[0:40] Ian: Hello and welcome back to the smart ADHD podcast. Today we're exploring the emotional and cognitive landscapes that shaped the lives of those of us with ADHD. And I'm really happy to welcome Monica Hassall, a seasoned executive function coach with over a decade of experience and a deep understanding of ADHD.
[0:58] She incorporates insights from neuroscience, mindfulness and coaching principles into her work offering creative and practical strategies that empower her clients. Her expertise has been featured in publications like ADDittude and attention magazine and she brings a wealth of knowledge to help us understand The ADHD volcano, what's that?
[1:19] Well, it's a way of exploring and understanding ADHD. And I think that is a really, really useful thing to do. So if you're interested to know what on earth the ADHD volcano is, and if you're wanting to understand ADHD more fully and its impact on all areas of our lives, stick around.
[1:38] Let's get on with it right now.
[1:40] Hello, I'm Ian Anderson Gray, and this is the smart ADHD podcast.
[1:54] Now if you're a smart, creative entrepreneur or business owner navigating your life with ADHD, This is the podcast for you. Now, I'm no ADHD expert, but I'm eager to share my story on what I've learned by talking with experts, as well as digging into the personal ADHD stories of successful creatives and entrepreneurs.
[2:17] I was diagnosed at age 46, and it answered so many questions in my life. But of course, that was in many ways, only the start of my journey. So let's learn together. Smart stories, smart strategies, smart ADHD.
[2:44] Hi Monica, welcome to Smart ADHD. How are you doing
[2:48] Monica: Very well, thank you Ian. Thank you so much for having me tonight, or today, wherever we are.
[2:53] Ian: today, tomorrow, this morning? It's the time zones. They're very confusing. So you're dialing in from sunny Australia. Is it sunny at the moment?
[3:02] Monica: It's dusk, so yeah, but it's pretty hot because it's summer, so it's hot all the time.
[3:06] Ian: Exactly. Thank you. Thank you for Monica Monica for joining us. So your husband has already been on the show, Jonathan, and we were talking about neurochemistry. We were talking about lots of other things as well, and we met In Anaheim just last month for the international ADHD conference.
[3:25] That was amazing. And I went to your talk, which was all about the internal pharmacy. Now you're coming back to talk about that in a future episode, but One of the things that I found fascinating was this idea of the ADHD volcano maybe before we get on to the ADHD volcano I'm sure listeners are thinking what on earth is that?
[3:45] But how would you first describe what ADHD and why do you think it is so hard to understand? And get our heads around.
[3:53] Monica: I think one of the things about ADHD, there's a lot of stigma around it, and people hear about, they have this old fashioned ideas about only being in boys and about being hyperactivity and being naughty. So many parents that I've spoken to said, oh, but my kid's not naughty, but they're dreamy. And ADHD is not about being naughty.
[4:09] ADHD people get caught up in what the core symptoms are, inattention, impulsivity, hyperactivity. They're used as diagnostics and that is very similar to the name, isn't it? Detention, deficit, hyperactivity. But where people really need to put their attention and where they will get much better understanding of what they need to do moving forwards is understanding this lens of executive functioning.
[4:31] So 10 years ago, when we started coaching, there wasn't a lot of information around that was a new conversation and I found it quite confusing. I thought well, what are these core symptoms? What are these executive functions? Which led me to create this model called the ADHD Volcano.
[4:44] Ian: Yeah, and you're so right about the stigmas I still feel that with This show, for example, this podcast I'm almost nervous or I have been nervous in the past to, to talk about it, to, to share it on online because there, there are so many, so many myths, so many stigmas. Even with people who think they have a ADHD, they think yeah, I don't really wanna talk about it.
[5:04] So I think. That's one of the reasons why I do this podcast is to address those myths and to help us understand more. And that's one of the reasons why I love this ADHD volcano thing. Can you explain what it is? What is the ADHD volcano and
[5:19] Monica: it's just a visual model, and I actually came up with this concept when I was going to a primary school and I was speaking to a deputy principal about the behavior of these kids with ADHD. And what I noticed is that he was just focusing on the behaviors, and I thought there's actually a lot more going on underneath than just behavior.
[5:37] So I came up with this model, and I think we're going to go through the different layers of the model. And ADHD is actually quite a layered condition. Yeah, what I realized, yeah, the, so there's the behaviors at the top. And when we have a look at a model, there's the diagnosis under that.
[5:52] But under that is the executive functions, but under that is brain chemistry. But there's a lot more to it than that.
[5:57] Ian: Gonna say, obviously this is quite a visual thing, but we will be going through all of that and this will be on the show notes and we'd be putting an image on this on YouTube. Sorry. I interrupted you. That's a typical ADHD
[6:08] Monica: Oh, no, that's fine. I was going to say, another sort of inspiration for doing this is the fact that one day, a fortnight, I worked for a psychiatrist and I do his adult intake sessions, and this lady came in for an ADHD assessment, and I said, what's brought you in today for this ADHD assessment?
[6:23] And she was in her early thirties, and she had a few kids, and she said I've been to three different GPs, I've been on four lots of antidepressants. She said, the chaos is still there, but I just don't care about it anymore. And what I was realizing was that people were missing the diagnosis of ADHD altogether, and sometimes people were getting diagnosed with anxiety or depression, and they're different things, which is what the volcano can visualize.
[6:47] Ian: That, yeah, that's absolutely so important because I speak to so many people who have been misdiagnosed with depression, anxiety, even other things like bipolar and it's. It's a huge problem for in my own life it was anxiety and depression particularly my 20s 30s And it's not really been until fairly recently that I've had this, . Confirmed that the anxiety that I've had is from my ADHD.
[7:14] I almost didn't believe that. When I was, diagnosed, they said you have ADHD with anxiety. And I thought, oh, okay. I wasn't expecting that. And, it wasn't actually until I started taking medication where the anxiety almost disappeared. vanished, I realized, Oh, wow. Okay. It really was, was that.
[7:33] So I think this is why looking under the surface is so important.
[7:37] Monica: Absolutely. Yeah. I would agree. When we look at this volcano model, I always draw people's attention. These are the things at the top of the volcano. These are the things that happen to people with A DHD or the things that other people around them might notice about them. And typically the behaviors that are at the top of the volcano might be being easily distracted or they're focusing, but they're focusing on the wrong thing.
[7:57] Procrastination is a huge one. Missed appointments, not managing time, catastrophizing or exaggerating, more sensitive to feedback. And there's a huge number of words up there and I won't go through all of them. But these are typically the things that might, indicate ADHD.
[8:13] And like I say to my clients, just because people don't have ADHD doesn't mean they're perfect. These things can happen to people without ADHD as well. Not good planning or catastrophizing. But with ADHD, it's what we call pervasive. And it happens in more than one life area.
[8:28] So if it was just at school, it would be a school based thing. But if it was at school, your child at school, at home, at the party, at the library, fidgety, all these other behaviors, it was in more than one life area, it could be ADHD. If there's only one life area, it's probably not ADHD. Yeah.
[8:42] Ian: Yeah that's really helpful because I remember saying to somebody but a few years ago, a friend of mine said that I've ADHD. And I think this was in that stage when I, it was like something new to me. And I think. I wanted to say it to people probably oversharing
[8:59] Monica: Mm, mm,
[9:00] Ian: And he said to me, Oh, ADHD.
[9:02] What's that? And then I felt under pressure to try and explain some of the things that I would struggle with. And I said, procrastination. And he said to me, but everyone struggles with procrastination. And I think it's what you said, though. It's that it's not just in one area or one place.
[9:17] It's across all those areas. And it's also it's not just some of the time. It's a lot of the time, would you say?
[9:24] Monica: Yes, absolutely. It's sort of a, it's almost like groundhog day for some people. They have those days and they're terrible and think it'll be better tomorrow, but then it happens again and it happens again. And, unless they know what the cause is, what's underlying that, it can just lead to a lot of frustration, so when they actually happen to lock and cause, management time frustration frequent arguments, it's a variety of things that can happen because of those behaviors.
[9:47] And what we need to do is find out what's happening underneath.
[9:49] Ian: Yeah so just one more thing on the top before we go down that I think it's important is that, of course. There are, as I keep on saying on this podcast, there are as many types of ADHD as there are people with ADHD. So those top things presumably will be different in all of us. And would you say also that we all can sometimes come up with strategies to mask those things?
[10:14] So like for example, things like time. I actually overcompensate often. I will actually arrive early because I've learnt that I don't want the anxiety of being late. Would you, is there, would you say that's true? That some, sometimes we can build those strategies, there's masking, we're all different.
[10:30] What would you say about that?
[10:31] Monica: Look, I think that like you said, everyone's individual and I get people saying, Oh, I'm inattentive, but I'm not hyperactive, but they're talking at a hundred miles an hour. And that's because they're looking at purely the core symptoms that, that language. I had someone recently say, the core symptoms, they sound a bit like the name, like we said, inattention, impulsivity, hyperactivity, we need those for diagnostics.
[10:51] Unfortunately, it doesn't cover everything. One of my clients recently said core symptoms, they're just the things that annoy other people. They're things that have already happened. Where we get better coverage, we get better understanding, and we get a better idea of where to put structures and strategies and tactics in place if we understand where the deficits are or the challenges are with executive functioning.
[11:13] So when I coach people, I'll often say to them, if you had to define ADHD to someone, what would you say? And they might have had a diagnosis for 20 years or 20 months or 20 days, and a lot of people don't know. They might say, Oh, it's like having bees in your head or it's had one guy say, it's like having 10 televisions on in your head and I want to look at all of them.
[11:31] One other guy said, what? Only 10, I've got a hundred or I want to have five conversations with myself in my head at one time. So that's how it feels, but that's not what it is. And ADHD can better be understood as challenges with self regulation and self regulation or self control of these executive functions.
[11:50] So executive functions are skills, a suite of skills, and they take place in the front part of our brain. The brain has different areas for doing different things. And the executive function part of our brain is at the front, and that's the part that doesn't always get the fuel. And, we can explain that
[12:05] Ian: I think that's really helpful. We have talked about the, we have talked about the executive function on the podcast before, but it's one of these concepts that I still find very confusing. I, so this is, am I right in saying this is mainly in the prefrontal cortex, which is right at the front?
[12:20] Monica: Yeah. Yeah. Mainly there. Yeah. . And the way we can remember is it helps us execute tasks. That's the easiest way to remember it. It's not about knowing what to do. We know that we need to not yell at people. We know we need to get to appointments on time, or we know that we need to manage time better or, do the thing, but then you or get the report in, but then you're not always doing what you know, and it's the doing part.
[12:42] Ian: there's. There's that disconnect and that, that's almost worse because you then, because you're aware of those things, it's then very easy then to beat yourself up and say Oh, I'm always late. Like, why do I do this that it's not because we are lazy or because we, we want to be late or whatever, but because, yeah, it's what's happening in there.
[12:59] So we've got the challenging behaviors. I'm looking at the volcano. Now we've got things like being distracted, missed details, perfectionism, hyper focusing, Avoidance, I'm laughing because yes, I know these things fatigue poor prioritization, poor money management, so there's a lot, there's a lot of stuff there.
[13:18] Let's get, let's go down. What's the next layer?
[13:21] Monica: See, under that is the anxiousness or despondency that can come with those ADHD behaviours. And when I reveal this slide to my clients, at that time when we're talking about anxiousness and despondency because of ADHD, The two other little volcanoes come up either side.
[13:38] One, one volcano, small volcano at the side is about coexisting mood conditions, which is generalized anxiety disorder, or major depression, or bipolar, like you mentioned before, or obsessive compulsive. So that's on one side. And then the other volcano on the other side is coexisting academic, which we can get into a bit later.
[13:57] But the reason why I like to lead with the anxiousness and despondency is that's the part that's sometimes missed or misread. And people will often go to that, they've got generalized anxiety disorder or major depression. And I've had a number of people saying, Oh, I've been, they tell me it's depression but it doesn't feel right, or I've been labelled treatment resistant depression because they've given me these medications and it's not changing.
[14:18] Like that lady said, I've been to three different GPs for lots of antidepressants, the chaos is still there, I don't care about it anymore. That medication was treating the wrong thing, it wasn't treating ADHD symptoms.
[14:29] Ian: Now that's interesting. So we've got the challenging behaviors. That's the really obvious stuff at the top. And then it looks like on the volcano, this is the lava flowing down the edges of anxiety. And what else did you say? Depression and other things that,
[14:44] Monica: or I had one fellow say I'm disheartened I just can't get up to that next level of my work because I don't get my reports in on time and I'm late for meetings so that's because of the ADHD symptoms it's not because of depression.
[14:59] Ian: And this is so important because I think again, we, we look at ourselves and. We know what we want to do, but we sometimes can't do it. And and that's in a way can feed into these things like depression and anxiety. Presumably it can feel in my expense, it feels like a vicious circle that you can't break out of.
[15:20] So So, yeah, we've got those things flowing down the sides of the volcano. So what's
[15:25] Monica: On the other side, things that can happen at the same time as ADHD but they're not, is what happens at school, the dyslexia. About 17 percent of people with dyslexia also have ADHD. And dyslexia is when people have troubles with numbers and symbols. I had one lady say, 8's my favorite number because I can't get it upside down or back to front.
[15:43] And there's a lot of people with ADHD that also have that. There's one called dysgraphia, which challenges processing language, so that can also impact spelling. That can be about sequencing of language or being really effortful to write sentences, which sometimes can get covered up in school somewhat, but when people are in the workforce, when they've got to write reports, that can be really effortful.
[16:03] And in the way of, for a career, I've had people, have left school and, found it so hard to, at higher education because that was really difficult for them. Also one on that side called dyscalculia, which is a learning disability with maths. But coming back to the volcano, ADHD can mimic some of those things as well.
[16:22] You know, Zoning out, not getting work done, not paying attention, not being able to do maths because they didn't listen. Being the class clown and being sent out of school so you don't, out of class so you don't even get to hear some of the lessons. So ADHD can affect learning.
[16:36] Ian: so yeah, that's interesting. So what you're are you saying that you said that ADHD can mimic some of those things like dyscalculia or whatever, but you people with ADHD can also have those. I don't know if the right word is conditions as well. Can the ADA is the ADHD feeding it feeding that are these executive function things that are going on.
[16:59] I'm trying to understand what's going on
[17:01] Monica: there could be some overlap. So someone who's sitting in class, if they're in maths and they have a learning difference with maths, they might get fidgety or disruptive or try and be the class clown because they don't want to, they want to mask not being able to do something. It's not ADHD.
[17:14] There might be a different, that learning difference with maths. But when we think about it, it's all brain based. So there could well be overlaps for some people. This is all about, behaviour is all about what's happening in the brain.
[17:25] Ian: I loved the idea of maths. I wanted to be really good at maths and I was like, I'm not going to put myself down. I was all right at maths, but I found that I needed to have a slower pace in terms of the teaching. I needed to I felt like I needed to understand everything.
[17:38] In order to then do it. And I also, in English, I found English comprehension exercises really difficult. And I always thought I was just like a bit stupid . But I think, but I'm pretty sure that it, this, for me, maybe it's an executive function thing or it's related somehow to the A DHD. Would you say that's po
[17:56] Monica: Could, possible, maybe, if you didn't know you had ADHD and you didn't have the brain chemistry to help you keep your attention on your English, that could have been part of it as well. But maybe your attention would be drifting, but you didn't know it. Or maybe there's a learning difference with processing language.
[18:11] We see this graph here, we see messy handwriting in kids, but, and that's processing language, but we also see having the message in your head and being able to sequence and get it out, which is, more advanced.
[18:22] Ian: Definitely. So what's next? We've talked about the outsize of the volcano. Are we going in yet?
[18:27] Monica: the
[18:29] Ian: Haha.
[18:30] Monica: ADHD in learning challenges. So It can happen at primary school, secondary school, and once you've left school as well.
[18:37] Not focusing, not turning up to lessons. We've had students at university come to us two weeks before exams, week twelve and say, I haven't seen any of my lectures yet, because they're all recorded now, and they have to try and catch up. Delaying work, leaving work to the last minute.
[18:51] Some people say they're driven by anxiety, so they can do it when they have to, but It's probably never their best work, because they haven't allowed enough time, and time management's part of that ADHD experience. And on the other side of the volcano, the last thing we look at before executive functioning, I call it self medicating.
[19:06] So self medicating is really when people might eat too much, they might drink too much, They might use, they might smoke or vape. Now, none of those things are illegal if you're over 18, but they always speak to instant gratification. And, further to that, it might be about using illicit substances.
[19:22] Having that craving for things. And I also put too much screen time in here as well. If the brain is under stimulated, it'll get it from somewhere else. So they're all about pursuit and craving those things there. So once we understand that we need to think what's happening underneath all of that and underneath all of that It's those challenges with executive functions.
[19:41] So, I use a blend of Dr. Russell Barclay's theory of executive function and I've pinched a little bit from Dr. Thomas Brown, who's a psychologist also. So I've created little cards for my people to talk them through the executive functions because, there's seven executive functions that I like to talk about and unless you've got a really good idea there's all these words floating around like.
[20:01] Inhibition and impulsivity and self awareness and attention. We need to be able to have a much better understanding of what are executive functions. So that's why, I wouldn't expect anyone of my clients to remember all of those words. So I create these cards so they can engineer their environment.
[20:16] So they can see them within their environment. And this is, what we're doing. Dr. Russell Barkley talks about engineering your environment. So if we can't keep it all in here, in our working memory, we have to engineer the environment. Which is, like having a watch. We engineer the environment for time using a watch.
[20:29] Just as an example. So there are seven executive functions that I like to talk about. So the first one is self awareness. And sometimes people with ADHD aren't aware that things are going off track, or they're losing time, or they're talking too much. So they're not really noticing if things are going off track.
[20:44] The next one is about attention, and attention's got three layers, so there's being easily distracted, there's being hyper focusing on things, and I had one lady say hyper focusing is focusing so much that the rest of the world doesn't exist. You don't get hungry, you don't get tired, people talk to you, you say you'll do things you didn't hear what they said and then you're in trouble for it.
[21:01] The other layer of attention is not being able to shift your attention when you need to, because that takes dopamine as well, so it can be really effortful to shift your attention if you're engaged in something. Because that feels really good, because you've got lots of dopamine to put your focus on.
[21:14] So that's three layers of attention. We go to inhibition, and inhibition's got three layers as well. Inhibition has motor inhibition, so that's that fidgetiness. We see it in kids that can't sit still. It sometimes, goes into adulthood with being fidgety, playing with your hair. Playing with pens, leg bumping.
[21:31] That's that motor or muscle inhibition. There's also cognitive inhibition. So cognitive, anytime you hear the word cognitive, we're just thinking the word thinking. So it might be doing things that aren't the right choice, like speeding, gambling, watching YouTube, getting on that doom scrolling.
[21:46] where you've actually got something more important to be doing. The other layer of inhibition is verbal inhibition. This one really ticks a few boxes with some people. They're a bit surprised when I talk about it. That verbal inhibition is sometimes when you ask someone with ADHD a question, they might take a lot of words or a lot of sentences to answer the question.
[22:05] They might go off on tangents. They might blurt things out, say the wrong things, talk over people. And the tongue is a muscle too. And what you can see, we've already covered Inattention, impulsivity and hyperactivity. We haven't even got to working memory, planning, emotions and motivation yet. And that's exactly why we need to look at ADHD through the lens of executive function and not the core symptoms.
[22:25] So Russell Barclay says it the best. He says to look at ADHD as just to be as being hyperactive or impulsive is to trivialize the impact of ADHD. And there's much more to it than those.
[22:36] Ian: Now that's fascinating. So what are the seven again for executive function so I can try and remember all of that
[22:40] Monica: The last two, we haven't got to the last two. Cause, oh no, the last four areas. In the volcano I have it in that layer, but in my little orange card I have them in a different way a different sequence. We still have working memory, which is, I like to say, the memory that we're using while we're working.
[22:55] It's that right now memory. And it's the only memory that's involved in our future, because we have to remember things to be successful. Is planning. Planning and problem solving. A lot of people with ADHD don't love planning because they'll say my plans mock me or my plans judge me because they haven't gone well before because that they haven't got the time element right and we can support that very easily.
[23:15] So there's working memory planning and the last two areas are motivation And I break that down into activation and task initiation, that's the smallest task that you can start, motivation, and probably one of the most important is emotional regulation as an executive function, and that's not mentioned in the core symptoms.
[23:32] So with emotional regulation, I like to discuss it with my clients, is often with ADHD, yeah, they can be despondent, but it's not the same as depression. With ADHD, it's that range of emotions, and the emotion can be right, but the volume is wrong. So whether it's enthusiasm or excitement, ADHD can really get a hold on them.
[23:51] They can be super excited and hard to rein it back in. Or it could be about getting feedback from someone. So instead of interpreting something as feedback, they might interpret it as criticism and that can be paralyzing for some people. Or I've had people say, it's like being kicked in the guts if someone gives me feedback.
[24:07] Ian: is that the kind of rejection sensitivity?
[24:10] Monica: Yeah, that rejection sensitivity. So yeah, the emotion is right, but the volume is wrong, and they are more sensitive to feedback, for sure. And yeah, it could be about anger as well. Could be ticked off by something, but someone with ADHD might be really angry about it momentarily.
[24:23] That's where it's different from depression. Depression is that lack of joy and the brain chemistry behind that. They might not even be able to get out of bed. With ADHD, the emotion is right, But the volume is wrong. That's why I've got a little dial on my diagram of an executive function. They're the seven executive functions that I like to talk through.
[24:40] Ian: that's so so helpful. I haven't actually thought about it in those ways. I didn't realize That it was so so many things that were to do with executive function. So that, we could have a whole other episode on that. I was fascinated about the whole concept of self medication.
[24:55] Again, that's, we could do a whole other episode on that. We are almost out of time, Monica. So I know that underlying all of that, we're probably now getting into the neurochemistry side of things. Can you explain what, what's at the bottom?
[25:08] Monica: The second last layer, which is actually the bottom layer, is the brain chemistry. Medications can help, but diet, sleep, exercise, and stress management, because when people are stressed, there's nothing that changes their brain chemistry more quickly than that. From the bottom to the top, if the brain chemistry is not where we'd like it to be, that impacts the executive functions directly.
[25:27] If the executive functions don't have the fuel that's why the behaviors at the top happen. Because any time I see those behaviours at the top, I'm thinking one of those executive functions, or all of them, might not be doing their job. There's one extra layer, and I call it the fallout layer.
[25:41] So the fallout layer, if we don't do something about it, is guilt, shame, negative self talk, frustration yeah, so those sorts of things as well.
[25:49] Ian: But there is hope.
[25:50] Monica: is the other one. Oh, there is hope, yeah, understanding executive functions, we can do a lot about it.
[25:55] Ian: and that's, that's one of the great things about this ADHD volcano. At first glance, you might think, oh, wow, this is a bit depressing. But the point of it is that with this knowledge, you can then do something about it. And we're going to talk about, brain chemistry or your internal pharmacy, which is, what, There are tools in your head that you can actually use to help with all of this.
[26:14] Medication is one path, it is an important path for many, but there are lots of other things that we're going to talk about. That's been, wow, we've managed to talk about so much in that, and I feel there's so many more things I want to ask you on that. Have we covered everything on the volcano?
[26:29] No,
[26:30] Monica: I think the volcano we have. Yes.
[26:32] Ian: we've done a
[26:33] Monica: about. Yeah. Yeah.
[26:33] Ian: You've done it. I'm sure there's probably more things that we could talk about. I'm very excited to talk to you about the internal pharmacy, which we'll do in a future episode. But thank you so much, Monica. It's been Ah, fascinating, really enjoyed hearing all of this and getting more of this clarity and this and knowledge about how ADHD works or manifests in our brains.
[26:55] Thank you so much.
[26:56] Monica: Thank you so much Ian for having this opportunity to chat with you. To connect with you. It's all about connection.
[27:01] Ian: Exactly. So how can people find out more about you? Obviously you are a coach you are specific type of coach. Can you just explain what type of coach you are and how people can get in touch with you?
[27:10] Monica: I have a nursing background, and that's where I met my husband Jonathan. So we've got a nursing background, so the neurochemistry is important. But we're ADHD, and we like to also qualify it as executive function coaches as well. Because that's where we need to do our coaching, through the lens of executive functioning.
[27:24] So we're at www. connectadhd. com So we're from Connect ADHD Coaching. So it's nice and easy to remember, just, connect.
[27:31] Ian: Connect. Yeah that's the word. Thank you, Monica. It's been great to have you on the show and thank you for plugging us into your ears or watching on the YouTubes. And until next time, I encourage you to be smart with your ADHD.
[27:43]