Kadınlarda DEHB İçin Radikal Bir Rehber

The original title is A Radical Guide for Women with ADHD. It came out from New Harbinger in 2019. Its subtitle consists of three calls: embracing neurodiversity, living boldly, breaking through barriers.

It has two authors. Sari Solden is a psychotherapist who wrote the first book on ADHD in women. Michelle Frank is a clinical psychologist specializing in the diagnosis and treatment of ADHD; she combines the cognitive behavioral approach, mindfulness work and psychoeducation. The foreword was written by the clinical psychologist Ellen Littman.

Its Turkish edition came out from Serenad Yayınevi in 2023, translated by Maide İdil İspir. I saw the details on Kitapyurdu; in this article I refer to it by its Turkish title.

What is radical

The word in the title looks like marketing at first glance. The book uses it in a particular sense: fully and unconditionally accepting your own ADHD brain.

The acceptance here stands in a different place from the superpower narrative I criticize on this site. The book does not say ADHD is an advantage. What it says is this: your brain works differently, the difficulties of this difference are real, and no strategy holds for long without letting go of carrying these difficulties like a character flaw.

When I read this, something settled into place inside me. One reason every system I tried collapsed after a few weeks was that I built the system with shame. Every lapse felt like evidence.

A workbook

This book was not written to be read and closed.

Inside the chapters there are questions asking you to stop and think, exercises to fill in, pages asking you to write your own story. The authors combine the knowledge of conventional ADHD treatment with the tools of acceptance and commitment therapy, that is, ACT.

I can describe ACT briefly like this: instead of fighting difficult thoughts and feelings, making room for them, clarifying what is valuable to you, and taking small steps in the direction of those values. I described it in detail in the article acceptance and commitment therapy in ADHD.

A warning: the evidence for ACT in adult ADHD is not yet as extensive as for cognitive behavioral therapy. The studies are fewer and smaller. I also could not see a study showing that this book itself was tested as a program. You need to read it knowing this.

How ACT works here

To make the concept concrete, let me think through a situation familiar from my own life.

You forgot a friend's birthday. The first thought that comes is "I am a terrible friend." The cognitive behavioral approach wants you to question this thought: are you really a terrible friend, what is the evidence?

ACT's approach is a bit different. Instead of arguing with the thought, it asks you to notice it as a thought: "The thought that I am a terrible friend is passing through my mind." Then it asks: what is valuable to you in this friendship? And what small step can you take now in the direction of that value? Maybe sending a message, maybe adding a reminder to the calendar for the next birthday.

The book's exercises proceed with this logic. It does not try to destroy shame; it looks at what shame keeps you from doing.

This approach has an appealing side in ADHD. Constantly monitoring and correcting your own thoughts is also an executive function load. ACT lightens that load a little.

The identity triangle

This is, I think, the book's most useful idea.

According to the authors, ADHD affects identity in three areas, and these three areas are connected to each other.

Core self. Who you are. ADHD is a part of it but not the whole.

How you feel about your brain. How you approach your own mind. Do you see it as a broken instrument that constantly needs to be fixed, or as something you try to learn how it works?

Your relationship with the world. How your beliefs about yourself show up in your behavior, and how that shapes your relationships with people.

The book explains that these three areas are entangled with each other. For example, you forget a task. This is an event about your brain. But it immediately turns into the thought "I am an unreliable person," which touches the core self. Then you do not go to the next invitation, because you are afraid you will forget something again. This narrows your relationship with the world.

A single lapse spreads into three areas at once.

The shame cycle and isolation

The book says this entanglement produces two cycles.

The first is the shame cycle. Disorder or a lapse gives rise to harsh self-criticism, self-criticism grows shame, shame drains energy, and when your energy drops the lapses increase.

The second is the isolation cycle. Negative beliefs about yourself keep you away from people. The more you keep away, the more both support and gazes that see you differently decrease. And the beliefs remain untested.

Reading the second cycle I sat for a long time holding a pen without writing anything. I had never thought about why my friendships quietly dwindled from this angle.

Facing hiding

A theme that was already central in Solden's 1995 book becomes a separate area of work in this book: hiding.

The labor spent so that no one sees you struggling. The forms I know are these: not inviting anyone home, preparing for a task many times more than needed, not asking for help because asking for help shows that you are struggling.

Today this is more often called masking. The consensus statement by Young and colleagues published in BMC Psychiatry in 2020 explains that the compensatory strategies developed by girls and women both delay diagnosis and carry a serious cost in exhaustion. The book makes the everyday counterpart of this finding workable.

The book does not ask you to stop hiding all at once. It suggests first seeing where, from whom and at what cost you hide, then trying to be visible in the small areas you find safe. This felt realistic to me.

Self-talk

An important part of the book is about the inner voice.

The criticisms heard since childhood at some point stop coming from outside and begin to speak from inside. The book asks you to notice this voice, to find where the sentences come from, and to create some distance between yourself and them.

This part resembles the thought record in cognitive behavioral therapy, but the aim is a bit different. Rather than weighing the thought as true or false, the goal is to see that you do not have to believe it. The ACT influence is felt most here.

On this subject there is also the article shame and self-compassion in ADHD on the site.

What is missing

I liked this book, but I cannot ignore its shortcomings.

Few tools for executive functions. If you are looking for concrete methods for time management, planning, order at home, the book will not satisfy you. This is also the criticism most often voiced in reader reviews. The authors argue that strategies only work after the shame is resolved. This is logical, but it should not be a reason for leaving the reader without strategies.

Limited clinical information. Topics such as what ADHD is, how the diagnosis is made, what research says are passed over very briefly. The book assumes you know these.

Examples from a narrow group of women. Many readers say that the stories in the book largely portray women who are well-off and live within a traditional family structure. The book names intersectionality but does not really enter the experience of women in different circumstances. Reading this criticism I agreed too; for someone reading in Turkey, in a different economic and family context, some examples may feel distant.

The tone does not suit everyone. The encouraging language can sound condescending to some readers. The motivational-poster air of the chapter titles contributes to this. The title of the second chapter calls on you to begin boldly, for example.

Not a source on medication. The book does not exclude treatment, but it is not the place to go for information about medication. The decision on medication is made with a doctor; this book offers little to prepare for that conversation either.

The line between acceptance and giving up

I also want to write down one worry of mine.

When misread, the language of neurodiversity and the emphasis on acceptance can slide to the point of "I am fine as I am, I do not need to do anything." The book does not say this. It builds acceptance as a ground that makes taking action possible, and the emphasis on breaking through barriers in its subtitle comes from this.

But the reader has to hold this distinction themselves. If you need treatment or accommodations, acceptance should be a reason to ask for them. It should not be a reason to give them up.

For whom, at what stage

Women who have the diagnosis and have passed the information stage. You know what ADHD is, you have read a few books, perhaps started treatment, but your relationship with yourself is still the same. This book works exactly at that point.

Those who see that every system they try collapses. The problem may not be in the system. It may be in how the person who builds the system looks at themselves.

Those who have just noticed masking. If you have begun to see how much you hide, the book offers a good framework for thinking about it.

Whom I would not recommend it to: someone wondering whether they have ADHD, since this book says nothing about diagnosis. Someone looking for a concrete system. Someone who wants to work alone during a period of severe depression; the questions a book of this kind asks can be too heavy in that period without the support of a therapist.

The irony of a workbook for a reader with ADHD

I cannot go without saying this.

Workbooks rest on exercises done regularly, in order and to the end. Exactly the thing someone with ADHD struggles with most. Half-filled workbooks are quite a familiar sight in ADHD homes.

I do not know how much the book takes this risk into account. But my own experience was this: skipping an exercise or leaving it half done does not make the book useless. Trying to finish this book flawlessly would be the very perfectionist shame the book opposes.

That Ellen Littman, who wrote the foreword, has worked on women with ADHD who are especially intelligent and have complex pictures and are overlooked is also meaningful in this respect. A significant share of the readers the book addresses are women who look functional from outside and constantly try to correct themselves inside.

How to read it

If you read fast, almost nothing remains of the book.

You need to go through the chapters in order, giving each a few days and really doing the exercises. It would be good to keep a notebook beside you; especially for those who do not want to write inside the book.

It also suits reading in a group very well. The Attention Deficit Disorder Association, ADDA, in the US has organized study groups based on this book. Discussing one chapter a week with a friend or a small group counts as a move against the isolation cycle too.

The book runs a little over two hundred pages in the original edition, and about two hundred and sixty in the Turkish. A short book but one to be read slowly.

Reading it together with Solden's 1995 book is also interesting. The themes of shame and hiding are the same, but twenty-five years later they are rebuilt in the language of ACT and neurodiversity. The first tells you what you are living through, this one makes you think about what to do with it.