Speaker 1so we had a member who asked us for a resource or a conversation around working with people with undiagnosed adhd and i thought that would make a great topic for us to discuss on the podcast before we get started i think the first thing to mention is that maggie you have created us a wonderful course on working with people who have some kind of neurodivergency so we've covered a few different areas of that on the course i know i say we uh obviously you did it not me but i'm going to claim some kind of credit for this so remember there is a course and it's well worth working through that if you're working with with clients with adhd or any number of different elements that um are on that kind of spectrum of being neuro neurodivergent neurodivergent so i think that's probably a good place to start really because if we start with working with people who have a diagnosis then we can circle back towards the end and carry on or like expand on that for anyone who's not diagnosed yet so maybe you could you know give us a bit of a summary of your course things we might need to know if we're working with people
Speaker 2with neurodivergence yeah so the course covers quite a wide range of um diagnosable conditions uh which is probably the next thing to touch on but uh we look at asd autism spectrum disorder we look at adhd um also a little bit sensory processing disorder dyspraxia dyslexia and that's because a lot of the times these conditions don't sit alone and they actually cross over um into other spaces um commonly called comorbid conditions which i think is an awful way of describing things but a lot of this is because of the way that we're working with people with neurodivergence and we're working with people with neurodivergence um and that's one of the first things i would say about this is that a lot of people who are diagnosed and some who aren't but would identify as having a neurodivergent condition and we'll talk about why you would identify not be diagnosed um but essentially a lot of people actually reject some of the language around it as well because it is very clinical um and um identifying with that kind of level of clinical language doesn't always um help that person to express what it is that they feel is them and they also don't necessarily want to be defined by that condition either um i think particularly when it comes to something like autism spectrum disorder and adhd where the presentation of it can be so so so so different but also it is hugely stereotyped um in our society um and i and i think there's there's a very kind of social political kind of lens that has to go alongside understanding that there's a what it's like to have this because we don't if you have this condition or you think you do or you're even looking for a diagnosis of it you are entering into a world where people are making judgments on you and i think that's really important to identify first of
Speaker 1all yeah absolutely and i think that's a good place for us to as personal trainers to kind of start with is almost like what comes to mind when you think of these things because if you're working with clients with these conditions you kind of need to be quite broad in what your expectations are and and that might need some adjustment or you might need to go away and do a bit more research on it so that you don't make all these assumptions because it isn't something where you can go well if you have a client with this you need to do this this this and this because there's always that human element that goes on top of it and i you know something that i've become really aware of recently because having spent the first nearly 50 years of my life where i would have absolutely told you that i wasn't neurodivergent and that was it um i've i've been rather recently going through a period of coming to the conclusion that no i absolutely am and and that that is amazingly really common particularly for women to discover this during things like perimenopause and these particular changes in in sort of hormone levels and things like that and it's just opened up a huge amount for me that i've still got loads to learn about where i'm kind of seeing something oh no that is me and and in a very very very stereotypical way i would have said in the past nobody would ever have called me hyperactive in any part of my life um and there is a little bit that goes well adhd surely that's got to have a hyperactive element to it and and then you go well it can't be me and so even when i started to have those kind of questions over maybe there was some kind of neurodivergence that's pretty much how i described it to myself because i was like can't be adhd but it must be something else um and then i can't start exploring more and i'm so say still got a load more to to learn but it has opened up and changed my perception about what it is what it would mean working with others who have have it or what it might mean and things to be aware of and all of that kind of stuff and where it crosses over into personal training which is obviously what we'll focus on today but i think it's a great place to start is kind of questioning what you see as neurodivergence and what you would expect from a client who says i'm diagnosed with adhd or autism or whatever um because the chances are you might need to expand your understanding if it's not something that you or someone you're close to is dealing with yes exactly um so i
Speaker 2think let's take adhd is a really good example of that because it's a um and look at like that stereotype so you immediately went to well i'm not hyperactive um and there are three different types of adhd which i think a lot of people don't know about there's inattentive hyperactive and then there's combined type and that's changed over the years when i talk about this i'm talking about clinical criteria because actually if we're talking about diagnosis we're talking about another person sitting down with us who is trained in this clinical criteria to listen to what you have to say and what you have to say and what you have to say there's a short test um in inverted commas um it's like tick boxes of how often you are likely to do these things that it suggests um and then after that it is basically an hour or an hour and a half interview where they go through different ways in which you react to things and do things they ask you questions um and try and get this idea of how you fit this criteria i always have a problem we've probably covered this before in other podcasts i always have a problem with this clinical criteria because essentially it is through the lens of a colonial white western male patriarchal capitalist lens right and we can't remove any of those things and so when i say that mental health is very political it's very political because people are making decisions and those people have lived experiences that are unique to them but these people have particular group experience and also they are they they have they have a purpose behind what they're doing you know they're they are medicalizing something there's a lot of people that actually don't want to go for diagnosis because they don't want to medicalize the things that they have they just want to understand it um and it is a big leap as well if you do go for diagnosis that is then in your medical record any um medication that you might want to take for it goes into your medical record it affects like some places when you go for visas you are asked do you have a psychiatric diagnosis adhd autism things like that a psychiatric diagnosis so it is quite a major event in someone's life and it does make you question like even what do i do with this so particularly i think when you come to it in later life there are three things that happen in because we used to think first of all we first of all we didn't understand adhd and adhd rather than trying to branch out too far we didn't understand it and literally adhd until about two early 2000s um was seen as something that little naughty boys had and it was seen as hyperactivity so and i've taught those children i was an scn teacher for quite a while and essentially i've taught children who were so clearly adhd they bounced literally off walls and when you medicated them they're able to sit down and pay attention and they said themselves i feel like i can be me again i feel like i'm not going to be me again i feel like i'm not going to i can hear my own thoughts and i can control my own body like it changed their lives so that that level of hyperactivity um was what we saw as being adhd and we saw boys way more as likely to have it than girls were now that's going to impact the way a diagnostic criteria is written and actually if you have a look at the diagnostic criteria which i had a little bit too much of a look at because um we were talking before this about overthinking we'll come to that in a bit as well essentially you can look at that criteria you can go through it as an adult woman and go well i don't do any of that and then someone says to you but do you want to oh well i mean i'm constantly stopping myself doing all of that yeah because it's rude so the first time i read through that criteria i went well of course i do that's rude do you interrupt people no it's rude and then i'm watching myself over the next few weeks oh you interrupt people all the time i catch myself i've interrupted them and i'm like oh i do that all the time and i say are you constantly moving or feeling like you're on the go and you've got like a relentless feeling of having to move or like thoughts being like that as well it's not written like that in the criteria though and you're like no and then my friend's like you literally never stop moving like oh but what you do particularly as a woman is you realize that those things are inappropriate you're told that's why I remember as a teenager being told off all the time for things like not paying attention looking out the window talking too much being over emotional all these things so then you hold it in and you stop it and it's called it has a name it's called masking we learn these strategies then how do I stop myself from doing this how do I make sure that I get on with it I could have told you ages ago that oh well no I don't have a problem with deadlines it's not normal to be completing your essays five minutes before it's due in and then having to run to make it to the university test to hand it in but my friends used to do it with me and that's because Claire we collect each other so also what's likely to happen in later life is that you suddenly realize that your friends have got these conditions or they started to be um diagnosed with it and you go huh I thought that was normal so me and my friends have a little bit of a joke now we're like oh we're very neurotypical because all the things we do amongst us are very normal um and you say things to your family you know with your nephews and your grandchildren things start getting diagnosed you go that's normal isn't it they're like no oh so so generally speaking it can be something that particularly because we didn't understand it for so long because it's something that is better understood and because of social media which has its highs and its lows to it we're starting to understand better we're starting to see that there are these things that are a part of us or things that we do that there might be an explanation for rather than us just being useless or whatever or all the masking that that person was doing particularly women do this all that masking they were doing in their life at perimenopause and menopause point absolutely falls apart because of the additional symptoms of perimenopause and menopause and the hormone dysregulation that occurs in that and they think that the drop in estrogen impacts the dopamine directly and dopamine is particularly instrumental in um in adhd they believe there's a lack of dopamine that causes um the inattentivity and the hyperactivity that can occur in it so essentially because you've got that hormone dysregulation taking place it's much more likely for women to now be diagnosed around that perimenopause age of course what that's leading to is this media going and it's an over diagnosis it's not if anything we believe that there is an over diagnosis because it's still so highly stigmatized and the media contributes by that with their stories of over diagnosis uh but essentially a lot of people don't want to acknowledge it or to do something about it or to go and speak to someone about it and even when they do that's difficult because there is either you pay for diagnosis which is around two to three thousand pounds that's a lot of money or you wait on the nhs now in some areas on the nhs there's a two thousand year wait list literally that's how long they believe it would take to get through all the people that want to get diagnosed on the nhs they created this thing called right to choose by that where they use private companies to take on some of that load but now that is so overloaded that actually it is still probably now in most areas it's at least a year in some areas it's up to five to six years even to get a diagnosis as an adult so diagnosis even then even if you decide that's the route you want to go down even if you want to try out medication and see if it helps all those things they are still very very very hard to access um so a lot of people actually in their adult years are undiagnosed and that's why it's so important to recognize that as something that you don't need a little tick or a psychiatrist to say or a psychologist to say this is what you've got you don't need a piece of paper or certificate although some of us do love uh but it doesn't it doesn't need that what it does need is an acceptance that what someone is telling you is there are certain things i struggle with and i'm going to tell that to you as my pt in a helpful little bubble of so i do have adhd or i think i have adhd or i've got undiagnosed adhd and what they are saying to you is i would like to have an adhd and i would like to have an adhd and i would like to have more of a conversation about how that impacts me and that is your moment to go oh tell me more about that and to find out more and to ask them how does that impact is there anything i can do as your pt that will help you with that that sort of thing because at the end of the day we don't need to know whether they're inattentive we'll probably be able to tell or hyperactive um or combined we are not the ones diagnosing them that is not something we need to have a full understanding of what we're doing and what we're doing and what we're doing and what we're what we need an understanding of is how does that impact you what does that mean to you what do you why are you telling me that what do you need me to know about it or even just understanding how that might present in someone because some of those things as i mentioned before are considered rude so for example i have complete and utter time blindness it has a name turns out i'm not just useless at being anywhere on time and i'm not rude but for much of my life i was told it was rude and i was told that i was i was saying something about the people and the place i was going to that i didn't care about them that i was i was somebody who didn't care about other people but i tell you the stress the burnout it would give me to try and get to places on time and then the anxiety that i would be like absolutely consuming me when i didn't make it there on time and i tried so hard and it didn't make any sense all of that was very real so actually it perhaps one thing also you can do is when people are in front of you and they are maybe sometimes always late or they sometimes look like they're not listening it's not they're rude they they might have a reason and again it can be then a matter of i mean don't say if i haven't said it to you if you've got ADHD although it's usually a pyramid scheme we diagnose each other uh but um but saying to them oh um i know she's owned out a little bit there is there like are you okay do you want me to repeat it like you know don't assume someone's being rude when things happen that don't seem like they are in inverted commas normal i think that's really
Speaker 1important isn't it it's kind of understanding one that not everybody so not everybody's got ADHD will have time blindness not everybody that's got ADHD will zone out and and so it's gonna vary from each individual and if they know what it is that they struggle with they can tell you and it's being open to that and and open to them coming up with solutions as well so you're not trying to fix somebody it's not kind of like well have you set an alarm or
Speaker 2have you done this
Speaker 1thing don't ask
Speaker 2about alarms there are so many
Speaker 1alarms um but it's not it's about kind of getting them if they know themselves you know what what helps them what doesn't help them what doesn't help them what doesn't help them what are the things that you can change that that work for them and make it work for them and the last thing you want to do is to come across as sort of judging them because that's when you're going to lose the client because ultimately none of us want to be judged um and and so it is being open to the idea they're not doing it on purpose they're not making excuses and the there might be stuff you can do to make things easier there might be stuff that you just have to change the way you think about it and you can't change the way you think about it and and that will take away your own stress and instead of getting frustrated with somebody you'll just accept it and be able to carry on yeah yeah
Speaker 2completely i think one of the most annoying things that somebody could say is oh we're all a little bit adhd because in some ways yes we are right we all miss appointments sometimes we're all sometimes late we're all people who might forget things we're all people who like have occasionally forgotten where they put their car keys but imagine that being a level that you live at constantly like everything is always hard everything feels paralyzing or distressing or stressful like that is your constant rather than occasional and imagine how stressed you feel when you're leaving the house at a certain time and you can't find your keys now think about that level of stress how much anxiety how it would affect your self-esteem and your confidence and the way in which you approach things and that is how it feels to live with that all the time this feeling like i'm useless at being a human adult why am i useless at being a human adult and you only feel useless because other people tell you that you're useless well i find my key i i just put my keys in the same place every time well believe for you some of us put our keys down without having any idea we put our keys down then that's no use is it so it's like without really like again you can be really easily a little bit judgmental just by saying oh well i have that problem i'm not going to sometimes and this is what i do and it's really hard to explain to someone who doesn't have it like what it feels like and how you just didn't know that happened I can't retrace my steps because I don't even remember my steps because something else was happening at that time that didn't put me in this moment and so we all have strategies and again like I said I think particularly for women when we enter perimenopause the strategies we had that worked double diary I have a phone diary and I have a paper diary does that work anymore no and the thing is a when I looked at the list of perimenopausal symptoms which has led me to a list of ADHD symptoms as I looked at them I'm like this is already me I've been like this my whole life what am I supposed to do with this it just got worse
Speaker 1that's that's the interesting thing is so many things can be so many things and you end up going around yourself and that's why you know a lot of people both with perimenopause and people who may not be perimenopausal at all but who have ADHD or whatever could be diagnosed with something like anxiety or depression or there's so much overlap between so many symptoms around so many things that it can be a real challenge to work out where things are and as PTs we don't need to work that out but we do need to be able to work with the person in a way that is supporting them and I think that's where it is important to try and again work with the individual because they we are all different and you know I've sat here and you reeled off your list of things and I'm like but I've never done that I don't forget things I haven't yet um this is my point of life though well these things are like well I haven't but it feels like it's only a matter of time before I lose my keys just not done it so far you know that kind of thing um and so but that doesn't mean to say that the other stuff there are there aren't other things that impact and that as you know a client if I was working with a PT you'd need some kind of kind of adjustments too so I think quite common things to be aware of and maybe this this what we can do now so things to be aware of that may or may not help depending on the individual so I feel like we've we've covered the the time blindness issue quite some detail so we'll skip that for now um but things like you know goal settings goals for example may not be the best way of of doing it I was the one of the sort of common issues with ADHD is the we are driven more by that sort of dopamine hit and so the dopamine now versus some point in the future when I may get this benefit or reward for what I'm doing and yeah it's it's huge difference right so the looking at that sort of the idea of doing our exercise regularly and getting stronger at some point in the future or feeling fitter at some point in the future there's a disconnect so it could be that you're looking at different ways to to keep things sort of interesting and get that reward in the moment yes you'll still get the reward at the long term as well but that's not motivating the action so what is that motivating the action and what can we do as a PT who is designing a for a client to make it interesting and engaging for that person at the time they're doing it rather than based on this benefit that may or may not come in the future
Speaker 2this is it and so like you said right I think it's really important to note here and we know but um everybody is going to be different and so some people might struggle with one thing some with others some with all of it like essentially it will be different and ADHD is commonly comorbid with ASD so and they they actually we are weird little bedfellows because um the ADHD is like there's two time zones there's now and there's not now which is commonly a part of the time blindness problem but like you said as well it can really impact goal setting and things like that and setting plans for the future but with ASD with autism spectrum disorder quite a lot of times people actually consider the future more so um kind of like I'm gonna inverted commas it now but overthink I I always think that's like a a challenging way of describing things because that suggests that there's a normal level of thinking um but overthinking the future and worrying about it and that produces anxiety and then there are odds with each other those two conditions because the dopamine needs the now and it goes well that's not now and the ASD is like but not now is important because that's a future and it can create quite a bit of anxiety but essentially the the now and the not now is is a very important part for a lot of people with ADHD it's what makes them late uh because they're not leaving now because it's not now uh then when it is now it's too late um it's what stops them from starting things um and it's what means that they can start something seem really really engaged with it and then drop off all of a sudden um and it also is something that can create burnout burnout is very common in people with ADHD because the now is filled with so much without any thought for the not now that when the not now appears and you've done too much you're now burnt out and tired and fatigued and you don't know why it's because you never really considered any kind of pacing about anything so I think there's two things we want to look at in terms of this there's making sure that the client in front of you isn't doing too much in the moment because it can be very very easy particularly your new clients come to you and to go I want to do five days a week because I'm doing exercise because it's now and you're like oh five days a week is a lot um but also what are we looking at in the rest of your life and what does that look like and helping them to actually make sure that what they're putting in place exercise wise does actually work in the grand scheme of things um so just having a conversation with someone to understand their life can make sure that that now moment is actually not going to burn them out and then the other part of it is that essentially the now also needs to be stimulating and we know as PTs um the the progression requires a um a consistency and so it quite often when we're programming we might be like right well we'll set this particular program and it will remain the same for 12 weeks and then we'll look at it and change it now particularly if you're working with someone where they're not with you and you're online you're giving them a plan they might drop off that after a couple of weeks and you'll be wondering why and it's because it got boring to find maybe ways that stimulate them in a different way so it becomes interesting but you're able to still get that progression out of it because I I know I give up on something and I never really understood why I just thought it was useless at sticking to things but if it's the same for too long I give up on it unless it's challenging then I will stick with it until I've got it so there has to there's something that raises that dopamine level and it's very much working out what works for your client um because it will be absolutely different for everybody and for some people that is simply going to be you that coming to you raises their dopamine level they enjoy that session and that moment with you and that is so important um and they're doing something they wouldn't do on their own
Speaker 1yeah so it doesn't have to be I need to turn every session into a variety based wonder of exercise it can be that you're just you're engaging with the person and that's that's enough if you see people as you say it's different if you're not seeing them and if they're doing stuff without you as well as seeing you and all of that kind of things that that's when things would be different and again just being aware that there might be a difference between when someone is with you and when they are not with you and what they need for the for those kind of things if you're programming for sessions they're doing on their own but I think what you mentioned there because sort of like obviously a common way of saying some of the stuff you mentioned there is that like that all or nothing thinking and that they that can be something that we might notice in terms of the way somebody's engaging and we might categorize it as that rather than seeing it as anything else and what we categorize it doesn't doesn't matter so much as being aware of what it might mean and how we can work with it rather than just going well they're not going to stick around because they they've given up and they're now in the nothing part of this so I might as well write that client off because they're not doing it um they're and that sort of stuff so when you're looking at those kind of check-ins with a client um and what they're working towards and whether or not they're still interested in what you thought they were interested in and and that kind of thing is being open to those changes and being aware of them because it can help with your retention and if you're sort of aware that this is something that could be relating to the diagnosis if they've mentioned it or other stuff and then you can come up with practical solutions and that's where it comes to and that's also where the whole do you need to be diagnosed or not it doesn't matter most people some people that aren't worried bothered about getting the diagnosis is because it's kind of I don't need to know that to get the certificate but I do kind of need to know so that I can come up with the how do I manage this side of things so that's the kind of thing that can help and the other area where what you've said crosses over I think is the um around the RSD which is again another kind of like common symptoms so that's rejection sensitivity dysphoria and can be alongside that can be a bit like that fear of failure which might also lead you into the not doing things um and or the overthinking about doing things and and there's a lot of complicated thinking that goes on as a result of that which would massively cross over into things like starting a new exercise regime and meeting new people around going to a new place to do it um what you're doing when you're doing it whether or not you're being judged whilst you're doing the exercise am i doing it right am i not doing it right are people looking at me there's an awful lot that can be going through your head um as a result of it relating to what we do
Speaker 2yeah and it's interesting right because rsd is not in a diagnostic criteria it doesn't appear in the clinical criteria whatsoever but it is commonplace it's commonly recognized amongst people who have adhd as being a really big part of it and people with autism as well often feel that that it crosses over into their lives as well and you described it really well it is but it can feel so this is more than anxiety that i i'm going into a new place it's more than oh i said something silly oh silly me like rsd can prevent you from walking into a place in the first place because it feels like you're going to be in a place where you're like that paralyzing feeling inside of you that if i walk into this people judge me i can't do it and it all builds up and then you end up not doing it so it can create this paralysis that stops you ever getting to a place and i think that's important to understand when you're having conversations with people before they even turn up because one thing that can be really helpful is to offer them to come into the space when no one else is there and meet you first see the space first because knowing what you're walking into where you're going to park what you're going to be like knowing it doesn't matter at that moment in time if you're going to be in a place where you're going to be late because you're not going to walk into a room of everybody staring at you and you're going to have to walk all the way through it and apologize and all the rest of it and be judged for it like all these things matter so being able to check out a space in advance can be hugely beneficial um so that that that is kind of removed a little bit at least from the situation but also rsd creates this after effect too and you might not have said anything wrong and you as a pt might not have noticed it right but there's something there's one moment where someone said something For the next 10 years, you'll replay that in your head and we have that conversation about it. Honestly, it's ridiculous.
Speaker 1It's funny you said I described it well. I was about to say, still replaying like 50 years of stuff. It may or may not have been an issue. And things that you know completely 100% sure that the other person that was there at the time has long forgotten anything to do with it. And I'm still obsessed over it.
Speaker 2Why is no one else holding on to the moment when I was six years old when I asked my teacher, can I marry my cousin? And everyone laughed at me because I thought I wanted to marry my cousin. Why do I remember that? Why did I actually remember where I put my phone today? Like, honestly. But yeah, it's that. And the feeling of it inside, it's so hard to describe if you've never felt it. I used to think I was shy. And I think actually what it was, was RSD. It was just so paralyzing. And it is possible to, to work through it and get over it if you understand it. And I think a lot of this is where people who are coming to a sort of a later life diagnosis are kind of going, oh, this is helpful. But there's two parts of that. Because on the one hand, I now understand. On the other hand, I don't know what to do with that information. And then also, if I'd known this when I was 15 years old and I'd had this knowledge my entire life, would my life have been different? And it's kind of almost like a grieving, that takes place of, well, what's happened? Why didn't I know this? And why didn't I have ways of dealing? Why have I blamed myself all this time? What have I missed out on? There's all of that that goes into it as well. So it's really deep and complex. It's way more than just, oh, I'm a little bit worried about people will think of me. It's like, it's deep rooted. And you feel it, I think, physically as well. I mean, I know I do. I've always described this ball in my stomach that feels like it's spinning. It starts to consume you after a while and you have to have different strategies to help you with that. But if you don't know what it is, how can you? And that's why people often get diagnosed, particularly women as well. Again, they're much more likely to be diagnosed with things like depression and anxiety. Because when you describe how you're feeling, what it is, it sounds like anxiety. And in some ways it is, but it's very specific and it's all connected to other reasons. So yeah, I think also being aware that like making sure someone knows, catching those moments. I've got somebody I work with who is diagnosed autism and ADHD. And one thing I noticed about her quite quickly is she apologizes all the time. So, oh my God, I'm really sorry. I'm like, oh, I'm so silly. She does that like all the time. So when I noticed she did that, I just made it really clear. And I was like, that wasn't silly. That wasn't, it's totally normal. Absolutely fine. No, don't be sorry. We do things like that all the time. I just try and really kind of pull it back, not to minimize what she said, that's very important. Like not that, like totally get what you're saying. That I feel that too. Don't worry about it. I would never think that about you. Like, oh goodness, no. Of course I don't think you are that way. No, I mean, I can see why you're worrying. That's RSD though, isn't it? Oh, what's RSD? Oh, it's this. Have you ever experienced that? Like understanding a little bit about it can help you help that person because I know for a fact that what she will do, and I know because she's told me what she will do, she will go away from the PT session if she hasn't meant it, there'll be something in there where she said something, thought she sounded stupid, and then she won't come back for two weeks because she embarrassed herself. And it's like, you have to somehow understand that, let them understand that you've not embarrassed yourself. I wasn't bothered by that in the slightest. Don't you worry about it. Honestly, it's already forgotten. I think you're great.
Speaker 1Yeah. And I think being aware that sometimes that, I don't know, there's always a question when you do sort of written communications or any communications that you do, on how the other person is perceiving something. But that's sort of even more pronounced with this because of that level of thought process that goes alongside it and the emotional response that comes with it. And then because of the lack of regulation around the emotions that some people may struggle with, that's when coping mechanisms and stuff might come in. Maybe that's avoidance a bit like you said. Lady might not come in for two weeks or she might have other things that she does that she turns to that means that things that were happening aren't happening now. So whereas your client might have been turning up regularly or filling in your check-in forms or doing certain behaviours and it's all going completely smoothly and then they've stopped and it's not because of the thing, it's because of a sort of reaction to something else, something that was said or the way. the way they've interpreted a communication or the way they just thought something may or may not have happened. You know, somebody looked at me funny or they might not have even noticed but I was aware that I did this thing and somebody else might have thought that and then you've built this up into something and then you either build it up into something that's so big that you can't come back or in order to deal with that, you've turned to. some other thing that you do that's meant that you're now no longer doing the things that you were doing which was working towards the fitness goals that you had or whatever. So it can really kind of lead people away from stuff or you think everything's going fine and all of a sudden it sort of goes a bit pear-shaped and it could be for any number of reasons that kind of come off of the back of something that might have been really quite small if you just looked at it from a. sort of a logical view. But the way it's been interpreted, the way that's then been dealt with has just led down this sort of whole rabbit hole that you just wouldn't have ever gone. How did that thing there turn into this over here?
Speaker 2And I think there's two parts that we could probably think about in dealing with this as well, right? So the first part is that actually, just saying positive little snippets to someone about how well they're doing, even though like, oh, I love it when you say things like that. It makes me laugh. Like little things like that about the person or the things they're doing could be helpful. My friend always jokes and says, but it's totally true. Like unless you tell Maggie explicitly that you like her, she thinks you absolutely hate her. So just a little bit of reassurance. And I don't mean sycophantic 'cause that's even worse. Like, oh my God, that's embarrassing. Don't tell me nice things. But just little snippets in places that let that person understand that they're good, they're safe, they're happy with you. That's like. And then the second part of it is that you might also be experiencing RSD, and you don't know it. And when a client leaves and then you go, oh my God, what have I done wrong? And then you think back on all the times, all the things that you might have done wrong with that client, and then you get stuck in that paralysis moment, because you must be an awful trainer, because you're absolutely terrible, because that client left you, and maybe two or three times. And then you think back on all the things that you might have done wrong with that client, and then you get stuck in that paralysis moment, because you must be an awful trainer, because you're absolutely terrible, because that client left you, and maybe two or three times. two others left you at the same time, and, and, and, and then you blow it out. And sometimes that is because you are experiencing that and maybe you didn't realize it so also catching if you do things like this because clients leave and if that feels like the hardest and worst thing in the world for you then that might well actually be rejection sensitivity um you know and it's not just adhd and asd to experience it you know it can come with many other neurodivergences and also it can happen you know on its own so to speak but yeah it could be that that's something you experience too so always question the moment where you're going i am the worst person everybody hates me and it's like
Speaker 1absolutely i think um i mean we've obviously covered a lot of different things to be aware of in terms of things that you can do we've mentioned something so whether that's um making sure that there are um um um um um there's a sort of like an interest in what people are doing um or potentially another one might be maybe making things like smaller so um you know really small steps and sometimes you need to be they need to be like smaller than you might think um so that it feels like it's achievable and that kind of thing uh i think another one is is having flexibility in whatever it is that you're doing it's not too rigid and too specific in terms of what is what needs to be done so that it's got that element of flexibility in there um you've already mentioned positive stuff but i think not just sort of positive things when you're having conversations but that you know celebrating all the little things because they can make a difference but not only so they they work well in terms of obviously making someone feel good but alongside that you get going back to that sort of like dopamine hit and uh and so like an easy way some to some of giving that is to celebrate those wins but again a bit like you said they've got to be kind of real ones they've got to be something that the person can sort of recognize as a win or see as a positive we can't kind of create stuff because if it's being discounted then it's not going to have that effect um anyway right
Speaker 2absolutely and i i think and i would say this about training anyone but particularly particularly if you're training someone with adhd then autonomy is massive and that's partly because we have felt a lack of autonomy for most of our lives because most of our lives we've felt we've been told many many times many more times they believe that people with adhd get told many more times in their life that they are failing at something than somebody without um so there is this chance that there is the person you're training already just assumes that they are not good at choosing their own goals at working towards things at doing things achieving things so on and so forth because that that negative feedback has evidence surrounding it that it happens more times that it's more likely and then that becomes in your own negative feedback loop in your head and so on and so forth but essentially autonomy is so important just making sure that somebody has the ability to say this is what i want and this is how i want to do it um because the fear the fear of autonomy is the fear that somebody will take that from you is real because throughout your life people tend to have taken it from you oh you're doing it too slowly let me do it oh that's not how you do it let me do it like it's just it's being quite constant so autonomy is massive but also just for psychological um like benefits to anybody autonomy is massive i mean i would say that about anyone but really hold it in mind so let people set their own goals have a conversation with them about it and and guide them but you know don't be telling them that the goal is stupid uh help them understand that that might take longer or this is how it works whatever you need to do to help somebody to move through it also recognize i think that for something like adhd but also with autism spectrum disorder um interceptive awareness body awareness um can be much much much lower so when you are training people and they're moving weights around and moving into different positions and things like that you might have to have a certain amount of awareness and you might have to have a certain amount of awareness and you might have to have a range of different cues and things like that available um particularly as well cues where aren't necessarily touching because sensory awareness is also quite an issue for some people um but to be able to describe to show to help communicate in different ways because it is more likely that someone with a neurodivergence will not be able to feel a muscle working than someone without um it's more likely that if you you're giving them a meal plan you say well just eat when you're hungry that they will not know when they're hungry like it is much harder for somebody with neurodivergence to um experience that interceptive awareness um and so having that understanding things like rpe might not work so well for example like on a scale of one to ten where are you from you know one being lying down and ten being working really hard a blank face it doesn't make any sense you're asking me something abstract i cannot apply that to this moment so thinking about how else you can get that information and help that person understand what it feels like and also recognizing that for a lot of people with adhd they also have hypermobility um and that's going to change again with with the way in which they experience things so it's also um hydration um i always offer my clients particularly the ones i i am aware of and we talk about this because i i know it is a thing but how much have you drunk today are you hydrated and some like i know two people are sharing with adhd they literally carry like a liter bottle everywhere with them and they are so hydrated it's unbelievable and then there's others who are like i'll add a cup of tea this morning i'm like great do we do we want to do more the people that carry
Speaker 1the water with them but don't drink it some people carry the water which may well be me with a two liter bottle of water that they carry with them and go yeah that's not meant to still be in the bottle is
Speaker 2it yeah and then that's also a question about if they are diagnosed are they on medication because the medication will impact hydration as well um and it also impacts their hunger and so a lot of people on um medication find that they're not hungry at all during the day so you might also need to check in on them as how they're eating or if you're writing meal plans for them that's going to impact it so just understanding these things as well and how the medication affects them could also be something that you want to have a conversation with if you are talking to someone who's diagnosed they're undiagnosed they're not on medication so it's not a conversation you need
Speaker 1to have but yeah i'm just following from what you're saying then when you're actually coaching people is being aware that again not all i mean none of this is solely about people who have adhd or another condition because the elements of this just all apply to just working with the human in front of you right but being aware that you know you might have to repeat yourself or you and it's them being useless when you're telling them the same thing that you told them every session for the last five years or whatever um because again i've spoken to a lot of personal trainers so i can't well nobody the people i'm working with aren't interested in um what i'm doing and then i'm not i'm struggling because what's the point because yeah yeah they turn up but i have to tell them the same thing every time and and they there's that kind of again sort of of them not taking this information in that i've given them yeah
Speaker 2and this is this this is a typical example of inattentive adhd right because actually what's happening there is a cognitive processing difference and i think psychiatrists would probably like to call it a deficit but i'm going to call it a difference um um because actually they're not not paying attention um but they aren't necessarily your working memory is struggling it processes differently with adhd it just does and so in the moment that you are learning something you might do really well with it that week and then you come back the next week and it's as though they weren't there the week before you're like but i taught you this and it's like why didn't you remember it we have to do it again you have to do it again just assume that's okay you have to do it again i and and there are some people people i've been training for 10 years now and i know that when i show i say i can't even say the name of the exercise they won't know it i would just be like so it's this one and i'll demonstrate and they go oh yeah if i said oh we're going to start with a deadlift i'll be like blank face and it's just cognitive processing differences um and it's not that they don't care or they aren't interested it's just that their brain works differently um and so they might never retain that information equally what you might find at the same time is despite the fact that you have to show them that exercise the same way every single time they have a very niche interest and know all the facts on a particular topic and you're like how on earth do you know that but you can't remember what a deadlift looks like and that's my friends it's called hyper focus
Speaker 1and the reason why this is important because as a trainer so many trainers will it impacts their own mental health because of the interpretation they're putting on what they think is going on with the client so like that example they don't care what i'm trying to get them to do that's why they haven't bothered trying to remember it or learn it so what's the point in me telling them in the first place and as soon as we kind of reframe that and we go well it's just a learning difference for them it's not about me anymore as the trainer and then I feel better because instead of being fed up with what I'm doing or fed up with my clients I can go so I'm still making a difference I'm being useful they're coming every week they're getting the physical benefits that they get from this activity and that's what I'm here for and that's all completely fine and I don't have to beat myself up anymore or take it as a sign that that they're not interested and it just makes our own mental health so much better because we're not internalizing anything from what is ultimately a kind of story we're making up based off of a piece of information that we've got and that is
Speaker 2all it is right when we are interpreting some a behavior or in front of us it is simply an assumption we don't know essentially but I think like one thing to look at as well in this situation is what is your sensory environment like that you have this client in so if they are struggling and you are in say for example a busy gym and it's got lots of people in it and it's got some mirrors and it's got some music playing and it's got therefore lots of chatting and it's got a lot of people in it and it's got a lot of so on and so forth right inattentive type ADHD I always think is is more about too much attention in different places not no attention in the one place so yes I'm listening to you but I've also noticed that somebody's left something over there and that looks a bit dangerous and what's that exercise that person's doing I've never seen that before it looks a bit dangerous I wasn't told to do it that way and it's playing it's my favorite song and oh did I did I turn the oven off when I left the house and oh my goodness did I lock the door when I left the house and you've just finished explaining exercise and went on really sorry I didn't hear that and you're like why weren't you listening I literally gave you my full attention showing you this exercise so one thing you could do is is think consider the environment this seems to be a thing that's happening with your client consider the environment because if there is a lot going on their attention is split their attention is going to be split anyway if you've got inattentive ADHD it's constantly split and it's like 10 tabs open plus three radios playing someone talking to you and the television's on over there and you're tuning into all the different ones at different times and it's essentially about helping that person find a space that works for them now what's interesting is sometimes that space is noisy because when there are that many tabs open you can put that in the background and listen to that person and when it's silent you start overthinking it in inverted commas again that's when the RSD pops up so having a conversation with the client and go does this environment work for you would you be able to do that if you're in that environment and you're like how would it work better if we went in this room how are the lights I do have a room where we can turn them down a bit you know all that sort of thing if they do seem distracted or they don't seem like they're listening or interested but they are turning up so they obviously are maybe think about the environment that you're in and whether it's possible to you know shift them around so they can't see everything that's going on behind them or move to a quieter room or you know how can you adapt that space I have two people I train who won't let me play music that's hard because I then sing the music in my head and it sometimes comes out my mouth but to them they need that silence in order to concentrate I have three people I train who were like why is it so silent in here what's happened to the music can you play the music please so it's very personal absolutely and I think
Speaker 1it's looking at other things you can do as well because sometimes you can't do anything about the environment sometimes it is what it is it's not something you've got any control over but what you can control is how long you're going through your explanation if you know that spending 10 minutes describing the exercise is going to mean that all they've remembered is the last 10 seconds how can you break it down so that what they're actually physically moving they've got the piece of information they need for the thing they need to do first there'll always be some clients for whom there is no point in explaining what their session is going to look like they just need to know what they need to do now they might need a bit of an overview but you don't expect them to remember it and I think that's it we've all had clients where we kind of go through do these exercises they might do the first one and then they're like yeah what's I'm doing again now and that might be the third set of doing those three exercises or whatever and they still can't remember what comes next but that's fine and it's being there with those kind of like useful sort of prompts at the time they're needed and that's where just paying attention to the client in the room and if obviously if you have a group then knowing that you're doing it right you're doing it right you're doing it right which ones are the ones that probably can remember the entire session are going to be fine and which ones are the ones that are going to need that reminder again of what it is because we're so used to giving so much information and it's never just this is the exercise particularly if it's a group it's like small group pts and it's normally right you're going to do these three exercises this first one's going to be in a range you know 10 to 12 I want you to do that one in 8 to 10 reps of that one and this one you're going to do until you feel tired it's kind of like right I've got to remember three different ranges and three different exercises where I'm going next and how this is all working and for us as the trainer we've probably run session we've run sessions like that we might be the third time we're doing the same session depending on how you program your sessions in your space but for them it's the first time they're seeing it and it's kind of like that's a lot of information and at the same time we're asking them to think about their foot placement and their hand placement and they've got tension in the right parts of their body but not tension in the wrong parts it's just so much to think about right so it's it's being aware with the different clients which ones the ones where yeah that information is is going in it's useful and it's it's all something that's going to work and which are the ones where they just need to know this thing now and the next thing can be done next when they need it and that makes it a lot less frustrating for you as well because you don't have those moments where you're like I have just explained all this to you and you've just looked at me blankly and gone so what am I doing yeah that's it
Speaker 2that's it exactly and I think that goes back to again the idea that we we are essentially always getting feedback from the person in front of us and then trying to adjust it so that that person is getting what they need from us and of course that's easier in a one-to-one environment than it is in a group environment but understanding the different people's needs in your group environment means that you can plan in advance for that person the next time they come I find like for example I always write things on the board and that's partly that comes from having been a teacher maybe but also knowing from being a teacher that when you have a visual cue as well as the verbal cue that actually is helpful in that cognitive processing so there's there's always different ways that you can support the needs of the people and different things that you can try out and essentially it's about really considering and I think that is the right word consider don't just train consider the person in front of you consider their needs and the adaptations that they might require or would just be helpful to them and consider them as a person who is not trying to annoy you they're very definitely not and if you are feeling annoyed by them that's probably a challenge for you and that's probably a challenge for you as well so I think that's a really good to check in on your own reaction and consider why you feel annoyed by them and a lot of that is society telling us that these things are unacceptable and this is the way we should behave but actually people are people and we want to coach the individual
Speaker 1yeah I mean let's face it not many people are going to sign up to a personal trainer for the purpose of annoying them better things to do their time and money right I'm gonna go there and I'm just so I can irritate that person it's the only reason
Speaker 2I'm going yeah it can be so easy to become irritated by behaviors and go oh I swear they're just doing that to annoy me and it's like no no one's doing it to annoy you
Speaker 1yeah is there anything different that you'd be kind of aware of relating to accountability um when working with people with ADHD or other conditions
Speaker 2so ADHD in particular um I think that what can be really hard is routine we're bad at it now if you've got someone with ADHD and autism they're great at it because the autism fights back if you've got someone with autism they're superb at it routine is key right but ADHD one of the biggest issues with that is is that people really struggle to create and maintain routines and they might look on the surface like they're doing really good with that but actually it's really challenging to do that and I think that's and when I say that I mean even down to some of the smallest things that we might see is like daily habits like cleaning my teeth eating breakfast at a a routine time like taking the dog for a walk these things because sometimes we'll get half a food I go I didn't and it was something that someone else would consider as just routine so some people know they've they've worked through and they've worked out a way that works for them of creating a sense of routine um that doesn't feel too routiney because then that's a problem um they might have multiple alarms it might be that you have a booking system system that can warn them in advance that they're coming and then you could say to them like if it's possible like to set that email up for them or that text message say would you like an email or a text message that warns you that you're coming in in 24 hours or an hour 24 hours it's probably too long away but most booking systems only let you do that so i don't know uh but that that can be helpful um they're gonna need if there's gonna be a change thinking particularly if someone has asd then if there's a change to the normal routine that can feel pretty so i think it's always nice to warn people if there's like a roadblock outside or there's traffic works that you know are in place and just to say oh your route's going to be impacted it might take an extra 10 minutes so just to warn you so you can time it appropriately that sort of thing can be helpful um and um collaborating with people around that again it's got to be something that's going to be helpful and i think it's going to be something that's going to be something autonomous and not assuming that what works for you works for them because it can tell you the number of things they've tried is unbelievable and it's still not working and yes i should just be able to set a reminder on my phone but i can't um and what i try and do though i obviously struggle too so but what i try and do with clients who i know have adhd struggle with the um timings of things is when i've moved them to a different time if i remember i send them a message the day before and say remember we're not in at this time but we're in at this time instead today and they're like oh god thank you for that so there's little things you can do that that would just be helpful um with that sort of thing um and in terms of plans just checking in maybe a little more often than you would do that the plan that they are following if you're setting them a plan to do on their own the plan they are following is working for them and if not sort of finding out what it is that is they're struggling with um and so i think it's really important to have that what you can do to tweak that together and to create something different for it and sometimes that's as simple as how are you sending them the plan like i am not going to go on my laptop and open an excel spreadsheet but i can pick up my phone and go to a whatsapp message so like you know it's how how many layers of distraction are there on the way or potential i haven't got my laptop with me so i can't do that like what how many layers of potential distraction or on the way to them doing this help them remove those most simple way forward because the other issue is as well like as soon as you go to your phone there's a problem because you go to it and go oh i need to check and now you're in your whatsapp messages or your instagram or because the stupid little number popped up on the phone and you're like oh something and then you forget why you were there and then you thought you did do it and you didn't do it anyway but like this is just a confession of maggie and all the things that she struggles with
Speaker 1yeah we've all we've all got a long list of ways to to help maggie uh achieve things which is which is useful um or things not to do maggie it's also useful um is there anything else that you feel is important relating to the sort of undiagnosed element of it we've already sort of mentioned that there'll be potentially reasons why people choose not to go down the diagnosis route um or where they don't have a choice because they're still waiting for that element um or for whatever reason but in terms of you know working with clients is there anything that you feel is sort of different or to be aware of do you know
Speaker 2what i think that word different is a really important one i think what we need to do is start normalizing different let's start normalizing that it's okay to be different and that it's okay to um to do things differently and have different needs and to be able to see that in a person and go oh they don't react in a way i expected them to react in a way i expected them to why and you don't need the answer to that you just need to know maybe because they are you know they have a neurodivergence or they have additional needs that i could support and then to have a conversation with them doesn't go do you have additional needs are you adhd do you have autism uh because they might not have considered that for a start but to have a conversation with them which goes oh uh you know i've stuck i've noticed that um you you you're always 10 minutes late for our session would is it the session time or is there a way i can help you with that or is it it's okay and you don't mind being 10 minutes late and everything's fine yeah you can have that conversation and i think normalizing that we all have things that we find struggles with and that we can have a conversation with someone so long as it's curious and compassionate rather than judgmental and pointy finger where we can have these conversations go i've noticed and i was just wondering if i can help you in any way um and it might be yeah you can it might be oh do you know what if you move this 10 minutes later i'll be 10 minutes later so like we're just gonna accept all these 10 minutes of my session i'm fine with that if you're fine with that that's okay do you know what i mean like so i think compassion um it's about not discriminating it's about not stereotyping it's definitely as well about not minimizing we don't have to make what is different normal we just have to accept difference and the more we can do that i think just generally in the world but as pts with our clients the better experiences we'll create for them and for ourselves as
Speaker 1well brilliant and i think just to add to that the being aware of how we're interpreting things and our own biases our own thoughts our own processes and all of that kind of stuff and how we can make those changes us feel better because so much about how we interpret what other people are doing has a negative impact to us because it's us that feels frustrated it's us that gets angry it's us that feels um upset that we're not making progress it's us that starts doubting our own abilities and all of that kind of stuff and it nine times out of ten it comes out of something that we've created ourselves in terms of our own interpretation of something that may or may not have happened and if we can look at reframing that and change it to make it that it's i appreciate that you don't like the word just but i'm going to use anyway it's just somebody else um doing something differently and it's not a reflection on me personally it just makes it easier for us as well so it's not about having to change everything we do around every person we work with it's about sort of relaxing a little bit more in our own thought processes and the pressure we're putting on ourselves as well as what we're expecting from others and rather than having a kind of set this is what should happen i do this you do that scenario we kind of relax into this idea that if i do this you could do any number of a range of things and they're all okay and it becomes a lot easier for everybody involved and it takes some of that pressure away for us we're happier clients are happier and we've got a much bigger chance of a longer time in the industry doing something that we're enjoying absolutely
PodcastTranscript AI