309: Rethinking Adult ADHD with Dr. Russell Ramsay

309: Rethinking Adult ADHD with Dr. Russell Ramsay

Breaking down the increments of time to organize behavior for people with ADHD is like driving in fog at slow speed. Listen to Eric and his guest Dr. Russell Ramsay as they discuss this, and many other topics on this episode of ADHD reWired. Dr. Ramsay is the co-founder and co-director of the University of Pennsylvania Adult ADHD Treatment and Research Program and an Associate Professor of Clinical Psychology and Psychiatry in the Penn State Medical School. He is also the author of five books, including the recently released Rethinking Adult ADHD, along with many articles with issues relating to ADHD.

How do we break down tasks to make them more actionable? Listen as Eric, and Dr. Ramsay discuss Cognitive Behavior Therapy, the difference between agency and efficacy, automatic negative thoughts, and core beliefs. Dr. Ramsay also shares that there are no trade secrets with coping strategies; the issue is with implementation and follow-through. Eric wonders if clients can be taught to change the questions they ask themselves and instead of being discouraged because all of something does not work, look and see if a part of it will work, look at the smaller picture.

Listen in as Dr. Ramsay shares the difference between procrastination and front end perfectionism, along with general cognitive disorders in the general population versus overgeneralization with ADHD. Dr. Ramsay says that it is ok to start toward something with the end in mind, but remember to implement the next incremental step to reach the goal. 

Eric and Dr. Ramsay both share some extraordinary information about ADHD. Even though Cognitive Behavior Therapy sounds hard, these two break it down into layman terms so that we can all understand it. Small steps with realistic expectations can help you reach whatever goal you want to achieve.

You’ll Learn:

  • [02:47] Dr. Russell Ramsay, welcome back to the show!
  • [03:09] Dr. Ramsay why are we rethinking adult ADHD?
  • [05:40] He speaks about the main cognitive theme in CBT [Cognitive Behavior Therapy].
  • [08:04] Dr. Ramsay discusses a scale that measures distorted positive thoughts.
  • [09:57] Do you know the difference between agency and efficacy?
  • [12:30] Dr. Ramsay speaks about automatic negative thoughts and core beliefs.
  • [15:45] There are no trade secrets for coping strategies we know they work, the problem is implementation.
  • [18:06] How do we break down tasks to make them more actionable?
  • [28:56] Dr. Ramsay addresses the overgeneralization of distortions in positive and negative ways.
  • [31:46] Eric wonders if maybe clients should be taught to change the questions they ask themselves.
  • [33:17] Dr. Ramsay says that writing is hard for everyone, so if you can sequence your thoughts conversationally, it can help you express things in a more precise way.
  • [34:20] Are there differences in general cognitive distortions in the general population versus overgeneralization with ADHD?
  • [37:02] Dr. Ramsay speaks about procrastination and front end perfectionism.
  • [38:03] Dr. Ramsay shares some areas of perfectionism that many people do not recognize and productive procrastination.
  • [41:04] What something you can do behaviourally even though it is not actionable?
  • [47:44] Dr. Ramsay discusses the unrealistic expectations of reality, lowering the bar of sufficiency.
  • [50:30] Organizing behavior across time towards an outcome that we want to achieve.
  • [51:33] Dr. Ramsay says to start with the end in mind but implement the next incremental step toward your goal.
  • [53:51] How long does it take for replacement thoughts to become automatic?
  • [56:39] Dr. Ramsay gives examples from a study of framing bias and remarks that framing a task so that it is actionable makes it seem more natural to accomplish.
  • [57:43] Dr. Ramsay, do you have any final thoughts for our listeners?
  • [59:28] Thank you so much for being on the show today.
  • [1:00:41] If you’re a regular listener, consider becoming a patron and on our Patreon at


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