Where Science Meets Soul: An Interview about Jungian Psychology and ADHD with Rebecca Stein, Part I of II

Rebecca Stein is a therapist with a practice that helps women build resiliency, focusing on ADHD and chronic pain. She is also a first first-year student in our Depth Psychology with Specialization in Jungian Psychology and Archetypal Studies (DJA) Ph.D. program. I’m delighted to speak with her about her professional experience and her first year at Pacifica.

Angela Borda: You are reaching the conclusion of your first year of student in the DJA program. How has that been and what led you to Pacifica?

Rebecca Stein: It’s been a life-changing experience. Before coming to Pacifica, I didn’t know too much about Jungian psychology; I’d only read some introductory books. But something kept calling me to apply. Once I was admitted, I looked further into archetypes, and my inner child very much related to that imaginal world that was so different from the clinical background that I have. I felt like I had a somatic body experience of feeling my whole body calm down when I engaged with the reading, in particular Carl Jung. I’m really lucky that my cohort gets along really well, and I feel like I’ve made life-long friends. Reading all the material and having various experiences, even my own individuation journey, has been an almost indescribable experience. I hope to write a book about some of the numinous experiences that I had even in the first quarter of beginning the program.

Angela: How does the study of archetypes feed your practice as a therapist? Do you know what you will ultimately focus on as your dissertation topic?

Rebecca: A lot of people have asked me this recently. Having ADHD, I have so many different ideas, so I have a running list of topics for a dissertation. One of which is related to Judaism in relation to Jungian psychology today. There’s a lot of interest in ADHD and chronic pain, two things that I specialize in, and the different therapies I use. I have a background in more Freudian psychology and ISTDP therapy, which is excellent, but I’ve found many times that something was missing, both for the therapist and the client. There’s something very rich with archetypes I’ve found, especially with the population I service, which tends to be people with ADHD. It reawakens this access to a rich inner life that maybe they felt ashamed to deepen because of societal structures that prioritize logic. I’m still navigating this, figuring out how to weave the two together. There’s something integrative in incorporating the aspects of the anima and animus, a union of these opposites that is needed collectively right now.

Angela: You’ve had a long road with ADHD. I have become increasingly aware of people within my close community who have symptoms that could easily be classified as ADHD, although it is not clear if that would be the medical diagnosis. My first question is why is this so hard to diagnose? How is it that people only find out they have ADHD when they are forty or fifty?

Rebecca: That’s a good question. There are different ways to answer. As a clinician, I can give one answer, but in a more Jungian way, I feel like Jung would give a different answer. Personally, I take both as being right in their own way. From a clinical perspective, women more than men have been misdiagnosed. So women can go through the system for years, myself included, doubting themselves and looking up to people like doctors to give us all the answers. Because of that, we might not trust our gut instinct that there’s something else going on. Women show symptoms differently, especially as children. There’s very much the stereotype of women needing to appear quiet and not as rambunctious as boys. So you might see a boy acting out in class, while a girl is also hyperactive, but it’s in her mind. Same thing with daydreaming, where a lot of women will mask by accomplishing things, to the detriment of their health. This perfectionism can also show up in co-morbid eating disorders. Stephen Hinshaw’s famous study on young girls with ADHD found that those who were misdiagnosed had higher incidences of suicide, self-harm, unplanned pregnancies, and sexual abuse. This is serious stuff. Also, since women internalize more than act out their symptoms, they may have insomnia, which might be misdiagnosed as bipolar with a very important and often missed differentiation. These women are tired but can’t turn off their brain.

The breaking point is often when people get older, because in your 40s typically people have children and the demands on them have increased significantly and they reach a level of severe burnout. Also, hormones definitely play a role in later diagnosis as we know that estrogen levels go down in perimenopause and menopause, which correlates with lower dopamine and various other neurotransmitters associated with executive functioning. Women with ADHD may have figured out ways to barely get by but when they hit their 40s the dopamine deficit makes their symptoms appear even more dramatically.

Overall, there is a real gender disparity in the research—where women undiagnosed have higher incidences of psychiatric hospitalizations. Since many of the ADHD research studies have left out girls, there has been unnecessary and sometimes re-traumatizing medical and institutional gaslighting where women’s symptoms are not taken seriously. Women with ADHD are also more likely to suffer silently in abusive romantic relationships.

That being said, men can also be diagnosed later in life. I’ve seen men diagnosed in their late 60s or later, which is unfortunate. Because you see patterns like addiction and substance abuse that was a way of handling those core symptoms that nobody knew about. It’s unfortunate that it usually takes a burnout, or the person’s spouse to nudge them in the direction of diagnosis. Lack of metacognition, or awareness, is common. So if you have ADHD and are married or living with someone, it may be your partner who says that might be something going on. You may have been diagnosed with anxiety or depression, but never got the right help. That’s the clinical perspective.

Angela: And the Jungian perspective on ADHD?

Rebecca: I recommend Scattered, by Dr. Gabor Maté, to all of my clients. He talks about the potential origins of ADHD. It’s a controversial topic, how much of it is biological and how much is experiential. But he makes really good points as to how the symptoms themselves first start appearing. For many of the inattentive or combined ADHD types, one of the first symptoms is going into this daydream world, which brings in the Jungian view. In Memories, Dreams, and Reflections, Jung talks about his own childhood and going into this dreamlike world, because he didn’t feel he belonged at school or at home. I don’t know what they would’ve diagnosed Carl Jung with, or if he was just different. I don’t think different has to be bad. Look at what Carl Jung created; it’s phenomenal. He very much had these theories way back before these modern-day therapies were created. He might have a different take on ADHD. We’re living in a world where it’s more neurotypical, where Logos and rationality are prioritized, which is the antithesis of Eros, of the feminine imagination, which is a super strength. It’s very much the thing lacking in the collective today, this lack of Eros and imagination, leading to trauma. So people with ADHD might be the very solution to the collective trauma of today.

In order to survive, we are taught that we need to produce a certain amount of things. And some of those things may be truly needed for survival. So that’s where the treatment of AHDH can help. But we need to balance this idea of needing to produce and get things done, while still embracing the strength of creativity.

Angela: You already touched on this a little. But I’ve noticed that often great distinction is made between how men and women manifest ADHD characteristics. Is this a distinction of socialization or physiology? Can you tell us more about what you’ve found in this regard?

Rebecca: I treat couples where one or more partners has ADHD. And you see this difference between genders very much. It’s a combination of women feeling like they need to work and take care of the kids and their spouse, and it’s overwhelming, so they end up masking. Men do it as well, but there’s much more that’s happening with women. From a Jungian perspective, it’s putting on a persona. It takes away the process of individuation, and women feel like they have no other choice but to put on this mask, because the alternative is such a great degree of rejection. Rejection sensitivity dysphoria is this feeling of intense fear of rejection that’s common with ADHD, and because of that, sometimes people do whatever they can to avoid that rejection. In my clients, I see women masking this and having too many responsibilities, and then they develop chronic illness and pain, and autoimmune conditions. Women sometimes don’t know how to manage that, because if they’re being truthful, it means showing themselves to their partner and saying they may need to do less, they may need extra strategies. And the fear of rejection is so strong that they feel the need to put on this mask.

INTERVIEW WILL CONTINUE IN PART 2.