Areas › Focus, starting, and ADHD › Shame and stigma
By the time somebody comes for an assessment, the poor opinion of themselves is usually decades old. Assume it is there even when the person in front of you is visibly doing well.
It rarely arrives as a complaint. It shows up as apologising for taking up your time, as brushing off achievements, as a joke about being useless that lands a little too flat. Asking about it early, rather than waiting for it to surface, tends to save a great deal of time later on.
Qur’an and Sunnah
If any of you has foolishly done a bad deed, and afterwards repented and mended his ways, God is most forgiving and most merciful (Quran 6:54). The deed is called foolish and the person is still addressed with care, a distinction shame refuses to make.
وَإِذَا جَآءَكَ ٱلَّذِينَ يُؤۡمِنُونَ بِـَٔايَٰتِنَا فَقُلۡ سَلَٰمٌ عَلَيۡكُمۡۖ كَتَبَ رَبُّكُمۡ عَلَىٰ نَفۡسِهِ ٱلرَّحۡمَةَ أَنَّهُۥ مَنۡ عَمِلَ مِنكُمۡ سُوٓءَۢا بِجَهَٰلَةࣲ ثُمَّ تَابَ مِنۢ بَعۡدِهِۦ وَأَصۡلَحَ فَأَنَّهُۥ غَفُورࣱ رَّحِيمࣱ
When those who believe in Our revelations come to you [Prophet], say, ‘Peace be upon you. Your Lord has taken it on Himself to be merciful: if any of you has foolishly done a bad deed, and afterwards repented and mended his ways, God is most forgiving and most merciful.’
Qur’an 6:54read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
A systematic review with a qualitative study looked at what stops NHS doctors seeking help for their own mental health, and at the less studied question of what makes it possible. High functioning and high need sat together comfortably in that group. The findings concern doctors specifically, so read them as an illustration rather than a general rule.
Zaman N, Mujahid K, Ahmed F, Mahmud S, Naeem H, Riaz U, Ullah U, Cox B. (2022). What are the barriers and facilitators to seeking help for mental health in NHS doctors: a systematic review and qualitative study.. BMC psychiatry doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
A long standing belief about yourself filters what you notice, so it does not fall away just because life goes well.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
Talking a lot is on the diagnostic list. It sits with the impulsive symptoms, which makes it part of the condition rather than proof that you are self absorbed.
When you are choosing where to start, take the easy one rather than the important one. Direction matters more than size at the beginning, because these things gather speed whichever way they are pointing.
A man in a support group said his sisters can arrive two hours late to a family barbecue and nobody comments, while he is ten minutes late and everyone starts. That is unfair, and the noticing is also real.