The Powerful Effects of ISTDP in Managing ADHD Symptoms

Many people who come to therapy with an ADHD diagnosis, or who suspect they might have ADHD, describe a familiar set of difficulties.

They find it hard to stay focused. Tasks get started but not finished. The mind jumps from one thing to another, sometimes in a rush, sometimes in a fog. There may be impulsivity, forgetfulness, disorganisation, or moments of intense frustration when things don’t go to plan.

But there’s often more going on beneath the surface.

Alongside the attentional issues, people often describe a chronic sense of shame, self-criticism, or feeling like they’re “failing at life.” Many have spent years developing systems to cope, only to find those systems eventually fall apart. Others have tried to push through with willpower alone, while quietly battling anxiety, burnout, or emotional overwhelm.

For some, these experiences may be part of ADHD. But for others, they may be symptoms of something else, unresolved emotional blocks, inner conflict, or long-standing patterns of defence.

This is where ISTDP (Intensive Short-Term Dynamic Psychotherapy) offers a different approach.

Looking Beyond the Symptoms

ADHD is typically understood as a neurodevelopmental condition, and for many people, a diagnosis can bring relief and clarity. But a diagnosis alone doesn’t always explain why certain difficulties persist, or what can help create lasting change.

ISTDP doesn’t challenge the reality of ADHD. Instead, it asks:

• What else might be contributing to your struggles with focus, impulsivity, or emotional regulation?

• Are there internal conflicts; about anger, sadness, closeness, or self-worth, that haven’t been fully processed?

• Could some of the patterns that get labelled as “ADHD symptoms” actually be psychological defences?

ADHD and Emotional Avoidance

One of the key ideas in ISTDP is that when strong feelings are blocked, whether through fear, guilt, or early relational experiences, the body and mind find ways to manage that internal tension. Sometimes that looks like anxiety. Other times it looks like avoidance, distraction, or a need to stay constantly active.

In this sense, some ADHD-like patterns may reflect defences against emotional pain.

For example:

• Difficulty focusing might stem from unconscious avoidance of a task that stirs up feelings of failure or inadequacy.

• Procrastination may be linked to inner conflict, wanting to succeed, but fearing the pressure or scrutiny that might follow.

• Emotional outbursts may signal deeper frustrations that have no safe outlet.

ISTDP helps identify and work through these patterns, not by managing them, but by understanding the feelings underneath them.

The Role of Anxiety

Many people with ADHD also struggle with anxiety, though it’s not always recognised as such. In ISTDP, anxiety is seen not just as a diagnosis, but as a signal that emotional conflict is occurring.

This might show up as:

• Physical agitation

• Restlessness

• Cognitive overwhelm

• Racing thoughts or blanking out

By helping someone learn to recognise how anxiety operates in their system and what it’s connected to therapy can begin to restore clarity and a sense of choice.

A Different Kind of Focus

As therapy progresses and the internal blocks begin to lift, people often report:

• Feeling more emotionally stable

• Greater access to sustained focus and follow-through

• A more compassionate inner voice

• Less shame and self-criticism

• The ability to act with more intention, rather than being swept along by anxiety or avoidance

The goal isn’t to fix someone’s attention, but to understand what’s getting in the way of being fully present.

When a Label Doesn’t Explain the Whole Picture

ADHD is real, and for many people, medication and support strategies are essential. But for others, the symptoms may be better understood as part of a deeper emotional process that hasn’t yet been addressed.

ISTDP offers a way to work with the emotional drivers beneath the surface. It’s not about managing symptoms, it’s about resolving the internal barriers that keep a person from functioning freely and authentically.

If you’re living with ADHD-like struggles and want to explore what might be going on underneath, therapy can offer a space to understand yourself more deeply and find a way forward that’s actually grounded in you.

You can learn more about my approach on the homepage, or get in touch if you’d like to discuss whether this kind of work might be a good fit.