کیا آپ کا ADHD دراصل صدمے (Trauma) میں جڑا ہوا ہے؟ | Michael Drag, LPC

Host

Hello and welcome back to Therapist Voices at ReachLink. My name is Jessica Hurwitz and I oversee our network of therapists. Today, I'm thrilled to be joined by Michael Drag, founder and therapist at Space Between the Words. Uh, Michael is a licensed professional counselor in Pennsylvania and you've been practicing since 2014.

Guest

Internship was 2014 and then, you know, graduated 2015, licensed 2017.

Host

that stuff that falls in between, in between, between the words. So I know you've got some really cool experience on community counseling, drug and alcohol rehab setting, trauma, especially adult survivors, I believe addiction. There are 2 things that really, really stood out to me when I was investigating, investigating you for our talk today. And one of those was your, your experience working with and, and possibly Incorporation in your own life, perhaps of neurodivergence. I wondered if you could talk to us a little bit about how that became something that, that you work with, anything you're comfortable sharing, as well as maybe a little bit of education. I know that's such a, a hot topic. I hate to say, but—

Guest

Sure.

Host

Maybe I don't hate to say, maybe in a really good way that this is all coming more to light and people are getting these diagnoses that they need. So tell us a little bit, if you could, about this. Yeah.

Guest

I mean, following the pandemic, I was at a job. It was a rehab. It was not great. Things started getting worse. They were, you know, they eliminated the quarantine protocol. Things started feeling more and more unsafe. I felt like I can't be here anymore. And the stress, the more stress that came on, the more numb I felt and the more numb I felt, the worse the symptoms would get. And at that time I wasn't diagnosed with anything. So I went to a therapist and then that there, it was a weird thing, that therapist. was anti-vax and they got fired from practice. So I had to go find another therapist and I found another therapist.

Host

Oh, spicy.

Guest

But both therapists had said, do you think you have ADHD? And I'm like, no, no, I definitely don't have ADHD. I mean, I was raised in the '80s, '90s, early 2000s. And back then they said everybody has ADHD. They're giving these kids all these pills and it's unnecessary. So I was almost internally fighting the idea that Well, I can't have ADHD. That doesn't make any sense, right? I was successful. I made it through college, even though it was difficult. I made it through college. And so how could I possibly have ADHD? Between all that, I got diagnosed. It was weird. I started to accept it, right? I started to notice the symptoms before I was even diagnosed. I ended up, the algorithm put me on ADHD TikTok. And so I was getting those videos for a long time. And what really helped me with that was just the symptoms that are not in the DSM.

Host

Yeah.

Guest

The symptoms that nobody talks about, especially like—

Host

What are those?

Guest

Like limerence specifically, the obsession with a person. I had lots of relationships that just would not, they did not work out at times. And just letting go of those relationships was so difficult. And I didn't understand why. And it was just that obsession with a person that was just not healthy and not understanding it was not healthy and how to let go of that and have healthy relationships and have boundaries and that kind of stuff. It was a whole different thing.

Host

Yeah.

Guest

And not only limerence, but like the rejection-sensitive dysphoria, even like no-shows would, I would not write my notes for 3 days because suddenly I'm just can't, I can't focus on anything. I can't do it. I could continue to do sessions, but like anything that took executive function would shut down. I've dealt with that. I don't feel rejected by that anymore, but like rejection-sensitive dysphoria is a big reason I don't love doing the social media side of things. I don't love the, I, I don't want to be Perceived. That's the opposite of what I would want.

Host

Who does? Who does?

Guest

The only reason I do this kind of thing is because I know people out there feel the same way and that they would want to know someone sees them. And I mean, I probably, the first time I felt validated in my life was during my internship at 29. Right. And to feel seen was a gift that, I mean, I think everybody deserves.

Host

And I think it is, I, Very much have to applaud you because when it's not easy to talk about this stuff and not wanting to be in any kind of limelight of sorts, but it being so much stronger, the urge to help other people, that's really wonderful. And I actually didn't know about the symptoms that were not in the DSM. Are there any others than those 2?

Guest

Off the top of my head, I can't.

Host

Mm-hmm.

Guest

Off the cuff, just that I wrote a book based on my own experience and based on, I had about 10 clients that came out of nowhere because I didn't really treat ADHD. I didn't treat neurodivergence. I was mainly treating trauma. I was mainly treating addiction at the time. And then suddenly I get 4 clients with alcoholism and like 6 other clients that didn't have alcoholism but had similar symptoms. I started looking at like, what, what is going on here? Why do these people seem to Some are diagnosed with ADHD. Some look like they should be diagnosed with ADHD. What is the similarity? And every time I traced it back, it seemed like there was a narcissistic parent in their life. And so I started looking at that. Now the book doesn't make any solid claims. It's more of a call for research, better research, because the research out there does not make this link very much at all. There's very little. that does start to hint at it, but not, not enough.

Host

What is the book called? I'm going to make sure I link it at the end here.

Guest

It's called Heir of Narcissism. Heir like H-E-I-R.

Host

You know, I had a feeling there was going to be a cool tie-in, especially with the name of your, of your agency. Okay, great. I'm going to link that.

Guest

Yeah. I specifically named it Heir of Narcissism because ADHD can have narcissistic-looking traits. And oftentimes my clients who come to me are like, oh, I'm afraid I'm a narcissist. And they don't understand the intent that a narcissist actually has in the behaviors. Whereas they don't have that intent. They're just mimicking the behaviors that they saw in their abuser.

Host

Don't spoil too much because we want to read the book. What else did you find with these clients?

Guest

The reason I linked the two and the reason I think that it exists the way it exists is that the narcissistic voice gets inside our head. And we develop that internal voice, but after a while, we just think it's our voice, right? And so our head starts to become unsafe because of all the negative self-talk. The negative self-talk makes us avoid ourselves, makes us try and focus on anything outside of our head so that we are never in our head alone, right? That's why boredom is such a problem with ADHD and why we struggle to focus on things for a long time, because if you're sitting there focusing on anything for too long, start to think. If you start to think, you start to beat yourself up. And if you start to beat yourself up, that's that abuser voice coming in there. And so I started to link all the avoidant symptoms of PTSD to the avoidant behaviors of ADHD. You're avoiding stimuli, you're avoiding the anxiety, you're avoiding the boredom, you're avoiding all these triggers, avoidance of stimuli, right? You have negative alteration in cognition and mood, which is you think badly about yourself and you feel badly about yourself. Your arousal rating is increased. So you kind of fly off the handle and go into these emotional outbursts much easier than you should, which also damages relationships. The intrusive symptoms of anxiety, the negative self-talk is an intrusive symptom. Oftentimes people have nightmares and that feeling, that urge to run when you're sitting still for too long, that's an intrusive symptom, right? And that's that. I think that was 4. And then the You know, the 5th symptom of PTSD is exposure, which would have happened in childhood.

Host

What kind of exposure?

Guest

So like the little t's of criticism every day, being doubted constantly. You come up with a good idea, your parent tells you why it's a bad idea. You start to learn to counter that before they, you even bring the idea to them and they still crap on the idea. And so after a while, you, you lose that confidence in yourself, that, that internal voice starts to become— it's their voice, but it starts to speak in your tone. You know, our internal monologues, if you have an internal monologue, it doesn't have a different voice. It doesn't have a different sound. It sounds like us. And so when we internalize someone else's voice, it becomes our voice.

Host

That's really interesting to think about. I'm really excited to read this book, quite honestly, because I think that is not necessarily something that I have heard, but hearing you explain it, I can clearly tell there could quite possibly be something very much to that. How long were you seeing, were you seeing these clients that, that you kind of, this all came about with, or were you seeing them for a while?

Guest

Yeah, a good while. I had even started a group for recovery process group for the addiction side of things. And every client in that group was with these symptoms, right? And then I had other clients who I was seeing individually and some of the clients in the group Well, all the clients in the group I also saw individually.

Host

And I guess, how do you ignore that when you're thinking, wait a second, something, these numbers, something's adding up or not adding up?

Guest

I mean, statistical, like, significance starts at 10 instances, right? 10 data points. And so when I reach 10 clients who have very similar stories and it's hard to ignore.

Host

Well, thank you for not ignoring it because This will probably be great information for, for all of us in the neurodivergent realm. What are some other diagnoses that you work with? So I know you, you work with ADHD.

Guest

I have, I have some clients who have OCD, some who I think have OCD because they have ADHD and they were, you know, you're raised in a house where ADHD is not acceptable. So you just start trying to control your behavior. But you can't. So you start trying to control everything else and the development of OCD. I don't know if it's developed because of ADHD or, you know, it's on that neurodivergent spectrum. So is it just something that also exists that pops out at the same time? People who are like, I don't really work with, I don't work with children just because I specialize in trauma. So the idea of working with someone who's in the trauma is intolerable for me because the foster care system is a mess and I don't want to deal with child line if I don't have to. And just that, that whole realm of things. I don't, I don't want to deal with someone who's powerless to change things. And then also have to talk to the parent who's probably part of the problem and they refuse to change anything. I don't want to feel helpless in my own practice.

Host

And good for you. Good for you for acknowledging that truly.

Guest

So I wait till they're adults and then I, then I help them.

Host

Right. Yeah.

Guest

Um, so a lot of the, I went into that cuz, uh, I end up with a lot of clients, not a lot, a, a few clients who likely have autism, right? But very, very high functioning where they're, and I don't know what the terminology for, because I don't work in the autism world. So I know the high functioning versus low functioning is not the thing. It's, and some people talk about level 1, level 2, level 3. I don't know. Just like with like first-degree murder, second, I don't know the difference between those murders. I don't know the difference between that.

Host

Those murders are very confusing. There are levels. As someone who watches a lot of that on TV, you'd think that I would know more about the levels of murder.

Guest

I don't. Yeah. So just like I don't understand those degrees of murder, I don't understand the levels of autism. Usually these are people who go fully undetected. They're able to participate in society perfectly well, become successful. They just have little quirks here and there that they might not understand or how these symptoms might be affecting them. And then sometimes I start off with the gentle language of neurodivergence because that's a much more accepted term. And then sometimes I'll go, do you think it might be autism?

Host

When you know it's kind of safe and you've tried that out with, because exactly that really very much resonates that saying neurodivergent might be much more tolerable for the person who, whether they have thoughts about it or not, than saying something else.

Guest

Yeah. So I have a few clients who, some have been decided to go get diagnosed. Others haven't, you know, it's hard to decide whether or not you want to get diagnosed. If you get diagnosed with autism, some countries, if you ever wanted to leave this country and become a citizen of other countries, Some countries like Germany don't accept autistic people.

Host

Can I ask you more about that?

Guest

Well, it's—

Host

That's the question.

Guest

It just came up on the TikToks of like the neurodivergence, especially when, you know, the administration's changes changed and people were like, oh, I need to get out of this country. And, you know, you're on neurodivergent TikTok. They're like, well, if you have autism, there's certain countries that won't accept you just based on your diagnosis. And there's, there's not really a medication for autism. There's not really a specific treatment for adults who are functioning in life with autism. You have to decide for yourself, is the diagnosis something that it's, it's worth it to you, or is it something that's going to inhibit you and harm you in the long run?

Host

It seems like that's what a lot of people within the first year of COVID or 2 years, it was so common. You know, I'm in all these like mom Facebook groups. that so many people, they had been diagnosed with ADHD as an adult and how, you know, what that did for them. It was just so interesting what a plethora, you know, just an outpouring of people. I don't know what it was about that time. People are—

Guest

I think it was the, I think it was the stress of the society, right? Because I mean, I don't have any evidence towards this, but I think that COVID literally caused brain damage that made people not only more selfish, but more aggressive. So I think we're going to have a high rate of narcissism that comes out of just the COVID You know, we already have a high rate of narcissism within the baby boomer generation, just because of the lead, leaded gasoline issue. I think we're going to have this similar thing that comes out from COVID Interesting.

Host

I had mentioned there were 2 things that were particularly so interesting to me on your, on your site. You had mentioned that your call to trauma was no accident. Do you mind Sharing with us a little bit more about that? Yeah.

Guest

I mean, I was probably resistant to that, just like I was resistant to the ADHD diagnosis. I remember in undergrad, professors always saying, you know, we get into this field for a reason. I'm like, I don't know what you're talking about. I just want to help people. Yeah.

Host

I just want to help people.

Guest

I don't know what you're talking about. And then, you know, the, the one trauma that always comes to me that people are like, oh, I don't have trauma, but they have symptoms of trauma. is neglect, right? And when we say neglect, everyone thinks like, I forget what the girl's name was. I wrote it in my book on one of the chapters on like the wild children. So everyone thinks of neglect as like the wild children, like the girl who was kept in a dog cage in a dark room for 10 years or 7 years. And that's neglect. No, neglect can be something as simple as when you go to your parents and you say, I'm sad. they don't do anything about it, right? And that happens enough times that you stop going to them, right? And you start dealing with those feelings on your own. And as a kid, it's too hard to deal with those feelings. And so then you, you don't trust anybody. You don't feel connected to anybody. You don't feel seen by anybody. And it causes all kinds of its own trauma. That, that happened to me where parents were not necessarily safe to go to. I had a sibling who was high needs, not in the neurodivergent sense, although he was probably neurodivergent, but in the like acting out sense. I was the, you know, the good quiet kid. Right. And so that, that became the neglect, whether it was intentional or not, that led me into the field and then led me towards the trauma healing side. And then—

Host

So that is what led you into the field?

Guest

Yeah. Ultimately, whether I knew it or not, it's what led me towards trauma specifically.

Host

If you care deeply about mental health, Whether as a therapist or someone seeking support, this message is for you. If you're a therapist listening and you're looking for more flexibility, more balance, or a way to expand your impact, ReachLink is growing. We've been building a community of thoughtful, dedicated clinicians who want to make care more accessible through telehealth without losing the human connection that matters most. With ReachLink, you can work from anywhere, set a schedule that fits your life, and let us handle the administrative work, So you can focus on what you came to do— help your clients. And if you're looking for support, at ReachLink, we believe mental health care should meet you where you are, in how you feel and in how you live. Whether you're navigating stress, burnout, relationships, or major life changes, you don't have to go through it alone. With the ReachLink app, you can connect with licensed, experienced therapists through secure, convenient telehealth sessions from your space on your time. No commute, no waiting rooms, just real support when you need it. So whether you're ready to start therapy or ready to offer it, ReachLink is here. Download the app or learn more at reachlink.com because better mental health should always be within reach. But I love that part, the whether you knew it or not, because, you know, it's cool. It's awesome either way. But for it to even have been an unconscious subconscious thing, it came out when it needed to and seems like allowed you to help other people by acknowledging what had gone on for you.

Guest

It shows up in, in the therapy sometimes where like, you know, we repeat our family patterns. There's a TikTok sometimes that will say like, it's not your type, it's your pattern, right? For dating. Or I'll even see it where people will end up in careers at companies that mimic their family system. And it can be so toxic. Yeah.

Host

Is that something that you confront or bring up?

Guest

Yeah, absolutely.

Host

How is that reacted to?

Guest

People seem more helpless when you do that. Like they seem more, less willing to change it because when it comes to a career, especially in these job fields, the way that everybody talks about, well, I can't find a job. I've applied to this many jobs. Nobody's hiring. People are like, well, I mean, this isn't as bad as in a relationship, so I guess I'll just deal with it. So it's much, much more resistant to change.

Host

That makes perfect sense. I can imagine hearing something like, oh, you have, you noticed this is kind of what you've described in your family and that's being kind of replicated in your relationship, very different from have you noticed in your career? Because exactly like you're saying, who's going to today who is going to readily, excitedly say, I'm gonna switch careers. It's a great time to switch careers.

Guest

Yeah. And it's harder. I think it's harder for people to recognize that, oh, you realize you're talking about your boss the same way you talk about your parent, and then them relating their boss to their parent. I think there's just a disconnect there that, you know, work is work and home is home and never the two should meet, right?

Host

Do you do any or a lot of group work?

Guest

I worked in IOP, so I would run 12 groups a week. And then when I worked in the rehab inpatient, I would run probably 9 or 10 groups a week, but those were the same clients in every group. Whereas in IOP, there were different clients and different programs that were— I was working with. So I would work with co-occurring drug addiction and mental health. And then we had specifically mental health program on the side too.

Host

For some reason, it just came to me when you're talking about all these people that are experiencing similar, similar symptoms. I thought, wait a second.

Guest

Yeah. Group is hard to maintain. It's hard to get people into because nobody, nobody really understands what it is. Then people think, well, that's probably not for me, even though they've never necessarily experienced it.

Host

Even if it might totally be for them.

Guest

Yeah. And then the extra hurdle of virtual versus in-person is even more difficult. So the amount of effort it takes to force a group, uh, my colleague Kat, she runs a group, she runs a DBT group that's just, you know, skills building. And I pay her to run that group. So it's technically free because getting any Insurance doesn't want to pay for group more than like $20 a person, which isn't necessarily sustainable. And then to charge people, I see people being charged $80 a group, which seems crazy to me. So I, I just pay her, you know, what she would get paid for a single client for to run that group. And it's partly marketing, but it's also providing a service because I suck at teaching skills. I am much more psychodynamic, much more talk therapy. A lot of my clients who need skills, I will literally just send them to her and have them get taught the skills.

Host

I imagine the best part of having someone that you're working with. Tell us a little bit more about, about your practice in general. So you started your practice when?

Guest

I know when we were talking earlier, you'd mentioned kind of like coming off of the beginning of COVID So my practice really, I created the practice and all the legal paperwork and all that stuff back in 2017. when I got my license and I was hired as a 1099 at a different practice. I needed it for tax write-offs. I needed it for all that side of stuff. And it helped me maintain continuity of care for clients who would drop off if I switched from this practice to another practice and people wanted to follow me, you know, not actively recruiting because that's a no-no, but people who would literally seek me out through my Psychology Today profile. And The new practice didn't take the insurance or the practice I was at dropped that insurance and the client suddenly would have to be dropped or would have to pay, you know, a private pay fee. Uh, and they wouldn't necessarily be able to pay that. So luckily I've been able to hang on to people. And in some cases where even I couldn't take their insurance, I would do like a copay match and just take that for the fee. Or if I do take the insurance, I can take them that way. And I've been able to make sure people don't fall through the cracks.

Host

I mean, really, someone's gotta be looking out in that regard. I know you've got someone in your practice that runs the group, so it's the two of you that are in the practice.

Guest

Yeah. So I'm in the practice. I have my own clients. I don't actively— if you look at my Psychology Today, it says waitlist only, multiple reasons.

Host

I sure did. I saw that waitlist.

Guest

It's because I haven't taken clients since probably June of last year, even in the practice that I work at for somebody else. Right. Because one, I was preparing for the baby. My wife was pregnant. We had our baby in September and I knew come February when my wife's maternity leave ended, I was going to have to figure something out. And I had said, you know, I'm in charge of childcare. If I can't do it, then we'll have to find somewhere to take her and put her, but I don't want to deal with bringing home illnesses. I don't want to deal with the cost. If, if I can have clients who are willing to work with me, I'm able to do that work. Again, that's why I'm not actively recruiting, cuz I, I didn't know what I was gonna walk into. I didn't know what it was gonna take. And so I didn't want to have, be in a situation where suddenly a lot of clients need to be reassigned.

Host

And good for you for, for having the wherewithal to think that way. I mean, someone could have very easily thought, doesn't matter, gimme all the clients, I'll figure it out. And I do know from experience it does not work that way with BB.

Guest

Yeah. No. It's been fun. It's been easy, pretty easy for what it is. But luckily I have my own practice to cover myself for that. Just in case, let's say my, the other practice is not a problem with any of that stuff, but I'm also a 1099, so they technically can't be upset with me because I'm not an employee. They can't legally, you can't tell a 1099 what to do. Right. So everything's good with them. If it wasn't, I have my own practice I can fall back onto. You know, I have the stability to be able to make these choices. And the same thing with, uh, Kat, when I decided she worked at the same rehab I did, we worked together for years, the same reasons I left. She just left years later when it was even worse.

Host

What a perfect fit then.

Guest

And she had gone through the DBT trainings because she worked in the DBT program. So she has a lot of those skills. Uh, I helped her get the EMDR trainings to just add more skills to her. toolbox. Getting her clients is, you know, it's been slow going because last year I think a lot of people were struggling. A lot of therapists were struggling to get more clients. And then we went into winter, which is always a crappy time to recruit new clients. But then new year came, we started getting more. I'm still actively recruiting for her, but yeah, I don't take on any clients. Maybe that'll change sometime this year, but who knows.

Host

Is there going to be a Another book.

Guest

I've thought about one on boundaries and codependency. I don't know how to make it long enough. And I tried to dump everything into the first book just in case I never wrote another book in my life because of the ADHD. Sometimes rereading my book, I did an audiobook version of it and I recorded it myself. So the quality, I don't know how perfect it is.

Host

It's going to be great.

Guest

Even sometimes in reading it, I'm like, oh my God, I sound like this sounds like it was written with, by someone with ADHD, cuz I'll just blah, blah, blah, blah, blah, and then it suddenly cut off and go to another paragraph. And—

Host

But isn't that though so easy for someone else to say, put yourself aside, which it sounds like you're doing. That is, that's so great. I mean, this podcast, every, every episode I look back and I say, oh my God, if it's not glaringly obvious that I've got ADD, I don't know what else is. But then people can, can learn from it. And exactly what you're saying, especially that you've been open about your experience and with this mental health stuff, it just makes you so much more relatable and so much more human. And that is my all-time— if you could have any quality, it's being genuine.

Guest

I mean, that's— I'm a Rogerian therapist, which is funny when you say Rogerian, it sounds fancy when you're just naming yourself after Carl Rogers. Right? And the 3, 3 aspects of Rogerian therapy are genuineness, congruency, and unconditional positive regard, right? So not only do I try and exhibit those things myself, but I try and teach those to people to, to live a more genuine life too.

Host

When I first learned about Carl Rogers and back in, I guess, undergrad, that stuck with me so much. And I remember getting to grad school and thinking, all right, when are we going to talk about the guy who talked about unconditional positive regard? Like, where is that? And then it came and I thought, this is it. So many good theories, wonderful, wonderful people before us. But when that really resonates, it does.

Guest

In grad school, we watched the Gloria tapes. I don't think her name was actually Gloria, but she went to 3 of the very famous psychologists, psychiatrists at the time. One was Carl Rogers. I think who did REBT was whoever did REBT. He was one.

Host

Albert Ellis.

Guest

Yeah. Ellis. Ellis. Uh, and then I wanna say someone who did DBT or CBT was, was the third one. And she ultimately picked one, but she, later on they interviewed her again and she said she had wished she had picked Carl Rogers.

Host

Really? And what's it, tell me again what that's called.

Guest

The Gloria Tapes.

Host

Did you say Gloria?

Guest

Yeah.

Host

The Gloria Tapes. And her name may or may not be Gloria.

Guest

But there, there were 3 different interviews, 3 different sessions with these very famous men.

Host

Well, let's just say I probably wasn't paying attention that day because I'm not familiar. So now I'm really excited to check out Possible Gloria.

Guest

Yeah.

Host

And I will link that in our episode too. Thank you so, so much for, for being here. I feel like we have so much more to talk about, so hopefully there could be a part 2 sometime. Um, I'm gonna link your book and some other things that we touched on at the end here so everyone can take a look. But thank you so much for being with us. This is so fun. Thank you.