begrudge anyone taking that break. I think it, you know, give yourself a break. And in fact, giving yourself a break is the key not only to sort of managing your ADHD symptoms, but also having a successful recovery.

Mm-hmm.

So ironically, the fact is that perhaps drop, you know, 'cause it is relentless. It is, A constant sense of shame and failing. And is it any wonder, by the way, that you turn to substances to get some relief?

Yes.

Right. And can you think of, can you think of a self-diagnosis as, you know, I can let myself, I don't have to beat myself up today. We, you know, there but for the grace of God, we would be doing this, Dallas. So there's no, there's no, there's no need for any additional shame. Yeah, I think is what I'm saying.

Yeah. Yeah.

The question is, is it, is it serving you? And can we Is there a— is there another way of functioning that gives you more of what you want from your life?

Yeah.

Sorry. I'll let you speak.

No, no, no, no, no. That's perfect. No, I love— I really love how you, you really, again, bring my blind spots to light. And you're still doing it. But yeah, I would imagine what it would be like, because I do know— so I will say, If I lose my phone repeatedly in the same day, I start to get very agitated, dysregulated a little bit. So I'm imagining if that was my life every day and it was everything, like, I would say, yeah, I could see that I would be very highly dysregulated, very highly anxious. And if, if a puff of meth or more would take all that away, I could definitely see the allure of that for sure. For sure, I can see that. And I'm still— I'm having some empathy because I do— there are people that I talk to, they're like, you know, I just, I cannot function without my Adderall. Like, I literally can't get out of bed.

Hmm.

You know, um, so who am I to say what their experience is? Um, but so, so anyway, I'm saying that I'm saying this out loud to say it's all about the spectrum of it, isn't it?

It is very much. Yeah, it is. It is. And, and, you know, the, the, there's the, there's the insidious double whammy of there's, you know, stimulants provide relief for people with ADHD, you know, who experience ADHD. There's, there's, you know, the jury's out about whether it actually, you know, there's a— in the same New York Times article, which I don't want to rely on only that one source, but it was a useful source, it sort of talked about the fact that they, you know, you give stimulants to children and, and they are able to sit in their seat and work and learn and function, but the evidence doesn't suggest they're learning any better. They're just sitting in their seat and doing more of the activity.

Hmm.

And, but what, what actually, what, what actually the evidence then further shows Is that they think they're doing better. And so, if you think about you know the way substances work in our minds and the experience they give us of ourselves in the world, is there a bit of that going on as well? And actually, most people don't stick with the stimulants. If you they're quite the evidence is that people try it and don't tend to like it, which is interesting of itself. But you know, I remember I I took one of these. I don't the brands are different here, but it was the it was the. the methamphetamine one, which I think is Adderall. I took one, a friend of mine, this same friend, actually, I won't name her. But she gave me when I was writing a dissertation 3 or 4 years ago, I had to, I don't know how I keep finding myself in master's programs. I've now written 3 or 4 of them. It's insane. I don't, it's very self-destructive. But she said to me, I'm going to give you a couple of my ADHD medications, and you'll have the best day writing your dissertation. And so she gave me one, and I took it at 8 AM on a Monday morning. And by 10 AM, I was so high, I couldn't function.

Ah.

And, and I thought to myself, I probably don't have ADHD. And the irony is that, and I rang her at 6 PM and I said to her, what were you thinking? And she said, oh, it just makes my brain go very clear.

Yeah.

And the irony is I had a terrible day and I wrote nothing and I didn't enjoy it. And I woke up the next day and I found another, she gave me 2 and I found the other one. I was like, oh, there's another one here. Should I take it? Even though the experience was terrible, You know, that, that, that, that, that, um, dopamine, it's really a strong force for programming behavior. I didn't take it. I flushed it, but it was tempting. And, you know, I think people would, it's a very common occurrence that people that have ADHD diagnoses or symptoms, they take the pill and it changes their experience of themselves in a way that they find really helpful.

Yeah. Yeah. Right. And then there's a lot of people who cannot only take one, Like they're over.

Yeah.

You know, they take all of them and then they crash for a week, you know, or whatever, and then get their prescription again. Yeah. I mean, that's, that's, go ahead.

It is. It's a, it's, you, I think, you know, one of the things that Gabor, I don't know how to say his name, is it Gabor? Gabor Maté also says is that the reason that you develop a problem, and I think this is true, combined with a bit of biology, which we can talk about as well. But the reason, the reason you got addicted is because the first time you used the drug, it gave you a, there was a real benefit. Something was going on in your life. You were, you had a need that was unfulfilled. You had a sense of not fitting in or depression or sadness or whatever it was. And you took the drug and those feelings went away.

Mm-hmm.

And it's, and the dopamine system then kicks in and says, whatever you were doing, do when you would, whatever you would, whatever you were doing when you got this dopamine release, next time you're in that place, do the same thing. And, and the great irony of the dopamine system and the reward system is that it programs in the behavior even without any sense of pleasure or benefit. So, you know, cigarettes are a great example. I mean, I did smoke and stopped smoking, but I don't remember ever really getting anything out of a cigarette. But oh God, my God, was I addicted to them. So you get the addiction without the pleasure. And anyone who's been in a long-term addictive situation knows that feeling, I think, is what am I doing this for? I'm taking this drug just to feel normal. I don't know how we got onto this, but—

No, there's so much to talk about with this topic. You know, because, and I think that's why it's so controversial, is just so hard to pin down. Like, you cannot say all ADHD is genetic, all ADHD is environmental, everybody who takes it, uh, Adderall shouldn't be on it. You know, I mean, you know, we can't— there's just, there's so much context and relativism to all of it. One of the issues though is the The fact that I had a client went on a telehealth visit with a doctor and had Adderall in his hand in two hours without any kind of assessment whatsoever besides I can't focus, you know. And then he takes Adderall, which triggers his triggers him because it feels a lot like meth. He happens. Yeah, well, it is meth, right? It is meth. And then he's taking, you know, he's taking 5, taking 5 of them to get up to the— to— and so, well, I do think there is an issue with the doctors prescribing it willy-nilly like that. So there's, you know, I don't know how it is over in the UK, but here it's just so easy to get is part of the problem.

Well, yeah, it does feel a bit like the opioid crisis in some ways, doesn't it? Um, which is not to say that ADHD isn't real and isn't and the drugs don't treat real problems. But is there overprescribing happening? And this, this came up in our handover yesterday, and I won't again name any names, but this was somebody who has a problem with crystal meth who very— who got a prescription for Adderall and is now using that and feeling great about things, and the cravings have gone away and life is great. And it does feel— it feels like the, um, it feels like a false dawn, I think is the phrase that I used in supervision yesterday.

Mm-hmm.

It feels like a false dawn and that this This, this individual has managed to alleviate, you know, some of the feelings of, with, you know, with some of the withdrawal, some of the dysregulation. But are they kicking the can down the road? Because actually they're still taking the substance that was problematic for them.

Right.

And at some point it's going to roar back. And I'm sure, I'm sure that'll be the case for them. And, you know, the, the guidelines are very strict that you shouldn't be, you should not be, you should be prescribing stimulants as a last resort for people that have a problem with stimulants.

Yeah.

And, um, and there are other drugs that are not stimulants that are effective. They can take longer though to be effective. And so they're not going to be the instant cure-all that you get from taking that, from taking the stimulants. So people might think they don't work or they're not as effective or whatever it may be. And there is a pro— you know, there is a, there's a, there's a, there's a price that you might have to pay if you if you have had a problem with stimulants and you do need to treat your ADHD and they're offering you a medication that isn't a stimulant, it may be that you do have to wait a couple of weeks. And it may be that it delivers a benefit to you that doesn't feel like the meth that you've been using recreationally or problematically.

Mm-hmm.

But maybe that's okay. Maybe it's okay if it doesn't, if it doesn't take away all of the, you know, the difficulties that you've had. Maybe it's okay if it doesn't feel quite as good or quite as effective. Maybe, you know, tolerating that, tolerating a slightly less perfect solution is a good, is a good, is a good solution though, because it is, it's helping you address the problem without masking it completely in a way that your addiction may have done and in a way that the Adderall may do for some others.

Mm-hmm.

There are other options. But, you know, we, we know that you simply answer the question, you check, if you check the form and say no problem, then you'll get Adderall because it's the one that they issue. It's the one that they prescribe first.

Mm-hmm.

And, you know, do the doctors know that they're, you know, healthcare as a business rather than a service drives suboptimal behaviors?

Mm-hmm.

Um, you know, you want to keep the client, you want to keep the client happy, the patient's the client. So, you know, let's not make it hard. If they want Adderall, they can have Adderall. But that doesn't, you know, it's the thing is though, actually, it's worth saying it's just as easy to get onto Grindr or ring your dealer and get the meth.

Yep.

It doesn't take, it doesn't take longer than 2 hours. So what are you, what, what sort of, are you deluding yourself by saying it's prescribed?

Right.

When, well, I had to, I had to sort of tick the wrong box on the form and say that I don't have a problem, but it's still problematic use. It's just you're using a prescription drug instead of the street drug.

That's right. That's right. Yeah. Yeah. I think if, if I'm a listener and I'm thinking about this, what I'm gleaning from our whole conversation so far is to be cautious about it. Have a really in-depth conversation with your medical doctor. Be honest about your past and find, uh, you know, find ways to address your— what you think your ADHD behaviors are. And maybe you can get diagnosed with, with ADHD, but I think doing a telehealth visit and getting it and getting some amount at the pharmacy just because you think you need it is just— it's not wise when you are trying— when you're in chemsex recovery, when you're in meth recovery. You have to know what you're doing and be cautious about this. But also is really think about— to me, I just think, where are you on the spectrum too? Because one thing that Gabor Maté says is that yes, medication is, is a, an answer, but only temporarily to bridge you, to bridge the gap. Kind of like, well, I think he even says this about SSRIs.

Mm-hmm.

Is that this is not a lifelong medication. This is to get you stabilized enough that you can start instituting different techniques into your life so that you can beat depression, right? And so the same with this in terms of getting you stabilized enough so you can think straight and then go into other, other alternatives. Like he talks about mindfulness and addressing, going to a psychotherapist and addressing Attachment and emotional wounds, lifetime lifestyle changes like exercise and sleep and, you know, and relationship healing. I mean, he goes into all of those kinds of things as alternatives for long-term, uh, management of ADHD. But the Adderall is just something temporary to bridge the gap. So I, I think— I don't know that there's a clear answer, but that's one alternative.

Yeah, I mean, I think, you know, with a, with With, with substances generally, the other thing that it is worth saying, and I'm sure, you know, your listeners know this, is our contemporary life heightens ADHD symptoms. So if you, if you lock somebody in a room who has never before tested positive for ADHD symptoms and give them a smartphone and leave them alone, they'll show up as ADHD.

Yeah.

Right. So the smartphones are doing it and the way we live is doing it. And also the drugs are doing it. So if you have a, a crystal meth problem, it's going to be disrupting the way that you're, you know, it's going to be disrupting your physiology and your, and the way that your brain is working to the next, to an extent that even without an ADHD diagnosis, you'll be behaving like somebody that has ADHD. And so it may be that you haven't, you know, you didn't get a childhood diagnosis, but actually if you were to be tested today, you'd show up as strongly impaired. But that might be a function of lifestyle as it relates to substance use and also lifestyles that relates to technology use. I mean, the evidence base is building, but there's more and more of it around and it's difficult to unpick from those lifestyle factors. And the, the, the, the, the, you know, the, the— it sounds, it sounds, it sounds too— it— for what feels like such a serious problem, the solutions seem too simple to be realistic, but they do work. And it is time in nature, time spent socially connected, um, time away from substances. managing smartphone and social media use. And they, they do all— because you don't, you know, the opposite of love is not hate, it's indifference. And as, as you know from the video that we show everybody that comes into Controlling Chemsex, the opposite of addiction isn't sobriety, it's social connection.

Mm-hmm.

And you're no longer an addict when you, when you don't miss it. And it's not— you're not— you're not— what's the word? You are not cursed as somebody that's a recent or even current user of crystal meth or other addictive substances with a lifetime of misery of missing these drugs. This is not what's going to happen to you. You're going to evolve out of it. And you'll come to a place where, you know, you might remember that incredible high that you had one time. But you've got no particular compulsion to repeat it right now in your life. It just doesn't, it doesn't have salience. It doesn't have meaning. It doesn't, you know, the, you don't even, you don't even consider it seriously. But if you did, you'd put together the, you know, the recovery and the, the how it's gonna, how it's gonna the next day and letting people down and what it's gonna do to you. And you just don't, you don't even get that far. You're just like, oh yeah, that was an interesting thing that happened to me once.

Hmm.

And I think that's very difficult for people to believe because actually, as you are grappling with, as you are sort of beginning and passing through this recovery period, the idea of not having access to the substance is terrifying. And a life without it is terrifying. And you think to yourself, you know, I remember thinking to myself, I don't think my life is worth living without cigarettes. And it feels completely insane as I say it. But if you find a smoker right now, they'd say that to you. And, and because you're, you know, the reward system, the dopamine system has been completely hijacked. And so every time you do something fun or social, nicotine is present. And the hijacking is the fun is the nicotine, not the fun is the connection. And it takes some reprogramming of your belief system and it takes some distance from the drug. for you to realize that actually that, that was nothing. It feels really, really like— it feels like the absolute truth, but it's not the truth. It's a perversion of the truth. And it can still be that you've had some great times on meth, but that you don't miss it.

Ah, right.

That, that, that's— that, that you— both things can be true. And I think that's impossible to believe when you're early on in the recovery. Mm-hmm. Mm-hmm.

That's right. Yeah. Yeah, I agree. Um, and just—

I don't know how this has to do— what this has got to do with ADHD, but—

Well, I think it has everything to do with it because I, I firmly believe, and this is anecdotal, right? I firmly believe when you do the work of recovery, you know, you're, you're going to dig deep into, like you're saying, you're talking about acceptance. Right? Like, this happened, that was there. I, I don't, I don't miss it anymore. I don't have to ruminate about it anymore. It happened. I'm moving forward, right? When you start moving forward in recovery and, and you start digging deep into your attachment, right, and your emotional wounds and your trauma and all that kind of stuff, then you want meth less and less because you're, you're not coping, right? And so in a way I feel like ADHD-type behaviors have been a way of coping, of distracting ourselves from the trauma that's too big for us to deal with. And so we distract ourselves by looking elsewhere or doing something else quickly or diverting our mind to our phone and those kinds of things. So in a way, I think when you start doing the work of recovery, if you temporarily have to get on Adderall to, to get your mind cleared, and then you start working on deepening and healing and trauma recovery, then I think you're going to have less and less tendencies of ADHD behavior depending on where you are in the spectrum, right? I know there's got to be severe— there's got to be severe people who just cannot function. You know, I, I, I get that. There's— I get that.

Yeah.

But open them. I think I feel like opening your mind up to say, as I'm doing recovery, I think I'm going to also wean off of Adderall. I think I'm, I can also soften the tendencies to be, to, of the ADHD type behaviors as I go along, because I won't need to cope anymore with this.

Yeah, well put.

Big, big emotion. Is that right?

I think that's absolutely right. And I think, but it is worth, yeah, no, that is right. And look, I think, look, I will say that I do, I do. The reason it's on my website is because I've seen You know, in any offers, because I've seen it work. I've seen how talk therapy over a period of time, you know, in 12 months or 18 months, leads people to change their relationship to their ADHD. This is severely— people diagnosed with severe impairment as a result of ADHD have come back. You know, we see them and then we have a break and come back. And after 6 months, they come back and tell me, you know, things— it's not that they are dramatically better at managing their lives, but their relationship to the way that they live is completely changed. And that massively reduces the stress, the shame, the, you know, the embarrassment, the humiliation. And it has, and it does, it does affect their, you know, it massively increases their capacity to function in a world that they say isn't made for them. And who am I to say that's true or not? You know, so many people with ADHD have said that exact phrase to me. I kind of accept that that's their experience. You know, you do, you really can, time and space. And I think talk therapy, you know, the right kind of talk therapy is really helpful. It's a nonjudgmental, it's a less jud— you bring, we all bring a very judgmental, our harshest critic is ourselves. You know this, we know this. And we bring a very judgmental, negative, attacking eye to our failings. Or what we perceive as our failings. And so, you know, the process in therapy with me is, I mean, a great— this may not be a great example for your audience, but it was a good example in this case is an individual who's sort of saying, I can't get out of bed. And I said, well, then just don't get out of bed. What are you getting out of bed for? Because it's what you have to do. Well, is it? Have you structured your life so that you can? What's the— why follow those rules if you can't make them work for you? And no one had ever sort of said this to this individual that that was possible. And in the end, I don't know if they did end up changing their lives in that way, but it never occurred to them that they didn't have to beat the shit out of themselves for the fact that they felt like a massive failure because they couldn't get out of bed at a certain time of day. But I want to— sorry, a final thought is I think it's really, you know, there's a great— the guy that— the program that I stopped smoking with is called the Alan Carr Easy Way, not the British comedian, but it is a British business.

Yeah.

And he's got— they've got Um, they've got a— they've got material on all sorts of, uh, drugs and behaviors. And the key thing that they say is that, you know, it's about the false belief of you think you're getting something meaningful and pleasurable from this drug. You're actually just alleviating your withdrawal symptoms when you take the drug. And, and they say, and I think I believe that it's really important once you've stopped using the drug to stop. And so they would say that nicotine patches are not the way to stop smoking because you stay in addiction. And, and if you're going to stop drinking, just stop. And by the way, you're getting nothing from drinking. You think you are, but actually you're not because of that dopamine system hijacking. And so I think it's worth just sort of saying, if you do, if you do, if you are, if you, if you do have ADHD and you have had a problem with stimulants and you are on medication or considering medication, you're probably better off not using the stimulant-based medication. Because it's probably better for you in the long time, for your— in the long term, for your recovery, not to be using stimulants because it's a constant reminder. It's a constant pullback as opposed to the non-stimulant treatments, which, as I say, are effective, but they might feel softer or take longer. I think that would be a good, you know, obviously consult, obviously consult medical professionals.

Sure.

But I think that might be something for people to explore. Yeah.

Yeah.

And it could be that, it could be that stopping Adderall feels hard because, you know, you're getting something out of it that felt a bit like the problematic use of the substance before. And that's a, that's a good reason to interrogate your feelings and think maybe, maybe this feels a bit too good.

Yeah, that's right. That's right. It's all about the motivation, right? If my motivation for not giving up Adderall is that it's my, my one Last connection to meth. It's, it's my meth light, right?

Yeah.

If that's your motivation, then that's, that's not supportive of your recovery.

Give yourself a break. You're making it harder for yourself. You're keeping yourself wanting something that, you know, where the, where the reality isn't, isn't— there's a disconnect between beliefs and reality. Let it go. Move on.

Yeah, yeah, yeah. Yes. So if I— one thing I wanted to ask you, if I came to you as a psychotherapist and I say, I think I have ADHD, you're going to probably tell me to go to a medical doctor, I guess. But are there questions? No. What would— what questions would you ask me?

The first thing I'd say, what does that mean? What does that mean for you? Ah, tell me, tell me what that means for you. Tell me about your experience of that. And, and, and give them a, you know, give them my, my attention and help them, help them make sense of it because it's part of the, part of the way we learn what we believe and what we think is by talking, ironically.

Mm-hmm.

And so, and, you know, in therapy, I don't make any demands of you can, it's your, it's your process and it's your time. And all I do is hold the space. And so you can kind of, you know, if you don't, if you don't come, then I'm not harmed. You, you, you know, there's, but so for you, so for you, for my ADHD patient, I'm here, we're still finishing at the end time. And so if you can, you know, if you find something that's meaningful and valuable here, you'll find the capacity to attend. And sometimes you might not get there. And sometimes you might get there late, and sometimes you might be there early. But, you know, what's available is available for you unconditionally within the window. But it's over to you. And, and I, and it's, and we can, we can think about what goes on that gets in the way of you attending. And we can, I can help you think about your strategies for it. But I'm not, you know, like the, like when you're sitting waiting for your friend at lunch you were describing earlier. I don't know if it was lunch that you were talking about. You're sitting waiting for your friend and they're late again, and they text and say it's my ADHD. Well, it can be whatever it is. It's, it's, it's your— I'm here to help you think it through, but you have to be present with me to think it through.

Hmm.

So I don't give it— I don't give too much advice. I do a lot of interpreting about what I'm experiencing. I think about what's going on in the relationship between me and my patient, because the chances are that's what goes on in the relationships that the patient has with the people in their world. And it'll reflect also their early childhood relate patterns of relating. So that's kind of how psychodynamic psychotherapy works is, what are you doing to me? What is the, what are the, what are you projecting into me? Or what are you trying to, what are you evoking in me? How might that reflect what happens in your relationships generally? So for example, I had a patient who, who was very, um, when he was very When he was at his most distressed, he was at his most attacking.

Okay.

And so his way of managing his distress was to attack. And it meant that I had to sort of, I was sort of retaliating in defense. And it took me months to realize that that's what's happening. And I sort of, oh, this person feels incredibly lonely and unhelped because whenever he's really distressed, people experience him as attacking and they run. And it multiplies his loneliness. And I was able to, through months and months of experiencing it, Work it out, think about it, share it with him. And he was able to think about it. And it took, you know, it doesn't just— the knowledge doesn't cure, but through time, recognizing that pattern means that ideally in his life, when he's next feeling overwhelmed, he won't go on the attack to hide his vulnerability from those around him. He's able to be more vulnerable and therefore receive help, the help that he's craving.

Hmm.

So I don't, I don't sort of think of it. I don't think or treat ADHD any differently. I'm, I've become I become aware of it and I think about how what I'm saying or doing might be landing with the patient or the client. And I might make reference to what I see them doing with what's happening. But it isn't, it's not, it's not, it's not different from, because I retain always the, I retain, you know, for you, for you as the patient, the hope and belief in growth. And so if I treat you as being limited because you tell me you've got ADHD, then I am limiting you. If I can create a space where you can find out what's possible, then it's a space of growth. I'm getting a bit evangelical. I think maybe I should stop there.

No, no, I think that's, I think that's, that sounds so safe for someone. what you're describing, what your relationship— it sounds like a very safe environment. And I would say, to me, there's the ADHD people with ADHD that, like I said, they make it their identity. Like every conversation, well, you know, I have ADHD. Well, it's my ADHD. It's my ADHD. Then you have those that are kind of suffering in silence who are ashamed of the fact that they can't maybe get to lunch on time Right? Or, or can't find their keys or whatever. And those people really need a safe, unconditional environment like you're talking about.

I would think they both do. I think they both do, actually. And I think, I think the person who, the person who is saying it's my ADHD, they're not get— they also are not, you know, the person who's suffering in silence, um, you might need some help to know that it's okay to share what's going on for them. The person that's shouting about it might need to know that, you know, that actually— what would they need to know? That it's okay to be different, but, you know, I'm going to be who I am. And so I'm not here to— there might be a degree of— is it a degree of not feeling seen or heard or understood? And so they feel the need to shout ever more loudly. Because they're not. And the irony is it has the effect of creating exactly the condition that they are trying to— they want to be seen, heard, and understood, but they're engaging in behavior that makes it less likely they're going to be seen, heard, or understood. And so for that person, I might, in therapy, I might sort of say it's sort of, I guess, people, maybe you have a— maybe it's common for you to be— for people to tell you that you're, you know, that you, you know, they're evoking They're evoking perhaps a past where they didn't feel understood. And I might sort of say something like, you, it's difficult for you to believe that I might understand what you're going through. And, and that'll be a moment of being understood that they may not have experienced before, which might provide some relief and reduce their need to shout.

Yeah.

Does that make sense? So it's a very, it's a very ephemeral and delicate process of What's going on for you that this is how you move through the world?

Right.

And is it still serving or is there, are there other strategies?

Right. Yeah. Yeah. And sometimes I just think about the chicken and the egg kind of thing. Right. So because ADHD is characterized by impulsivity. Right. So are you, are you impulsive because you have ADHD or are you impulsive first and that means you have ADHD? type behaviors. Because what, what I'm reading is that impulsivity and ADHD go hand in hand with sex addiction, video game addiction, gambling addiction, phone addiction, right? Like all of those.

Yeah.

Usually people, especially sex addiction, um, they have impulsive behavior and they're almost always, from what I'm reading, almost always co-occurring with ADHD. And I always kind of wonder, like, which came first? Right?

No, no, it matters. Yeah.

Yeah.

Well, there's a bit of, you know, the biological part of the biological mechanism is depressed dopamine. And you can imagine an anhedonic state that comes with that where it's difficult to feel anything at all. And so that just that drive impulsivity in order to have a sense of feeling, feeling anything at all or feeling alive. Um, you know, if you go back to this idea of shame, which I think is quite core in, in ADHD, even though people who might consider themselves ADHD may not be able to relate to this idea of shame, it might be there in the unconscious somewhere.

Mm-hmm.

You know, if you do feel shame, then what do these compulsive behaviors do? They move you very far away. They might give you a sense of power. They, in the case of casual or, um, compulsive sex might give you a feeling of, of, of being lovable, being wanted, that it's difficult to feel. Um, you know, there's a thrill and there's a thrill in gambling. There's a bit of, there's a bit of life or death about gambling. Um, so you can sort of, you know, again, you could put an ADHD label on it. You could probably put other labels on it. You know, there's a very— it's interesting that of the 5 or 6 or 7 signs of ADHD, there's a heavy overlap with all sorts of other diagnoses. And so—

Mm-hmm.

There's a bundle of something that isn't, there's a bundle of something that isn't sort of functioning ideally for the world as it is, that gets, you know, it's hap— you know, I'm not, there's a, you get a diagnosis, you know, most people don't get, you know, psychotherapy is an inherently inefficient treatment because it's one-on-one. So there's only so many hours in the day. Medication is much more efficient. It's much more able to be commercialized. Um, the drugs undoubtedly deliver benefits to people. You know, we can unpick the medical, um, what do you call it, the medical pharmaceutical industrial complex, or we can just sort of say, well, people are struggling, let's help them think about it. Yeah. Um, but I think, I think for you, for you as an individual, if you're constantly, if, if what, what happens for you is that it's, you find it triggering that people let you down and then blame their ADHD, then what can you do about that? I think you can— perhaps there's a boundary issue for you, Dr. Dallas Bragg, as an individual around, well, that's okay. Well, I just won't rely on you going forward. And then the individual has an experience of a consequence. And so they might think, it's Dallas. I really care about him. It really matters. I'm going to work extra hard to be there or whatever it is. But there's something going— there's a dynamic between the two of you that is particularly triggering. And look, you're human, and we are human, and it's difficult to feel. You know, I have friends that sometimes let me down or behave in a certain way. And I sort of accept that that's where they're at. And I withdraw. I don't rely on them. So I'll make sure that there's a place for them in my life. But, you know, if I was going to book a movie, I'll make sure that there's 3 of us going, not 2, kind of thing. Because I didn't— do I have to tell— I don't tell that individual that I can't rely on them. But I make allowance, you know, I might make allowances for them. And so they can get what they can tolerate in terms of their, in terms of my need for them to be dependable. At the same time as I don't get hurt by their, you know, their failures when they can't quite get there. But it's a very magnanimous, you can't, you can't be, you know, I'm not perfect. And it does slip and people do let you down and it can be upsetting.

Yeah, yeah, yeah. I mean, I, Uh, I, for me, with this particular friend, for instance, if we're sitting on their back deck, right, and we're in the middle of a conversation, and then I see this in the middle of the cameras.

I want to know, your camera froze, so I couldn't see you.

Oh, so I see them pick their phone up and start scrolling in the middle of our conversation. Oh, it's just my ADHD. Oh, no, bitch. That's— that is not. I, I mean, if it is, then I, I believe— I think, okay, I'm having a conversation, I'm going to turn my phone off. If I, you know, that way it systemizes it sort of so that if it is your ADHD, you— and if you do just habitually pick your phone up, it's off. You can't do anything with it.

Right. So anyway, yes.

So yeah.

So that's—

yeah.

So you might sort of say to them when they arrive, can we have our phones off? Because I noticed that it's difficult for you to—

That's right.

And then you might— and you might sort of say when the phone comes out, you might sort of say, it's— I've just— it's really hurtful when that happens because it makes me feel like, you know, I'm not as important as whatever.

And then— I say that, but in my own way.

Not like that.

Put it away, bitch.

Right.

But Yes. Yeah, yeah, you're right. Yeah. And yeah, that's very good, good information.

You know, look, look, I, I— this is where it's— all of this sounds very easy when you say it quickly. It's not, you know, what I'm telling you about how to— this is not how I behave, but it's how I, you know, you'd like to be able to.

Yeah, yeah. Well, I would say with the impulsivity, real quick, I, I do think that, that— because I have— there's several type of— several types of clients, right? There's a client who I can tell you 4 days in advance of when they're going to relapse because it's like a domino effect and it's this cycle that happens, right?

Mm-hmm.

Then I have other clients who everything's great, everything's fine, everything seems to be rolling along. They're journaling, they're doing all their stuff, and then something clicks impulsively walking out of work and they, they go. Right? Like there's no warning sign with that. So I do think in my mind, I'm like, well, if that is ADHD, if that's a— if impulsivity is part of that, if they were on some kind of low-dose medication that thinned that out, that helped them be less, less impulsive, I wonder if that would help them think through an impulse to use You know, in a way that would stop them from doing it, help them to think it through instead of just impulsively going. So I do wonder about that part as well.

Hmm. Well, I mean, I, you know, I think, you know, anyone, anyone that's got an active addiction, I think would probably, as I said, as I said in a different form before, show up as ADHD because I think it does drive the impulsivity so much part of it, whether you call it ADHD or not. Um, uh, there's, there's gonna have something— well, for, for the individual who snaps, there's, there's what I, what I found in, in work, in the key working at Controlling Chemsex, you know, before I was doing the supervision, but doing the actual key working with our clients is that— and I learned this from Ignacio, our CEO, who I know has been on, on your program before— is that there's— if somebody, when somebody says, I just snapped, I have no idea what happened, the decision to use has been made well before.

Mm-hmm.

And so, they may not be— there's not a conscious awareness of leaving the office, you know, I'm texting the dealer, but actually, there has been some decisions and there has been some triggers. And the work is— and when people say, you know, I've done this and it's useless, the answer is, well, we didn't get there. We haven't gone deep enough. We haven't actually found the thing. And so, let's replay the week again. And, you know, and let's replay it again. And what did that feel like? And what was going on then? And you can start to put the pieces together and build the story of, you know, the feeling usually of loneliness or not good enough or shame or whatever it is that drives that. Because, you know, I've said it to you, I think I've said it to you enough. So I'll say it again, is that we use drugs to change our emotional state. And we want to feel differently. And the drugs are the fastest and easiest and most, you know, if I can use the technical phrase narcissistic, I don't mean it in the common You know, that it's sort of, I'm, I'm, I do the thing that I, you know, I satisfy myself is what I mean by that. I don't need to express the vulnerability of sharing with somebody that I need a hug. I can get the hug from the pill without any other person being involved or the line or whatever it is. And so I've forgotten my train of thought, but there you go. But there's, there'll have been, you know, that they will use drugs to change our emotional state always. And drugs as simple as sugar, by the way, you know, I, there's—

Yeah.

I'm not drinking alcohol right now. And I, I've discovered sugar, who knew? And, and it's an, it's an almost imperceptible shift in emotional state. But that's what we're doing it for. But the trouble is, it's a false promise, because you take the drugs to feel differently, because something— you've got a problem. But when the drugs wear off, and you're in your, in your, when you're sober again, you've still got the problem. Plus, you've also got the comedown from the drugs. So you've done nothing proactive to solve the problem. And then you've got the comedown. Well, what's the solution? Let's take the drugs again and stop the feeling. And that's where addiction comes from.

Yeah. Yes. Yeah, exactly. Yes, that's good. That's good. Yep. And I still, I still go back to taking the drugs. Like, if you took Adderall for ADHD and then you're, you're taking it long term and not doing work, you know, not doing psychotherapy, not digging deep, then you're just compounding the issues, not going anywhere. Right.

Um, you can get— you can expand your— you can, with, with the right kind of good psychotherapy that you stick at, you'll get— you can— I'm not saying you cure ADHD, but you change your relationship to it in a way that is supportive of, of a greater degree of sort of happiness and contentment. I, I absolutely believe that's true, and I've seen it.

Yeah. Love that. Love that. Yeah. So I have some questions, but I think we've answered them, or some of them are just scientific. In your experience, how does untreated or poorly managed ADHD impact relapse risk? We've kind of talked about that in terms of the impulsivity.

Um, I'd rather somebody— I'd rather somebody with untreated ADHD get psychotherapy than get on a stimulant. I think, but I'm not saying that they shouldn't explore the other drugs. And I'm also not a psychiatrist, so I'm not medically qualified to say that.

Right.

Yeah. So those are my 3 provisos.

Which strategies help people with ADHD cope without returning to meth or other substances? You know, there's a list here from Dr. Gabor Maté that I read that I think is, if you want to read, review that, rerun. I think that that's, to me, a, a pretty exhaustive list in terms of if you're not— if you're not, you know, cope with returning to meth, um, you know, there's lifestyle changes and relationship healing and finding meaningful work, environmental modifications, right? Mindfulness practices, addressing attachment, psychotherapy, self-understanding, all of that, self-awareness, all of that.

Stop beating the shit out of yourself.

Right.

Is the key one. Stop beating yourself up.

Yeah. Yeah.

Which mindfulness is about. Mindfulness is that, isn't it? It's about acceptance and self-acceptance, I think.

That's right. That's right. Yeah. And mindfulness can help you observe your thoughts too, right? And observing the thoughts that are going through your head a lot of times helps you kind of be able to control them more because you're the observer. You're not, you're, you're not being thought by the thought. You're thinking the thought.

Precisely. Exactly. You get control back. You're not in the fight-flight. And there's something about, there's something about, there's something about, you know, in particular, a craving for, to use it, to use substances that you, when a craving hits, it's all-consuming. And it doesn't, and mindfulness can feel very, it can feel very flimsy. And But actually, mindfulness plus a bit of time, you know, 10 minutes, 15 minutes, as you'll, as I'm sure you'll know, is incredibly powerful. You're like, oh, well, I don't have to use and I won't. And I've got other things that I can do.

Right.

But you need, you need the little reset, the space for some mindfulness and some mindfulness. And you're like, I still want to. Well, you don't have to. And it's a false promise. You think you're going to get this, but you're really going to get that. Well, actually, I don't need that tonight.

That's right, right, that's right. Yeah, yeah. And be able to think ahead. A lot of times, like, we're thinking about using on a Friday, we forget that we have brunch planned on Sunday morning, right? First, we're not thinking ahead, we're just thinking of that immediate gratification. And what you're going to get is letting down your friends again, or showing up obliterated, or, you know, all the other—

And feeling— and feeling worthless as a result. You're gonna feel terrible. And that's going to drive you to want to use again. That's right.

That's right.

So it's not, it's not actually the letting their friends down. That's the problem. It's how that's going to make you feel. Well, they're both the problem, but the feelings are the thing that we seek to avoid and that drive the continued use. I love it.

Yeah. Well, what did I miss today?

You know, it's been, it's been a good conversation. It's a, it's one I was anxious about having with you because, you know, as I say, I You know, I don't know. I think the only people that are expert on ADHD are the people that are living through it.

That's right.

And I know that it's one that it is, people do feel there's a, you know, if you do, if life feels like an incredible struggle and you get a diagnosis and it feels like some relief and somebody tells you it's made up, it's in your head. I don't, I think I'm not surprised that people get angry.

Yeah.

And defensive and, I think the reality is there's suffering and a struggle and, um, and people, you know, want and deserve help with that.

Yes. Yeah. Yes. Yeah. And there's no clear answer here, right? There's just no, I don't think that, you know, I don't think we've answered any big complicated questions, but we are starting a dialogue and a discussion about it. And I hope that this podcast helps you listener feel seen and heard. Um, if you are experiencing, if you've been diagnosed with ADHD or you're experiencing these characteristics and don't want to come out, um, if you're looking for something that might help you in your recovery, um, I just, I hope that it helps you at least think about that. Um, and know that we're, we, we care enough to take the time to discuss this. Um, it's definitely something that, that needs more study, especially with chemsex. So I, I looked and looked in the research. I could not find a study that looks at ADHD and chemsex specifically. Now, substance use disorder, yes. Um, gambling, you know, gambling and alcohol addiction and even opioids. I, I saw it, a lot of studies there, but not in, uh, with chemsex. So I think there's a maybe a gap in the research too.

It's an interesting— yeah. And one of the, one of the thoughts that occurred to me, I just last night, there's a BBC's made a, I don't know if you'd be able to see it in the US, but if you can, it's great. It's Inside My ADHD Mind, I think it's called. And there's a series, there's one on autism and one on dyslexia. And what it made me, and they talk about shame, and it made me realize that growing up gay, you've got a shameful secret you don't understand.

Hmm.

Growing up with ADHD, you've got You know, there's an equally, I suspect, an equivalently powerful sense of shame, which is, I don't fit in, I can't get stuff done, I'm not like the other kids. So there's a compounding. And I think, and I wonder about that, you know, I think, you know, you talk about the use of alcohol and drugs together and how there's a compounding. And I wonder if you put growing up gay with growing up with something that looks and feels like ADHD, if that just— what an incredible burden to have to carry.

Yeah.

Is it any wonder that we turn to solutions?

It's true. It is true. Very good. Very good thought. Thank you. Well, we'll end it there then.

All right.

I hope that you all enjoyed this discussion. And if you'd like to join in, feel free to comment. I think we're probably going to get a lot of comments. I probably will get a lot of @s as usual, but that's okay. You can@ me all you want. But under the YouTube video, you can start a thread under in Spotify. You can also comment there. You can also send us a text through the show notes. Otherwise, I hope you all enjoyed this episode and we'll see you next week. Thank you, Daniel.

Thank you very much for having me. It's been, it's been, it's been a stimulating conversation. Good luck to you and everybody. And also, hopefully I'll see you again in a few months.

Yes.

Thank you. All right.