The 10 Minute

Guide to Mindfulness
for Adults with ADHD

By Juan Sangüesa

10 min.
Why Mindfulness for ADHD?
(…or how in the world do you think I’m going to
be able to sit still, meditate and clear my mind of
thoughts? …I mean, are you kidding me?)

Well, I want to tell you right from the start that in order to benefit
from mindfulness you don’t need to sit still, nor try to clear your
mind of thoughts, and most of all that mindfulness is not the same
as meditation in the traditional sense… because you don’t have to
embrace a new belief or philosophy of any kind…

So what is mindfulness, then?

At its most fundamental level, mindfulness is the natural awareness

that arises from purposefully paying attention to our experience in
the present moment, with an attitude of openness, curiosity and
non-judgment.

This awareness is a natural ability that everyone has and that

we can access anytime… although, most of the time it happens
spontaneously.

Like those moments when we feel totally alive and connected with
ourselves and others… think for example of:

those first dates when you’re just falling in love

the moment your child was born
during a walk in nature
or admiring a breathtaking landscape…
How did you feel in moments like these?
Feels good, doesn’t it?
How cool would it be to create those moments whenever you
want to?

Well, when you start a mindfulness practice (yes, it is a practice)

that’s exactly what you learn how to do :-)

Ok. To make it even more clear we have to also understand what

Mindfulness is not…

Living on Automatic Pilot.

Mindfulness is the opposite of automatic pilot.

How many times have you commuted from home to work (or
school) or vice versa, without knowing how you got there…without
noticing your surroundings and sights during your trip, lost in
thought, planning your day or just daydreaming?

We’re on autopilot whenever we become absentminded or lost

in thought and preoccupations. It usually happens during routine
activities like eating, driving, walking or taking a shower.

This experience is universal. And, on one hand, its pretty amazing

that we have the capacity to do stuff and at the same time use our
minds to plan our next actions or reflect on what has happened to
us…

BUT, on the other hand, whenever our attention is wandering

within, drifting in a sea of mental activity, we might miss out on
important things that are happening right in front of us…

So that is one of the greatest benefits of practicing mindfulness:

being able to step out of automatic pilot at will, thus being able to
be more present and aware of what’s going on in our lives.
Sounds good?
Cool! …and the best news is that we can train our capacity for
mindful awareness and develop and strengthen it with practice,

And science is showing that we can derive a LOT of benefit by

doing it.

But, before we turn to the benefits of mindfulness for ADHD, we

need to briefly address the underlying cause of ADHD symptoms.
Executive Functions:
The Conductor of the Symphony of the Brain
The concept of Executive Functions (EF) comes from
Neuropsychology and is VERY important for people with ADHD.

There is growing consensus among researchers that ADHD

manifestations (what are usually called “symptoms”) are related to
the erratic workings of some of the EF.

Executive functions are higher order cognitive processes that depend

on the activity of the frontal lobes, specifically the pre-frontal cortex
and its connections with deeper (“sub-cortical”) parts of the brain.

EFs underlie our capacity for self-control (or what mental health
professionals and researchers call self-regulation).

In simplified terms, executive functions help us plan our actions,

direct our focus and sustain our attention, ignore distractions,
manage time, regulate our emotions, etc.
They are the set of mental capacities that enable us to choose the
right actions in the present moment so as to maximize our future
gains.

EF’s are like the conductor of the symphony of the

brain.

Both the brain and an orchestra contain a number of individual

parts which may be viewed as functioning separately. For example,
the brain is made up of numerous systems, such as memory,
attention, emotions, and so forth…

An orchestra, on the other hand, has components such as drums,

violins, and pipes…

EFs are pretty much like the conductor of the orchestra, not in
control of how each component operates, but responsible for their
activation, regulation, and integration as a whole.

Without a good conductor the symphony simply cannot

make good music…

Without the EFs doing their work properly, the brain simply is
NOT able to effectively accomplish tasks.
In practical terms, EF deficits can explain a lot of ADHD traits and
behaviours like:

• distractibility
• impulsivity
• disorganization
• poor planning and follow through
• time management problems
• forgetfulness
• emotional difficulties

So, now you know about the importance of executive functions for
understanding (and ultimately overcoming) your ADHD difficulties…
 And that brings us to the:

5 ways mindfulness can help you improve

and support your executive functions:

1. Attention control
First of all: Attention Deficit Disorder is a misnomer.

There is not a real deficit of attention in ADHD, like say a deficit of

vitamin C in scurvy…

The real problem in ADHD is a problem with attention regulation.

That is, our capacity to direct, sustain and also switch the focus of
attention when necessary. The ability to filter and inhibit distractions
and maintain our focus on the task at hand.

This is called executive control and is one of the EFs.

The problem with attention regulation explains why sometimes you

can hyper-focus on things that you are really into… but you might
find it nearly impossible to sustain your attention on things that
are… well, less than absorbing, or repetitive or just plain boring.

So, the real problem is the inability to

regulate attention properly.
And as William James, one of the
founders of American Psychology,
once said:
“The faculty of voluntarily bringing back a wandering attention, over
and over again, is the very root of judgment, character, and will. No
one is compos sui [master of himself] if he have it not. An education
which should improve this faculty would be the education par
excellence. But it is easier to define this ideal than to give practical
directions for bringing it about.”

- William James, Psychology: Briefer Course, p. 424 (Harper Torchbooks,

1961)

Well, mindfulness is one type of education that can teach you how
to do just that… bring back your attention.

Mindfulness practice starts with training our ability to direct

our attention to the present moment, in a flexible manner, with
openness and curiosity.

And the research has shown that it works!

Many studies have demonstrated that both people with and without
ADHD can improve on neuropsychological tests that measure
attention control after relatively brief periods of mindfulness
practice.
2. Impulse control
Ready, FIRE… aim?

Impulsivity is, of course, one of the hallmarks of ADHD.

Blurting out a response before the question has been finished, saying
something to someone that you regret having said afterwards,
acting without thinking of the consequences… are all examples of the
impulsivity that often occurs in ADHD people.

How can mindfulness help?

It’s very simple.

Victor Frankl, Psychiatrist and author

of Man’s Search for Meaning, once
said:
“Between stimulus and response there is a space. In that space is our
power to choose our response. In our response lies our growth and our
freedom.”

When we develop our ability to pay attention to the present moment

we also learn how to pause, which in turn, helps us make that space
between stimulus and response bigger and bigger…

In the research study I conducted as a graduate student, we

measured the performance of adult ADHD participants on a
neuropsychological test called Continuous Performance Test (CPT).

The CPT measures sustained attention and response inhibition (a

measure of impulse control).
When taking the test you have to pay attention to a computer monitor
in which a succession of letters are presented very quickly at varied
intervals.

The instructions are that you have to press a button every single time
any letter other than X shows up on the screen.

Since the X shows up very infrequently, this creates what is called a

prepotent response to click, thus making it difficult to withhold the
response when necessary (when you see an X).

So, every time you are unable to inhibit the response and click when
an X is on screen, that counts as a “commission error”.

Thus, one of the indices of performance in the CPT is the number of

commission errors the participant makes.

In my study, there was a significant reduction of commission errors

after a period of the training in both mindfulness and cognitive
behavioral techniques (therapy).
The percentage of commission errors decreased from an average of
38% before the training to a 20.2% after the training.

Almost a 50% decrease! (Which is usually interpreted as an

improvement in sustained attention and impulse control).

Similar results have been observed with children with ADHD after
they receive medication.

BUT the participants in my study were not taking any ADHD

medications during the course of the study.
3. Stress reduction
You probably know too well that ADHD and stress go hand in hand.

The more ADHD interferes with your ability to function well in your
daily life, the more stress and chaos it creates.

This is why it’s so easy for adults with ADHD to start

feeling overwhelmed very easily.

Well, the good news is that many studies over the last 15 years or
so have shown that mindfulness is a powerful way to combat stress
and create more well-being in our lives.

One of the most studied and well-validated mindfulness programs,

used worldwide for a wide array of medical and psychological
conditions, is the Mindfulness Based Stress Reduction program
(MBSR), created by Jon Kabat-Zinn in the 70s…

…and one of its main effects is… well, stress reduction :-)
4. Emotion regulation
Many researchers argue that one of the key components of ADHD is
deficient emotional self-regulation (DESR).

Although this is not part of the official diagnostic criteria, studies

have shown that emotional regulation problems are a major source
of distress for adults with ADHD.

Have you ever felt overwhelmed by your emotions, or maybe

reacted impulsively or out of proportion, when flooded with
negative emotions such as anger, anxiety, irritability or maybe
hopelessness?

Well, emotional self-regulation is our ability to manage our

emotions, or more specifically, to actually feel them, be aware
of them and be able to choose our response and not react
automatically or impulsively in the presence of intense or negative
emotions.

This is another example of ADHD not allowing executive

functions to do their job properly.

And mindfulness here can make a huge difference, because the

training helps us be more aware of what’s going on, both outside
and inside of us… allowing us to be more skillful in how we respond
to our emotions.
5. Negative thinking
Most of the time, ADHD can have a negative psychological impact
on many levels, from low self-esteem to lack of confidence in our
own ability to reach our goals.

Studies have shown that ADHD adults often report more negative
thinking than people without ADHD… which is not surprising when
we think about the chronic nature of ADHD struggles.

I mean, when you’ve been struggling with the same obstacles

over and over again, not having found an effective solution, it’s no
wonder you might sometimes feel defeated and hopeless, right?

Of course this can have a negative impact in your life, draining your
energy and preventing you from reaching your true potential.

Here mindfulness can be an almost magical tool.

The reason is that with mindfulness we can learn how to look at our
own minds from a different perspective, from a safe place where we
can observe, notice and not be carried away by negative thinking.

This is why mindfulness has been so widely

incorporated in psychotherapy.

There’s a whole movement of mindfulness based therapies (or what

is called the 3rd wave of behavior therapies).

Take for example MBCT (Mindfulness Based Cognitive Therapy), a

therapy that has shown in clinical studies to be at least as effective
as medication to prevent relapses for people with recurrent
depression.

Ok, so now you may be wondering… this sounds really cool, Juan,
but how do we do it? How do I practice mindfulness in a way that I
can get all these benefits?

Well, this is what we’re going to see next.

 S.T.O.P.
a Simple and Portable
4 Step Mindfulness Exercise
for Daily Life

First of all, there are many ways in which you can practice
mindfulness.

I would recommend that you start with an introductory course,

either live or online, so you can benefit from the guidance of a
qualified instructor and also from the interaction and support that
occurs in a group setting.

Meanwhile, I want to give you a taste of how simple it can be to

incorporate mindfulness in your daily life with a simple exercise that
you’ll be able to deploy anytime you want.
Here it is.

It’s called STOP and it has 4 steps:

1. S toP. All you have to do here is pause whatever you’re doing and stop
for a second.

2. T ake a breath. Pay attention to your breath. Notice when the in-
breath begins (try to feel it in your body: belly, chest or nostrils), and when
the out-breath begins, unfolding, dissolving… You don’t have to breath in any
particular manner nor try to control the breath, only pay attention to how it
feels in your body.

3. O bserve. Now pay attention to what is going on, both outside and
inside. What sensations are you feeling right now? What emotions might be
present for you? What thoughts show up? How’s the weather inside your
mind?

4. P roceed. Here you choose what your next best action is going to be
and simply proceed with whatever you have to do.

It’s that simple. I promise: it took you longer to read the whole description
than it will to actually do the exercise.
 Try it and then let me know how it went.
(You can shoot me an email at jssanguesa@gmail.com)

Now that’s all for now, and I invite you to watch for my future emails
because I’ll be sending you cool stuff and resources to help you in
your journey to overcome ADHD.

ADHD can be frustrating and confusing, but I assure you that with
the right tools and a little help you CAN improve.
About the
author

Juan Sangüesa is a Clinical Psychologist

based in Chile and a UCLA Certified
Mindfulness Trainer. He specializes in
cognitive-behavior therapy for adult
ADHD.

Juan received his clinical training at

Universidad Catolica de Chile, where
he also attended graduate school. And
thereafter he went to the US several
times in search of more professional
training both in mindfulness and
mindfulness based therapies. Ultimately
he completed the year long program for
mindfulness facilitators at UCLA’s Mindful
Awareness Research Center (MARC).