By: Dr. Brianna Henning, DSW, LCSW | PILLARS OF WELLNESS

When beginning the journey into parenthood, many parents envision what pregnancy will look like, how labor and delivery will go, and what life will be like once they bring their baby home. This is especially true for mothers. Many spend time imagining each trimester, creating a birth plan, and thinking about what bonding with their baby will feel like. Unfortunately, what they envision does not always become reality.

Many mothers do not experience the immediate, overwhelming bond with their baby that is often portrayed in media or discussed by others. For some, that connection develops gradually over time. When this happens, mothers may wonder if they are doing something wrong. So, why does this happen? Why do some mothers not experience that immediate bond?

What Can Affect the Bonding Process?

Author Ayo Ayeni (2023), writing for a Postpartum Support International (PSI) article, highlights several factors that may contribute to delayed bonding with a baby. One significant factor is the presence of perinatal mental health conditions, which can occur during pregnancy or after childbirth. Common conditions include anxiety disorders, depression, and postpartum psychosis.

The Postpartum Den (2026) also discusses how these conditions can affect a mother’s ability to bond with her baby. From feeling emotionally numb or disconnected to experiencing constant worry, worst-case-scenario thinking, or a persistent sense of doom, these challenges can make it difficult to form that early connection. Both articles also note that a traumatic birth experience or having a baby admitted to the NICU can affect bonding. Mothers may feel disconnected from their bodies after a traumatic delivery, while early separation from their baby can interrupt the bonding process.

The Role of Emotional Burnout

Another important factor is emotional burnout. Sleep deprivation, feeling overwhelmed, and having little time or energy to care for yourself are incredibly common during the postpartum period, especially for mothers. When you’re simply focused on meeting your baby’s needs and making it through each day, developing an emotional connection may feel more difficult. While these are some of the more common reasons bonding may take time, every mother’s experience is unique, and there are many factors that can influence this process. So, what are some ways to help promote bonding with your baby?

Ways to Strengthen the Bond With Your Baby

Both PSI author Ayo Ayeni and expert Dr. Dotun Ogunyemi offer several helpful suggestions. One recommendation is skin-to-skin contact, which encourages the release of oxytocin, often called the “bonding hormone,” while also helping regulate a baby’s body temperature, heart rate, and breathing. Breastfeeding is another activity that may help some mothers feel closer to their babies. However, if breastfeeding is not possible or is not the right choice for your family, that is completely okay. There are many other meaningful ways to build a strong bond.

Intentional everyday interactions can also strengthen the parent-child relationship. Talking to your baby, singing, giving gentle infant massages, making eye contact, reading books together, or simply spending quiet time together are all opportunities to nurture connection. Over time, these consistent, positive interactions can deepen a mother’s bond with her baby.

You Are Not Alone

Many mothers feel pressure to experience an immediate connection with their baby, but that, simply, is not everyone’s experience. These authors note that approximately 1 in 5 mothers do not feel that instant bond after birth. They also emphasize that bonding is a process that develops and deepens over time.

If you do not feel immediately bonded with your baby, or if your relationship doesn’t look like what you see portrayed in movies, social media, or other forms of media, you are not alone. Bonding is not measured by one moment, it is built through countless moments of love, care, and connection over time.

References

American College of Obstetricians and Gynecologists. (n.d.). Bonding with your newborn: Here’s what to know if you don’t feel connected right away. https://www.acog.org/womens-health/experts-and-stories/the-latest/bonding-with-your-newborn-heres-what-to-know-if-you-dont-feel-connected-right-away

Postpartum Support International. (2023, December 13). Mother-infant bonding: It’s not always instant. https://postpartum.net/mother-infant-bonding-its-not-always-instant/

The Postpartum Den. (2026, March 18). Bonding with your baby: It’s not always instant. https://thepostpartumden.com/how-protecting-the-mother-baby-bond-supports-maternal-mental-health/

If you or someone you know could benefit from support, Pillars of Wellness is here to help. Our Maternal Mental Health team provides compassionate, evidence-based care for individuals navigating pregnancy, postpartum, and the emotional complexities of early parenthood. Please visit pillarsinspires.com or call (219) 323-3311 for more information or to schedule an intake. Most insurances are accepted.

The post Bonding With Your Baby: Why It’s Not Always Instant and What You Can Do appeared first on Pillars of Wellness.

By: Shelbi Goble, MS, LMHC | PILLARS OF WELLNESS

If you’ve ever coached, parented, or been an athlete, you’ve likely seen it: The athlete who trains hard, shows up consistently, performs well… and still doubts themselves.
Confidence in sport isn’t just about performance. The pressure, identity, expectations, and internal dialogue shape it; and across sports and levels, many athletes struggle with confidence that feels unstable, rising with success and crashing with setbacks.
So, the question becomes: How do we build confidence that actually lasts?

The Hidden Struggle Behind “Mentally Tough” Athletes

Athletes are often described as mentally tough, and many are. But the same traits that drive performance can also create vulnerability. Across sports, athletes commonly experience:

• Perfectionism and fear of failure
• Performance anxiety
• Negative self-talk
• Over-identification with sport performance and the athletic identity
• Constant comparison to others

These patterns can create a fragile, unstable confidence. When confidence depends on outcomes, such as wins, stats, and rankings, it becomes inconsistent and difficult to sustain.
Research consistently shows that confidence is not a fixed trait, but a dynamic construct influenced by context, experience, and psychological processes (Vealey, 2001).

Why Traditional “Mindset” Approaches Fall Short

Many mental training approaches emphasize controlling thoughts:

• “Stay positive”
• “Replace negative self-talk”
• “Be confident”

But here’s the reality: you cannot fully control your thoughts, especially under pressure.
In fact, trying to eliminate doubt often amplifies it. Athletes can become stuck in a cycle of:

• Fighting thoughts
• Becoming more aware of them
• Feeling even less in control

This creates more anxiety and self-doubt, not less. What athletes need isn’t better thought control, but rather a different relationship with their internal experiences.

A More Effective Approach: Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy (ACT), developed by Steven C. Hayes, offers a different framework.
Instead of trying to change the content of thoughts, ACT focuses on increasing psychological flexibility, the ability to stay present, open, and engaged in meaningful action, even in the presence of difficult thoughts and emotions (Hayes et al., 2012).
Psychological flexibility allows athletes to:

• Experience anxiety and self-doubt without being controlled by it
• Notice negative thoughts without buying into or attaching to them
• Stay present during performance
• Act in alignment with values, not fear or avoidance

In other words, an athlete can think: “I’m feeling nervous… and I can still perform.”

The Core Processes That Build Real Confidence

ACT develops psychological flexibility through six interconnected processes:
1. Acceptance
Athletes learn to make space for discomfort (e.g., anxiety, pressure, fatigue) rather than avoiding it. Avoidance may reduce short-term discomfort but limit long-term performance (Hayes et al., 2006).
2. Cognitive Defusion
Instead of getting stuck, or fusing with thoughts like “I’m not good enough,” athletes learn to see thoughts as mental events, not facts. This reduces the impact of thoughts or feelings on behavior.
3. Present-Moment Awareness
Focus shifts from past mistakes or future outcomes to what is happening right now, where performance actually occurs (Kabat-Zinn, 1994).
4. Self-as-Context
Athletes develop a broader sense of self that is not defined by performance, results, or temporary setbacks, including body acceptance. Through this, they also broaden their identity outside of their sport. Who am I outside of being an athlete?
5. Values Clarification
Rather than chasing outcomes, athletes identify what truly matters to them, such as growth, effort, teamwork, and resilience, and use those concepts as a compass to direct choice and action.
6. Committed Action
Athletes take consistent, values-driven action, even when it’s uncomfortable or difficult. For example, the athlete will consistently practice a skill, even if it brings discomfort when they do not get the skill right the first time.
Together, these processes help athletes move from reactive to intentional performance.

What This Means for Confidence

• Traditional confidence is often outcome-based: “I feel confident because I performed well.”
• ACT builds values-based confidence: “I can show up and perform in alignment with who I want to be, regardless of the outcome.”

This type of confidence is:

• More stable
• More resilient to setbacks
• Less dependent on external validation

Research shows that psychological flexibility is associated with improved emotional regulation, resilience, and performance consistency in athletes, thus leading to improved confidence (Ho et al., 2022).

What This Looks Like in Practice

This approach is highly practical and directly applicable to sport.
With ACT, athletes learn how to:

• Handle negative thoughts during performance without spiraling
• Stay present instead of overthinking
• Respond to mistakes without losing composure
• Continue performing effectively under pressure
• Reconnect to purpose during slumps or injury

Instead of trying to “feel confident” first, athletes learn to act with confidence, even when doubt is present.

Why This Matters

Confidence impacts far more than performance. It influences:

• Motivation and persistence
• Mental health and overall well-being
• Identity development
• Long-term sport participation

When confidence is fragile, athletes are more likely to disengage from their sport or give up when things get difficult. Not because they lack ability, but because they lack sustainable psychological skills.

Final Thoughts

Confidence is not built by eliminating self-doubt. It’s built by learning how to move forward with it by your side, instead of in the driver’s seat.
When athletes develop psychological flexibility, they gain the ability to:

• Handle pressure
• Adapt to challenges
• Stay grounded in who they are

And ultimately, they don’t just become better performers. They become more resilient, self-aware individuals, as one D-1 athlete’s wellness journey shows.
That’s the kind of confidence that lasts.

References

Hayes, S. C. (2004). Acceptance and Commitment Therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy, 35(4), 639-665.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). Guilford Press.
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and Commitment Therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1-25.
Ho, Y. Y., et al. (2022). Acceptance and Commitment Therapy in sport psychology: A systematic review. Journal of Contextual Behavioral Science, 24, 1-15.
Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. Hyperion.
Vealey, R. S. (2001). Understanding and enhancing self-confidence in athletes. In R. N. Singer, H. A. Hausenblas, & C. M. Janelle (Eds.), Handbook of sport psychology (pp. 550-565). Wiley.
If you or someone you know could benefit from support, Pillars of Wellness is here to help. Our Sport Psychology & Performance Coaching team works with athletes at every level. Please visit pillarsinspires.com or call (219) 323-3311 for more information or to schedule an intake. Most insurances are accepted.

The post Building Stable Confidence in Athletes: Why Mindset Alone Isn’t Enough appeared first on Pillars of Wellness.

By: Korynn Amm, MA, LMHC-A, NCC, 500CYT, Wellness Specialist | PILLARS OF WELLNESS

Trauma and Disconnection from the Body

According to Felicia Cover’s dissertation, The Experience of Implementing Trauma-Informed Yoga through the Eyes of the Clinician (2022), Americans face approximately a 1 in 12 chance of experiencing a traumatic event severe enough to induce Post-Traumatic Stress Disorder (PTSD) before the age of 75. However, in the wake of COVID-19 and rising racial tensions, this number is likely even greater today.

Trauma can change the way we experience and relate to our bodies. The body serves as an anchor for our sense of self and how we interact with the world around us. Through constant communication between the brain and body, we process physical sensations, emotions, thoughts, and experiences. Our nervous system continuously receives information from within the body, such as heart rate, muscle tension, and breathing, as well as from the external environment, organizing these signals and using them to guide our responses and behavior. Trauma, especially severe or chronic trauma, can disrupt these neural pathways and interfere with how sensory information is processed and integrated. Research on Post-Traumatic Stress Disorder (PTSD) and its dissociative subtype (PTSD+DS) shows that trauma can alter multisensory processing, which affects thinking (cognition), emotion regulation, social connection, and our sense of self (Kearney & Lanius, 2022).

Trauma survivors may experience a nervous system that remains stuck in a defensive state, leading to chronic sensory and emotional overwhelm. Common signs of this include being hypervigilant or shut down, difficulty regulating emotions, impulsivity, reduced sense of agency or control, social withdrawal, or difficulties in relationships. Research suggests that trauma is not solely stored as memories or thoughts; it is experienced through the body and nervous system. Because trauma disrupts the brain-body connection, healing often requires approaches that engage the body directly. Yoga may help restore awareness of bodily sensations, improve nervous system regulation, strengthen the sense of agency, and rebuild a felt sense of safety within one’s own body (Kearney & Lanius, 2022).

What Trauma Research Tells Us About Embodiment

Bessel van der Kolk is one of the most influential trauma researchers and clinicians in the world. He is a psychiatrist, educator, and researcher best known for helping shape our modern understanding of how trauma affects both the brain and the body. He has spent decades studying Post-traumatic stress disorder (PTSD), childhood trauma and adverse experiences, dissociation, the relationship between the nervous system and healing, and body-based approaches to trauma recovery, including yoga, movement, neurofeedback, and mindfulness.

Van der Kolk is perhaps most widely known for his bestselling book The Body Keeps the Score, which brought the concept of the mind-body connection in trauma to a broad audience. In the book, he argues that trauma is not simply a story stored in memory but an experience that becomes embedded in the nervous system, physiology, and body.

Van der Kolk et al. (2014) noted in his research that traditional PTSD treatments tend to focus on thoughts and symptoms, whereas trauma also affects a person’s relationship with their body. Trauma survivors often experience a reduced awareness of bodily sensations, difficulty identifying and expressing emotions (alexithymia), problems regulating emotional responses, and an altered perception of internal bodily states. Because body awareness is essential for emotion regulation, reconnecting with physical sensations may be a key part of healing. Van der Kolk et al. (2014) argued that healing from trauma involves more than changing thoughts; it also requires restoring awareness of the body and its internal signals. By helping individuals notice and tolerate bodily sensations such as breath, tension, and arousal, yoga offers a pathway to healing that complements traditional talk therapy and addresses the profound impact trauma has on the mind-body connection (van der Kolk et al., 2014).

Why Yoga Helps: Breath, Choice, and Interoception

Yoga is a 3,000-year-old mind-body-spirit practice that integrates physical movement with mindful attention to breath, energy, and internal experience. The term “yoga” comes from the Sanskrit root yuj, meaning “to yoke” or “to unite,” and is often understood today as a practice of union between body, mind, and awareness.

Mindfulness can be developed through several therapeutic approaches, including Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), and Mindfulness-Based Stress Reduction (MBSR), all of which have shown benefit in trauma treatment. However, some researchers argue that purely cognitively (mind) focused interventions may offer a more indirect route to addressing the dysregulated physiological responses triggered by traumatic memories or reminders (Minton, Ogden, & Pain, 2006; van der Kolk, 1996). In contrast, incorporating body-based practices such as yoga may provide a more direct pathway to healing by emphasizing present-moment awareness and engaging the body to strengthen interoceptive awareness. Interoceptive awareness is your ability to notice and interpret internal bodily sensations. In simpler terms, it’s how well you can “feel inside your body” and understand what those signals mean. This increased awareness can support individuals in noticing and tolerating internal physical and physiological states rather than avoiding them, ultimately enhancing their ability to respond to internal cues in a more adaptive way.

Emerson and Hopper (2011) shares that there are two primary roots to our suffering: craving (greed, grasping, clinging, addiction) and aversion (fear, terror, hatred, avoidance, anger, and resentment). Trauma is an all-encompassing, deeply embedded aversive state that becomes hardwired and persistent in the nervous system. “An experience becomes traumatic when this natural fight/flight defense is aborted” (Emerson and Hopper, 2011).

When someone is in the middle of a traumatic experience, the mind often goes into survival mode, sometimes shutting down, fragmenting awareness, or narrowing attention just to get through it. But the body doesn’t simply “turn off.” It holds onto the survival responses that were activated in that moment: fight, flight, freeze, or collapse. Especially in states of freeze or helplessness, the nervous system records a powerful message of “I had no control here.” That imprint doesn’t stay in the past in a neat, cognitive way; it lingers as felt experience (Emerson & Hopper, 2011).

For many trauma survivors, this is why the aftermath shows up less like a clear memory and more like sensation: tightness in the chest, nausea in the gut, shallow breath, tension, dizziness, numbness, or a deep internal sense of dread. The body can respond as if the danger is still happening, even when intellectually the person knows they are safe. This is because trauma is stored and reactivated through sensory and physiological pathways, not just narrative memory.

This is where yoga becomes both powerful and, at times, initially uncomfortable for trauma survivors. Yoga asks us to turn inward, to notice breath, sensation, and internal experience. But for a body that has learned “inside is where danger lives,” that invitation can feel counterintuitive or even unsafe at first. The very act of noticing the body can activate protective responses, because the body has been associated with overwhelm, violation, or loss of control.

And yet, this is also where healing begins to shift. Contemporary neuroscience increasingly supports the idea that our sense of self is deeply rooted in interoception, the ability to perceive and interpret internal bodily signals. In trauma, that connection between mind and body can become disrupted or dysregulated. We may feel disconnected, flooded, or unable to accurately read what our body is communicating (Emerson and Hopper, 2011).

Healing as a Return to Ourselves

When people think of yoga, they often think of stretching, flexibility, or difficult poses. However, in the traditional yogic understanding, these physical practices are only one small aspect of a much larger path. Yoga gently works to rebuild that connection. Rather than forcing awareness, yoga invites individuals to gradually reconnect with their bodies in a way that emphasizes personal choice, respects individual pacing, and reinforces a sense of safety. Through this process, the nervous system can begin to experience the body not as a source of danger, but as a source of grounding, stability, and self-awareness. Over time, this can help the body learn a new association: that internal awareness does not automatically equal danger. Instead, it can become a place of grounding, regulation, and reconnection.

In that sense, yoga is not about “fixing” the trauma but about supporting the nervous system as it relearns safety in the body. The trauma may belong to the past, but the body’s alarm system can continue reacting as if it is still present. Healing involves slowly updating that system, bringing the body back into the present, where the danger is no longer happening, even if it still feels that way for a while. Disconnection from the body and self can reduce awareness of danger, stress, and personal needs. As a result, individuals may struggle to respond effectively to stressors, engage in self-care, and develop meaningful relationships with others (Emerson and Hopper, 2011).

Many traditional therapies use a cognitive, or “top-down,” approach that focuses on thoughts and beliefs. Yoga-based interventions use a “bottom-up” approach that begins with bodily sensations and physical experiences. Through movement, breathing, and mindful awareness, yoga helps individuals reconnect with themselves and their bodies. It encourages people to stay present, notice their internal experiences, and develop greater comfort with what they feel. Over time, this increased self-awareness can improve emotional well-being, mental health, and relationships with others (Emerson and Hopper, 2011).

In “A Practical Approach to the Eight Limbs of Yoga,” Sharma (2023) explains that yoga is far more than physical postures; it is a comprehensive system for ethical living, self-discipline, mental focus, and spiritual growth. Drawing from Patanjali’s Yoga Sutras, the article presents the Eight Limbs of Yoga as a practical roadmap for achieving harmony of body, mind, and spirit. The eight limbs are:

• Yama – Ethical principles that guide how we relate to others (e.g., nonviolence, truthfulness, non-stealing).
• Niyama – Personal observances and self-discipline (e.g., contentment, self-study, purity).
• Asana – Physical postures that cultivate stability, strength, and comfort in the body.
• Pranayama – Breath regulation practices that influence physical and mental wellbeing.
• Pratyahara – Withdrawal of attention from external distractions to develop inner awareness.
• Dharana – Concentration or sustained focus on a chosen object or point of attention.
• Dhyana – Meditation, in which concentration becomes continuous and effortless.
• Samadhi – A state of deep absorption, unity, or self-realization.

The article emphasizes that these limbs are interconnected rather than isolated practices. While many people in the West primarily associate yoga with physical postures, Patanjali’s model suggests that true yoga involves ethical behavior, self-reflection, breath awareness, concentration, and meditation. Following the eight limbs helps individuals cultivate self-control, reduce suffering, improve health, and move toward a more meaningful and purposeful life.

For trauma-informed work, this distinction is especially important. Yoga is not about achieving the “perfect pose” but about learning to meet the body with curiosity, awareness, and choice. The practice offers opportunities to notice sensations, regulate the nervous system, and attune to self, and reconnect with oneself in the present moment, making it a powerful tool for healing and self-discovery.

Conclusion

Trauma can leave us feeling disconnected from our bodies, our emotions, and even from ourselves. While traditional therapies can play an important role in healing, recovery often involves more than understanding what happened; it also involves reconnecting with the body that carried us through it. Through breath, movement, mindfulness, and the freedom to choose what feels right in each moment, yoga offers a gentle pathway back to ourselves. Over time, it can help cultivate a greater sense of safety, presence, and trust within the body. In this way, yoga is not simply a form of exercise, but an invitation to reconnect with who we are beneath the wounds we have carried, a compassionate journey of coming home to ourselves.

References

Cover, F. D. (2022). The experience of implementing trauma-informed yoga through the eyes of the clinician (Doctoral dissertation, The Chicago School of Professional Psychology). ProQuest Dissertations & Theses Global. https://www.proquest.com/openview/d4a2606bf7ac1d1595d64eb31b510114

Emerson, D., & Hopper, E. K. (2011). Overcoming trauma through yoga: Reclaiming your body. North Atlantic Books.

Kearney, B. E., & Lanius, R. A. (2022). The brain-body disconnect: A somatic sensory basis for trauma-related disorders. Frontiers in Neuroscience, 16, Article 1015749. https://doi.org/10.3389/fnins.2022.1015749

Minton K, Ogden P, Pain C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. W.W. Norton & Company, Inc.

Sharma, D. (2023). A practical approach to the eight limbs of yoga. Annals of Yoga and Physical Therapy, 6(1), 1052. https://doi.org/10.26420/annyogaphysther.2023.1052

Van der Kolk, B. A., Spinazzola, J., Stone, L., West, J., Rhodes, A., Emerson, D., & Suvak, M. (2014). Yoga as an adjunctive treatment for posttraumatic stress disorder: A randomized controlled trial. Journal of Clinical Psychiatry, 75(6), e559-e565. https://doi.org/10.4088/JCP.13m08561

If you or someone you know is navigating the effects of trauma, you don’t have to do it alone. At Pillars of Wellness, our clinicians provide compassionate, evidence-based care tailored to your unique needs, including approaches like mindfulness and yoga-informed therapy. Whether you’re looking for individual therapy, specialty services, or our Rapid Relief Intervention Program, we’re here to support you. Meet our team or call us at (219) 323-3311 to get started today.

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By: Jessi Kiefor, MA, LMHC, NCC | PILLARS OF WELLNESS

Someone you love dies. A friend reaches out and says, “I didn’t want to bring it up in case it made you sad.”

They meant well. They almost always do.

But here is what that message communicates: your grief is too much to handle. Bringing it up will make it worse. You probably weren’t thinking about it before I said something, and now I’ve ruined it.

None of that is true. And yet we say versions of it all the time.

The Lie We Were Taught

From a very young age, most of us were taught that discomfort is dangerous. That if something hurts, we should move away from it. That a good friend protects you from pain rather than sitting inside it with you.

We say things like: “I didn’t want to upset you;” “I didn’t want to bring up bad memories;” “I didn’t want to make you cry.”

We dress avoidance up as kindness, and underneath it, we are really saying one of two things: “I don’t think you can handle this,” or “I can’t handle it if you get emotional in front of me.”

It is discomfort and avoidance wrapped in a caring tone.

What Avoidance Actually Does

Here is what I have seen, both in the research and in the therapy room: avoiding pain does not make it smaller, it keeps it exactly where it is.

When we stop talking about someone who died, we don’t protect the grieving person. We isolate them. We send the message that their loss is something to be managed quietly rather than carried openly. We take away one of the most powerful tools in the healing process: being witnessed.

Grief is dynamic, shifting, and deeply personal. Some days the loss feels fresh even years later, some days it doesn’t. What helps people move through it is not avoiding the pain, but building a new relationship with it. A new narrative. A new meaning.

That process requires leaning in, not away.

We Are Socially Trained to Do the Opposite of What Helps

The problem is bigger than grief. We live in a culture that treats discomfort as failure. A culture that values “good vibes only,” tells people to stay positive, look on the bright side, and not dwell.

What we are really saying is, “I care about you, but I do not know how to be with you in this pain.”

This is how avoidance becomes a social norm, and it is exactly why so many people struggle. Avoiding fear does not make fear smaller. It makes fear louder. Every time we sidestep something uncomfortable, we teach our nervous system that it was worth avoiding.

Fear grows, and the world shrinks.

What Courage Builds

Therapists have a name for what happens when you stop avoiding. It is called inhibitory learning, and it is the reason exposure-based therapies work. The brain does not learn safety by being told something is safe, it learns by experiencing it directly.

You cannot always think your way out of fear. Sometimes you need to walk through it.

This is the foundation of Exposure and Response Prevention therapy. Clients are guided to face the very things that feel unbearable, not because suffering is the goal, but because tolerance is built through contact.

Every exposure is a vote for a bigger life. Every time you stay in the discomfort instead of escaping it, your nervous system recalibrates.

The same principle applies outside the therapy room. When a friend asks how you are really doing after a loss and stays present when the answer is hard, that is an exposure. When you say the name of the person who died out loud and let yourself feel it, that is an exposure. When you stop pretending you are fine and let someone actually see you, that is an exposure.

Over time, what feels unbearable becomes something you can carry. Not because the pain disappears, but because you discover you are stronger than you thought.

Leaning Into Growth

Real healing is not about going back to who you were before. It is about becoming someone who carries things differently when you feel it instead of outrunning it. Not without weight, but with more space around it. That is what meaning-making looks like, not an answer to the pain, but a different relationship with it.

That starts with someone being willing to bring it up, to ask the hard question, to sit with you while you answer it. It starts with choosing presence over comfort. And sometimes, it starts with a therapist who understands that healing is not about feeling better. It is about getting better at feeling.

If you or someone you love is struggling with grief, anxiety, OCD, or the weight of unprocessed pain, Pillars of Wellness provides evidence-based, values-driven care across Northwest Indiana and Chicagoland.

info@pillarsinspires.com | (219) 323-3311 | pillarsinspires.com

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By James Shuler, MRC, LPC, CRC, ADHD-RSP | Pillars of Wellness

Adult ADHD is increasingly recognized as a significant public health and mental health concern. While symptoms often originate in childhood, many individuals remain undiagnosed until adulthood, particularly those whose difficulties were attributed to personality traits, anxiety, depression, stress, or lack of motivation.

As mentioned in previous blogs, ADHD research and identification of characteristics (until the past decade) has focused on male population. Recently, more time and effort is dedicated to recognizing, identifying, and implementing strategies beneficial to women living with ADHD characteristics. Adult ADHD affects multiple domains of functioning, including career advancement, financial stability, intimate relationships, parenting, academic achievement, and emotional well-being. Recognition of both shared and gender-related symptom presentations is essential for accurate identification and treatment.

Core Characteristics of ADHD Common to Adult Men and Women

Although symptoms may vary in adults, several features consistently appear across genders. I want to start with looking at “What is meant by adult?” For this article, an adult is a person past the typical college age group or over the age of 26. A future article will address the transition from high school to college and the identification and impact during typical college age (17-26). Considering core characteristics of ADHD beyond this age group include six main areas of living.

• Executive Functioning Deficits: Difficulties with planning, prioritization, organization, task initiation, sustained effort, follow-through, time management, meeting deadlines, managing daily responsibilities, and translating intentions into consistent action despite understanding what needs to be accomplished.
• Attention Regulation Difficulties: Challenges sustaining attention, filtering internal and external distractions, effectively shifting between tasks, managing cognitive overload during transitions, maintaining focus during conversations or meetings, and regulating periods of hyperfocus that may result in loss of time awareness and neglect of competing responsibilities.
• Emotional Dysregulation: Increased sensitivity to criticism, frustration intolerance, irritability, emotional impulsivity, rapid emotional shifts, heightened reactions to perceived setbacks, difficulty aligning emotional responses with situational demands, and prolonged recovery from interpersonal, occupational, or personal disappointments.
• Occupational and Productivity Impairment: Chronic difficulties with punctuality, attendance, deadline management, productivity, project coordination, administrative organization, workload management, workplace consistency, achievement commensurate with abilities, and maintaining satisfaction and effectiveness across occupational responsibilities.
• Interpersonal and Financial Management Difficulties: Relationship challenges characterized by forgetfulness, inattentive listening, communication difficulties, emotional reactivity during conflict, household management concerns, and unequal responsibility distribution, accompanied by financial management difficulties including impulsive spending, budgeting challenges, missed payments, poor long-term planning, and inconsistent maintenance of financial records.

Considering the commonalities that both men and women typically experience, what are those aspects that each group reports or may experience that differ from their counterpart.

Adult ADHD Characteristics More Commonly Observed in Men

While individual variation exists, men are more likely to exhibit externalized characteristics in three main areas.

• Behavioral Impulsivity: Difficulties with impulse control characterized by rapid decision-making, risk-taking behaviors, sensation-seeking, financial impulsivity, frequent career changes, and limited consideration of long-term consequences.
• Occupational Instability: Recurrent career disruptions, difficulties with workplace expectations and supervisory relationships, inconsistent performance, and challenges maintaining stable occupational functioning despite adequate ability and training.
• Restlessness and Hyperactivity: Persistent internal restlessness, feeling constantly driven or mentally active, difficulty relaxing, intolerance of boredom, excessive activity, and a need for ongoing stimulation.

Adult ADHD Characteristics More Commonly Observed in Women

Women frequently present with fewer externally visible symptoms and may remain undiagnosed for decades.

• Internalized Symptoms: Chronic feelings of overwhelm, mental exhaustion, self-doubt, anxiety related to disorganization, excessive self-monitoring, and persistent feelings of inadequacy despite objective success and achievement.
• Compensatory Perfectionism: Reliance on excessive preparation, perfectionistic standards, overworking, extensive organizational systems, and substantial effort devoted to masking or compensating for underlying difficulties.
• Invisible Functional Impairment: Outward competence accompanied by significant challenges managing household responsibilities, scheduling demands, parenting roles, administrative tasks, and the cumulative emotional burden of maintaining daily functioning.
• Relationship-Based Distress: Heightened sensitivity to rejection, chronic guilt, concerns about disappointing others, emotional fatigue associated with caregiving responsibilities, and difficulties balancing personal, family, and occupational demands.

Conclusion

Adult ADHD is a complex neurodevelopmental condition affecting multiple aspects of daily living. Whether male (exhibiting more external characteristics) or female (living with internalized aspects), assessment and therapy demonstrate benefits whether common or specific characteristics to their gender. Trained professionals with specific knowledge of characteristics of ADHD can recognize these patterns that frequently are misdiagnosed, whereas a comprehensive assessment can provide clarity, reduce self-blame and increase awareness of effective strategies to improve and enhance daily functioning and quality of life. Therapy can help you harness characteristics mentioned in this article as well as demonstrate your true ability and facilitate using the positive aspects of ADHD (which is an entirely separate article commonly not discussed)

Related Articles by James Shuler

• Understanding ADHD: Your Brain and Therapy
• Executive Function Affecting Relationships

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.; DSM-5-TR). American Psychiatric Publishing.

Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (4th ed.). Guilford Press.

Hinshaw, S. P., Nguyen, P. T., O’Grady, S. M., & Rosenthal, E. A. (2022). Annual research review: Attention-deficit/hyperactivity disorder in girls and women. Journal of Child Psychology and Psychiatry, 63(4), 484–510.

Young, S., Adamo, N., Ásgeirsdóttir, B. B., et al. (2020). Females with ADHD: An expert consensus statement. BMC Psychiatry, 20(404), 1–31.

Kooij, J. J. S., Bijlenga, D., Salerno, L., et al. (2019). Updated European Consensus Statement on diagnosis and treatment of adult ADHD. European Psychiatry, 56, 14–34.

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