ADHD, Avoidance, and the First Step Toward Change: An ACT Perspective
One of the most common things I hear from teenagers and adults with ADHD is:
“I don’t let myself think about all the things I have to do.”
This kind of avoidance is incredibly common. At the same time, it creates a bit of tension with how ADHD is often described.
Dr. Russell Barkley, one of the most influential ADHD researchers and clinicians, often says that ADHD is an issue of “doing what you know” rather than knowing what to do.
The idea is simple.
Most people with ADHD understand what actions they should take, but struggle to actually follow through.
ADHD Isn’t Just About Execution
As a kid with ADHD, I was painfully aware of what I needed to do. Like most teenagers, I struggled through high school. But one thing I did not struggle with was reminders about what I should be doing.
Teachers reminded me.
Parents reminded me.
My grades reminded me.
Those reminders were often the only reason any schoolwork got done at all. And frankly, I hated it. But if you had asked me what I felt about that dynamic at the time, I probably wouldn’t have known what to say.
When the weight of our struggles goes unexamined, it becomes much easier to ignore them. So the question becomes: What does it actually mean to “let ourselves know” what’s going on?
That’s where Acceptance and Commitment Therapy (ACT) offers something powerful.
The First Step: Acceptance
People with ADHD get very good at making excuses. I know I did. Avoidance becomes a coping strategy. If something feels overwhelming, uncomfortable, or shame-inducing, it’s easier not to look at it too closely.
This is where acceptance, a core concept in Acceptance and Commitment Therapy (ACT), comes in.
Acceptance doesn’t mean giving up. It doesn’t mean gentle parenting or lowering expectations. In ACT, acceptance means allowing ourselves to experience uncomfortable thoughts and feelings without immediately running from them.
For many teenagers and adults with ADHD, this is a big ask.
Because the moment they slow down and look directly at what’s happening, difficult feelings show up:
Shame about grades /work.
Fear of disappointing people.
Frustration with themselves.
But avoiding those feelings doesn’t make them disappear. It just pushes them further underground. And when we avoid our feelings, we often avoid something else as well.
Our values.
Avoidance and Behavior
Like many teenagers with ADHD, I spent a lot of time lying to my family to get them off my back.
“No, I don’t have homework.”
“Yeah, I studied for that test.”
I also spent a lot of time ignoring bad grades. How did I do that? The way most people do: distractions.
For me it was hanging out with friends, getting high, and playing guitar. Like many teenagers, I was far more interested in that than reflecting on what might have helped me get a better grade. If someone had asked me, I probably could have admitted that my behavior was avoidant. Teenagers can actually be surprisingly reflective when the consequences are annoying enough. But what I couldn’t have told you was how to sit with the feelings underneath it all.
I didn’t know how to pause, look honestly at the situation, and make a choice with clear eyes. I also didn’t understand the cost of not doing that.
Feelings Point Toward Values
Here’s something important that often gets missed: We feel things because we care about something.
When I was younger, I didn’t like getting bad grades. I didn’t like the tension that came with them at home either. Those feelings weren’t random. They were connected to values.
Maybe the value was pride in my work.
Maybe it was wanting to hold my head high.
Maybe it was wanting my parents to trust me.
When we avoid uncomfortable feelings, we often lose access to the values hiding underneath them. Avoidance doesn’t just distance us from our problems. It distances us from our why.
The ACT Shift: Turning Toward What Matters
Acceptance and Commitment Therapy helps people with ADHD do something that can feel incredibly unfamiliar at first. It asks them to slow down. To notice uncomfortable thoughts and feelings. And instead of immediately escaping them, to ask a different question:
“What actually matters to me here?”
When people reconnect with their values, behavior begins to shift.
Not because someone forced them to. But because they’re choosing actions that move them toward something meaningful.
Maybe it’s:
Being someone who follows through
Feeling proud of their effort
Building trust
Creating a future they actually care about
Values don’t eliminate difficulty. ADHD still affects focus, motivation, and follow-through. But values provide direction. They give people a reason to tolerate discomfort and take small steps forward, even when it’s hard. And often, that’s the real first step toward change.
Frequently Asked Questions About ADHD and ACT Therapy
How does Acceptance and Commitment Therapy help with ADHD?
ACT helps people develop awareness of avoidance patterns, tolerate uncomfortable emotions, and reconnect with personal values. Instead of focusing only on productivity or discipline, ACT helps people understand why certain behaviors matter to them.
Why do people with ADHD avoid thinking about responsibilities?
Many people with ADHD experience shame, overwhelm, or fear of failure around expectations. Avoidance becomes a short-term coping strategy to reduce those feelings, even though it can create bigger problems later.
Can therapy help people with ADHD improve follow-through?
Yes. Therapy can help people understand their emotional responses, develop regulation skills, and align their actions with values rather than avoidance. Approaches like ACT, executive functioning coaching, and relational therapy can be especially helpful.
Is ADHD just a motivation problem?
No. ADHD is a neurodevelopmental condition affecting executive functioning, attention regulation, and impulse control. Motivation can be affected, but the challenge often lies in translating intentions into action.
ADHD Therapy in Brooklyn and NYC
At Mindful Self Therapy, we work with people navigating ADHD, avoidance, and the emotional impact of feeling stuck. Our approach integrates Acceptance and Commitment Therapy (ACT), relational therapy, and nervous system–informed work to help clients build awareness, clarify values, and move toward meaningful change.
If you are struggling with ADHD, overwhelm, or avoidance, therapy can help you understand what’s happening and begin developing tools that actually work for your brain.
If you're curious about ADHD therapy in Brooklyn, NYC, or across New York State, we invite you to reach out for a consultation.
