ADHD Sex Drive Explained: How Executive Dysfunction, Sensory Overload, and Hormones Affect Desire | Dr. Leann Borneman

Dr. Brighten: [00:00:00] Well that makes an interesting prop. Uh, how, how are mic levels? Everything good? Yeah, it's good. You recording? 

Background: Yep. 

Dr. Brighten: Stretching my jaw.

So the initial question is just to try to draw people in and then we'll get more a DHD specific, because I think also a lot of this stuff applies to like the temporary A DHD of perimenopause, which is not A-D-H-D-I get really mad. First question is, so you're fine. Okay. Did you do that in the first one?

Yeah. Yeah. I just snag some free hair from you and almost threw up my cup. Now if there's any point that I need 

Leann Borneman: to pause before 

Dr. Brighten: I 

Leann Borneman: answer, is that okay? 

Dr. Brighten: Yeah, that's fine. Okay. Oh my God. Like we had, we had one doctor, she's so brilliant and I loved her episode so much, but there was literally a two minute pause before she answered the question.

Our editors were like, what was happening? That she just paused and she was like. Was that awkward for you? Like, [00:01:00] well, I mean it was for like, I was like, do I interrupt her? Do I ask her if she's okay? Like, what am I supposed to do? And I'm like, I think I'm just supposed to observe, like I'm just supposed to sit here.

Like, but fair. There's a big learning curve on how to people while you're, uh, doing a podcast host. Like I said, like some of those like vaccine conversations completely caught me off guard. 'cause I'm like, who understands science? And would say this like, this is wild. Yeah. Are the cameras rolling? Oh, cool.

Cool. We got that hot take right there. Okay.

What's the most common misunderstanding you see about desire when it comes to long-term relationships? That it should be spontaneous. Ooh, okay. That's kind of like a hot take straight off the gate. It it, what does that mean? People might not know. 

Leann Borneman: Um, I can't tell you how many couples come into me saying that the goal is to be like, they used to be spontaneous, free, flowing, like ready to go.

And I'm like, [00:02:00] okay. It's, it's, that's cute. I like that for you. But it's not the reality. And I think that gets into a lot of issues and conflicts when we think that desire should just be spontaneous. 

Dr. Brighten: Why do you think so? People, so many people are buying into the narrative that desire should be spontaneous.

Leann Borneman: Have you ever seen a movie? 

Dr. Brighten: Yes. I actually wrote all about this in my book. Is this normal the way media literally ruins our sex lives? 

Leann Borneman: Oh, it does. And and it so funny because like I teach this all the time in my human sexuality class. You know, what we see is really important, but what we're not seeing is just as important.

Mm-hmm. And we don't generally see in the movies and the TV shows, people having to gravitate and work up towards desire. It's just like instant, like wife comes home, person enters room, and it's like, oh yes, yummy. And then you're jumping into it and it's like, oh, no, no, no, not reality. 

Dr. Brighten: Yeah, I always joke too, there's, you never even see like condom [00:03:00] usage happen in media, right?

And there's never time to put on the condom. It's very rare to see that, but yet we still understand like the importance of condom usage. And we can understand this disconnect there. But when it comes to desire, we're like, no, that should be exactly like that. 

Leann Borneman: Yeah. And I think my nerd moment just went off.

Me and my husband will be watching a movie and it'll be a sex scene, and the woman gets on top of the man and all of a sudden she's like, sighing. And I'm like, where was the lubrication? How did that just happen so quickly? And he's looking at me like, oh my gosh. I'm like, this is not reality. Yeah. 

Dr. Brighten: Well that.

Brings up another important point, um, and we're gonna be getting a lot more into desire in today's episode, but that, you know, there's a big myth that women think that they should be able to self lubricate at all times in their cycle, at all phases of their life because that's also what they see. We know hormones dictate that.

And the only key hormone that is giving you that self lubrication to be ample is only gonna hit like a week, maybe a week and a half out of your cycle. And I think, um. [00:04:00] I've seen a lot of men on the internet as well be like, if you know she's not getting wet for you, then she's not the one for you. And I'm like, oh, I hate to break it to you, but, um, you just told on yourself, you don't understand a female 

Leann Borneman: body and the amount of pressure that gets placed on both people for that mm-hmm.

It creates such friction. And I think one of the first things that I always, not that I think one of the first things I ask my couples when they come in for any sexual discrepancies is I ask them, so what is the lube that you have on the side table of your bed? Mm-hmm. And they look at me like, what? You need lube?

Mm-hmm. Lube is your best friend because it takes the pressure off of your body, the assumptions, the scripts, the expectations that are just not realistic to our anatomy. 

Dr. Brighten: Mm-hmm. No, that is so true. And I think sometimes the, um, pressure of feeling like, oh my gosh, am am I gonna self lubricate enough? And also on then the pressure of like, oh, is, is she getting wet enough?

Can also shut down desire, which is what we're gonna be talking about today. For people listening, we're gonna start talking about A [00:05:00] DHD 'cause you have some really fascinating research that you've been doing regards A DHD and sexual desire. But for everyone listening, if you are 35 or older. Your brain undergoes changes thanks to your hormones changing that can make it mimic in some ways what the A DHD experience is now for you.

Fortunately it's transient, but that transition can be seven to 10 years, sometimes 15 years. So even if you don't have a DHD, I definitely want you to listen to this episode. Don't scroll away. So I wanna go into two truths and a lie. So everybody listening, this is your opportunity to play a game with us.

I am going to read three statements and I wanna see if you can identify the lie. So go to YouTube, leave us a comment, let me know how clever you are. 'cause I do think you're gonna be very clever with this one. So let's read these out. A DHD medication can improve intimacy when used correctly. That's our first statement.

Second one, the A DHD brain needs novelty and safety at the same time. The third [00:06:00] statement is, if you forget to initiate sex, you are not attracted to your partner. So. You all go, guess which one is the lie and I'm gonna get your hot take. Well, they're guessing. So what's a common tip given to couples wanting to improve their intimacy?

That doesn't always work for those with A DHD that you wish everyone would stop acting like is the quick fix or like the golden ticket scheduling sex. 

Leann Borneman: Oh, I hate it Dish. I hate it. Oh my gosh, it is so annoying. 'cause when you think about scheduling sex, well, you have to then say, okay, then you're gonna be in the right mind when you put it in your calendar.

Mm-hmm. I'm sorry. But that right there, not a DHD friendly, not perimenopausal friendly, not being parent friendly. Like where is your bandwidth? Where are you gonna be? And then what ends up happening is this idea of putting it in your calendar means, okay, we're showing up for one another, we're making it a point, and then the alarm goes off.

You're not there. Mm-hmm. You're not ready. So now what ends up happening now you think, oh wow, you don't [00:07:00] care about us. You don't care about me. You're not prioritizing. And so what ends up happening is it creates more friction than benefit, and then it also creates more shame. So scheduling sex, if you are neurodivergent.

Throw that, that, that advice out the window mm-hmm. Out the window. It is not for you most likely because I can't tell you how many clients have come and walked through my door saying, we've tried the scheduling sex and it doesn't work. And I have to explain the exact reason why, because when you're scheduling it, you don't know where you're going to be within your bandwidth.

And that creates now shame, guilt, frustration, disconnect. 

Dr. Brighten: Yeah. There's, uh, so I will often say to like, people who have children, um, scheduling your date night, when you schedule the date night, get the nanny earlier, so not like nanny shows up and you're leaving the house. We get the nanny earlier. So you'll have space for that connection.

And if it happens, it happens. And if it doesn't, it doesn't. But that is something that I think so many couples follow the script of like, you know, dinner and a movie, and then we get intimate and then [00:08:00] they find at the end of that, that they're like, I'm so tired, I'm not interested. Like I just wanna go to bed.

Or you get home and Right, you've already taken off your makeup, you're in your pajamas and you're like in the covers and you're like. Now I gotta like do a whole thing and we're gonna talk about executive function because executive dysfunction hits every single person with a DHD for their life, and most women in 

Leann Borneman: perimenopause as well.

And what you're also talking about is when you think of this idea and concept of scheduling sex, you're then integrating this idea that it should be spontaneous. Mm-hmm. Yeah. And it's not, and what you just talked about was giving yourself a bridge, giving yourself that space of having the nanny come earlier, giving yourselves time to kind of like, feel it out.

If it happens, cool. If it doesn't, it doesn't, what are you just doing in that moment together? Yeah. Because it have to always be about sex. No, you can find connection in different ways, but again, it's this idea of scheduling then also means spontaneous. Mm-hmm. It, it's, it's, it's set up for failure. 

Dr. Brighten: Well, let's get into these three statements and you're gonna tell us, which [00:09:00] is a lie.

So first one, A DHD medication can improve intimacy when used correctly. True, but some nuance. We'll get into the nuance that's gonna surprise some people. I bet some people's jaws just dropped right now, so, okay, second one. The A DHD brain needs novelty and safety at the same time. True. So the third one's a lie.

If you forget to initiate sex, you are not attracted to your partner. Absolutely false. Okay. Why is 

Leann Borneman: that false? Because if you have a DHD, you're gonna struggle to work with your working memory, and that's that post-it note memory, right? So if you're forgetting to initiate, that doesn't get to weigh and measure that you don't want your partner or you're interested in your partner.

So that's holding neurotypical expectations on how you're supposed to be showing up. And that's why it's false, because everyone is different. And when we think of A DHD, we cannot. Put those expectations on how we're showing up. Mm-hmm. Because sometimes the initiation is just because, maybe it's not insight in mind.

Maybe you are stressed, maybe you don't have [00:10:00] the bandwidth. There's so many other reasons there. You might still find your partner sexy as all hell, and you want to initiate, but maybe you don't have the access to in that moment. 

Dr. Brighten: Mm-hmm. I think that's really comforting in giving people a lot of permission there, because there is this expectation that like, if you're actually into someone, then you should always be like grabbing up on them, rubbing up on them, trying to get things going.

And I think within that, that myth, I think it gets placed on men predominantly. Yeah. And when a man doesn't have that spontaneous kind of desire, I always say like for some people with responsive, like, things gotta get going before your brain and your body get going. Yeah. Like you have to be in it before your whole body's like, oh yes, we like this, this is great.

Like, oh, I, I recognize this. And I think that that pressure also can lend itself to shame. Oh, a hundred percent. Shame is a killer to everything. Mm-hmm. So let's go back to the A DHD medication question because certainly there are people who have started A [00:11:00] DHD medication and they've experienced low desire, low libido.

They would say it. So from their baseline it dropped. What's going on there? 

Leann Borneman: So first and foremost, with medication, when we're talking about A DHD experiences, medication doesn't always work for everybody. And there's so many variables that play into this. Um, and even for the individuals that medication does work, it's not going to be a quick fix to your full executive functioning.

Mm-hmm. And that's why if you're on medication, you might see benefits in the bedroom. And we see it across the literature, um, but not in a statistical or significant way. Mm-hmm. And that is, again, because we still need to lean on environmental supports, and that's what I do all the time. So medication can.

Only helps so much. So yes, it's true that it can be helpful, but if it's not working for you, and I think that's why I wanted to bring the nuance here. Mm-hmm. You're not broken. There's nothing wrong with you. Your medication might be helping you outside of the bedroom. What then we have to look at is what are the [00:12:00] environmental switch ups that we need to make?

So it is aligned with you and you are being accommodated. 

Dr. Brighten: Mm-hmm. And for people that A DHD, you know, medication has increased their desire or maybe freed up their bandwidth so that they are receiving like sexual inputs. Like what is going on there? How is the medication actually helping? So 

Leann Borneman: stimulants can happen in twofold.

So some people will actually see their desire go up and desire is more of the interest and the openness and the drive. Um, and then other people can actually. See a disconnect in their desire, so it can actually cause a disconnect to wanting to show up. Mm-hmm. Um, and there's a variety of reasons. I'm not a neuroscientist, so I like to stay in my lane, but I'm going to assume that the reason we see these differences is because everyone's biology is different.

Mm-hmm. So how that stimulant is affecting you and your brain and your chemistry will also depend on how it's affecting your increase or decrease to initiating sex. 

Dr. Brighten: Yeah. And I've read about, you know, people who are like, oh, I got on medication and now [00:13:00] I am more interested in sex. And in the theory being, well, dopamine pathways, uh, well, dopamine actually working.

Right? Like, that's lovely, really reinforcing like the experience. But it's always something that when I look at that, I'm like, and this person had a healthy relationship and like they dealt with body images, like Right. There's like all of these layers to it that it's not as easy of just saying like, oh, this medication helped.

And on the flip. Some women in particular will start a DHD medications and the stimulants stimulate them towards anxiety and now their nervous system is so frazzled that it's like, yeah, you know, I, a hug would probably help. An orgasm would probably help, but it is the furthest thing from my mind. 

Leann Borneman: Yeah.

And I think you're speaking volume. While I say I am not a neuroscientist, I do know that when we look at stimulants, they affect something called your HPA access. Mm-hmm. Which is your hypothalmic, uh, adrenal, uh, oh my gosh. Hypothalamic pituitary adrenal access. Thank you. Jesus Christ.

There's [00:14:00] something called your HPA axis, and this is what's going to help you navigate your cortisol production, um, just how it navigates in the brain. And so the stimulant is actually helping increasing it to like normal levels, typical levels. Mm-hmm. I think that word button for all intense purposes.

And what that then does is then it helps the dopamine, right? It helps the regulation, it helps you be more present. But the problem is, is that when somebody has insecurities, someone isn't necessarily fully integrated in a safe way. Now when you're fully attuned, you can 100% become more irritable and then you're gonna shut down.

Mm-hmm. And then that's where disconnection can come. Yeah. So you're pointing in how everyone is going to be different. It's everyone's not just genetics, but what are the social conditionings and what are the things that are in your day-to-day that are also playing a part in it? 

Dr. Brighten: I think this is important to explore.

We're gonna get into more tips, very actual things in this podcast because [00:15:00] you might be like, yes, my desire has gone down, but I'm actually succeeding at school. I'm succeeding at work. Like, I'm keeping, like, you know, deadlines and meetings and relationships are getting better in other ways. And so, you know, I, I hate to see somebody be like.

Oh, I have to just give it this medication 'cause this side effect, you know, even though it's helping me this way, I can't live with this side effect. So we'll definitely talk through more of the nuance of things, but, uh, one of the truths we had was the A DHD brain needs, novelty and safety at the same time.

Can you speak to that? 

Leann Borneman: Yeah. So a lot of us, and I say us, I'm an A, DHD or hello, um, we need stimulation. Stimulation's very important for us because it keeps everything going. Mm-hmm. And so novelty is newness. It's, it's sparking that interest. And when I say novelty, it doesn't have to be you literally doing something new every single time.

But what I'm saying is, is that doing. The same thing every single time isn't going to be novel, which means your brain can probably become more [00:16:00] bored. Mm-hmm. Disconnected. Now, when we think of novel and safety, arousal, states are really important. If you are stressed or, and let's just say stressed by an insecurity or maybe your partner's side in a certain way, and now you feel like maybe they're rejecting you or there's criticism, your body's going to go into a stress response, you are going to not be in a state of calm.

And then that creates even further disconnect from our brain and how it's functioning. Um. So when we are engaging novel equals stimulation. Mm-hmm. And safety allows our arousal state to be calm. And that's very important because we need to be in that calm state to access sexual arousal. 

Dr. Brighten: So is this what's happening when mid arousal, someone's like, I was in the mood and now I'm couldn't be further from it?

Leann Borneman: Yeah. And I think a lot of the times people don't recognize that their brain is acting before they even realize. Yeah. You know, there are moments that we can say like, Ugh, I'm not into this. Right. That's that conscious tapping [00:17:00] in. But then there are more times that our brain just disconnects because there hasn't been enough stimulation and now it's looking for it.

Mm-hmm. And now when you have that pause and you realize you've checked out, what tends to happen is if you don't realize what's going on and why it's happening, you become stressed. Because now the expectation is, oh, I, I should still be in the mood. I should be able to do this. And now you start freaking out.

You're stressed and now you start shutting down and again, in order for you to access sexual arousal, you have to be in a calm state, not a stress state. Mm-hmm. So that's also where the disconnect comes in. 

Dr. Brighten: Let's talk through some executive functions. So task initiation, working memory, emotional regulation.

How does, how did these in particular, influence the sexual response? 

Leann Borneman: Okay, so I'm gonna have to go off of an example and I think for me, I'm gonna get personal 'cause I don't wanna throw my clients into this. Um, when I am at the end of my day, 'cause I'm a mom. So at the end of the day is generally where we [00:18:00] get time to pause and try to be, uh, sexual with one another.

Task initiation means that you have to see what's in front of you and feel okay. For a lot of us, ADHDers we struggle by looking at something and it kind of looking like a messy room. Mm-hmm. You don't know where to start and that right there can cause us to become very like overwhelmed. And so for me, I'm big on needing to take showers.

Mm. So 

Dr. Brighten: say more about that. 

Leann Borneman: So for me, in order for me to even wanna have sex, I have to have a shower. Mm. Which now means I need to do a task. Yeah. Because keep in mind, people, sex is task. I know that does not sound sexy. Mm-hmm. But it is a task. And I like to call it sex paralysis because think of the example I'm giving.

If I need to take a shower before I have sex, now that's a task. Think about it. I'm in the shower. What do I have to do? I have to lather my body up. And now if you also have, no, this sounds so silly, but if you [00:19:00] have bottles that have caps that you actually have to take off, that's another demand. So always get squingy caps.

'cause they're, they're so much better. That's my whole shower. Yeah. I'm like with you on that. I'm like, yes. Pumps only. Yeah. And then so now you have to dry off. Now you have to get dressed. Or maybe you're gonna walk into the bedroom naked, but now you're looking at sex and you're like, oh crap. Now if fluids are exchanged, I have to take another shower.

Do you have the bandwidth for that? Mm-hmm. You might not. And now you might start avoiding and you might not wanna engage. And so task initiation, there is a huge demand of what is being demanded of you. How does it feel safe? What are you doing? When are you doing it? That's a lot of pressure. Mm-hmm. And then when you think of even emotional regulation, keep in mind if you're looking at sex and you feel overwhelmed and there's all these things going through your mind, you're gonna become dysregulated.

Mm-hmm. And for us, A DH Ds, when I talk about dysregulation, a lot of us, we deal with intense emotions. And [00:20:00] so I don't like people to think just in the sadness or the frustration. Like I feel my emotions intensely even with happiness. Like I can feel happy and like I can feel it in my ears and I can sometimes cry just because of how intense I'm feeling it.

That also can cause shutdown. Mm-hmm. And now you're disconnected there. Working memory. Okay, what do I want? How do I want it? Remember the post-it note memory. That's a lot when you think about it. And if your brain isn't functioning all in, its like. Flow state that makes everything easy. It's overwhelming.

Mm-hmm. And again, sex paralysis can set in where it's like a deer caught in the headlights. Yeah. Or worse, you're showing up and you're not really there. 

Dr. Brighten: Talk to us about what are some tips, strategies, things that A DHD brains can do to overcome some of these executive functions that feel overwhelming getting in the way of 

Leann Borneman: them getting some.

So this is layered. So one of the one things that I like to say, and I know a lot of us say it in our field, if [00:21:00] you're not comfortable talking about sex, you should not be having sex. Mm-hmm. So the first thing, nobody likes to hear that I know, I know because they, you know, it's vulnerability at its finest.

So before you can even get into the nitty gritty of what can we do? How can we, do, you need to be able to feel comfortable to communicate with your partner. Mm-hmm. What are your needs? How are things showing up? How can you set yourselves up for success in the way that works with your brains? So a lot of the times for my clients, I, I get nerdy with them and the, if they have kids, we have to be creative.

But I have some clients that will actually get a whiteboard and they'll put it in their bedroom and they'll put it up on like the side. They don't actually hang it up. It's like kind of just on the wall or in the closet. But it's insight in mind and it has all these things that they're interested in.

And what that does is it allows you to actively go through like, what are you interested in tonight? What are we not interested in? You're already creating a space for you to kind of like take pause. Mm-hmm. Communicate, see what you're into. How [00:22:00] do you navigate that? What are you wanting, not wanting? And now you're releasing the pressure.

The pressure is going to allow you to feel safe, calm, right. So if you, for instance, I'll go back to the shower example. Me, um, there are some nights that I wanna engage with my husband, but I don't wanna have to take another shower. Mm-hmm. Now that's an executive functioning barrier for me because that is enough of a barrier that's gonna stop me from initiating.

So what can help me is, okay babe, what are some non fluid interactions that we can have where we can still show up? Mm-hmm. And I don't have to take a shower again, so that might look like me giving him a hand job. That might mean oral, it might mean him touching me in places that don't need lubrication.

There are a variety of different ways to do that, to make it safe. Where now instead of avoiding, I've engaged and I've supported my executive functioning needs. Mm-hmm. 

Dr. Brighten: Does that make sense how I explain that? Oh, it does. It's also, um, I would love to hear from the [00:23:00] audience if you have a DHD, like what is your hangup with like the whole shower routine?

Because I know this is something really relatable. Um, I, my whole thing is that I have to dry off and then I have to put lotion on and like, and you know, and I try to make like body oil rituals and do different things, but also having to do makeup. I love the end product. I hate everything about it. Like I, that is for me, like some days will keep me from even wanting to shower because I feel like there's so many steps that have to happen afterwards that I'm like, I'd rather put on gym clothes and then work out and like do a sauna at the end of the day than get in the shower and just be like, it's straight to pajamas after that.

Right? Like lotion, pajamas, like nothing else after that. So I think it's really relatable and it's. You just turn the lights up on Something that we never talk about in sex is that the post coitus cleanup. Right. Even having to do the awkward waddle sometimes to the bathroom to just pee. Right. And you're just like, this is so much work.

And like they just roll over and go to sleep and [00:24:00] you're like, ah. As if, like 

Leann Borneman: as if, yeah. And I think you spoke volume when you were just talking about your shower routine and how some days there's just so many different things you know you have to do. That's also talking about sex. Mm-hmm. All the things you have to do.

You have to kiss, you have to do foreplay, you have to touch, you then have to get the lube, you have to do this, you have to do that. That right there is the task initiation and the shutdown. That can happen with so many of us. Yeah. Because it becomes very overwhelming and like for instance, I took a shower the other day and I got out of the shower and I had to sit on the couch for like 10 minutes before I could blow dry my hair.

Mm-hmm. Because just taking a shower can be so exhausting depending where you are. At some days you might have it in you to do the whole routine, start to finish, but then some days you might not. And it goes back to this concept and idea of sex can never be about consistency. It has to be about persistency because that also is a support to the A DHD brain.

Dr. Brighten: Say more. What do you mean by persistency? For people listening. 

Leann Borneman: Yeah. So persistency is this idea [00:25:00] of showing up when you can. Consistency is this idea of you have to do it all the time. So for instance, if you have this idea that sex has to look the same in the sense of foreplay start to finish, you are setting yourself up for failure.

'cause you might not be able to start and finish. Mm-hmm. You might just be able to start, you might only be able to do foreplay. That is then about showing up and doing what you can when you can. But when we don't know that we have access to have persistency in the bedroom, we avoid because we're thinking we're failing.

Mm-hmm. Or that we're not gonna do it. Right. Right. And that again, creates the disconnect. 

Dr. Brighten: Yeah. No, I think this is going to help a lot of people because it, it's, it's normalizing the experience that we all have with A DHD. And I like to also frame it as like, you only have so many decisions you can make in a day.

You only have so many, and so I mean, I will tell my family when I'm tapped out, I'm like, I've made all my decisions for the day. I have nothing left. Or I'll tell my assistant like everything else has to [00:26:00] go to tomorrow because I will make the laziest decision possible and it's not the right decision.

That's awesome that you're able to tap in and you know that about yourself. Well, yeah. Well that took lie getting to my forties, let me tell you. So I'm like, let me be fair. I do this podcast so you all like don't fall into the potholes that I did on this road of life. And I'm hoping that we can illuminate those so that you're like, oh, I'm just gonna sidestep that.

So I wanna ask you though, because you are a practicing clinician, you work with neurodivergent people and. But you also are within this field that quite honestly, not everybody really understands neurodivergent people. What are the most common mistakes clinicians make when addressing sexual dysfunction in neurodivergent people?

Before you answer everyone, sexual dysfunction, air quotes is what the studies, the research says and medicine diagnoses you. I don't like the term, but there Do I? Yeah. I just, I don't want you to feel like you're dysfunctional, but it is the, um, often sexual dysfunction just for people listening to is not a, that something is wrong with you and you are broken.

[00:27:00] It is that something is off and it's distressing you and it's affecting you in a negative way. So also wanting to frame it in that way. I don't want anyone to feel bad about 

Leann Borneman: themselves. Yeah. No, and I think that's a great, uh, layer to that because the word itself is not sexy at all and it can make you feel like crap.

100%. Um, but I think when we look at the field, uh, the field is coming. And growing. But we are still so far behind. We see it in the research pathologizing A DHD experiences about where we're failing. We have higher levels of divorce, we have higher levels of dissatisfaction. We suck at conflict resolution.

We're not able to have orgasms and satisfaction, and we're more likely to have low desire. And it just keeps repeating all these things and no one is asking why. Right. And so when we look at sex therapy and we look at mental health, when we're navigating sexual discrepancies, we're gonna use that word.

Mm-hmm. Um, [00:28:00] one of the biggest issues is that therapists that don't have an A DHD lens, they are using interventions that were not by default created for a neurodivergent brain. 

Background: Mm-hmm. They 

Leann Borneman: are expecting keen executive functioning. I don't know about you, but I don't have that as an a DH dear. I have barriers to that.

So when you are instilling interventions or approaches that are relying on functions that your brain is struggling to tap into, what ends up happening is now the person showing up, they're doing their part, right? They reached out, they identified a quote problem. They're being given interventions.

They're now trying it. It's not working. What ends up happening? You feel shame. Mm-hmm. You are broken. You are the problem or worse, the relationship just isn't meant to be. And that right there is a huge issue we still have in the field because not enough people are understanding the A DHD lens to the experience specifically when we're tapping into executive function.

Dr. Brighten: You [00:29:00] brought up scheduling sex. What are the other tools that you wish that people with A DHD would be aware of that might not work for them so that they don't feel like a failure? 

Leann Borneman: So there's a few. One of them is mindfulness. Now. Mindfulness is a beautiful, beautiful, beautiful 

Dr. Brighten: technique. I just, I'm sorry I'm laughing because I've had my own experience with a therapist who was like, you just need to meditate for an hour.

And I'm like, you said you were a DHD literate friend. I don't think you are. And she's like, well, I can meditate for an hour. I'm like, are we talking about you? Well, are we talking about me there? Yeah. So sorry. Go for mindfulness. Let's vote. I, I 

Leann Borneman: appreciate the laughter because we've all been there. Yeah.

And we've all been, without really understanding. In those moments, we've learned to internalize it and think that we're the problem. Mindfulness acquires self. Uh, awareness. Mm-hmm. Right. Interception. So one of the core executive functioning barriers, or how they define it in medical terms, deficits, is self-awareness.

Self-awareness is, let's say you're going about your day, [00:30:00] something happens and you are automatically able to say, Hey, how's that making me feel? Right? And interception is our ability to tap into those internal cues, those alarms. So think just about like appetite, like you're hungry, you have to go to the bathroom.

Mm-hmm. For us, ADHDers, we have barriers, deficits to those things. So let's say you are in the moment with your partner and your therapist is saying, practice mindfulness. In order for you to gravitate, navigate mindfulness, guess what? You have to be self-aware. Mm-hmm. And if you have deficits there, you're not gonna be able to grab that tool.

And so now how are you supposed to implement it? Mindfulness is wonderful post reflection. Giving your, and that I think is a huge strength for us. A d, adhd, we're really good at reflecting after the fact, taking in data, asking ourselves what we were thinking and feeling in that moment, trying to pull as much from that experience.

But in the moment, mindfulness sucks. It is not helpful. And why? Mindfulness works better in the therapeutic room. Mm-hmm. It's 'cause your therapist is your executive functioning. [00:31:00] They're literally telling you what to do, how to do it. They're giving you the pause that your brain is struggling to do in the moment.

Mm-hmm. So that's number one. The other one is cognitive behavioral therapy. Oh, go off. I'm, I'm here for this. CBT. Um, CBT. Again, beautiful, beautiful thing to use. It helps you challenge your negative thinking. It gives you another area of reflection and pause. Stopping yourself from automatically going to one area.

But again, you need self-awareness to do that. And if you're a therapist listening to this right now, stop giving your A DHD clients homework activities that are paper. The last thing an A DHD is thinking in the moment of heightened stress is, oh, let me go get that PDF, let me go get that piece of paper that my therapist told me to print out and take pause and write down how am I thinking?

Why am I thinking this? Is there any other thought I could have? Oh, that is not A [00:32:00] DHD friendly. So again, CBT, wonderful tool, but not something that an A DHD or can just rely on because we have executive functioning barriers. Mm-hmm. 

Dr. Brighten: I think that is so important for people to hear. Uh, and I have, I wanna say for people who follow this podcast, I've talked about cognitive behavioral therapy for hot flashes.

It can work beautifully. 'cause I invited all the perimenopause women here. It can work beautifully for how it affects you. Mm-hmm. But I agree with the concept that, I mean, I just don't think CBT was ever made with the neurodivergent brain in mind. None. 

Leann Borneman: The mental 

Dr. Brighten: health interventions are, that's a whole like, okay, you're coming back on the podcast.

We're gonna talk about all that. But I mean, the other thing that we see though, okay, so we tell people that are struggling sexually have C go into CBT. We tell women with PMDD go into CBT, uh, well, who has PMDD mostly neurodivergent women. The interventions that we're constantly giving people when it comes to CBT.

To treat things I want people to [00:33:00] understand. Do the studies look great? Hell, yes, they do. Because when you isolate a person and you do exactly what you said, you become their executive function. You do all of that in a controlled setting, which is what a research study does. The outcomes are gonna be phenomenal, but when you put it out into the wild.

We see people struggle and then they feel like they're, they must be broken 'cause it worked for their best friend. So why is it not 

Leann Borneman: working for them? And I'll even piggyback that off. There was a study done about two years, a year and a half ago. Very small study, but still significant in my professional opinion.

It was out of Australia, um, or Austria, I can't remember which place, but they had 10 participants doing CBT, all of which were ADHDers. And they were looking to see if they believed that CBT was helpful or harmful. And then they asked all these individuals to give actual, uh, feedback, which was wonderful.

It wasn't just like an assessment. They wanted the feedback. Out of the 10 participants, only one said CBT was helpful. Every other participant said it was stupid, a waste of time. It was harmful. It was not [00:34:00] helpful. The reason that one participant said it was helpful was because the person implementing it used an A DHD lens.

Oh, they tweaked it to actually work with the A DHD brain and the expectations attached to what it's like to live in an A DHD brain in real time. 

Dr. Brighten: Wow. Well, I'd love to see that study replicated on a larger scale because I think that could be really helpful. I wanna ask you about, you know, partners who may be living with an A DHD brain.

How can they differentiate that their partners struggling with executive function issues and it's not just complete shutdown or disinterest in them? 

Leann Borneman: Can 

Dr. Brighten: you ask 

Leann Borneman: that 

Dr. Brighten: question 

Leann Borneman: again? I'm 

Dr. Brighten: sorry. Yes, so let me do that. Yeah, let me do it. Totally different. So I wanna ask you for partners. That are living with an A DHD individual, how can they differentiate between disinterest and executive function shutdown?

Leann Borneman: So I think this is a good [00:35:00] question, but I would like to focus on the person in the relationship who has a DHD. Mm-hmm. Ask yourself, do you find your partner attractive? Are you interested in them? Do they bring you joy? Are you turned on by them? Um, in safe or settings when you're out and about or they're at work and you're on the phone and they say something and you're like, Ooh, I like, that's a really good way for you to navigate and understand that you, you are interested.

If you don't hold that you're not attracted to your partner. Uh, there there's more likely than executive functioning. Barrier is not necessarily the big thing here. Mm. It might just be disinterest. So I like to just gauge with my clients, like, if there is an interest outside of the bedroom, you love your partner, you're attracted, you're turned on.

That's a really good way for you to navigate and know that no, you are interested, but there is something blocking your access. And generally it does have to do with executive functioning barriers. Okay. 

Dr. Brighten: So let me ask [00:36:00] as a follow up. So in a relationship when one partner has a DHD, what helps keep the connection alive?

Leann Borneman: Communication, understanding each other's needs and sensory related concerns. One of the things that I see quite often, especially with my women, A DHD clients, especially going into the area of perimenopausal ages mm-hmm. Whether, um, perimenopause is a thing or not for them in that moment, um, sensory gets a big front for a lot of our concerns.

Um, so touches are gonna be different. Uh, smells might cause barriers. Um, sex ends up not looking like what you thought it was supposed to look like anymore. It's going to have to look more about what are your needs, how do you implement them? Can you be okay with it? So checking in and better understanding what are your.

Breaks and accelerators. Mm-hmm. And understanding too, within that one day, a [00:37:00] break might be a real break, but the next day you might be able to navigate it differently. Um, so this goes back to the persistence versus consistency as well. When you say breaks versus accelerators, can you break that down for people listening?

Yeah. So Emily Kowski used this term, um, breaks versus accelerators in terms of our interests. So if you are interested and it feels safe, you're gonna have this accelerator in your brain. You're gonna wanna go and gravitate towards it. You're gonna be present. But if there's anything in your interaction that is a turnoff or something is affecting your ability to be in line and feel safe, your breaks are gonna go off.

Breaks are basically saying that it's a no-go. You're not gonna wanna show up, you're not gonna be tentative. You're not gonna be present. 

Dr. Brighten: Mm-hmm. And for people listening, this is born out of the research from Bancroft and Janssen. Yes. Which was originally done on men. So this is whenever, of course it wasn't originally done on men, but they were like, we should explore this.

Does it apply to women? Lo and behold it does. So what do we know? Any body [00:38:00] on the planet has these breaks and these accelerators, and this can affect you. And I think this is really important because we often get into a conversation of gender dynamics and women just never want sex, and men always want sex.

And I think those myths harm people as well. 

Leann Borneman: Oh, a hundred percent. And I love that you are a wealth of information because that was very important too. Um, when we think of also accelerators versus breaks, it goes back to the main concept of the work I do. My job is to help formulate where are the blocks, how do we gain access?

Because at the end of the day, I like to always reinforce this to all of my clients. It's not you being incapable. It's, there's a block to your access. Mm-hmm. And access in this domain is the accelerator. Your ability to feel safe and able to show up in that moment. And when we have an A DHD lens, it's important because in the literature and when we're looking at therapeutic styles and interventions, [00:39:00] we're not thinking about that layer.

Mm-hmm. Even in the research right now on low desire, an A DHD lens has not been integrated in that. 

Dr. Brighten: Well, let's talk about that. 'cause you've actually developed a model too. Integrate the A DHD lens and break free of like this traditional mold that we're all being expected to, to fit in. And, and this is, I'm talking clinically Yeah.

We're being expected to fit into this mold and it doesn't necessarily work for us. So talk to us, like, tell us the name of your new model and 

Leann Borneman: talk to us about it. Yeah. So, uh, the last three and a half years through observation, combing through all the research, working with so many amazing clients, my own personal life, I started creating and, and identifying patterns.

Um, that I was reading all the books on low desire. I was taking all the educational classes for my certification and my PhD on better understanding, low desire. And I was still struggling. I was implementing all these things and my clients were struggling. And I had like a moment I was like, wow, am I a really shitty therapist?

Like, what is going on here? And then I had [00:40:00] my aha moment and I was like, holy crap. We are not integrating an A DHD layer here, and this is where executive desire model came about. Mm-hmm. And what I'm doing is I'm creating a layer to the desire understanding. So think of like Shrek and his Onion. I don't know if anyone here and listening has a watch.

Shrek. I, I love my Shrek desire is like an onion. Mm-hmm. There's multiple layers to it. And the neurodivergent layer has not been integrated. And what I'm doing is I'm saying. If you are somebody that let's even say, has struggled with responsive desire, right? Responsive desire is this idea. I know you know this, but, uh, but not everybody I, I know, right?

You're not here to educate me. You go off. So responsive desire is this idea that you need to get into it. So think about like whenever you make a plan with a friend, I always like using this example and you're really excited to make those plans. And then the day comes and you're like, uh, why did I make my plans?

But you're getting dressed. You're still struggling immensely. You [00:41:00] get in the car, you're driving, you get there, you're with your friend. You start, you know, conversating, interacting. You become responsive. You're like, oh, I'm having a good time. You're enjoying it. You're engaging. That's responsiveness in the bedroom as well.

Sometimes you need to integrate, get into it with your partner before you're really like, okay, I'm ready. I'm there. Um, Dr. Lori Mi, a wonderful woman, wonderful researcher. She says that sometimes. It's about having sex to get horny, not being horny to have sex. Mm-hmm. And that's kind of a good example of responsiveness.

But when we think of a DHD, sometimes that's not enough. Because what if you're showing up and your environment isn't set up for your success? Mm-hmm. What if your environment is not supporting your neurodivergent needs? Now you've done the deed, right? You've shown up, you're touching your partner, your partner's touching you.

But what if the other things haven't been implemented? Now you've failed, right? [00:42:00] Because lo and behold, you've been advised, there's spontaneous, there's responsive, do this, you'll be fine. But you're still not integrating the needs to support your brain. And that's what the executive desire model does. It's bringing in that layer.

Of understanding that if you have a DHD and you are still struggling and you're horny, you're turned on by your partner, but something is stopping you, it's most likely the executive functioning barriers that become the gate to accessing your desire. 

Dr. Brighten: Okay. So talk to us about what are the signs of executive functioning gatekeeping during intimacy, and how can couples start 

Leann Borneman: to work around it?

So the biggest, most common one is sensory related issues. Okay. Okay. So, if you are experiencing any level of sensory issue, your brain is gonna shut down. You're not gonna feel safe. Think of your nervous system. So for instance, if I'm gonna go personal, my husband has a beard, I love his beard. But beards also can have smells to them and texture.

And certain things have to be in place for me to be able [00:43:00] to gain access to my safeness to show up and access the desire. So, for instance, my husband knows it has to be freshly trimmed. He has to use his beard oil, it has to be freshly, uh, shampooed. He has to brush his teeth. All of those things are otherwise barriers and that I'm not gonna show up to.

That's a sensory barrier. Mm-hmm. And that's a gatekeeper to my desire. If I am able to have a conversation with him and he's able to do all those things, I now gain access to it. I'm now showing up. I'm there. Another one is, um, when we think of, uh, task initiation, you know, if you believe that sex has to have a start and a finish, you might struggle and now you're gonna avoid, that's a gatekeeper.

But if you have a conversation and you're like, listen, I just wanna cuddle, I wanna have kisses tonight, and that's all you do, guess what? Now you're accessing your desire. Right. These are those examples of how executive function plays and how we're [00:44:00] showing up or what's causing us to not wanna show up.

Because again, I work with a lot of people that sometimes, yes, they're struggling to even feel horny, but more times than not, my clients are horny. They're interested. Mm-hmm. They're turned on by their partner, but something is stopping them. And when we are able to take apart and map out how their A DHD is showing up for them specifically, where are their concerns, that's where we can navigate and create access to it.

Another example I like to give, and I think this goes back to the sensory related issues. I apologize it's very common, but lube. I have women that literally cringe with the idea of lubrication. Mm-hmm. It is a noise and also a tactile sensory experience that can completely shut them off. So finding ways to navigate that is going to help then gain access to feeling safe to even show up.

Because if again, you don't feel safe to show up, you're shutting down. 

Dr. Brighten: Yeah. I think about, um, the Cardi B song that came out. What. And she said, [00:45:00] macaroni in the pot. I didn't know what that meant. And like I had to get it explained to me by my husband. He's like, you know, that sounds sometimes that's like, and I'm like, oh no.

And that is something that like, I was instantly like, oh, that's so gross. Um, and like, you know, my husband is like, what, what's wrong? Like, why is that gross? Like, it's just normal. It's what normal bodies do. We, I just appreciate that from him. But I'm like, it's a sensory thing. I hear certain noises and like my stomach flips upside down or I just, I just.

You know, feel like sometimes like my teeth will fall out. I don't know, I can't explain it. It's just the sensory input. And so I think, you know, for women listening, hearing you say that is really validating for them to, and I think also, you know, what I'd love you to speak to is like the use of like toys in the bedroom.

Because a lot of therapists are like, just bring in toys and like toys can be great. I like to call it like. Batman's accessory tool belt, like, right? Like you use whatever tool you need to get the job done. However, it doesn't always work. It's not always [00:46:00] the solution. 

Leann Borneman: And it's also sometimes very overstimulating for some people.

Exactly. So that's another form of a barrier for a lot of people. We have to talk back to the concept of stimulation. And there's twofold. You can either be overstimulated or understimulated and that's gonna also depend on your availability. To access your desire and showing up. So when we think about toys, toys can be a great tool if indeed you're struggling to be understimulated, where you need more stimulation to keep you present and to feel fulfilled and to stay in the moment.

But for a lot of women, it can be over stimulating. And on top of that, again, I think you speak volume to the concept and the scripts and the pressure that get placed. Oh, spice up your life. Bring in a toy and then let's say your's, this person that's like. Toys don't work for me. And then you feel shame and then maybe you don't feel comfortable saying that.

And that's a whole other barrier that you need to address and how you're integrating it in the bedroom and now you're not even having a good time. [00:47:00] You're overstimulated galore. Toys don't always work. Sometimes it compliments the a compli complicates the situation. Um, so again, this goes back to you having to map out what are your needs.

And your needs are not wrong. They're yours, but important to know what they are. So you can navigate that. Mm-hmm. Especially when we're talking about toys through the executive 

Dr. Brighten: desire model lens. What do you think that therapists are getting wrong about low desire with those in, with that heavy, lemme just start that over.

Sebastian's gonna be like, yeah, this is great. Okay. Through the lens of the executive desire model, what do you think clinicians are getting wrong when it comes to low desire in A DHD individuals? 

Leann Borneman: What I see when people come to me, they don't have low desire. Mm-hmm. They don't, because low desire means that you have no interest.

You're avoiding that is generally what low desire is describing. [00:48:00] But for a lot of my clients, they do have interest. They're just struggling to feel comfortable and safe to show up to it. And it is because of it not being set up for success. Think about sex. Sex has a expectation placed on him. Sex in general is not set up for neurodivergent brains.

Can you explain that when you say 

Dr. Brighten: it's is? So, sex expectation. Sex expectation, there you go. Uh, why is that set up for the neurotypical brain? Like, what does that mean when you say that? 

Leann Borneman: Because when you think of executive functioning, it's basically the management system that's letting you literally go across your day-today, do things, plan, prioritize, show up, be aware, make changes, stop yourself.

Right? Okay. Us adhd, we have deficits attached to all of those systems. Okay? So when we think of sex, sex has this expectation, you're gonna show up, you're able to just jump right in. You're gonna kiss, you're gonna do whatever your idea looks like, you're going to be able to transition with [00:49:00] no issues, uh, this, that, and whatever.

And then you're done. Girl, that is not a DHD friendly. Mm-hmm. Because for first and foremost, we generally can't jump think of, uh. Uh, task switching. That's another big one that I forgot to mention. For us, ADHDers task switching is this concept of being able to go to one thing to another with little ease, right?

Like pretty easy for us. We can't jump, this is like very common for like, let's say you're in the living room or the kitchen. You're on your phone, your child or your partner walks in and they start talking to you and you start to get like irritable. Yeah. It's because you were literally zoned into one thing and now you're being demanded by your environment to switch.

Our brains don't do that very well, so what we end up experiencing is distress because our brains are like, huh, what's going on? Mm-hmm. That applies to the bedroom. The bedroom reinforces and expects you just to be able to switch tasks, tasks switch [00:50:00] so easily. We can't do that. So when we think of sex, sex has to be integrated in a way that, again, works with our brains, not by a default of what has been expected.

Neurotypically and neurotypically, I'm talking about no issue with executive function, like you have easy transition. You're able to pause. Think about even if, let's say you are having sex with your partner and something doesn't feel right, for somebody who has no deficits or barriers to their executive function, they're going to be able to execute their inhibition.

They're gonna be able to pause. Now they're gonna be able to self-reflect, right? Self-awareness. Like, Ooh, what's bothering me? What am I not liking? They're gonna be able to relay that information. For a lot of us ADHDers, we are not able to take that pause. We're struggle with that self-awareness, and so now we may be integrating and we're not enjoying something, and now we're creating conditions where we're disconnected.

Mm-hmm. [00:51:00] Does that make sense? 

Dr. Brighten: Yeah, it does. And as you bring this up. I think about, um, the research that we do have that shows that women with a DHD and autism are more likely to be diagnosed with endometriosis and end myosis, which are two conditions that can lead to pain with sex. And so as I hear this and I think about nervous system dysregulation that's taking place, trigger points in the, um, pelvis, like there are so many times in an, and so everybody I am to be very clear, maybe you're picking it up and I'm talking about, uh, heteronormative, like penetrative sex In this instance where a woman would be experiencing pain, but she doesn't have the executive functions and the bandwidth to be like, wait, this isn't right.

I need to communicate. We need to switch things. And how that, that executive, this is like a light bulb moment for me of like this executive dysfunction lending itself to more sexual issues because of the pain and not being able to communicate it. And then the reinforcement of pain [00:52:00] and it starting. I may be very careful here.

This is not trauma in the sense that your partner did something wrong to you, but it's trauma in the sense that you experience pain during this situation. And the nervous system says, guard, protect, keep us safe at all costs. 

Leann Borneman: And that right there I think is where a lot of therapists also get things wrong is because what you're talking about is executive functioning barriers.

And this is what the executive desire model is trying to outline, is that executive functioning barriers are always there. Mm-hmm. When we think of low desire, low desire, Dr. Braddo does a wonderful job of explaining that there is like an initiation, like a thing that provokes it, whether it be medication, uh, chore division, issues, what have you.

And then there are just engagements that reinforce. That. Mm-hmm. So there is a provoked thing that occurs. And then the reinforcement, you're talking about executive functioning, provoking it at every corner and turn, and then let's say continuously [00:53:00] repetitively doing something that doesn't feel good. You are reinforcing the disconnect that Yes.

Can 100% lead to then low desire. Mm-hmm. But if you don't understand executive functioning barriers, you're never going to be able to help clear out the reinforcement piece of it because you have to set it up originally to work with your brain, not against it. Does that make sense? 

Dr. Brighten: Yes. And so what I wanna ask now is that how can women be able to step back?

Well, as well, if you're listening, I wanna help you too, but to actually be able to, 'cause Right, you said earlier on communicate like communication's so important, but that requires. Interception executive functions. Mm-hmm. So how can people start to cultivate that to get the sex life that they want? 

Leann Borneman: Never try to do it in the moment.

Okay. That's fair. Okay. So one of the things is pre and post. So pre check-in. So think of, UH, kink and BGSM. Okay. Kink and BDSM is [00:54:00] wonderful in the sense that they have a wonderful platform for so much communication. Communication is vital before, during, and after. This is one of the biggest mistakes we all tend to make when we're trying to have sex, especially heterosexual couples where we forget.

The most important part is communication. And for a ADHDers in the moment, communication can be hard because we might need to take pause, or our partner might have to be the pause for us. So doing something before and then after can be very helpful in these moments. So before can look like. Where are you at?

You know, are you overwhelmed? Do we need more of a bridge before we can get into it? What are you interested in tonight? Are you interested in soft touch, firm touch, uh, do we wanna do sensory exploration? You can think about all these different things, and then after the fact, you can also check in and say, what did you like about that experience?

What didn't you like? You can use that as data understanding [00:55:00] though that data doesn't get to be applied as a consistent thing. 'cause what ends up happening a lot of the times what I see in my couples is that partners, it can go both ways. Wives, husband doesn't matter. The second they see something work, they latch onto it.

Especially if they have a DHD, they become hyperfocused on it and they try to start implementing it every single time now. Mm-hmm. And the other person's like. Uh, no, it's not working for me. So conversation is huge. And so a lot of my clients, they are not able to start integrating sex until they have a conversation first, and then also during, but more importantly after.

Dr. Brighten: How do you approach this conversation if somebody has RSD? Because data and feedback isn't always received 

Leann Borneman: as just data and feedback. Yeah, so this is very important. Um, I actually have on my website, uh, an intimacy partner menu and also a, uh, A DHD informed bedroom check-in that kind of goes through all these different areas.

And the language I have specifically attached [00:56:00] to it is as a team, it's collaborative. So it's not about one person or the other. When we think of rejection sensitivity, it's a lot of emotional dysregulation to the sense of being criticized or being rejected. And when we think about conversations around sex, we have to practice curiosity and collaboration.

So jumping into these conversations, if you haven't been able to have them yesterday, you're can kinda automatically gonna be able to do them right now today. Mm-hmm. So we have to slowly integrate it and do it more on a collaboration. So not about I, more about we, how can we create this experience? Part of that is unlearning your role, right?

What are you supposed to be doing? How is it supposed to look? There's so many layers to this, so it's really hard for couples just to automatically be able to jump in and do everything without also feeling your feels and getting comfortable just about conversating and being a team when we get like into those [00:57:00] emotional dysregulation modes.

I experience RSDA lot in my relationship. Um, outside of my relationship. Anytime there's any sense of criticism and criticism can look like I said something and my husband laughs it off and I'm like, oh, wait, you don't agree with me? And like, I'll shut down. Like, I'll be like, Ooh, he doesn't love me. Right?

I have had conversations outside of those moments with my husband, so he is aware and we have a system. We have a conversation and a plan that he's able to check in with me. So having conversations outside of the moments of RSD asking each other, how can we show up if this happens, is also really important 

Dr. Brighten: for people who don't know what RSD is.

Can you explain it? Because I think sometimes people get it in their head that RSD is you just being dramatic, overly sensitive, but it's so much more than that. Yeah. 

Leann Borneman: So rejection, sensitivity dysphoria, it isn't an actual criteria [00:58:00] for A DHD. It's something that we just see more commonly across the board around emotional dysregulation, trauma response related as well.

Uh, but what we see, especially with A DH Ds, is that because we experience emotional dysregulation, so we experience our, uh, uh, experience, uh, emotions more intensely. Think of your upbringing. Many a D Hs. Unfortunately, we have grown up in a society that has told us we're not doing it right. We're screwing up and we've kind of learned that we're always being criticized.

We're always being rejected. Your body becomes conditioned to that within the realm of intense emotions. And so any form of trigger to rejection, criticism, whether it's real or perceived, it does not matter. Your body goes into dysregulation, but think of dysregulation on like steroids. Mm-hmm. Some people that can look like shutdown.

Other people, it can look [00:59:00] like literal crying. Other people, it can look like projection and anger. It is not being overdramatic. It is your nervous system literally being flooded and feeling very unsafe and your body not knowing what to do with it. And it is a very exhausting experience for a lot of people to the point that for some people the turnaround time of it can take days depending on the navigation and the thing that kind of triggered you in the moment.

Dr. Brighten: Mm-hmm. You brought up kink before and I think we should just talk about it for a minute. Last night we were at dinner, and I was actually thinking about this this morning because I said to you, you know, statistically speaking. One in five people have tried kink. So if you ever go to dinner, you say party of five?

No, that one person on that table has tried kink. We were, we were a party of 10 last night, so there was at least two of us at the table. But I think there was probably more fair. Our friends are gonna be like, what? No, but let's explain that because I think people think, um, kink and they think, um. You know, the only what has been seen in the [01:00:00] media, right?

What was that one big, uh, 50 Shades of Gray. People are like, that's kink. That's BDSM. Uh, it's scary, it's dangerous, and they shut down. So let's talk about that for a minute, because this is something that a lot of, uh, neurodivergent people gravitate towards. We see. And when I say that, I mean the umbrella of neurodivergent individuals.

We're not just talking a DHD here. 

Leann Borneman: Yeah. And I think first and foremost, uh, we have to go to the research first. So when we look at the research, there is significant gaps in the intersection of looking at neurodivergence and BDSM and kink. Okay? Now. We do have very little research, specifically looking at individuals, um, engaging in kink who have autism.

Uh, there was a study done, it was, um, I don't know how many years ago it was, but they looked at it and what they were able to see is that there was a lot more association of individuals with autism engaging in kink more than the general population that did not have autism. [01:01:00] And when we unpack what BDSM is, it makes total sense.

Mm-hmm. It is a supportive integration for a neurodivergent brain. Think of structure. Boundaries, conversations before you engage in scenes. Scenes are the conversations of like, what are we doing today? Are we doing impact play? So taking a whip or a a paddle, what is the level of pressure? How long are we doing this?

What are your sensory needs? Having check-ins while you're doing it. Not having to read anybody's cues, not having to be a mind reader. That is a like chef's KISS support system. Mm-hmm. And unfortunately though we haven't looked at the D'S experience, but the community has been talking about this for years.

Dr. Brighten: Yes. And that's the thing I'm gonna say is that we learn what to research by listening to lived lived experiences, but then not researchers so much, but clinicians will act like, well, if the research [01:02:00] isn't there, whatever you're experiencing invalid, not real, not true. And there can be that real disconnect that creates further shame in someone's life.

Leann Borneman: Mm-hmm. Yes. And as a clinician, um, I specifically wanted my dissertation research to amplify the community's voice because prior to my dissertation, there was absolutely no research looking at the intersection between BDSM engagement and A DHD, but my clients were talking about it. Mm-hmm. You go on FetLife or any other community in Reddit, like.

They're all talking about it, but no one is acknowledging the experience. And unfortunately, like you said, there's a lot of people that are not going to take these things seriously or know how to navigate and integrate interventions if the science isn't supporting that. So what my research did is I wanted to look specifically at, uh, heterosexual women.

ADHDers, I gave them an attention test, which was testing a mechanism of A DHD. I had them do the typical A SRS, uh A DHD [01:03:00] assessment screener. And then I had them do some BDSM related questionnaires to see if BDSM engagement was helping them be present and also help with their satisfaction. And what I found was all of the women that were failing the attention test and also scoring out on the as RS to be likely to be a ADHDers, they were also showing that BDSM engagement was actually supportive.

Mm-hmm. And this speaks volume to the importance of environmental support and how kink and BDSM doesn't just have to be a sexual preference. It can be a very well-informed adaptive environment and accommodation for a DH ADHDers. And when we look at society, there is so much. Stigma. There's still stigma even in therapeutic practices.

Like I've heard of sex therapists that do not wanna touch pink kink and BDSM with a 10 foot pole 'cause they don't agree with it, but they're sex therapists. How is that even possible? Mm-hmm. So we still have a lot to do in terms of that respect, but with that [01:04:00] shame understanding that sometimes how we navigate in the bedroom can just be also more importantly, an accommodation.

Dr. Brighten: And this checks two boxes that we brought up at the beginning, which is novelty and safety, which the A DHD brain needs. And I think that's the really important thing to understand. I was on a podcast recently and as I brought this up. And I brought up talking about this concept. I mean, the women who were also on the podcast immediately jumped to like, no, but this is not always safe.

No. It's dangerous for women. Women get tied up, things get done to them. And I'm like, no. Like that's unethical and that is not tolerated in these communities. Um, and it was interesting 'cause when I was going through my sex counseling training, that's the first time I was presented with the research of like, and it was primarily, you're correct with autistic individuals, how they gravitate towards this.

And the reasoning is nothing about sexual preference, it's all about predictability, communication. Um. That the rules of [01:05:00] engagement are laid out ahead of time. So what do autistic, and I would say A DHD individuals also struggle with this sometimes is knowing what's the right thing to do? What's the right thing to say?

How does this person want me to be? Right? They, we can fall into a trap of being mind readers in so many aspects of our lives. And what these practices do is they say communication forward. It's, this is front and center. Nothing happens until it's been discussed. 

Leann Borneman: Yeah. And I think also what's really important here too is you bring up ethical versus non-ethical.

Mm-hmm. I have tons of people that I work with where they are navigating kink and I hear that they're navigating kink in the little pieces that they've taken from their day-to-day knowings. They're not engaging in ethical kink. Mm-hmm. And that is a very huge, uh, discrepancy that you can practice. But it has to be ethical.

So one of the best things that I like to tell people is that if you're ever thinking of engaging in any level of kink, always learn the ethics behind it first, before you start engaging. Before you [01:06:00] start determining what you like, what you don't like, start learning about consent, the rules, the ethics, because you need a really good foundation before you integrate, so you also are aware and you're safe in your interaction, so you can advocate if someone else isn't informed.

Ethically on those approaches, how can people get informed? Read, there are to so many great resources out there. You just told a DH ADHD years to read. I know there's, there's also videos, there's YouTube. That's wonderful as well. Actually, 

Dr. Brighten: YouTube is a great place. There are, um, great practitioners, researchers who have made YouTube channels and I am very, uh, YouTube will not ever show them to you.

You have to go search for them. 'cause YouTube's like, this is bad, this is wrong. I'm like, this is researched backed like evidence based. Like this is as good as it gets. 

Leann Borneman: Yeah. So I, what's really struggling or frustrating for me is that I've done this research, I work with this, and then I always get asked like, what are some resources?

And I feel like I never have answers to them. I know [01:07:00] Tasha uh, dot org is a wonderful organization that anyone can look up. They are specifically research oriented with all kink related. Um, but then again, it's all reading. But if you go on YouTube and you just. Search, what are consent in BDSM? What's ethical versus non-ethical?

What's abuse versus non-abuse? You can indeed find resources that are going to help you better understand what these things are. Um, I also like to remind people, and maybe I'm jumping here, this is my A DHD brain going off, but like even BDSM and like scene creation is somewhat still neurotypical. And what I mean by that is like for instance, let's say you're into rope play and you are the A DHD, or your partner isn't A DHD and you are the one that has to hold the time.

Okay? Let's say you have to set up the scene. We kind of struggle with time blindness. Mm-hmm. And [01:08:00] understanding how long something may or may not take. So you can go into it and now maybe you've taken 30 minutes too long and your partner's sitting there like, what the hell is going on? Right. Or maybe when you're involved a clock can cause too much of a dysregulation or a clock in the room might not work.

So they actually have really cool resources like uh, candles that are time candles that when you light them, they can actually go across a time and they'll like burn out to the time. Do you 

Dr. Brighten: know where those candles originate from? No, I don't. So, um, and maybe they're not exactly the same, but the time candles, this is the story as it goes.

I grew up in a gold mining town and so have to learn the history of all these things. Um, so when as someone would come to court, your daughter, there would be a candle of time they got and more money and more so the more wealthy he was, the more cattle he owned, whatever it is, the more time would get put on that clock.

Um, and so that's your time to court my daughter. And they would, they would measure that. That is so [01:09:00] 

Leann Borneman: cool. I'm forever using that now. I love that. So yeah, those candles can be great and they can be very friendly to like your nervous system and how you react. Mm-hmm. Um, so that was just like a side note. I just wanna let people know also, even when you're integrating or you're engaging and you are maybe somebody that already understands ethical, uh, BDSM and kink, but maybe you're struggling and you're feeling like, oh, there's some things that aren't necessarily full on neurodivergent friendly.

Yeah. There's realities to that. 

Dr. Brighten: Yeah, I think that's all really important for people to hear and to just, you know, explore all that. Um, you know, I had, uh, one patient one time had said to me that why she liked B-A-D-S-M is because she liked Dungeons and Dragons. And so she was like, it's Dungeons and Dragons in the bedroom and it's something that I just find really fun.

And I was like, that is so interesting. And also like the most vanilla way to like put something, right? Because I think people who are outside of that, um, community or aren't educated on it, they're just like devious things, so [01:10:00] dangerous and bad. And then to hear that like, yeah, it's just like bedrooms, dungeons, and Dragons.

For some people they're like, that's the nerdiest thing I ever heard. But do you wanna know why? No say it. That's the 

Leann Borneman: stimulation. Mm-hmm. I can't tell you how many clients I've met that enjoy role play. They're in chat rooms and they enjoy just talking with people. They're not even integrating it in real time because of how stimulating mm-hmm.

Those conversations are. They're tapping into the brain in regards to what is needed in that moment. That is talking about the novelty, specifically to reinforce stimulation. Mm-hmm. When you think of Dungeon dragons. Everything is stimulation, it's creativity, it's thinking, it's on the like. It's amazing.

And so, yes, when you think of KIN and BDSM, it's the exact same thing. You are constantly integrating and engaging in such stimulating ways that right there is the accommodation. Mm-hmm. That is what your brain generally needs. And again, not everybody. And if you're not into kink and BDSM, that's totally fine being into kink and BDSM is [01:11:00] not a criteria for A DHD by any means, but we do know, at least with the work I've done and how the community has stated, it is definitely an accommodation to how our brains are wired.

Dr. Brighten: Mm-hmm. So I wanna go back to the conversation of like desire helping A DHD people navigate intimacy. And if you could challenge the audience to do one thing over the next seven days to really help them start to cultivate intimacy, what would that be? 

Leann Borneman: I would say map out sensory first. I say sensory because that can be a variety of different things.

It can be smells, taste, sight, tactile. Um, first start there. See what things you generally know you like and don't like. You know, are you the type of person that you don't like clutter? 'cause lemme tell you something, if you're in a room, generally the bedroom, and there's any form of clutter, you might be paying attention to it without even realizing.

And that in itself can be the barrier. Mm-hmm. So really start thinking in spaces outside of the [01:12:00] moment. What are your likes and dislikes? What are your sensory needs? Start mapping your experience out. Really become educated on what it means for you to have a DHD. How does it show up for you? What are those things looking like?

That is the really important place to start because if you're not doing that, you're never gonna be able to then start setting the environment up to support the needs. 

Dr. Brighten: What might people experience if they commit to this over the next seven days? 

Leann Borneman: Awareness that wasn't there. Which means that you have the ability to tap into access, to actually advocate for yourself and then to tap into integrating experiences that are empowering instead of making you feel like crap, that's a beautiful thing.

Mm-hmm. And then when you can start feeling empowered instead of feeling like you're broken or shamed, you then can also tap into, which I think is a huge strength for a lot of us, ADHDers, is that curiosity. Lean into it, get creative, collaborate with [01:13:00] your partner. Enjoy and when you can feel safe to, it's really nice.

Dr. Brighten: Well, thank you so much for sharing your expertise and taking the time to chat with us today. I 

Leann Borneman: really appreciated this. Thank you so much for having me. This was awesome. Yeah. 

Dr. Brighten: Awesome. 

Leann Borneman: Take a photo of us before I forget. Yes. I need it. I forgot to do it last night. I was completely, you know what's funny is I was like.