ADHD Perfectionism: Driven by Shame
In ADHD, perfectionism is driven primarily by shame — a lifetime of trying hard and still falling short creates deep fear of being exposed as inadequate. The perfectionism becomes a protective strategy. But the executive function deficits of ADHD make achieving perfection almost impossible, which deepens the shame cycle. Procrastination and avoidance are the result.
Addictive Patterns as Self-Medication
Adults with ADHD have significantly higher rates of substance use, gambling, screen use, and compulsive shopping. These behaviours reliably produce dopamine in a chronically dopamine-deficient brain. Abstinence-only approaches without addressing the underlying ADHD are far less effective than integrated treatment.
Therapy for Both
CBT targeting shame-based cognitions that drive ADHD perfectionism, combined with ADHD-specific executive function strategies and trauma-informed work where relevant, produces meaningful lasting change.
Want to talk to someone who understands?
Dr. Sneha Goyal provides specialist assessment and therapy for perfectionism and ADHD at Enable Workplace Consulting, 156 Collins Street Melbourne CBD. Medicare rebates available.
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