Chapter 25: Justifying One’s Existence – Self-Esteem

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I have wasted most of my life.

I haven't justified my existence yet.

It's such a striking statement, isn't it?

Really makes you stop and think.

It does, doesn't it?

Yeah.

Andrea's words really capture a feeling that I think so many of us can relate to on some level.

That sense of questioning if we're truly fulfilling our potential, you know, like we should be doing more.

Exactly.

That kind of existential wondering.

And it's particularly interesting to explore how this feeling of not being enough might be even more pronounced for individuals dealing with ADD.

Absolutely.

And that's precisely what we're going to delve into today.

The complex relationship between self -esteem and attention deficit disorder.

We'll be weaving together a few different threads here.

Andrea's powerful statement, of course, is our starting point, but we'll also be drawing on insights from various interviews and the author's own really thoughtful analysis on how these two things, self -esteem and ADD, are so closely intertwined.

So our mission today is to try to gain a deeper understanding of why low self -esteem appears to be so prevalent in the lives of adults with ADD.

Where do these feelings of inadequacy come from?

And how can we learn to differentiate between, as the author puts it, true self -esteem and a more fragile contingent form?

Hopefully, by the end of our deep dive, we'll have some useful insights that resonate with anyone who's ever wrestled with their own sense of worth, whether they have ADD or not.

That's the goal.

Now, right off the bat, the author points to this pervasive sense of guilt, shame and self -judgment that seems to be a common experience for many adults with ADD.

It goes beyond just occasional self -doubt.

It's like a constant undercurrent in their lives.

It is.

And it makes you wonder, why is this so prevalent?

What's going on here?

Well, the author points out that it can be surprisingly difficult to disentangle the direct effects of ADD symptoms.

You know, things like struggles with focus, organization, impulsivity from the impact these challenges can have on a person's self -esteem.

Right.

Because if you're constantly struggling to keep up, to meet deadlines, to stay organized, it's easy to start feeling inadequate.

Exactly.

It becomes a bit of a vicious cycle.

But the author takes it a step further and suggests that certain behaviors we might readily attribute to ADD might actually be external manifestations of this deeper, underlying lack of self -worth.

Okay.

Now that's really interesting.

Are you saying that some things we think are ADD might actually be because of low self -esteem?

That's the idea the author's exploring.

For example, think about workaholism, which is or that difficulty many with ADD have in saying no.

The author suggests that these behaviors could be rooted in low self -esteem.

I can see how that could be connected.

Can you elaborate on that a bit?

Sure.

Imagine if you don't have that core belief in your own inherent value.

You might feel this constant pressure to prove your worth through achievement, through constant activity, through always being busy and productive.

Does that resonate with anyone listening, by the way?

That feeling of needing to constantly do to feel like you are enough?

Definitely rings a bell.

And the inability to say no can also stem from that same place of insecurity.

Maybe it's a fear of disappointing others, a need for their approval, or this underlying belief that your own needs just aren't as important.

That makes a lot of sense.

And it's not just adults who navigate these feelings, is it?

The author talks about how low self -esteem can really show up in children with ADD, too.

And it can be heartbreaking to witness.

It really can.

The author describes those harsh self -put -downs, that intense drive for perfection, and how absolutely devastating even small failures can feel to a child with ADD.

It's like their sense of self is still so fragile and vulnerable.

So sensitive to making mistakes or not measuring up.

Yes.

And the author makes the point that this heightened sensitivity to failure, this fear of not being good enough, can unfortunately persist into adulthood if it's not addressed.

Okay, so we've got this clear picture that low self -esteem is often a significant part of the ADD experience, from childhood through adulthood.

Now, the common explanation we hear is that adults with ADD have low self -esteem because of the challenges they've faced as a result of their ADD.

Academic struggles, job losses, relationship issues, difficulties, that can often be linked to those underlying neurophysiological differences.

Right.

And on the surface, that makes sense.

It's a logical connection.

But the author argues that it might not be the whole story.

While those negative experiences certainly contribute, they don't fully explain the intensity and the persistence of the self -judgment that many individuals with ADD experience.

It often goes far beyond what seems warranted by the actual situation.

It's like they're holding themselves to a completely different standard, a much harsher one than they would ever hold anyone else to.

And that brings us back to Andrea's statement at the very beginning.

She said she would never judge her friend the way she judges herself.

That's a powerful point.

And that discrepancy, the author suggests, is a hallmark of low self -esteem, not just a result of a series of setbacks or failures.

It's a difference in how we treat ourselves versus others.

Exactly.

The author offers this really clear definition of self -esteem, the quality of self -respect that is evident in a person's emotional life and behavior.

It's that deep down feeling about your own worth.

And here's a really key distinction.

Someone can project an image of confidence, even arrogance, but that doesn't necessarily mean they possess genuine self -esteem.

So you're saying it's not just about outward appearances.

Yeah.

Someone can be really successful, even boastful, but still be struggling with deep -seated feelings of inadequacy on the inside.

Precisely.

The author uses the example of the classic workaholic, someone who might appear to have at all a successful career, a high income, all the external markers of success, but whose drive is actually fueled by this underlying need to prove their worth, to silence those inner voices of self -doubt.

It's like their sense of self is entirely contingent on what they achieve.

Exactly.

It's a defense mechanism.

All that activity, all that striving is a way to keep those deeper feelings of worthlessness at bay.

They haven't yet learned to value themselves simply for who they are, independent of their achievements.

This reminds me of that study the author mentions, the one done in Toronto that concluded that men have higher self -esteem than women.

Ah, yes.

That study was based on self -reported levels of negative emotions.

Men reported feeling less despondent and lonely than women did.

But the author offers a really interesting interpretation of those findings.

What was that?

The author suggests that maybe the study wasn't actually measuring self -esteem directly, but rather the societal conditioning around expressing vulnerable emotions.

Perhaps men were less likely to admit to those feelings of sadness or loneliness, not because they weren't experiencing them, but because they felt pressured not to.

Oh, that's an interesting take.

It makes you wonder about the role of social expectations and how we present ourselves, even in a study like that.

Absolutely.

And the author suggests that suppressing those emotions, putting on a brave face, can actually be a sign of low self -esteem.

It's a way of avoiding those difficult feelings rather than acknowledging and working through them.

So we're seeing this pattern emerge where low self -esteem can be present in the lives of with ADD, regardless of outward appearances or levels of achievement.

And then the author shares this incredibly poignant diary entry from a professional who, at least on paper, has it all.

That diary entry is so revealing.

Here's someone who's achieved professional success, has a good reputation, all of that.

Yet their inner world is filled with this nagging sense of not having done enough, of still yearning for so much more.

They list all these things they want to do, learn to paint, study new languages, get in shape, all these external goals.

What really struck me was what wasn't there.

Exactly.

They talk about all these things they want to accomplish, but there's no mention of wanting to cultivate self -acceptance, wanting to feel at peace with themselves regardless of those achievements.

It really highlights that disconnect between external validation and genuine inner contentment.

It does.

And the author then goes on to provide a more comprehensive list of how low self -esteem can show up.

And it's a lot broader than we might initially think.

It goes beyond just that harsh inner critic.

So we've talked about the workaholic who's constantly striving for external validation.

What are some of the other signs?

Well, it can manifest as that inflated ego we talked about earlier, which can actually be a cover for deep insecurity.

Or it can be constantly seeking approval from others, being overly critical of yourself or others, having a really hard time admitting when you're wrong, even to denying reality.

Wow, that's quite a range.

It is.

And the author also points out that how we treat ourselves physically can also be a reflection of our self -esteem.

Things like neglecting our physical health, abusing substances, pushing ourselves to exhaustion, consistently putting everyone else's needs before our own.

These aren't just isolated incidents.

They can be signs of a deeper lack of self -respect.

It's like we're saying my needs don't matter or I don't deserve taken care of.

Exactly.

Which brings us to that really crucial distinction the author makes between contingent self -esteem and true self -esteem.

Contingent self -esteem is essentially based on achievements, on external validation.

It's that I'm worthy if mentality.

Exactly.

I'm valuable if I'm successful.

I'm lovable if people approve of me.

It's constantly being evaluated and it's so precarious because it depends on factors that are often outside of our control.

Just like building your house on sand.

A perfect analogy.

In contrast, true self -esteem is unconditional.

It's the belief that I am a worthy human being simply because I exist regardless of my accomplishments or failures.

And that feels so much more solid and stable, doesn't it?

Absolutely.

True self -esteem is about recognizing your inherent value, irrespective of performance.

It's accepting, stable, and doesn't require external validation.

With contingent self -esteem, even when we achieve something and get that temporary boost, it's not really the self that's being valued.

It's the achievement.

I see what you mean.

But with true self -esteem, it's about who we are at our core, independent of what we do or don't do.

And this is where the author makes a really important point about adults with ADD.

They're not struggling with low self -esteem simply because they have ADD or because they've had a hard time in certain areas of life.

It's more complex than The author suggests that this low self -esteem often predates any conscious memories of significant failures.

It's often already there.

So where does it come from?

What are the roots of this low self -esteem, particularly in the context of ADD?

Well, the author proposes that low self -esteem and even the symptoms of ADD itself can actually originate from some of the same early experiences.

Things like stress within the family environment and what's known as disrupted attunement or detachment between the child and their primary caregivers.

This is where Carl Rogers' concept of unconditional positive regard comes into play.

That feeling of being completely loved and accepted for who you are no matter what.

Exactly.

Healthy self -esteem flourishes when a child's emotions and needs are consistently understood and validated by their caregivers.

But when a child learns that their feelings are often dismissed, ignored, or even punished, they internalize the message that those feelings, and by extension they themselves, are somehow wrong or shameful.

That's such a powerful message to internalize at such a young age.

It is.

And the author highlights a really common experience among adults with ADD.

A recollection of never feeling truly comfortable expressing their emotions as children.

Of not feeling that safe space to confide in their parents when they were struggling.

Instead, they often recall being very aware of their parents' own difficulties and feeling like they shouldn't burden them with their own problems.

Yes, and this aligns with the work of Alice Miller, who wrote extensively about the sensitive child who intuitively stresses and tries to meet the needs of their parents, often at the expense of their own needs.

So the child, even unconsciously, learns to suppress their own feelings and needs to take care of the adults around them.

Right.

And the author emphasizes that this failure to receive consistent, unconditional acceptance from caregivers is absolutely not the child's fault.

It's not something they did wrong.

It's just the environment they were in.

And while that early disruption and attachment is foundational, the author acknowledges that the link between low self -esteem and perceived underachievement isn't entirely unfounded.

Right.

Parental expectations, disappointment, and even shaming related to a child's performance can further reinforce those underlying feelings of inadequacy.

And then, of course, the school system often intensifies that focus on performance and achievement.

It all contributes to how a child learns to value themselves.

It makes me think about Andrea and how she talked about dismissing her own kindness, creativity, and teaching abilities.

Those things came easily to her, so she didn't see them as valuable.

She felt like she should want to be an accountant or a lawyer, something she thought would be more difficult, more worthy of respect, maybe something that would earn her father's approval.

It's a perfect example of how we can internalize these really damaging beliefs that if something is enjoyable or comes naturally to us, it can't possibly be truly valuable.

The author actually shares a similar experience of undervaluing their own writing talent because it felt easy.

Like we're conditioned to believe that if it's not hard work, it doesn't count.

It's like we have to suffer to prove our worth.

And the author even talks about how this can lead some individuals with ADD to pursue careers that are completely wrong for them, just because they need to prove themselves through difficulty and struggle.

Like choosing a career path based on what they think they should want, not what they're actually drawn to.

Exactly.

And then there's Debra, who we talked about earlier.

She felt dumb because she couldn't keep up with factual conversations, but she had these incredible gifts of insight and empathy, which she didn't seem to value nearly as much.

It's like she was measuring herself against the wrong yardstick.

It's so easy to fall into that trap of undervaluing our unique strengths.

If they don't align with some external standard of what's considered valuable.

It is.

And given all of these experiences, not feeling fully accepted for who they are, undervaluing their natural gifts,

it's perhaps not surprising that the author points out that many adults with ADD really struggle with a lack of a solid sense of self.

They don't have that strong core identity.

And the author connects this to the fact that many adults with ADD have a hard time identifying their own feelings.

Exactly.

They might know that something feels off or that they're feeling overwhelmed, but they can't quite pinpoint the specific emotion.

And the author explains that because a strong sense of self is so intertwined with our ability to recognize and accept our own emotions, if we're disconnected from our feelings, we're inevitably going to feel disconnected from ourselves.

It's like we're missing a piece of the puzzle.

And if we're not in touch with our own emotions, how can we know what we truly want or need?

How can we make choices that align with our authentic selves?

It's a real challenge.

The author talks about the development of a false self, which is essentially a persona that's built around what we think we should be or what we think others expect of us.

It's like we're living someone else's life in a way.

Yes.

And eventually that false self starts to feel really empty and unfulfilling.

It leads to that feeling of, I don't know who I am anymore, or I have no idea what I really want.

That's a common experience, not just for people with ADD, is that sense of being lost, of not having a clear direction.

And it's so closely tied to that difficulty in saying no that we talked about earlier, which the author observes is particularly prevalent among women with ADD.

Yes.

The author quotes Diane, who says, I don't know how to say no.

I guess it's my second nature.

It can feel so ingrained, like it's just part of who we are.

Right.

But the author rightly points out that chronic suppression of one's own needs and boundaries is actually a learned behavior.

It's not innate.

Think about how assertive babies are.

They have no problem expressing their needs.

They let you know what they want.

Exactly.

But somewhere along the way, many of us, particularly those who struggle with low self -esteem, learn to silence our own needs and prioritize others.

And the author suggests that when we lose that ability to say no, we're essentially surrendering a part of ourselves.

We're undermining our own self -esteem.

And the author uses this really vivid image of the ADD adult as being buried under a mound of yeses, which are actually unexpressed no's.

It's a powerful image, isn't it?

It is.

And it helps explain why so many adults with ADD feel constantly overwhelmed and stretched too thin.

It's like they're living in a perpetual state of reaction, trying to keep up with everyone else's demands while neglecting their own needs.

And the author's own anecdote about over -committing to patients, even during a major personal crisis,

really illustrates this.

It's like that need to be needed can become all -consuming.

It's a way of avoiding our own inner experience, our own pain, by focusing on taking care of others.

And the author explains that this need to be needed often stems from those early experiences of conditional acceptance, where the child learns, even unconsciously, that they have to earn love and attention through their actions.

And that can create a persistent underlying anxiety, a feeling of never being able to rest, of always needing to be on.

It can be exhausting.

And it perpetuates that cycle of seeking external validation rather than cultivating genuine self -acceptance.

It's that contingent self -esteem again, where what we do and what others think of us dictates our sense of worth.

Exactly.

The author even talks about how the workaholics' frantic activity can be a way of numbing emotional pain, of avoiding those feelings of inadequacy.

It's like they're running from themselves.

And then there's that powerful insight from the group therapy leader, who said that a truly important person allows themselves personal time.

I love that quote.

It's so simple, yet so profound.

And it really struck a chord with the author, who realized they were struggling to prioritize their own well -being, despite all their outward success.

It highlights how deeply ingrained that need to be productive, to be useful, can be.

We can even start to believe that our worth depends on it.

So we've spent quite a bit of time exploring the psychological and emotional roots of low self -esteem.

But the author also acknowledges the neurophysiological aspects of ADD.

How do these inherent differences in brain function play into all of this?

It's important to remember that ADD is, at its core, a neurobiological condition.

The author explains that the brain is constantly active, constructing and reconstructing our sense of self.

It's like a movie that's made up of individual frames, constantly changing and evolving.

So it's not like there's a fixed static self that exists somewhere in the brain.

It's more fluid than that.

Right.

And in the ADD brain, those neurological fluctuations can be more pronounced, more intense, and more frequent.

And the author suggests that this can lead to a sense of having less to hold onto, in terms of a stable sense of self.

Which can, in turn, make it more challenging to develop a strong sense of self -esteem.

Exactly.

And this is where the challenges with self -regulation come in.

Those more intense and rapid emotional and behavioral swings that are common in ADD can make it more difficult to develop that consistent impulse control that often underlies a more stable sense of self.

So we have this interplay of both psychological and neurological factors that contribute to the challenges with self -esteem that we often see in individuals with ADD.

It's complex.

But here's where it gets really interesting.

The author points out that even though many adults with ADD struggle with certain types of impulse control, they're often really good at suppressing their deeper, more authentic impulses.

The impulse is to do what?

The impulse is to pursue meaningful activities, to express their creativity, to connect with others in genuine ways.

Those deeper longings often get buried under all the shoulds and the have -tos.

It's almost like they're living someone else's life, even on that deeper, more existential level.

That's a great way to put it.

And the author suggests that the deeper those impulses get buried, the harder it is to connect with that true sense of self, to know who you are and what you really want.

Which makes it even more difficult to develop that genuine self -esteem.

Precisely.

And the author ends this section on a really hopeful note.

They say that the journey toward attaining genuine self -esteem actually begins with identifying and embracing those truer, more authentic impulses, those things that light us up from the inside out.

It's about reconnecting with that lost part of ourselves.

So as we wrap up this really insightful deep dive into the connection between self -esteem and ADD,

what are the key takeaways for our listeners?

Well, I think we've seen that low self -esteem is often a deeply ingrained part of the ADD experience.

But it's important to remember that it's not simply a result of having ADD.

It's more nuanced than that.

The roots often lie in those early childhood experiences of feeling unseen, unheard and conditionally accepted.

And those early experiences can then be reinforced by the challenges and the expectations of the adult world, which often places such a high value on achievement and productivity.

Exactly.

And it's crucial to remember that true self -esteem isn't about what we accomplish or what others think of us.

It's about accepting ourselves unconditionally for who we are, flaws and all.

And for those struggling with low self -esteem, whether you have ADD or not, the author encourages us to look at behaviors that might be masking a deeper sense of inadequacy, the workaholism, the people -pleasing, the difficulty in saying no.

These might be signs that we need to start valuing ourselves more.

That's a good point.

And I think the author's distinction between contingent self -esteem and true self -esteem is so valuable, it helps us understand that seeking external validation will never truly fill that void.

We have to learn to love and accept ourselves for who we are, not for what we do.

Precisely.

So as a final thought for our listeners today, I would invite you to ask yourself, what are the shoulds that might be driving your own sense of worth?

What are those deeper longings, those authentic impulses that you might be neglecting?

And what would it look like to start living a life that's more aligned with who you truly are, not who you think you should be?

That's a great question for all of us to ponder.

And with that, I think we've covered all the essential points from this chapter.

We've explored the author's key insights, the stories they shared, and the practical implications of their analysis.

Hopefully this has given you, our listener, a deeper understanding of this complex and often overlooked aspect of the ADD experience.

I agree.

We've covered it all.