ADHD Therapy, Purpose, and Change: What Alfred Adler Got Right (That Freud Didn’t)
Freud, Insight, and the Origins of Psychotherapy
Let’s start by giving Sigmund Freud some credit.
The idea that we are shaped by unconscious forces, that our symptoms carry meaning beyond what we can immediately explain, remains foundational to psychotherapy. Freud taught us to look beneath the surface and to take the past seriously. Much of psychodynamic therapy still rests on this insight.
Freud believed present struggles were expressions of unresolved experiences from earlier life. Therapy, in this model, is about understanding causes. If I can see where a pattern came from, I can loosen its hold. Often, that kind of insight is helpful and necessary.
But insight isn’t always enough.
Why Insight Alone Doesn’t Fix ADHD
Many people understand themselves well and remain stuck. This is especially true in ADHD therapy, where clients are often highly self-aware yet continue to struggle with follow-through, regulation, and shame.
They know why they procrastinate.
They know why they shut down.
They know their nervous system gets overwhelmed.
Yet nothing changes.
Knowing why something happens doesn’t always change what happens.
Alfred Adler and the Missing Piece: Purpose
This is where Alfred Adler offers a different lens.
Rather than focusing only on causes, Adler emphasized purpose.He believed behavior is organized around goals many of them unconscious. We are not just reacting to the past; we are moving toward imagined solutions to problems like:
Belonging
Competence
Safety
Self-worth
From an Adlerian perspective: Symptoms are strategies. This is a game-changing reframe in ADHD treatment.
ADHD Symptoms as Strategies (Not Deficits)
This reframing is particularly useful when working with ADHD. Procrastination, emotional intensity, or disorganization are often labeled as deficits. A teleological approach asks instead: what is this behavior protecting or attempting to accomplish? Procrastination, for example, often shields against failure or exposure. Once its purpose is understood, change becomes possible
In traditional models, ADHD traits are framed as impairments:
Procrastination = poor discipline
Disorganization = laziness
Emotional intensity = overreaction
| ADHD Pattern | Possible Purpose |
|---|---|
| Procrastination | Protects against failure, judgment, or exposure |
| Avoidance | Prevents overwhelm or shame |
| Hyperfocus | Creates a sense of competence and control |
| Emotional intensity | Signals unmet needs or overstimulation |
Suddenly, the person is not “broken.” Their system is trying, imperfectly, to protect them.When the purpose of a symptom becomes clear, new options can emerge.
ADHD, Shame, and Why This Perspective Is So Relieving
Adler’s ideas align closely with modern positive psychology and strengths-based therapy. Rather than asking only what is broken, therapy begins to ask what the person is striving for. This shift can be deeply relieving for adults with ADHD, many of whom arrive in therapy carrying years of shame.
Adults with ADHD often come to therapy after years of messages like:
“You’re not trying hard enough.”
“You have so much potential.”
“Why can’t you just do it?”
By the time they reach therapy, many carry deep shame and a belief that something is fundamentally wrong with them. A purpose-oriented approach shifts the question from:
“What’s wrong with you?” to “What are you trying to solve?”
That shift alone can reduce shame and open the door to real change.
How Purpose Changes ADHD Therapy
When therapy moves toward purpose, the work becomes less about “fixing a deficit” and more about:
Revising internal goals
Expanding tolerance for imperfection
Developing flexible strategies
Building regulation skills
Creating new ways to pursue belonging and competence
Instead of eliminating a behavior by force, we help the system find better strategies for the same underlying needs. That’s where movement happens.
Freud Looked Back. Adler Looked Forward.
Freud taught us to listen to the past.
Adler reminds us to pay attention to the future.
Both matter.
But in adult ADHD therapy, especially when shame and self-criticism are high, understanding purpose often unlocks change that insight alone cannot.
Symptoms are not random. They are directional.
And when we understand the direction, therapy becomes less about fighting ourselves and more about working with our system.
Looking for ADHD Therapy in NYC?
In my work as a therapist in NYC, this perspective often creates movement. Therapy becomes less about fixing a deficit and more about revising goals and developing more flexible ways of pursuing them.If you’re an adult with ADHD who understands yourself deeply but still feels stuck, therapy doesn’t have to be about trying harder. A purpose-oriented, mind-body approach can help you build new strategies without reinforcing shame.
