Therapy for adults with ADHD, online: the waves that arrive ahead of thought, rejection sensitivity, the simple things that will not start, and the shame collected in the years you did not know. We are not here to repair your ADHD.
This is for you if
Do not start with me if
You are in crisis right now
If you are having thoughts of harming yourself, do not start with me. Call 999, or Samaritans on 116 123, free and around the clock in the United Kingdom. I am saying it plainly because the order matters, not to close the conversation down. The place here stays open afterwards.
Drink or drugs are running your life
This is not about willpower and it is not a judgement. When substance use comes first, work on ADHD has nothing to settle on, however well we do it. Specialist support for that first, and then we come back to what there was to talk about.
You need a diagnosis on paper
I do not diagnose and I do not prescribe. If that is what you are after, I will tell you where to look: what the options are in the United Kingdom and in Romania, the waits and roughly the costs. There is no need to book in with me to find out.
You want to walk out of here as someone else
If the aim is to stop having ADHD, to be more efficient, closer to what everybody else does, I am not your man and I would rather you knew from the start. I work in the other direction: understanding how you are built, and stopping the fight with yourself.
What this looks like day to day
You worked out thirty minutes to get to work. A blocked road makes you ten minutes late. Except you do not lose ten minutes, you lose the day: the breaks you had set aside go, the order of things tangles, and you walk in already tired. Nobody sees this from the outside. It is called the sense of time, and it does not run the same in everyone.
A three-line email. Brushing your teeth. You sit in front of it and your body will not start, even though your mind knows perfectly well what to do and how little it takes. And then comes the part that hurts more than the job itself: if I cannot even manage that, what is wrong with me?
Someone said something brief and has probably forgotten it already. You turn it over all day, hunting for where you went wrong, reconstructing the tone. The reaction arrives ahead of the thought that might have put it in context. It has a name, rejection sensitivity, and it can be worked with.
What we do together
We are not here to repair your ADHD.
Most of what hurts does not come from the ADHD. It comes from the years you were measured with somebody else’s ruler and came to believe something in you was broken. That is where we start, because until that is undone, any strategy sits on a foundation that will not hold you.
Then we get into what it costs you day to day. The waves that arrive faster than thought. The voice commenting in your head that you learned to believe. And the practical side, where I do not read you the list from the productivity books, but we look at the moments when something did work for you, because there were some, and try to understand why it worked then.
If you ask what I draw on: Schema Therapy, to see where the old patterns come from. Internal Family Systems, for the parts of you pulling in opposite directions. From Dialectical Behaviour Therapy I take what helps with regulation and with riding out the big waves. And polyvagal work is for what happens in the body a few seconds before you notice anything at all. I do not take them in turn, like a programme. They mix according to how you are that day.
The psychometric questionnaires
The questionnaires: before the first session, or shortly after it.
I set you up with an account in the client area and send you a small pack. Usually three short questionnaires about how you are doing generally, about mood and about anxiety. Nothing on ADHD yet, nothing long.
When it makes sense, usually within the first two sessions, the part that concerns us directly arrives: ADHD traits now and in childhood, executive functions, how quickly things ignite and how long emotional regulation holds. If something else turns out to be in play along the way, social camouflaging, burnout, sleep, I will send from there too.
You fill them in on your phone or your computer, at your own pace. You can stop halfway and come back tomorrow, your answers stay saved. You can change the font if the text tires your eyes, and you can turn off the automatic jump to the next question if it rushes you.
So it is clear what these are and are not: it is not an exam, it does not hand down a verdict, and it does not replace a formal assessment. It shows me where we are starting from, in numbers, so that at three or six months we can check whether something has actually shifted rather than just feeling that it has. You see the results too, in your own account, they do not stay with me alone. And if there is a questionnaire you would rather not do, you do not do it; I will tell you what we lose and we move on.
The first few months
The opening conversation, 30 minutes, free
We meet on Google Meet, you tell me in a few sentences what brought you, and you ask me what you want to know. It is not an interview and you do not need to prepare. If by the end you realise I am not the right person, you found that out in thirty minutes and for nothing, which is a good outcome.
The small pack of questionnaires
It lands in your account before the first session or straight after it, whichever suits you. Three short questionnaires, so we have a starting point in numbers rather than only in impressions.
The first session
I do not open with a list of questions. You tell me what brought you, at your own pace, and if you cannot find the words for something we wait for them. There is no homework to prepare.
The first four or five sessions
We draw the map: what ADHD looks like in you, not in everybody. What costs you most, where you get stuck, what you have tried that did not hold, and why it did not hold. This is usually where the first stone drops, when you see that a great many things you told yourself off for have an explanation.
The second and third months
We go into what hurts: the waves, the shame, the relationships in which you lose yourself. Alongside that we build strategies too, but starting from what has ever worked for you rather than from what ought to work.
How we know it is working
At the end of sessions I give you two short questions about how it went, and every few months we redo one of the opening questionnaires. Not for the sake of numbers: so that we are not going on impressions alone. If it is not working, we say so and change something.
How long it takes
I cannot promise you a number. Some people need three months, others two years. What I can promise is that we stop now and then to look together at where we have got to.
Questions people ask me
No. Some of the people I work with are waiting for an assessment, others have decided they do not want one, others simply recognised themselves and that was enough. I do not ask you for paperwork before I take you seriously.
No. If one blocks you or feels intrusive, say so and we drop it. I will only tell you what we lose without it, so that it is a decision of yours rather than an avoidance we discover three months later.
They sit in your account in the client area, the two of us see them, and you can reread them whenever you like. They go to nobody else, and they do not reach your GP or your employer unless you ask for that in writing. The details are on the privacy page.
There is, but for something else. Medication works on attention and impulsivity. It does not work on what you came to believe about yourself in the years you did not know, it does not repair the relationships that wore thin in the meantime, and it has nothing to say about shame. That is where I come in.
No, it is your decision and I do not negotiate it. I will be straight with you about what can be reached without it and what is harder, so you know what you are signing up for.
No. You can look elsewhere, you can pace, you can hold something in your hands, you can turn the camera off when it gets too much. None of that is rude with me and none of it means you are not present. Sessions are online only, on Google Meet, 50 minutes.
Of course, and it is not off the point. Most adults with ADHD come to therapy with something else in the foreground. We work with what is burning now, and the ADHD explains why certain things cost you more than they seem to cost other people.
A standard session is £80 for 50 minutes. There is a reduced rate of £50 for Romania and Eastern Europe. The opening conversation is free, 30 minutes.
One small step
You do not have to write to me today. You can start smaller.
What clients say
“In moments of confusion, Giancarlo asks questions that every single time give me those AHA! moments, through which I manage to understand even better why I am and react in a certain way. And what's most important, these realisations come from within me — they're not imposed on me.”
Adult ADHD — regulation, shame, and strategies that hold
Therapy for adults with ADHD, online: the waves that arrive ahead of thought, rejection sensitivity…
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