Episode 12
A Radical Guide for Women with ADHD
Sari Solden and Michelle Frank, 2019
What changes when acceptance comes before strategy?
Juno and Beck are synthetic voices. They are not people, they are not clinicians, and nothing in this episode is about you. The script was drafted with AI assistance and edited and approved by Logan Williamson, a Licensed Professional Counselor in Texas and Louisiana.
Chapters
At the eyepiece
What the episode covers
Sari Solden, a psychotherapist, and Michelle Frank, a clinical psychologist, published A Radical Guide for Women with ADHD with New Harbinger in 2019, twenty-four years after Solden's Women with Attention Deficit Disorder. It is a workbook built on acceptance and commitment therapy with standard ADHD approaches folded in, and its argument is that shame, more than the symptoms, keeps capable women with ADHD small. The radical idea is radical acceptance: accepting your wiring as part of who you are, which the authors distinguish from resignation, and which they present as the step that frees energy for change. They split identity into three areas (your core sense of self, your feelings about your brain, and how you meet the world) and walk readers back to the messages they absorbed growing up. Its best story is an exercise for sorting old dreams, in which a girl's wish to be a rock star turns out to be a wish to be seen and heard, and is resized rather than thrown out. It is the mirror image of the book's chapter on hiding: staying quiet, apologizing first, not asking for help, turning down chances.
Beck checks the claims underneath the workbook, since the workbook itself has not been tested in a trial and does not claim to be. That adults with ADHD tend to be hard on themselves, and that it costs them, held as a link: in an online survey of 856 adults with and without ADHD, lower self-compassion helped explain poorer mental health, though a survey taken at one moment can't say which came first. That acceptance-based practice helps held partly, for a cousin of the book's method: in a randomized trial of 120 Dutch adults with ADHD, a mindfulness group added to usual care reduced clinician-rated symptoms, rated by clinicians who didn't know who'd been in the group, and a later analysis found that rising self-compassion explained feeling better but not the drop in symptoms. Two claims stay open. That being a woman makes the shame heavier: one study of 89 adults diagnosed in adulthood found lower self-esteem in both the women and the men with ADHD than in comparison adults, with no real difference between them, though self-esteem on a questionnaire isn't shame. And the acceptance method itself: an online program in Ireland combining ADHD education with acceptance and commitment therapy saw 257 adults rate their quality of life and self-acceptance higher afterward, with no comparison group.
Juno argues the book puts the strategies in the right order, after the part where readers stop calling themselves names; Beck grants the order but says a woman about to lose a job needs the deadlines met, and that a book about acceptance can sound like the other side of Barkley's argument that ADHD isn't a gift. The disagreement over the words (embrace last episode, radical in this one) joins the one over VAST and stays open. Juno shelves both Solden books, this one for a reader a few months past the diagnosis. The AI beat uses a chat window to brainstorm resized versions of old dreams, as a rehearsal room for a book that wants readers on a stage.
The scoreboard
What the book claimed,
and what held
One row for every claim the show checked on air, with the verdict in the show's own words and the method that produced each number. A figure from a registry and a figure from a twin study do not mean the same thing, so neither is printed bare. What each verdict means.
Held as a pattern
Adults with ADHD tend to be hard on themselves, and it costs them.
Beaton and colleagues, 2022. In an online survey of 856 adults (543 with ADHD, 313 without), lower self-compassion in the ADHD group helped explain poorer mental health.
MethodA cross-sectional questionnaire study with a structural equation model. It shows a link, not which came first.
Source01
Held
Acceptance does something beyond making you feel nicer.
Janssen and colleagues, 2019, and Geurts and colleagues, 2021. Among 120 adults randomized in the Netherlands, a mindfulness group added to usual care reduced clinician-rated ADHD symptoms through six months. Rising self-compassion explained the gain in well-being, not the drop in symptoms.
MethodA multicentre, single-blind randomized trial and a mediation analysis within it. Held partly: mindfulness-based cognitive therapy is a cousin of the book's acceptance and commitment approach, not the book's method.
Still arguing about it
Being a woman makes the shame of ADHD heavier, because of what women are expected to hold together.
Rucklidge and colleagues, 2007. Among 89 adults diagnosed in adulthood, both the women and the men with ADHD reported lower self-esteem than comparison adults, with no real difference between them.
MethodOne questionnaire study measuring self-esteem, not shame, which may miss what someone is hiding. The book's cultural account could still be right; the data comparing women with men haven't caught up to it.
Source04
Still arguing about it
The book's acceptance-based method helps women with ADHD.
Seery and colleagues, 2024. 257 adults in an online group program combining ADHD education with acceptance and commitment therapy rated their quality of life and self-acceptance higher afterward, and at three months.
MethodAn uncontrolled pre-post feasibility study of self-referred participants, so there is nothing to compare against. The workbook itself has not been tested in a trial, and it does not claim to have been.
Source05
Calibration
Sources
Every research claim on air is listed here with the method behind its numbers. Where a claim on air could not be traced to a source, it is named at the foot of this list rather than quietly left out, and the figure is not repeated on this page.
- Lower self-compassion helps explain poorer mental health in adults with ADHD.
Beaton DM, Sirois F, Milne E. The role of self-compassion in the mental health of adults with ADHD. J Clin Psychol. 2022;78(12):2497-2512. DOI
Online questionnaires completed by 543 adults with ADHD (62.7 percent female) and 313 without, University of Sheffield. A structural equation model found low self-compassion contributed to poorer well-being and greater depression, anxiety and stress in the ADHD group. Cross-sectional: it cannot show which came first.
- A mindfulness group added to usual care reduced ADHD symptoms.
Janssen L, Kan CC, Carpentier PJ, et al. Mindfulness-based cognitive therapy v. treatment as usual in adults with ADHD: a multicentre, single-blind, randomised controlled trial. Psychol Med. 2019;49(1):55-65. DOI
120 adults in the Netherlands randomized to eight weekly group sessions of MBCT plus treatment as usual (60) or treatment as usual alone (60). Clinician-rated symptoms, rated blind, fell more with MBCT (d = 0.41); 27 percent against 4 percent had a reduction of 30 percent or more. Self-reported self-compassion and positive mental health also improved; effects held to the six-month follow-up.
- Self-compassion explained feeling better, not the drop in symptoms.
Geurts DEM, Schellekens MPJ, Janssen L, Speckens AEM. Mechanisms of change in mindfulness-based cognitive therapy in adults with ADHD. J Atten Disord. 2021;25(9):1331-1342. DOI
Mediation analyses within the same trial (MBCT plus usual care, 43; usual care, 51). Increased self-compassion mediated improvement in positive mental health at six months; neither mindfulness skills nor self-compassion mediated the reduction in ADHD symptoms, which self-reported inhibition did.
- Women and men with ADHD didn't differ in self-esteem.
Rucklidge J, Brown D, Crawford S, Kaplan B. Attributional styles and psychosocial functioning of adults with ADHD: practice issues and gender differences. J Atten Disord. 2007;10(3):288-298. DOI
Questionnaires given to 52 women and 37 men with ADHD identified in adulthood and to 51 female and 40 male controls. Both ADHD groups reported lower self-esteem, more depression and anxiety and a more external locus of control than controls, with no specific gender differences within the ADHD groups. Across all participants, men reported lower self-esteem than women. Self-esteem was measured, not shame.
- An online acceptance and commitment therapy program, without a comparison group.
Seery C, Leonard-Curtin A, Naismith L, et al. Feasibility of the Understanding and Managing Adult ADHD Programme: open-access online group psychoeducation and acceptance and commitment therapy for adults with attention-deficit hyperactivity disorder. BJPsych Open. 2024;10(5):e163. DOI
257 self-referred adults with diagnosed or self-identified ADHD in a six-session online group program run with ADHD Ireland. Uncontrolled pre-post design. Quality of life, self-acceptance and ADHD knowledge rose after the program and held at three months; psychological flexibility rose by three months.
- Book details.
Solden S, Frank M. A Radical Guide for Women with ADHD: Embrace Neurodiversity, Live Boldly, and Break Through Barriers. Oakland, CA: New Harbinger Publications; 2019. Foreword by Ellen Littman.
Published July 2019, 216 pages, New Harbinger Self-Help Workbook series; the publisher describes it as combining traditional ADHD treatment with acceptance and commitment therapy. Confirmed in library catalog records (MCPHS, East Carolina University), the publisher's description as carried by booksellers, and Google Books. An audiobook followed in 2021.
- How the authors met.
Adulting with ADHD podcast. 'Radical Guide for Women With ADHD' pioneer Sari Solden on acceptance. https://www.adultingwithadhd.com/episodes/radical-guide-women-adhd
Solden says she met Michelle Frank at a conference in Detroit in 2013, that Frank joined her practice, and that both are women with ADHD. She describes radical acceptance as accepting differences in brain wiring and not as a description of who a person is.
- The first book's original subtitle.
Solden, Sari. Encyclopedia.com (Contemporary Authors entry). https://www.encyclopedia.com/arts/educational-magazines/solden-sari
Women with Attention Deficit Disorder: Embracing Disorganization at Home and in the Workplace (Underwood Books, 1995); revised tenth-anniversary edition 2005.
The book
A Radical Guide for Women with ADHD. Sari Solden and Michelle Frank, 2019.
This link earns Lone Star Telehealth nothing. The same book is at any bookseller or library, and your library is the cheapest way to find out whether you want it.
Book facts stated on air: title, subtitle and authors; Solden a psychotherapist and Frank a clinical psychologist; 2019, twenty-four years after Solden's first book; a workbook with exercises, built on acceptance and commitment therapy with standard ADHD approaches; the thesis that shame, more than symptoms, keeps women with ADHD small; difference read as a flaw of character, first by others and then by oneself; radical acceptance, distinguished from resignation; the authors' use of Carl Rogers on acceptance and change; identity in three areas (core sense of self, feelings about your brain, how you meet the world); early exercises on messages absorbed growing up; the first book's original subtitle about embracing disorganization; the sorting of old dreams and the rock-star example, resized to a local choir or an instrument; the chapter on hiding; taking up room and being seen and heard; noticing and choosing in the moment; strategies such as headphones, working in a coffee shop, and coaches and organizers, placed after the identity work; the authors meeting at a Detroit conference and Frank joining Solden's practice, and both being women with ADHD, from Solden's interviews. Several specifics (the hiding behaviors, the dream sorting and its example, the noticing-and-choosing practice, the strategies) were verified through published summaries of the book and the authors' interviews rather than the text itself. No passage is quoted.
Every word
Transcript
Every line, with the timestamp beside it. Tap a timestamp and the audio moves there.
Full transcript, 173 lines
Juno: Twenty-four years after her first book on women and ADHD, Sari Solden went back to the subject.
Beck: With a co-author this time. Michelle Frank, a clinical psychologist. And with a word on the cover she hadn't used before.
Juno: Radical.
Beck: Radical what, though?
Juno: The radical idea is that you stop trying to fix yourself.
Beck: Which is a bold line for a book that comes with worksheets.
Juno: That's today's question. Can a book tell you to stop fixing yourself and still help you get the bills paid?
Beck: We ran this experiment with Hallowell. Same author, a second try, and a lot of new evidence in between.
Juno: Today: A Radical Guide for Women with ADHD, Sari Solden and Michelle Frank, 2019.
Beck: The Observatory, from Lone Star Telehealth. One author, two books, back to back.
Juno: Last time Solden gave women a name for the shame, and I wanted to know which parts she'd still sign.
Beck: Most of them, it turns out. But this time she's less interested in the diagnosis than in the person standing under it.
Juno: So what are they arguing, on their own terms?
Beck: The symptoms aren't what keeps these women small. The shame is.
Juno: Say more.
Beck: Women with ADHD learn early that the way they think and work isn't the preferred way. Over the years, that difference gets read as a flaw in their character.
Juno: Read by whom?
Beck: Other people first. Then themselves. That second reading is what the book goes after.
Juno: So where does radical come in?
Beck: From radical acceptance, an idea out of mindfulness practice. You accept your wiring as part of who you are, and you stop treating yourself as a repair job.
Juno: That sounds a little like giving up.
Beck: They see that coming. Acceptance, in their telling, isn't resignation. It's dropping the verdict, so there's energy left for the work.
Juno: Huh.
Beck: They lean on an old idea from the psychologist Carl Rogers. Change tends to start once you stop fighting who you are.
Juno: That's an old idea to build a new book on.
Beck: Old, and still the step most people skip on the way to the planner aisle.
Juno: So acceptance first, and the change follows.
Beck: That's the bet the whole book makes.
Juno: Her first book's original subtitle was about embracing disorganization. This one says embrace neurodiversity, live boldly, and break through barriers.
Beck: From making peace with the mess to walking out in front of people.
Juno: Last time we heard her three Rs. The third was redefining how you see yourself. This whole book is that one, with room to write in.
Beck: Mm-hm.
Juno: And the identity part. They break it up, don't they?
Beck: Into three areas. How you see yourself at the core. How you feel about your brain. And how you meet the world.
Juno: And when those get knotted together, a missed deadline turns into a verdict on the whole person.
Beck: Right. A lot of the exercises are about pulling those strands apart.
Juno: Early on, it walks you back to the messages you picked up growing up. About what a capable woman is supposed to keep running.
Beck: So you can see where the voice in your head picked up its lines.
Juno: It's a workbook, then. Blanks and all.
Beck: Blanks and all. Built on acceptance and commitment therapy, with standard ADHD approaches folded in. I didn't fill any of them in.
Juno: You'd have had to invent a childhood.
Beck: And a dream to sort. We'll get to that.
Juno: How did they end up writing it together?
Beck: Solden has told it in interviews. They met at a conference in Detroit, and Frank later joined her practice.
Beck: Both are women with ADHD. And they kept meeting clients who were capable, whole people carrying a warped picture of themselves.
Juno: So the book came out of the room where they kept seeing that.
Juno: I've got a story to tell from this one, and it's a small one.
Beck: Go on.
Juno: There's an exercise about old dreams. The ones you had as a girl, before you started editing them down.
Beck: And you go back through them.
Juno: Like clearing out a closet. Some you keep. Some need updating. Some you finally let go of.
Beck: Which one's the story?
Juno: The girl who wanted to be a rock star.
Beck: Most kids want that for about a week.
Juno: And the book's point is that the stage was never the dream. The wish underneath was to be seen and heard.
Beck: Okay.
Juno: That's the page where the book stopped being a workbook for me. It's sad and it's useful at once.
Beck: Why sad?
Juno: Because the wish was so ordinary. She didn't want fame. She wanted to be listened to, and somewhere along the way she stopped asking to be.
Juno: So you don't throw it out. You resize it. A local choir. An instrument you learn because you like the sound of it.
Beck: And that's the mirror image of the chapter on hiding.
Juno: Walk me through that one.
Beck: They describe hiding as a habit that feels like safety. Staying quiet in the meeting. Apologizing before you've done anything.
Beck: Not asking for help. Keeping people out of a messy house. Turning down a chance before anyone can watch you struggle with it.
Juno: That's a lot of effort spent on not being seen.
Beck: And the book grants that it feels protective, for a while. Nobody sees the mess. Nobody sees you either.
Juno: So the rock star is the hiding turned inside out. A girl who wanted the whole room to hear her.
Beck: And a grown woman who says sorry before she speaks.
Juno: The last stretch of the book is about getting some of that girl back. Taking up room. Saying what you think at a normal volume.
Beck: With a practice for the moment itself, the way the book lays it out. Notice when you're running on shame and autopilot. Then choose.
Juno: Choose what?
Beck: How much of yourself to show, right then, and in line with what you value. Holding back can be a choice too, as long as it's a choice.
Juno: So it's not show everything. It's stop hiding by default.
Beck: Yeah. By default. Hiding turns into a choice you make, instead of a reflex you live inside.
Juno: Tell me your evaluation of the book. What can you even check in a book like this?
Beck: Not the worksheets. Nobody's put this workbook through a trial, and it doesn't say anyone has.
Beck: But a couple of the claims underneath it have been studied.
Juno: First one.
Beck: That adults with ADHD tend to be hard on themselves, and that it costs them something.
Juno: That feels obvious.
Beck: Worth checking anyway. A team at the University of Sheffield ran an online survey of more than eight hundred adults, with and without ADHD.
Juno: And?
Beck: The adults with ADHD scored lower on self-compassion. And that gap helped explain why their mental health was worse.
Juno: So the self-criticism isn't just a mood. It's doing harm.
Beck: It travels with harm, on this data. One caution. A survey taken at one moment can't say which came first.
Juno: Fair.
Beck: So it goes down as held, as a link. The book's premise has something under it.
Juno: Second claim. That acceptance does something, beyond making you feel nicer.
Beck: Here there's a trial. In the Netherlands, a hundred and twenty adults with ADHD were split at random.
Beck: Some added a mindfulness group to their usual care. The rest kept their usual care.
Juno: Mindfulness. Not this book's method.
Beck: A cousin of it, with the same root in acceptance. And the clinicians rating symptoms didn't know who'd been in the group.
Juno: So what happened?
Beck: The group came out ahead. Fewer ADHD symptoms by the clinicians' count, and more self-compassion by their own. It lasted through the follow-up.
Juno: So acceptance moved the symptoms.
Beck: Here's the part I like. A later paper from the same trial asked how.
Beck: The rise in self-compassion explained why people felt better. It didn't explain the drop in symptoms.
Juno: Separate things, then.
Beck: Yeah. Separate things. Kindness toward yourself lifted well-being. The symptom change came by another road.
Juno: Which is close to what the book says. Acceptance first, and the strategies still matter.
Beck: Close. Held, partly, and for a cousin of their method.
Juno: Logan put both Solden books back to back for a reason. So check the women part.
Beck: Here's the claim. Not only that women with ADHD feel shame. That being a woman makes it heavier, because of what a woman's expected to hold together.
Juno: Home, work, everybody's calendar.
Beck: Right. Organized, efficient, juggling all of it. The book says falling short of that picture is what feeds the shame.
Juno: That's a heavy picture to fall short of.
Beck: It's an argument about culture, and a fair one. The trouble is finding a study that tests it.
Juno: Is there one?
Beck: Not many. Here's one. It compared about ninety men and women diagnosed as adults against people without ADHD.
Juno: And the women had it worse?
Beck: No. Both ADHD groups had lower self-esteem than the comparison group. Between the women and the men with ADHD, no real difference showed up.
Juno: So the gap was ADHD, not gender.
Beck: In that sample. One study, with self-esteem on a questionnaire, which isn't the same thing as shame.
Juno: And a questionnaire can't see what someone's hiding.
Beck: That's the real limit. A woman who's spent years hiding might fill in a form just fine.
Juno: So, open.
Beck: Open. Their account of where the shame comes from could be right. The data comparing women with men hasn't caught up to it.
Juno: Okay.
Juno: And the method? You said nobody's tried the workbook.
Beck: Not this one. The closest I found was an online group program in Ireland, mixing ADHD education with acceptance and commitment therapy.
Juno: Did it help?
Beck: About two hundred and fifty adults took part. Afterward they rated their quality of life and their self-acceptance higher.
Juno: That sounds good.
Beck: It does. But nobody was assigned to go without it, so there's nothing to measure against.
Juno: So people who chose an acceptance class liked the acceptance class.
Beck: That's as far as that design reaches. Promising, and not yet a trial.
Juno: In fairness, the book never claims a trial.
Beck: It doesn't. It reads like what it is. A pair of clinicians writing down what they do in the room.
Juno: This stretch of the run keeps asking who you are once somebody finally names it. This book's answer is bigger than the name.
Beck: Sure.
Juno: Here's what I want to ask. Can you tell a woman to stop fixing herself when her bills are late?
Beck: Lead off. You picked the rock star.
Juno: Yes, because the book never says the bills don't matter. The strategies are in there. Headphones, a noisy coffee shop to work in, help from a coach or an organizer.
Juno: They just come after the part where you stop calling yourself names.
Beck: Go on.
Juno: And I think the order is the point. A planner bought as a punishment tends to end up in a drawer.
Beck: I'll give you the order. Here's my worry. Last time it was the word embrace. This time the subtitle opens on it again, and the title adds radical.
Juno: You were waiting for that.
Beck: A little. Barkley's line, back in episode three, was that ADHD isn't a gift. Read fast, a book about acceptance can sound like the other side of that argument.
Juno: It doesn't call it a gift. It calls it yours.
Beck: Fair. But a woman losing a job over missed deadlines needs more than a kinder relationship with her brain. She needs the deadlines met.
Juno: And the book would say she'll meet more of them once she stops hiding that she's struggling. Asks for it in writing, instead of nodding along.
Beck: That's a claim somebody could test. Nobody has.
Juno: This is VAST again, isn't it.
Beck: Yeah. VAST again. You like the kinder words, and I want the evidence before the vocabulary.
Juno: Then we still don't agree.
Beck: Not about the cover. About the hiding chapter, I'm with them.
Juno: Before we close. That closet of old dreams. Could a chat window help someone go through it?
Beck: As a scaffold for your own life, it could. List the old dreams, the silly ones included.
Beck: Then ask it what the wish underneath each one might have been, and what a version might look like at your size now.
Juno: The rock star becomes the choir.
Beck: Maybe. Or a podcast, or a slot at open mic night, or teaching a kid guitar. It can throw out a pile of ideas in a minute.
Juno: More than that girl ever got to say out loud.
Beck: And you'll throw most of them out. That's fine. You're the one sorting.
Juno: And the limits?
Beck: It's a brainstorming partner, not treatment, and nobody's tested it for this. And keep out anything you'd mind a stranger reading. A chat log isn't a medical record.
Juno: Here's the snag. The book's whole hope is that you get seen and heard. A chat window is the most private room you've got.
Beck: So use it as the rehearsal room. The book wants you on a stage, even a small one.
Juno: A Radical Guide for Women with ADHD, Sari Solden and Michelle Frank. Go to it for the hiding chapter and the closet of old dreams. Keep a pen close, because it asks things of you.
Beck: Bottom line on the claims. The self-criticism link held. The acceptance claim held partly, for a cousin of their method.
Beck: The claim that being a woman makes it heavier stays open, and so does the workbook itself. Ten books in, and nothing from this one landed in the didn't-hold column.
Juno: Both Solden books go on my shelf. Last time's goes to a friend who just got the word. This one goes to her a few months later.
Beck: Why wait?
Juno: Early on, she needs to know what it is. Later, she needs to stop apologizing for it.
Beck: I'd add a note to the shelf. Read the hiding chapter, even if the worksheets aren't for you.
Juno: I'll write that on the flyleaf.
Beck: Next time: Divergent Mind, Jenara Nerenberg. Solden stayed with ADHD in women. Nerenberg opens it out to autism, to the senses, and to the wave of adults finding out late.
Juno: A wider lens, then. I'm curious who it catches.
Juno: Read it or skip it. We read it.
Beck: Yeah. We did. Back in two days.
Juno: This has been The Observatory, from Lone Star Telehealth. Logan Williamson is a Licensed Professional Counselor in Texas and Louisiana. This was education about a book, not counseling, not a clinical opinion about you, and no substitute for care. Diagnosis takes a real conversation with someone who knows you, so there isn't one here.
Beck: The sources behind every claim are on the episode page, next to the transcript. There's a fresh one every other day.
Juno: A plain word before you go. Juno and Beck are both synthetic. We aren't people, we hold no license, and none of this was about you. Our scripts are written with AI, then edited and approved by Logan Williamson at Lone Star Telehealth. Logan Williamson is a Licensed Professional Counselor in Texas and Louisiana.
Corrections
No corrections have been made to this episode. If we got something wrong, write to [email protected] and say where in the episode it was. We check the claim against the source, then we fix it or we explain why it stands. Either way you get an answer.
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