Welcome to the ADHD Women's Wellbeing Podcast.

I'm Kate Moore Youssef and I'm a wellbeing and lifestyle coach, EFT practitioner, mum to four kids and passionate about helping more women to understand and accept their amazing ADHD brains.

After speaking to many women just like me and probably you, I know there is a need for more health and lifestyle support for women newly diagnosed with adhd.

In these conversations, you'll learn from insightful guests, hear new findings, and discover powerful perspectives and lifestyle tools to enable you to live your most fulfilled, calm and purposeful life wherever you are on your ADHD journey.

Here's today's episode.

Today I have Dr.

Cara Davy here, and we're going to be talking about the intersection of trauma and adhd.

So I just wanted to give you that heads up from the very beginning, this conversation, in case maybe you're not quite in the headspace for it, but Dr.

Cara Davy is an expert in this area and she is a clinical psychologist who is passionate about helping adults with adhd.

And she is also a trauma specialist with extensive perinatal training who really gets how ADHD presents in both men and women, including all the hormones and the difficult life events and how the times of transition impact on ADHD symptoms across a lifespan.

And Dr.

Cara has also got ADHD herself after the traumatic stillbirth of her middle child.

And she also has two other children with ADHD traits as well.

So she really understands and knows the impact of ADHD and on our lives personally as well.

And she understands that most adults with ADHD have never been taught skills to thrive in a neurotypical world and is passionate about sharing the tools she has learned personally and professionally to help other people benefit from them, too.

So, Dr.

Cara Davy, welcome to the podcast.

Thank you.

Thanks so much for inviting me.

Yeah.

So, I mean, obviously from the outset, this conversation, you know, we're going to be delving into that intersection of trauma and ADHD and being able to unpick the two differences, but also how they marry together and the overlap between them.

There's just so much there.

But maybe we could just start with maybe sharing your.

Your personal discovery of, of ADHD and how that came about.

Of course.

Yeah.

So I've been a psychologist for almost 15 years now and was specializing more in kind of trauma experienced my own kind of difficult fertility journey, including stillbirth of my daughter, as you mentioned, and it was around that point of trying to become a parent, parenting, and all of the kind of fertility issues that it become Obvious to me that I learned more about how ADHD presents in women.

And the symptoms of my ADHD increased hugely to the point that I was like, what's going on here?

And then, you know, having read more about ADHD and women look back and went, ah, these have always been here.

But they just ramped up incredibly.

And I think as a trauma specialist, I was already doing a lot of trauma therapy with people.

And so immediately after my stillbirth when I had trauma therapy was, you know, emotionally okay, then started helping and supporting other people with infertility and grief.

And, you know, emotionally I was fine.

But the forgetting my keys, losing bank card, you know, just general ADHD type stuff was not shifting at all.

And I was like, what is that about?

And I guess it took me into the space of being really interested, you know, as I learned about my own adhd, I then kind of looked more into executive functioning.

And so, you know, now I kind of specialize in, okay, what can we process through trauma therapy and how can we help and improve ADHD symptoms as a result of that?

And what is more about scaffolding, executive functioning, kind of ADHD type problems?

And I think, yeah, so my own personal journey helped me to discover my ADHD and just helped me to really, you know, it was four years of trying to unpick, how do I help this bit of my adhd?

How do I help this bit?

What do I do?

Which I'm now really passionate about supporting and helping other people to do, because, you know, trauma just exists so much people.

It really does.

I'm just interested to know, did you ever see or spot or think you had ADHD sort of growing up, or I guess maybe after the birth of your first child?

Like, did you notice, or was it kind of one of those things that a lot of us talk about is that we could have lived with it.

We kind of knew we were a bit scatty, we're a bit disorganized or prone to anxiety, all these little nuances.

But often it does take these big life events, and unfortunately, very often it is the traumatic life events that almost ramp up.

And I'm just interested to know if you'd had any suspicion there was ADHD there before.

Yes.

I mean, yeah, there'd been a bit of an ongoing joke of being a bit ADHD without really ever reading the criteria to know what it was.

And I feel a bit funny.

As a psychologist, I feel like I should have known.

But essentially, I think when I trained a long time ago, it was still very Much what was taught was the kind of naughty boys in class type stereotype of adhd.

So I'd kind of dismissed it as, yes, I did write lines for talking too much in class.

Yes, my school reports did say, Kara needs to think before she speaks.

Like, there were obviously some signs there, but generally I did okay and I went through the education system, so I didn't feel like I fit that.

But my mum worked as a secretary and a GP surgery, and she was like, keep getting these letters through about people with adhd.

She's like, this sounds very familiar.

And, you know, there was definitely, you know, I would make the mistakes that people might make occasionally, a lot more frequently than other people were making them.

And there was kind of, you know, a bit of chaos would surround me.

But I functioned okay until the trauma.

Like, that was the point at which it.

Despite those quirks, I just accepted them as quirks.

But yes, they were very much there.

But I.

I hadn't really recognized it in myself until I properly looked into it, until the trauma made it to a point where I was like, I need support and help to function, you know, kind of than I am now, because I knew it was significantly different to pre.

The trauma.

Yeah, no, absolutely.

And, you know, this conversation of trauma and adhd, and it can be quite a sensitive and an emotive conversation because there's a school of thought driven, I'd say, by Gabor Mate, by Dr.

Gabor Mate, who believes that a ADHD is a result of trauma.

And other people feel quite invalidated by that because they believe that their ADHD has always been there and we see it, you know, genetically.

And his argument is that trauma can be genetic.

My argument is, I think that people with ADHD are more likely to experience trauma.

So there's this sort of cycle of, like, trauma, adhd, trauma, adhd.

And until we unpick it and we are able to help ourselves and it can feel really hard to unpick.

It can feel really hard, like, what is this?

What's that?

And I obviously am not a trauma expert, but I'd just be interested to know what your thoughts are on all of this and how you see this intersection and I guess generationally as well, how we kind of just see trauma and being passed down alongside the adhd.

Absolutely.

I mean, I think there's a really complex kind of intersection between them, as you say.

Like, I'm very familiar with Gaba Mate, and I think he started off saying the genetic part of ADHD was a kind of sensitivity, someone being slightly More sensitive in terms of, you know, to their environment or emotionally sensitive.

And then there needed to be some difficult life events essentially to trigger that into adhd, I think was his kind of view.

But yeah, certainly some of the other stuff looks very invalidating in terms of.

No, it's all trauma.

You know, I won't get into too much of a GABA mate debate essentially.

But I mean, what I see again and again is as you say, they coexist.

And you know, it's so common for people with ADHD to experience trauma because other people find their behavior more difficult.

You know, whether you are more the hyperactive type kind of symptoms of adhd, where people will kind of label you difficult or, you know, kind of challenging or people will want you to stop doing things and try to kind of suppress you and you will get teachers finding you difficult or you know, parents might find you difficult, or you get parents where one parent is kind of almost like good cop, bad cop one, parents trying to be understanding and supported the others, no, we need to be stricter.

So you end up with lots of interpersonal trauma.

And I think for those who are more inattentive, even so people would be like, why are you not listening?

Like why are you not paying attention?

Or you're in your own little world or you know, so certainly other people notice those difference and I think it does cause interpersonal trauma and you can see more of a kind of, you know, you're more likely to feel misunderstood and you know that people don't understand you, don't get you.

And you know, so those kind of elements of trauma I think often exist and then we've got, I mean, it might be helpful to explain to small T and big T trauma.

So essentially if we're talking about trauma, you've got your big T traumas, which are the things that people think of when they think of kind of PTSD or trauma.

So someone who's in a car accident, someone who has a traumatic birth, someone who goes into war, you know, someone who's assaulted, those kind of things are our big T traumas, the things that are life threatening or kind of impact on our bodies and people associate those with these, will give trauma symptoms or PTSD and we will get treatment for those.

But actually there's also small T traumas which are things like interpersonal conflict, divorce, retirement, having complaints made about you, things that affect your ability to cope and send you into kind of overwhelm and are traumatic in terms of the, you know, have an impact on you and could still be really beneficial to have kind of trauma therapy for.

And yet they aren't necessarily recognized by society as being so traumatic.

And I think what you find with people with ADHD is they tend to have experienced a lot of those multi trauma growing up and sometimes when people then present for an ADHD assessment or looking for treatment, they have automatically internalized, I'm difficult, there's something wrong with me, or you know, there's a problem with me.

And they've experienced a lot of this trauma, but wouldn't even see it as trauma, but services might see it as trauma.

And then, you know, kind of there's this fear of will I be labeled as experiencing trauma?

And therefore the ADHD is yet again miss dismissed.

And so, yeah, I think there's a really complex interaction.

It's quite rare in my view to have done an ADHD assessment and at the end of it to come out and say this is trauma and no ADHD like they normally exist together.

It's very rare.

Will I've assessed someone and come out at the end and gone, no, actually I don't think this is ADHD because, well, just so often they do coexist.

So I mean, does trauma change your brain wiring?

Yeah, yeah, absolutely.

Yeah, absolutely it does.

And I think that's why partly, you know, we get this kind of intersection of symptoms that are the same between ADHD and trauma that some people and you know, if you go to see a clinician who's less understanding of ADHD and how it presents, they might be saying, well, these are all trauma symptoms.

But actually, yeah, trauma affects how, it affects our nervous system.

It makes our nervous system more kind of sensitive, it makes us more hyper vigilant and more aware of danger, affects our cognition.

So things like the executive functioning that you see in adhd, actually, you know, our cognition is changed by trauma.

It can affect sleep because it affects our executive functioning, it can affect attention, forgetfulness.

So it is really hard sometimes it can affect impulse control because of, you know, so there's a lot of symptoms that you will see down the middle of that overlap which, which as I say, if you've someone who's functioned quite well with ADHD and a practitioner doesn't know much about how that presents and masking might then say these are just trauma symptoms.

This is the impact of trauma on the brain.

And it's why you get, you know, a bit of a debate out there sometimes about the kind of validity of adhd.

But yes, trauma does absolutely affect the brain and it does affect how sensitive we are to emotions and how well we can regulate.

But some of those things can be, through trauma therapy can actually be kind of minimized back.

So essentially what happens is the brain becomes really sensitive to danger and the amygdala becomes more sensitive and therefore you react quicker to anything that might be perceived danger.

So threat, rejection, you know, whatever that threat might be.

And through trauma, you can kind of widen the window of how much we can tolerate before we send it into that fight flight response.

So yes, it does affect the brain, but we can also not reverse it completely.

But we can certainly through kind of processing trauma, we can reduce the impact of some of those things.

So it's not a kind of forever impact, although it does depend on the severity of the trauma when it was experienced.

Okay, so I'm thinking of like what you mentioned about the small T and the big T traumas.

And if we've had ongoing trauma throughout our life, these small T traumas, such as feeling rejected, ostracized, for so many of us, it feels very physical and it feels really hard to like contain.

And so the were having to put a lid on it again.

And put a lid on it on it again, which then obviously creates this highly sensitized nervous system.

This hyper vigilance, this, this fear, constant fear.

How, you know, I think it's really important for people to have that validation that this does have an impact.

These are traumatic moments through our lives because like you say, you know, no one, you know, God forbid, would ever want to go through what you went through.

Losing a loved one, losing a child, war, abuse, like anything like that.

It just seems so what we've gotten through, say, and compared to that, we kind of go, absolutely not.

That's not trauma.

But would you say it's actually helpful for.

To have that validated for us so we can actually understand what's going on in our bodies and our nervous systems.

Yeah, absolutely.

And I think when we think of big T trauma, often other people validate how distressing and upsetting that is.

You know, if you have a car accident, you lose a child, any of those things, often other people will say, goodness, that's so difficult.

I'm sorry you've experienced that.

It's really normal for you to, you know, obviously react to that or, you know, to have a bigger kind of emotional reaction to that.

And yet, you know, these small T traumas, in some ways, when someone comes for trauma therapy, it normally takes longer to support someone who's had ongoing invalidation and distress across their lifespan.

And that's hugely impacted their self esteem because it's assumed it's them because it is so ongoing and constantly there.

Like actually that sometimes much, much harder kind of emotionally than a really difficult event which if you get the right support for at that time, it might be that actually you can be supported through that and then go back to feeling okay because you've always felt okay.

And yet it has the same impact on our, on us emotionally in terms of Trauma affects the brain in the same way, regardless of if it's big or small, but also just the process of trying to unpick and go through.

Just to clarify, if you're doing trauma therapy for small T trauma, you don't have to process every small T you've ever experienced because obviously for a lot of people you'd be there for a very long time.

And one of the things I like about kind of EMDR trauma therapy is that actually it's very effective quickly at being able to process what you need to process.

But yes, I think it's hugely important to validate.

First of all, no wonder this has had an impact on you and actually where you've been made to feel like you're the problem all of the time.

Actually maybe these things happened because other people didn't understand, didn't know how to support you.

You know, you talked about intergenerational trauma.

You know, we know genetically it's much more likely if someone is neurodiverse that their parents, you know, are more likely to have been neurodiverse as well.

And parenting as a neurodiverse person and parenting neurodiverse children, like there's a web there of that's quite difficult, it's quite challenging circumstances.

And you might have been made to feel like it's all you and you're difficult, when actually that was a result of parents struggling with their own neurodivergence and how that kind of played out in the interplay.

So I think it's really important to get that message of maybe this isn't just me.

Like maybe this isn't about me, maybe this is about the circumstance and what I've been through.

And that then adds into.

You're more likely, if you've had an invalidating home environment, to perhaps then end up in a relationship where it's invalidating.

You might also then go into a work situation where you accept being treated in a way that other people might not.

So you then get it within the workplace or so you might have this pattern of it always happening in your life which is incredibly difficult.

And you just assume again that that's all about you.

So it's really important to be able to unpick, oh, maybe that's not what's going on here and maybe that's not understanding and maybe there are ways to change those relational patterns so that going forward from this point, things are different.

And I have relationships in my life that feel different and aren't invalidating and you know, kind of where I'm seeing.

Yeah, yeah.

And I think also we, our parents generation and the parents before that, they wouldn't have had the resources and the tools and the coping mechanisms and even understand and pick to have this language, I've said this so many times, is that, you know, back in, back in those days, it was literally they were taught a way of coping, a coping mechanism from their parents.

And it's only really this generation where we're talking about these things that we're having open conversations, conversations and using words like neurodiverse and trauma therapy and emotional well being and somatic, you know, healing and all of this.

Like people didn't have this 20 years ago.

So we're in a very kind of, I hope, exciting place of healing.

But also it's very challenging because we're able to look back and think, no wonder, like, no wonder my parents couldn't cope because they couldn't regulate themselves.

And if they're neurodiverse themselves, how are they then going to look after neurodiverse children if they can't regulate their own emotions?

And also we only are just understanding addiction and addiction patterns and first of all, seeing that we can see it genetically, we can understand why people become addicted, like what the emotional fallout is of that, all of this.

So I think it's just sending ourselves so much compassion for everything that we've gone through without any of the tools and the help that we did, you know, as children and only now, and I know that so many women like us are getting these diagnoses like midlife.

Whether it's come from sort of perimenopause or like you say, it's come from post trauma.

You know, we see this after the pandemic, you know, this explosion, because that was a global traumatic event for everybody.

While we were all dealing with our traumas within the house, you know, losing loved ones financially, working from home to homeschooling, not knowing what this outcome was going to be like, we, we've lived through this once in a lifetime situation that was catastrophic for many of us.

And I think we're only just processing this now, five, four or five years later.

What I'd like to ask you is a little bit about CPTSD and ptsd.

I'm very interested in CPTSD and for people to understand what that might be because I think there's a lot of us living with this undiagnosed and we don't even know what that is.

Yeah.

So CPTSD is complex ptsd.

It's essentially when there is more of a, as we were talking about, where people have experienced a lot more traumas.

It's kind of multiple traumas that are built on top of each other.

So you experience one difficult life event and then another and another and another.

And essentially it has more and more of an impact on the nervous system, more and more on our kind of emotional well being, our emotional ability to kind of regulate.

And I think complex trauma was often, you know, some of the mental health diagnoses out there are often, when we look back, there's now much more of a questioning of, oh, when people have been labeled as having, I don't know, say, a personality disorder or someone has been labeled as bipolar or actually have they experienced multiple really difficult traumatic events in their life and these are the result.

The symptoms they're experiencing or the kind of distress we're seeing, are they the result of that kind of complex trauma?

So, you know, PTSD is generally, then there's one event or, you know, one big event, that kind of big T trauma.

And your complex PTSD is when there's kind of multiple big events or you've got that kind of ongoing distress as well as kind of more multiple events.

And it has, yeah, as I say, a kind of a big impact on well being.

But again, both can be supported and helped through trauma therapy.

It's just complex PTSD tends to take longer to work through or might take kind of longer in therapy to get to a point where you're noticing a kind of difference on well being.

But, yeah, both can be very much helped and supported by trauma therapy.

Yeah.

And I'm interested to know you mentioned EMDR before and I think we're understanding a lot more that trauma can be processed.

Potentially it's more beneficial to process it through the body.

Somatically, I know that with my eft, I see how effective and efficient it is to be tapping and talking and validating as opposed to sort of just sitting there and having, you know, talk therapy.

And I'm wondering what you're seeing, I guess as clinical psychologists that you're understanding, do you think that somatic therapy is the way forward now for therapy, or do we need both?

I mean, I think it depends on the person's presentation and what they've experienced as to what would be most kind of supportive and helpful for them.

I mean, we certainly know that trauma is held in the body and that, you know, the impact of trauma affects us physically as well as it affects us kind of emotionally, psychologically.

So, you know, it makes sense that some of the more somatic therapies.

It makes sense that that is a way for people to work through some of that trauma.

I know less about.

No, I don't want to speak on something that I guess I'm not so kind of trained in.

So I know less about what is and what isn't effective.

I know at the moment the evidence base for kind of working through trauma more sits in trauma focused CBT and EMDR as the two that are kind of more effective.

And the reason for that is that they're processing the trauma in terms of what we know about memories, traumatic memories, is that because you're dealing with the trauma at the time, it doesn't get processed by the kind of memory system in the same way that other memories do.

And therefore, it's that kind of going back over the memory and being able to, as you say, to hear the distress in it, to look at actually what interpretation did I make and how will I feel about myself as a result of that?

And actually now when I look back at it, is that an accurate kind of representation of how I felt at the time, but then also physically moving it into the memory store where it should be to be kind of filed away properly?

We know that all of those things together are really effective in being able to process trauma.

But does it impact the body?

Absolutely.

And one of the things, the reason I go for EMDR therapy over other therapies is because it very naturally, the brain will go where it needs to in terms of trauma.

It will take you from one trauma to another in terms of.

Right.

This is what I need to process.

And you don't have to.

CBT for me feels much more manual.

I'm trying to guess or maybe this links to that or.

But I might be wrong.

EMDR naturally shows you where it needs to go, but we also very much in touch with what's going on in your body now.

What do you.

What can you see?

What are you experiencing?

And so I am there with someone and holding them so they're not going through that trauma again alone as they're Experiencing it.

So there's very much kind of, I'm here with you, you're not alone, it's okay, it's not happening again.

So you're processing in the presence of someone, which is different to that kind of alone experience people have had.

You're also moving the memory to a place in the brain where it's different and it's in the past.

And people will say very quickly, sometimes within a session or two, wow, that just feels so different.

Like, where is the power of that emotion gone?

But you also notice it's physically different.

So I've had people who've come in the clinic literally kind of unable to walk with a stick or whatever.

And as we've worked through the trauma that they've experienced, they've suddenly gone, oh, the chronic pain has gone in that arm and the pain's gone in that arm.

And I've had people can walk from the train station, 20 minute journeys, no longer got a stick.

Like suddenly the trauma's physically left their body as a result of processing.

So there is certainly an overlap between the impact of trauma emotionally and cognitively, but also on the body itself.

So people experiencing, you know, chronic pain, chronic fatigue, you know all of those physical symptoms?

Yes, very much.

It's bodily.

I know less, as I say, about the somatic theories to be able to say how well they are at working that through.

But I'm sure there is a good evidence base.

I'm just less familiar on it.

But yeah, what I like about EMDR is it does all of that.

I feel like it's very much a being with, and it also processes the trauma in terms of moving the memory across and it works with the body and the emotion.

So it feels very much like it's a very holistic type of therapy in a different way to other talking therapies.

And I think it's so effective so quickly.

I've had some emdr.

I'm not sure if it was the right practitioner, if I'm honest.

But what was interesting is that I went for one reason and like you say, my brain took me somewhere else.

I thought I was like, I'm going to go in.

I really want a soul of sorts, you know, this.

I want to be efficient and sort this issue out.

But actually it took me somewhere completely different to somewhere that I think I had been suppressing.

So we can never underestimate the power of getting curious and thinking, actually, maybe it is time.

Maybe it is time I start unpacking a little bit.

But on the flip side, you know, as a trauma therapist, would you say that some people have terrified, like they just think it's easier to suppress, you know, if I just hold it down, I've been doing it for decades, to then have to talk about it or look at it again.

It feels too much.

It feels too overwhelming.

I mean, what would you say to someone who is thinking, this is all very well, but I don't, I'm not going back there.

That was too much for me back then.

I don't want to address it again.

Yeah.

And I think different people have different coping mechanisms.

So I don't want to at all sound judgmental of different approaches.

For some people, they box away trauma and say, I don't want to go near it.

And they manage to function well enough and they're quite happy with that choice.

And again, if we go back thinking about older generations, often that's what was encouraged to do.

And you might find people of the older generation are just like, absolutely no way.

And, you know, we need to respect that if that is someone's kind of choice.

At the same time, often what I end up seeing is people who have tried that and then suddenly something happens that triggers when something has been boxed away.

Actually, you know, it's going to come back up or, you know, it can come back up and then people are in more crisis mode of, oh, I really have to deal with this now.

I see it a lot, for example, with.

In the kind of perinatal side of the work that I do with people who are pregnant again and go, well, I thought I didn't need to process that last traumatic birth or, you know, kind of my previous loss and now suddenly I'm terrified and I need to look at it also.

Sometimes people come then, but the reality is doing something like emdr, like looking at a trauma therapy, it is hard to do emotionally.

Like, I won't lie, I had EMDR myself after my loss.

Like, it's.

It's not an easy thing to do to go back to the emotion and at the same time, the shift that you can see if you talked about the right practitioner, I think it is really important to get the right practitioner, especially if neurodiverse finding someone who understands neurodiversity and knows how to adapt.

Trauma therapy for people who are neurodiverse is really important.

But if you go back, even within a few sessions for a lot of people, they will say, oh my God, like, I didn't realize how much of an impact this was having and how much I've been Holding onto it.

And a few sessions that have been really hard have then got me to a place where I feel completely different.

And I've been doing trauma therapy for over 10 years with people.

I've lost count of how many people I've supported through trauma therapy.

And I don't think I can think of a single person who at the end is like, oh, I wish I hadn't done that.

Like, everybody at the end is like, I can't believe what a difference it makes.

So I think whilst it's completely understandable for people to say I don't want to go there or it's too difficult or what if I open this box?

There's too many things that have been pushed in the box and it feels overwhelming.

At the same time, if you're finding the right therapist, you don't necessarily have to process everything.

And the difference that you might feel, you know, might be huge.

Some people say, I just want to do this one trauma.

Like, that's so different.

Actually, can I look at this while we're here?

Or the brain will take you to something else.

And then they're like, oh, like, actually that's completely changed.

You know, some people, especially people with adhd, might have got this kind of not being good enough, or there's something wrong with me, or, you know, we know how it affects self esteem and yet we do some processing of traumatic events within that.

And at the end they're like, this wasn't all about me, actually.

You know, I was misunderstood, you know, and it totally shifts what they thought was entrenched self esteem issues that they'd have forever.

And actually, you know, sometimes you don't realize how much you're holding onto until you process it.

So, yes, it's scary to do and I totally understand some people might feel like it's too big and at the same time, you know, the, the impact can be huge.

And you know, we've.

There's so many effective.

You know, there are things that are really effective for adhd.

I was going to say so many effective treatments.

We're not treating it because it doesn't go away, because it's there forever.

But obviously we manage.

You know, for some people, they manage it with medication.

For some people, they manage, they have ADHD coaching and try to manage the impact or structure their kind of executive functioning difficulties.

But I think sometimes people miss how effective processing the trauma can be in terms of creating a shift.

And for some people, in really small amount of sessions, I don't think it's known about enough, really.

Just how much of an impact it can be to process that trauma on reducing some of those comorbid, you know, the symptoms that, you know, are inherent.

Both ADHD and trauma.

Yeah.

And you can never be too old again.

I hear this from people maybe in their 60s and 70s, that they just think, no, I'm too old now.

I've lived long enough without having to deal with it.

But like you say, you know, even if you could just live your last few decades of your life feeling lighter, with more inner peace and more understanding and acceptance, that's huge.

And I get frustrated.

I've got some family members who are sort of, you know, in their 70s and they're just almost poo poo.

The thought of going through any form of, you know, therapy or anything or just talking about what they've gone through because they just don't think it's worthwhile.

They think, well, I've lived this for this long.

Which is a shame.

It's a shame because I think through other people, healing people, then there's a ripple effect in the family.

So someone, you know who is the matriarch or the patriarch of the family, they go through healing and understanding.

It can trickle down to the rest of the family as well.

So, yeah, I'm just putting it out there to anyone that's listening and they think they're too old.

I don't think, you know, you can.

I wanted to ask you, what would somebody have to be more aware of with.

With someone with ADHD who wants to go through trauma therapy?

I think there's a few things.

So first of all, you want someone who's got a good enough understanding of ADHD that they're going to validate and be able to, to work out what is, what is trauma versus what is adhd.

So you want that kind of ability to validate.

But in terms of how EMDR is different, I mean, people with ADHD often process much faster.

They are more likely to be distracted.

What I've noticed pre Covid the kind of go to for EMDR was that you would have your hand kind of go in front of someone's face to make their eyes move from left to right while they're thinking about the memory.

And the idea is you're taxing the working memory, but you're also processing it.

It imitates kind of REM sleep.

When we dream, when we process at night, what we're trying to do is get the eyes to move, to move that memory over to where it should be stored.

But what you would find is pre covered.

A lot of people I've worked with are like, but I can't follow and oh, that's making me feel dizzy.

Or I can't follow that memory.

Or like it was really hard to concentrate on all of those different things.

When we went into Covid, we realized you can do it online by tapping and actually you can have your eyes closed and your eyes still move from left to right.

It still imitates the brain left to right.

And suddenly by that shift for me with people with adhd, suddenly nobody's saying, oh, I can't do it anymore, I can't get into the memory, I'm too distracted or you know, like.

So there was a massive shift in people being able to actually get into the memory.

And I think sometimes people are still using methods of trying to kind of imitate the movement, the bilateral stimulation we call it, that aren't very ADHD friendly at all and that people can't get into it properly.

So I think there's.

That we process often at different speeds and I think we need to be aware of if someone is processing at a really fast speed, do they need as long a session or actually they're processing a lot and then you need to pause more to give a bit of space afterwards to talk about it, to regulate, to kind of work that through.

There are, you know, certain it depends on the person as to what the adaption is because it will depend on their presentation of adhd.

But I think when someone is familiar with ADHD and how it presents, they can see when they're processing, okay, when this isn't going as we would expect it to, or when it's feeling more emotionally overwhelming, what's getting in the way and what is it I need to do to adapt to that?

Whereas I think if someone doesn't have an understanding of neurodiversity, it's really hard to pick up what someone might need and to attune to that and adapt it.

So, yeah, it's not always the same adaptions, I would say, but certainly I do find it's different.

And I have a team of psychologists and within there there's a couple who prefer not to work with people with neurodiversity because, like, I can't keep up with this person or you know, so I think that's also really helpful for me to know who not to refer to in terms of if someone is neurodiverse, they might brilliant at other things, but I think it's, it's really important if you're going to seek out trauma therapy and you're not feeling like, I've got a good connection with the person in front of me, or I don't feel they get me, or they don't seem very confident that they can adapt it to what I need.

If I'm struggling a bit with the processing or I need it done a little bit differently, I think it's really important to consider that when finding the right therapist, because that's when the shift happens, is when it's attuned right with you.

And so important for people with adhd, as we say, because that achievement often hasn't happened in earlier years.

And getting it right in therapy is really, really important.

I think that's really validating, you know, for me, especially to hear that, because I just was like, I don't feel the connection.

But also I struggle with visualizing.

So if someone says, right, visualize yourself.

I really struggle to get back into that place.

My.

A lot of my childhood, like, my memories have just been wiped.

I have, like, very few childhood memories, so.

And I didn't experience one big trauma.

But from understanding and having some counseling and therapy and stuff, there were lots of mini traumas, but I couldn't visualize.

And so I felt I was over obsessing in my head.

Like, why can't you visualize?

Why can't you see?

You can't go back to that memory.

So I think my ADHD and my overthinking just kind of almost took over.

So I would love to try again with someone who really understands adhd trauma therapy.

And yes, I will be speaking to you about this.

Yeah, absolutely.

I think it's so, so important.

And I think you raised a really important point there about rumination.

And I supervise a lot of other psychologists who are starting out in kind of EMDR therapy.

That's one of the things I say is from the very beginning, be aware of if someone is in their head, I can't do this, I'm not doing it right, or I can't visualize.

As soon as somebody gets into that place where they're anxious or ruminating about whether it's going right or wrong is going to interfere with the process.

So at that point, it's really important to be like, okay, right, this has been difficult.

What can we do to make it easier for you?

How can we support you with that?

Like, I'm getting people to a place of confidence.

Very often, as soon as I see it, I'm like, it's really normal.

Don't worry, you might not be in the memory yet.

That's okay.

Let's go back.

What did you make this?

You know, just really helping someone to feel like I'm not doing it wrong.

I'm, I'm doing okay.

I will get into the memory, like, that kind of confidence in the process.

But also I'll help you to adapt this and we will get there together.

I think is really important because, yeah, as soon as someone is in their head, it gets in the way.

And I think it's something I see a lot with more kind of newly trained people in EMDR is that they then don't know what to do.

Like, the anxiety increases between the pair of them where somebody's seeking it, feels they're doing it wrong.

And the other person's like, oh, I'm not a good enough therapist.

And you get that kind of dynamic where they're not helping each other.

So I think confidence in being able to, to see exactly what it is that is the barrier and adapt it is really, really important.

And yeah, rumination and kind of anxiety and worry is a big, A big one, especially starting out in EMDR until people have got experience and can trust the process.

Okay, and would you say, does it work just as well online?

Was it better in face to face?

Like, what would you say?

So pre pandemic, I was doing it all face to face and I literally, as we went into the pandemic, I was really worried about what am I going to do.

My job is pretty much trauma therapy and I can't do it online.

So I don't know how I'm going to do this.

And I was very skeptical about the results of it.

I thought, you need to be in the room with someone.

Actually now because of I've got quite niche specialisms in terms of more perinatal infertility and loss and that ADHD side, people tend to come to me for reputation or specialisms, and therefore I hardly see anybody locally anymore.

And therefore I don't.

I'm not in the room with them.

But I genuinely haven't noticed any differences at all in effectiveness.

And if not, I would say it's more effective now doing it remotely than in the room.

And I think part of that is, as I said earlier, because I'm able to get people into the memory without worrying about this.

Am I doing it right or wrong?

I can't follow.

Or, you know, actually you're able to properly get people in because with their eyes closed and being able to kind of tap and maybe alongside Them online, actually, that seems to work much, much better.

So, yeah, I have noticed it's probably more.

I'm getting better results now and I guess probably over time as well, more and more experience.

But yeah, I genuinely don't think it's a problem doing it remotely.

The only exception to that is for people where there's a high level of what we call dissociation.

So if people cope with their trauma by essentially leaving the body slightly or kind of cutting off from emotions, and that's to an extent, extent where they're less present and they might need someone in the room to kind of help them to ground and come back around when they're dissociated, that's when I would work with someone more in the room.

So, for example, if someone's kind of.

What we say with the MDR is you want someone to have one foot in the past and one in the present, so you should be aware of the event that you're processing, but you should also be really kind of present and in the room here.

And if you've got someone who gets into the trauma so much that they're no longer aware they're in the room, then often we help people, people with that.

So we might be like, right, let's throw a ball to each other, like, you know, let's do some grounding exercises in the room physically with someone to help them with that.

And just a safety aspect that if someone is, you know, kind of with dissociation, sometimes people can look almost like they're falling asleep or.

So if someone has got much more severe trauma and they dissociate as a result, that was a kind of safety mechanism for them when they were younger, then we would recommend being in the room is probably safer and more containing for them to be able to know that somebody is right there physically with them and can help them with that grounding.

So, yeah, those kind of those cases, I would say in the room.

Otherwise online works, works perfectly well.

Yeah.

I mean, I find, and I don't know if this is just my sort of hypothesis, but I find with my clients who are all neurodivergent, that we all just quite like being online because we have, we're in our own space, we've got all our comforts, we've not got the anxiety of like parking, traveling, being late.

We've got a cup of tea, we've got like, it just.

We're sort of, we're in our own environment, doing our own thing.

And also sort of the eye contact, it can feel it's not as intense, you know, doing it online.

So I, I think with all my coaching clients, everyone's sort of more comfortable where they are and then it's, you know, done an hour and then you go off and do your own thing.

So I know it's all preference, but I think doing a lot of remote work, there's a lot of benefits to it as well.

I know a lot of people will probably say, right, how can I work with you?

Where can you direct people to?

Yeah, so I have two separate kind of websites, I suppose, so one is more kind of looking at ADHD type support and one is more the infertility and loss.

Both of them have kind of different free resources, but essentially the ADHD stuff is more under the name of Dr.

Davy Coaching, and that's ADHD coaching, ADHD assessments and ADHD kind of therapy.

And then the infertility and loss during kind of perinatal work is more under para clinical psychologist in Sussex.

And there are other people on the team as well.

And when I select psychologists in my team, I'm very, very careful to select people of this is their area of expertise so that if referrals come through and it's not me who would be able to see people because of availability or I feel I'm not the right fit and I'm very much like who in the team is exactly.

Feels like the right person for you, what you're saying.

So, yeah, if you've got questions or you unsure, feel free to contact through.

And we do ADHD coaching kind of under access to work as part of that.

Brilliant as well.

Fantastic.

Well, thank you so much for sharing all your expertise and your insights.

Honestly, it's so I think this will be very validating for people, for them to understand and also maybe maybe something that they've needed a little nudge along the way to maybe go and have some, some trauma therapy and process that and hopefully, you know, begin that healing journey.

So, Dr.

Cara Davy, thank you so much for being here today.

Thank you so much for inviting me on.

If today's episode has been helpful for you and you're looking for even further support, my brand new book, the ADHD Women's Wellbeing Toolkit, is now available to order from anywhere you get your books from, I really hope this book is going to be the ultimate resource for anyone who loves this podcast and wants a deeper dive into all these kinds of conversations.

If you head to my website, ADHD womenswellbeing.co.uk, you'll find all the information on the book there, which is going to be out on the 17th of July.

Thank you so much.