Emily Thomsen

How can I help you? 

Every client comes to me with different needs. Awareness is the first step and afterwards we put clear strategies in place. Often this needs to be combined with cognitive behavioral support to understand why you might be getting stuck with the obstacles.  Here is a breakdown of the ways that I can support you:

Individuals (children, teens and adults): 

• Pre-diagnosis Guidance-If you are questioning whether you have ADHD, I can help guide you to self-identification and then the clarity to move towards a more formal diagnosis with a doctor, nurse practitioner or psychologist.

   

• Misdiagnosis & Late-diagnosis Support-Finding out you have ADHD later in life can often be relief but also bring up a mixture of confusing feelings or shame. It is important to work towards acceptance and understanding how ADHD affects you (all the magnificence as well the frustration). 

   

• Navigating Newly Identified Neurodivergence- You may have been formally diagnosed and suggested medication. This leaves you with questions of understanding your brain and all the areas of ADHD and neurodivergence that make you think and act the way you do. 

   

• Executive Functioning-This is a big area for ADHDers. There will be things you manage well and other parts that you have difficulty with.  The idea of neuroplasticity (the brain's ability to reorganize itself by forming new neural connections) is an important aspect to start new habits or build structure when managing ADHD. By using cognitive training combined with behavioral therapies we can improve on the following areas: 

- Organization-Let’s get you to:  build organizational tools (using techie techniques or paper and pen), learn new systems and accommodations to succeed in school and work, and helpful ways to declutter.  

-Task Initiation-We want you to understand your challenges related to avoidance and lack of clarity about tasks. I can teach you how to breakdown tasks, support your dopamine levels, and understand your stimulus window. 

-Cognitive Flexibility- This often relates to “all or nothing” thinking. We want you to be aware of your difficulty with transitioning between activities and be able to adapt to sudden changes. We work on how to preplan coping responses for alternate scenarios and think outside the box.

-Planning- With ADHD it can be difficult to prioritize tasks or get stuck in perfectionism. This can cause A LOT of procrastination and focusing on the wrong things (usually what we are more interested in). We want to understand why and how you have these obstacles and overcome it through sequencing and prioritizing tasks.

-Time Management-Do you struggle to be on time, predict how long things will take or have decision paralysis? The ADHD brain struggles with an accurate perception of time. We work on the areas you get into trouble with time and develop strategies such as time blocking, technology supports and pacing systems. 

-Working Memory- This type of memory can be particularly difficult for ADHDers. It can be difficult to hold information or retrieve it (e.g. forgetting instructions, losing track of what you were doing, remembering details from conversations or something you just read). We try to support this through repetition, routines, using visual schedules/reminders, memory support strategies, habit stacking, and chunking. 

• Impulsivity- This can come out in many ways- saying things without a filter, buying stuff on a whim, having risky behavior, feeling impatient, struggling to wait your turn, or emotional outbursts. We work on recognizing triggers and thought patterns that lead to impulsivity, practicing “pause and delay” strategies, managing conversational impulses, and plan alternative action lists. 

   

• Depression & Anxiety- these two often co-exist with neurodivergence. Struggles with organization, time management, procrastination and overactive minds can lead to high levels of anxiety. Trying to manage daily tasks, avoid distractions and focus can lead to feelings of underachievement, self-doubt and burnout. It is important to understand what is causing the anxiety and how to work with it (rather than avoid). We can support you with techniques for nervous system regulation and working through negative thinking patterns.

• Emotional (Dys)regulation- I like to support clients by using this combination of strategies: 

  -Bottom-up approach- We look at the reptilian part of brain- when you are in SOS mode and involves rapid sensory input and quick reactions. We give you tools for soothing fight/flight mode, sensory overload, completing the stress cycle, and distress tolerance supports (DBT).

  -Top-down approach- This is related to the pre-frontal cortex and works with logic, reasoning and thoughtful analysis. Here we try to identify and process emotions, look at cognitive distortions, use reframing, and CBT. 

   

• Sensory Processing- I want my clients to be aware of any sensory triggers (noises, lighting, tactile, smells, etc..) and signs of sensory overload. We develop a sensory lens to understand more clearly what overstimulates or depletes them. We create a sensory safety plan to avoid overstimulation and build a sensory soother tool kit to counteract it. 

• Rejection Sensitivity Dysphoria- We want to discover how RSD affects you in relationships, school and work. We identify your triggers and patterns of behavior related to it. We try out strategies to use such as the survival technique, radical acceptance, and HARM free.

   

• Interest-Based Nervous System- It is important that ADHDers understand they have a distinct type of nervous system that is motivated by tasks that are interesting, creative or urgent. This explains much of the difficulty with task-initiation and lack of motivation. Once this is understood it is easier to identify challenges and strategies to work through it.

   

• Interoception- This is the ability to detect and respond to bodily sensations like hunger, thirst, pain and emotions.  Due to differences in brain functioning people with ADHD can struggle with eating on time, hydrating, getting overwhelmed from emotions, or overlook pain/injury.  We work on developing awareness of under or overresponding to signals, and identifying specifically what we need with reminders, useful apps, body scans and habits.

• Overwhelm & Burnout-This can be a common occurrence with neurodivergence.  Individuals often aren’t aware of their energy capacity or rhythms and can tend to go into a boom-and-bust cycle (pushing too hard and long without realizing you need some restorative time). We discuss the things/situations/experiences that energize or zap us and find new ways of pacing.

   

• (Un)masking- What is masking? Usually, it is behaving in ways that neurotypical people do to fit in, feel safe or avoid judgment. Some examples of this are: mimicking others’ behaviors in social situations (being careful to not overshare or say too much), reacting to situations as you think you are expected to instead of how you really feel,  developing perfectionistic tendencies in hopes that others will see how capable you are (at work, school, parenting, housecleaning), or hiding mental or physical restlessness to appear  in control.  Masking takes up loads of energy and can also lead to burnout and low self-confidence. We work on self-acceptance and self-compassion and finding ways to feel like our authentic selves without shame. 

   

• Sleep Problems- ADHD brains can make it difficult to fall asleep or stay asleep. We map sleep patterns and identify sleep issues and then work with interventions such as: sleep hygiene, sleep routine, sleep stimulus control, sensory supports, CBT-I, and relaxation strategies.

• Women: Gender plays a role in ADHD. We explore the following: 

-Women often have diagnostic challenges with inattentive symptom presentation related to inaccurate identification and treatment. 

-Their symptoms can be more internalized with mood and anxiety. 

-Hormonal fluctuations impact ADHD symptoms (but can be more severe during perimenopause), especially in the luteal phase, women can struggle more with a decrease in serotonin and dopamine which leads to increased difficulties with emotions and executive functions. 

-ADHD women feel the impact of societal expectations that lead to masking and camouflaging behavior.

• Couples: I work with couples that either one of both are neurodivergent. We explore where the problematic/stuck areas are and explore new ways of communicating, understanding how our brains work differently and strategies for shifting dynamics. Common difficulties in couples are: 

  -Breaking free from the child-parent dynamic where the non-ADHD partner can feel like a nag or resentful because they feel like they do most of the planning and organizing,

  -Difficulties with focus may seem like an ADHDer isn’t paying attention to their partner, and they can feel unheard or devalued.

  -Working memory can be an issue where an ADHDer might forget: to pick something up, important dates/appointments, something they had agreed on and then can appear like they are unreliable.

  -Emotional regulation is a struggle for many couples but ADHDers may have more trouble with it.  Impulsivity, rejection sensitivity, and a heightened nervous system are all areas to explore with regulation and co-regulation.

• Family:  

  -I provide parenting support- understanding your kid’s neurodivergent behavior, strategies for behavior management and emotion regulation, fostering a positive parent-child relationship, how to create structure and routine, and supporting challenges with executive function.

  -I give IEP Support & Advocacy-I help navigate the school system and look at what type of support your kid should receive, advocate for your kid’s IEP, and encourage accommodations that are specific to creating the optimum learning environment for them.

Neurodivergence: My information clearly focuses on ADHD but I want to be clear that in neurodivergence there is an abundance of co-occurrence with other ways our brains work. Many of my clients have also been diagnosed or self-identify as autistic, OCD, SPD, Tourette’s, dyslexia, learning/motor differences, giftedness or twice exceptional. I also have expertise with people with these wonderful brains.