PhD/PsyD Challenges as Intern with ADHD

[GotDopamine?]

Hello everyone!

I have ADHD and internship has brought out the worst of my symptoms. I’m on medication and working with a MD, but everyday I feel like a failure. I have a therapist, but ones covered by my insurance don’t really have training in “executive functioning” or adult ADHD (a very frustrating thing for many adults).

The workload is honestly less than I experienced before, so I don’t think it’s a matter of too many tasks. I think my job is way more monotonous than it would have been pre-covid.

My supervisor is extremely and consistently negative. I have worked hard to self-reflect and notice my own successes, but it’s tough feeling like a disaster everyday... no matter what.

I think I’m so on edge and worried about messing something up that I mess more things up, and I’ve never had this many challenges, so I’m struggling to cope. I’m worried that the supervisors’ perceptions of me will mess up my postdoc opportunities.

I’m wondering if anyone else has experienced these challenges with ADHD or similar concerns and bad advice. What helped? Did you talk to HR?

---

Members don't see this ad.

 

[conky124]

I have ADHD and am in internship. Check your DMs happy to chat with you or anyone else interested there since it will be more of a personal conversation.

 

[summerbabe]

My supervisor is extremely and consistently negative. I have worked hard to self-reflect and notice my own successes, but it’s tough feeling like a disaster everyday... no matter what.

I can't speak to the specifics you mentioned but this section made me wonder if you and your supervisor have done any formal or informal evaluation of your work so far.

I've had supervisors who I felt like were very critical only to find out during an eval that they actually thought I was mostly doing fine and that their supervisory/interpersonal style is just low on affirmation and perhaps heavier-handed when it came to teaching/feedback.

If this hasn't happened yet, maybe it might be possible to have a conversation with your supervisor to get a better sense of how they think you're doing overall, including initial strengths and areas for continued growth throughout internship.

 

[singasongofjoy]

I can't speak to the specifics you mentioned but this section made me wonder if you and your supervisor have done any formal or informal evaluation of your work so far.

I've had supervisors who I felt like were very critical only to find out during an eval that they actually thought I was mostly doing fine and that their supervisory/interpersonal style is just low on affirmation and perhaps heavier-handed when it came to teaching/feedback.

If this hasn't happened yet, maybe it might be possible to have a conversation with your supervisor to get a better sense of how they think you're doing overall, including initial strengths and areas for continued growth throughout internship.

YES. I definitely second this. Things may very well not be as bad as you think.

One thing you might find helpful is not waiting for formal mid- and end-of-year reviews; rather, ask for a copy of the evaluation form they use and do a self-evaluation, and ask them to do the same (evaluation of you using the same form) and see if your perceptions of your top 3 areas that you do well and top 3 that you could use some extra self/professional development are aligned. Then start the conversation from there and each of you might take some time to think about possible supports to help beef up those areas. PM me if you'd like and I"ll send you a copy of the form that we use; it looks at both more global professional competencies and more specific ones.

Some books I like for developing your own strategies based on your needs and areas of EF weakness include: Smart But Scattered (the adult version), The Clutter Connection (helped me think critically about the types of organizational strategies most likely to work and be sustainable for me and totally changed how I have my office set up) and ADD Friendly Ways to Organize your Life.

I'm several years out of grad school and internship at this point but still empathize hard with your situation (including the difficulty in finding a coach/therapist that has legit expertise in this area and didn't have a forever long waitlist). So.... here to tell you (and whoever else) that it is totally possible to be a good, effective, and even reasonably efficient / productive psychologist with ADHD- without running yourself ragged. Before you eventually get there though, the beating up of yourself is awful and can be counter-productive and may take some cognitive reframing on your part as you bit by bit figure out how to make that happen (which may take some trial and error and certainly some patience and perhaps sense of humor). Happy to converse in more detail if you want - just send me a PM.

 

[conky124]

We need some sort of online community for ADHD psychologists.

 

[borne_before]

I've got ADHD. I'd be happy to help you out.

I also want to caution about taking things so personally. One of my internship supervisors was pretty negative/absent. To make it worse, my "good" supervisor was on maternity leave for three months. I was making some mistakes in a couple of placements. I felt like a failure and even needed a corrective action plan per APPIC guidelines at the middle of the year. This was seriously traumatic for me. Felt like a huge "failure."

I got through the year fine and learned a lot once my "good" supervisor came back. I did take a little prozac, too. I recently found out that the "bad" supervisor was basically absent from campuses and leaving the interns to do ALL/most of her work with little supervision. She was an alcoholic, went to rehab, and is no longer at the site. What a crappy thing to do to an intern - wish I'd known that at the time.

What I'm saying is that with ADHD, and our rejection sensitivity proclivity, it's super easy for us to internalize negative feedback, and blame it on us or the ADHD, when in reality, your supervisor might just be a Karen or worse.

 

[borne_before]

Let's make an association of neurodiverse psychologists. Facebook or reddit might be the easiest way to make a group.

 

[futureapppsy2]

You may be eligible for accommodations under the ADA. Talk to a supervisor (doesn't have to be your direct supervisor) about this.

 

[Therapist4Chnge]

There is some excellent advice in this thread. The only thing I'd add is to speak w. your internship DCT and let them know what's going on.

 

[missplum]

I think one of the things that is helpful for me is focusing on the positive aspects of ADHD. For example, I think that it helps me think outside of the box and connect dots that other people don't see as easily.

Secondly, I know that one of my symptoms is increased sensitivity to criticism (that is viewed as rejection). When I realized this, I started to re-frame criticism as support and would ask myself "In what way is this person trying to help me through this criticism? What does it mean about how they care about my success?" This helped me a lot because instead of associating criticism with rejection, I started to see it as an indicator of supervisors and peers caring about me. I also found it helpful to communicate the best way to receive criticism. For example, I prefer feedback to be detailed and specific so that I can write it down and find a way to see my progress. If feedback is too ambiguous, I have no way of tracking my progress and instead always worry that I haven't changed.

Thirdly, since I choose to not be on medication for personal reasons, I set aside time to look up strategies to help me with my focus. There are a lot of helpful activities and interventions out on the internet. For example, I really find this youtube channel (How to ADHD) helpful How to ADHD not only for strategies but also for psychoeducation. Even if you're on medication and seeing a therapist, I still think that adding some strategies might be helpful for you.

Lastly, I understand that there are also other things outside of my ADHD that impact my ability to focus and do what I need to do such as nutrition, sleep, exercise, social support, and stress. I've learned that if I neglect those things, my symptoms get worse but instead of recognizing the source, I tended to blame ADHD, shake my fist, and do nothing about it. Now, when I'm feeling worse than normal I ask myself "did I eat? have I slept enough? have I been nice to myself today or overly critical?"

Lastly, Lastly, it's okay to admit that you're not superhuman. It's been hard, but I've learned to open up about where i'm struggling to my peers and supervisors and have been surprised by how much "me too!" and "how can I help?" I've gotten. Even if they don't have ADHD, we're all struggling. It's just easier to see it in ourselves than in others.

 

[PsySeeker]

Let's make an association of neurodiverse psychologists. Facebook or reddit might be the easiest way to make a group.

Severe ADHD/executive dysfunction here. I’m actually really heartened to see that I’m not alone in making it this far professionally. I’ve always tried to hide it and compensate with my intellect, which works, as far as it goes. I was fortunate to marry a neurotypical, and she was.... less fortunate, I suppose. She does all the things I’m terrible at, which is almost everything, and I do what I’m good at, which is doing treatment with trauma patients (lots and lots of treatment),running my practice, and loving my kids. It’d probably be good to add some new routines, but I’m closing in on 40 and I feel like if I’ve learned anything it’s that trying to do easy but boring things consistently or at all, often even at a sub-average skill level requires far more effort and psychic pain than does working to excel at the few things I find stimulating/challenging and which hold my interest, so I give up on boring things because I hate them, and spend most of my time doing what’s stimulating to me and which actually suits the few but pronounced strengths I do have, which I’ve fortunately learned how to make pay very well, so at least there’s that I guess. So I’d enjoy such a group, can you set one up via Reddit?

 

[GotDopamine?]

I've got ADHD. I'd be happy to help you out.

I also want to caution about taking things so personally. One of my internship supervisors was pretty negative/absent. To make it worse, my "good" supervisor was on maternity leave for three months. I was making some mistakes in a couple of placements. I felt like a failure and even needed a corrective action plan per APPIC guidelines at the middle of the year. This was seriously traumatic for me. Felt like a huge "failure."

I got through the year fine and learned a lot once my "good" supervisor came back. I did take a little prozac, too. I recently found out that the "bad" supervisor was basically absent from campuses and leaving the interns to do ALL/most of her work with little supervision. She was an alcoholic, went to rehab, and is no longer at the site. What a crappy thing to do to an intern - wish I'd known that at the time.

What I'm saying is that with ADHD, and our rejection sensitivity proclivity, it's super easy for us to internalize negative feedback, and blame it on us or the ADHD, when in reality, your supervisor might just be a Karen or worse.

I’m so sorry you had that experience. I agree that I need to stop having these comments weigh so much on me. I usually am able to accept feedback and enjoy learning from it, but this has just felt like I’m back in high school with a math teacher constantly yelling at me to “try harder” not to make a careless error and being annoyed when I ask for clarification on things. I did learn that others have had challenges with this supervisor for years, so this helped me realize it’s not just me. I’m learning to look for my own strengths. And, like you said, learning to realize that outside circumstances could be contributing to this behavior.

 

[GotDopamine?]

Let's make an association of neurodiverse psychologists. Facebook or reddit might be the easiest way to make a group.

Great idea!!

 

[GotDopamine?]

Severe ADHD/executive dysfunction here. I’m actually really heartened to see that I’m not alone in making it this far professionally. I’ve always tried to hide it and compensate with my intellect, which works, as far as it goes. I was fortunate to marry a neurotypical, and she was.... less fortunate, I suppose. She does all the things I’m terrible at, which is almost everything, and I do what I’m good at, which is doing treatment with trauma patients (lots and lots of treatment),running my practice, and loving my kids. It’d probably be good to add some new routines, but I’m closing in on 40 and I feel like if I’ve learned anything it’s that trying to do easy but boring things consistently or at all, often even at a sub-average skill level requires far more effort and psychic pain than does working to excel at the few things I find stimulating/challenging and which hold my interest, so I give up on boring things because I hate them, and spend most of my time doing what’s stimulating to me and which actually suits the few but pronounced strengths I do have, which I’ve fortunately learned how to make pay very well, so at least there’s that I guess. So I’d enjoy such a group, can you set one up via Reddit?

thank you so much everyone for your support and help! I have created a reddit. Free to cover suggestions. r/NeurodiversePsychs

 

[christypaffgen]

We need some sort of online community for ADHD psychologists.

I would love this so much. I've personally been worried for a while about how to transition academic accommodations to internship when I begin next year (e.g., minimal but extra time to complete reports if not permitted to work in a distraction-reduced environment, etc.) I've been hoping it could be a discussion with HR as opposed to something I'd need to immediately disclose upon arrival.

 

[christypaffgen]

Severe ADHD/executive dysfunction here. I’m actually really heartened to see that I’m not alone in making it this far professionally. I’ve always tried to hide it and compensate with my intellect, which works, as far as it goes. I was fortunate to marry a neurotypical, and she was.... less fortunate, I suppose. She does all the things I’m terrible at, which is almost everything, and I do what I’m good at, which is doing treatment with trauma patients (lots and lots of treatment),running my practice, and loving my kids. It’d probably be good to add some new routines, but I’m closing in on 40 and I feel like if I’ve learned anything it’s that trying to do easy but boring things consistently or at all, often even at a sub-average skill level requires far more effort and psychic pain than does working to excel at the few things I find stimulating/challenging and which hold my interest, so I give up on boring things because I hate them, and spend most of my time doing what’s stimulating to me and which actually suits the few but pronounced strengths I do have, which I’ve fortunately learned how to make pay very well, so at least there’s that I guess. So I’d enjoy such a group, can you set one up via Reddit?

Oh my gosh, all of this. Same!! For me, it's child therapy and neuropsych. Looking forward to Reddit!

 

[AcronymAllergy]

I would love this so much. I've personally been worried for a while about how to transition academic accommodations to internship when I begin next year (e.g., minimal but extra time to complete reports if not permitted to work in a distraction-reduced environment, etc.) I've been hoping it could be a discussion with HR as opposed to something I'd need to immediately disclose upon arrival.

Depending on where you're interning, I suspect it's almost certainly something that would/should involve HR, and would also likely involve the DCT. But I'd say it's definitely a conversation worth having sooner rather than later.

 

[borne_before]

I WOULD/DID NOT DISCLOSE ANY HIDDEN NEURODIVERSITIES WHILE INTERVIEWING (or before match).

 

[erg923]

NEURODIVERSITIES).

Is that woke speak for mental disorder? Lol

 

[WisNeuro]

Is that woke speak for mental disorder? Lol

In current taxonomic terms, it'd be a developmental category

 

[PsySeeker]

Is that woke speak for mental disorder? Lol

No. It’s neither woke speak nor is it in reference to a mental disorder... C’mon man...

 

[DebbieNAU]

Hi everyone! I know this is an old thread but if you are still interested I would love to connect with other psychologists and psychology interns with ADHD. I am an LMFT in California who decided to go back to grad school for my doctorate and I will be starting my internship year next fall. I am 50 and have been diagnosed with ADHD since I was in my late 20s. I struggled a lot in my Master's program pre-diagnosis but doing better in my doctoral program because I take Concerta, but I am still nervous about internship. Hope we can get a group going. Look forward to chatting with you. Debbie