In this third installment of the ADHD and Eating Disorders series, we'll take a look at an important "why" concerning the ADHD/ED connection- how we experience our thoughts. Working with our thoughts is fundamental in recovering from an eating disorder. What is it about the ADHD brain that might add some hurdles to the process?
ADHD Impacts Our Thinking.
ADHD and Cognitive Flexibility
Cognitive flexibility is one of the executive functions that can be impaired with ADHD. This is a skill that allows us to think about things in more than one way and mentally manage shades of gray (even when we may be more comfortable with black and white dichotomies).
It also helps us imagine (and accept) outcomes other than the ones we plan and allows us to adjust and accommodate in response to changing circumstances.
When you think of the type of thinking that is inherent in eating disorders, it’s the opposite of flexible. Rigid thoughts and rules dictate what is acceptable. These thoughts moralize things like what we eat, how much we eat, and even our body sizes and shapes. When how we eat is given this kind of role in our lives, perceived errors become moral failures and can cause intense shame and isolation.
The irony is, rigid thinking invites more erratic eating. Why? It’s just not possible to follow unbending food rules 100% of the time. So that means we end up having to sit with some pretty intense judgement and self blame. Rather than sit with that pain ( or challenge those unfair judgements), many of us are driven to do something, as in restrict, plan, binge, purge, etc.
In my opinion, it doesn't matter if the actual behaviors appear to be opposites, they are serving the same purpose. So whether my "go to" is planning/restricting "now I'll get this right!", binging "Well, I messed this up, now I'll do it properly", or purging "I'm going to undo that mistake", the true purpose of each is to move off of that uncomfortable feeling of self-judgement/shame and replace it with action.
Tips to build cognitive flexibility
I'll mention some other tools I used in the fourth and final post of this series (which covers mindset shifts related to intuitive eating and diet culture), but today we'll look at CBT (Cognitive Behavioral Therapy).
If you’re not familiar with CBT, it’s an intervention that focuses on identifying, challenging, and changing thought habits that aren't helpful to us. Everyone deals with negative thought habits (referred to as "cognitive distortions” in CBT) at times. The good news is, we can learn to notice these cognitive distortions and challenge and change our thinking.
Developing awareness about my thoughts helped me see how they impacted my emotions and behavior. At one point in my ED journey, I had collected so many rules about food that the only thing I could eat without excessive thinking/ planning was raw vegetables (I was super fun to go out to eat with- just ask my friends and family). On some level, I knew this wasn't logical or sustainable, but that's the thing about cognitive distortions, they don't need to be logical to stick!
Like mindfulness meditation, my work with CBT was not a quick fix, but it was worth it. It’s work that I did with a therapist initially until I had the tools to continue on my own. As I learned to notice and challenge my thoughts, I was eventually able to build the thought habits I wanted in my life and this allowed for real change.
ADHD and Impulse Control
All of us deal with impulses- not just those of us with ADHD. The difference between a neurotypical brain and one that would be considered impulsive lies in the pause between impulse and action. A typical brain is likely to pause longer to evaluate a situation before acting than an ADHD brain.
During this pause, a person will consider their options and imagine possible outcomes. With an impulsive brain, you may get a shorter pause (or sometimes none at all). Below is a visual of a typical vs. impulsive pattern- rather than “Ready-Set-Go” ADHD's default can look more like “Ready-Go”.
Adding or extending a pause isn't easy when you have a brain that leans towards impulsivity, but it can give us time to really check in with ourselves.
We may see food and actually be hungry, and in that case, the pause doesn't necessarily change our action. There are other times when the pause allows us to notice that we are actually thirsty, tired, bored, or lonely. This pause is the beginning of making a choice when it comes to our decisions around food instead of reacting to a trigger.
Pausing also permits us to get information about what foods our body is calling for so we can make choices that are in sync with our needs. Even when my relationship with food had moved to a healthier place, this wasn’t easy for me.
Several years ago I developed a sensitivity to corn. If I ate it, I would have stabbing stomach pains. It took me a baffling amount of slip ups to remember that corn on the cob and corn chips were the devil. Just to be clear- it’s not like these were my favorite foods and I couldn’t live without them. It was that if I was hungry and they were visible/available, I would eat them without thinking about my past experiences. A bit of a pause might have prevented some of my corn-related suffering.
Tips to help with impulsivity
What did I do to help stretch the pause and Practicing a pause before eating. For some people, it helps to have a habit like a prayer or closing their eyes, others visualize something that symbolizes that moment like a pause symbol or a stop sign. Anything that helps create some space before eating will allow us to check in with ourselves.
This is a habit that tends to slide when I’m busy or otherwise not tuned in, but I do make an effort to return to it. I tend to make more decisions and have less reactions when I commit to this habit, and that’s helped me build trust in myself.
There are still times that I may decide to eat for reasons other than hunger (or even eat foods that my body doesn't respond well to- just not the corn). I'm ok with that. For me, peace around food has stopped meaning eating in a certain way 100% of the time.
Today we looked at both cognitive flexibility and impulse control and how they can contribute to the struggles we have with our relationship with food and our bodies. In the next post, I will widen the lens and explore how the interplay between our ADHD brains and our culture can leave us vulnerable for disordered eating. Stick with me- it’s a topic that is worth exploring.
You can read the other posts in this series here:
Questions? Feel free to contact me on my website @TheADHDClarityCoach.com. If you are interested in working with me, you can schedule a free discovery call below:
*The information I’m providing in this blog series is based on my personal experiences and the strategies that helped me during my recovery. This is not meant to replace therapeutic interventions or substitute for work with a trained professional. Please get support if you're struggling with an eating disorder, you don't need to do this on your own.*