🏆 Fighting your thoughts with CBT doesn’t work for Women with ADHD
Cognitive Behavioral Therapy (CBT) is an established, evidence-based treatment, but for many adult women with ADHD, it can fall short. If your symptoms are heavily internalized—meaning you experience deep shame, paralysis, and self-criticism—CBT’s focus on fighting "bad thoughts" often gets you stuck fighting yourself.
This article, brought to you by Brilla Counseling Services (offering both in-person ADHD therapy in Sacramento, California and online therapy for ADHD throughout California), reveals why the CBT approach can backfire in the neurodivergent brain and introduces Acceptance and Commitment Therapy (ACT) as the choice, evidence-based treatment for ADHD in cases of overthinking, rumination, and internalization of symptoms.
CBT Trap: When Fighting Thoughts Gives Them Power
For women with ADHD, symptoms are often masked by intense effort, leading to a profound sense of failure and a critical inner voice. This voice parrots years of external criticism, telling you: "You're lazy," "You should be able to focus," or "You will fail."
When engaging in traditional CBT, the process often follows this damaging loop:
Critical Thought: "I will fail this task because I’m disorganized."
CBT Action: "I must stop this thought and replace it with a positive, rational one."
The Trap: The effort to refute the thought locks the woman into an internal tug-of-war. . By trying to eliminate the thought, she makes it the central focus, consuming valuable executive function energy that could have been spent on the task itself.
The result is a paralyzing belief that action is impossible until the self-critical voice is completely defeated—a fight that the neurologically wired ADHD brain, prone to rumination and RSD, can rarely win.
🛑 Why "Challenging" Is Exhausting for the ADHD Brain
The CBT model relies on logic and consistent cognitive effort, which directly targets the areas of the brain affected by ADHD:
Executive Dysfunction: Meticulously tracking and challenging thoughts are all high-demand executive tasks. When the homework inevitably goes undone or the internal debate is lost, it becomes more "evidence" for the critical voice, deepening the ADHD shame.
Emotional Intensity: ADHD is closely linked to Rejection Sensitive Dysphoria (RSD), where emotional pain is physically intense and neurologically rooted. You cannot simply "logic" your way out of an intense emotional flood caused by a perceived slight.
The cycle of trying and failing to fix the internal experience leads many women to conclude, "I must be broken, because this 'gold standard' therapy doesn't work for me."
🔑 ACT: The Key to Unhooking and Activating Life
Acceptance and Commitment Therapy (ACT) is a powerful "third-wave" therapy that shifts the focus from changing thoughts to changing your relationship with thoughts. ACT provides the perfect framework for the internalizing ADHD experience by teaching two crucial skills:
1. Observe, Don't Obey: Cognitive Defusion
ACT teaches Cognitive Defusion—the skill of seeing thoughts for what they are: just words in the brain, not commands or absolute truths.
The goal is not to win the argument with the thought, but to simply unhook from the struggle, allowing the thought to exist without dictating your behavior.
The Power Shift: Instead of fighting the thought ("I am lazy"), you observe it ("I notice I'm having the thought that I am lazy").
The Realization: "I can take action even when my thoughts are telling me I can't. If I can get unhooked, the negative thought doesn't have to be a barrier."
2. Action Over Perfection: Values-Guided Behavior
Once unhooked, ACT focuses on Behavioral Activation—taking small, manageable steps aligned with your deepest values (e.g., connection, creativity, competence).
ACT Strategy: Focus on your Value, not your Feeling.
Example: You take a small action that moves you toward the value of Competence (e.g., Open the document and write three bullet points), even with the thought of "failure" present. .
This approach honors the reality of executive dysfunction by requiring only small bursts of effort and teaches the brain, through direct experience, that you can be flexible and functional even when the internal critic is loudly protesting.
💡 Brilla Counseling: Evidence-Based ACT for ADHD in Women
At Brilla Counseling Services, we specialize in understanding the unique neurotype of women with ADHD. We provide neurodivergent-affirming care and recognize that for clients struggling with internalized shame, ACT is our preferred first-line therapeutic approach.
Our ACT-based therapy for ADHD is designed to:
Provide evidence-based treatment for ADHD that validates your struggles are due to a brain difference, not a character flaw.
Teach practical defusion skills that work with your emotional intensity and executive function challenges.
Offer highly specialized support for women with ADHD, addressing the unique ways their symptoms present.
If your experience with therapy has been a demanding battle against yourself, it’s time to shift your focus from self-correction to self-compassion and acceptance.
⭐ Ready to Unhook and Move Forward?
Stop pouring your energy into the internal fight. Start building the meaningful life you value with ADHD therapy strategies that actually work for your brilliant, unique brain.
Brilla Counseling Services offers both in-person appointments at our East Sacramento, CA office and convenient online therapy throughout California.
Contact Brilla Counseling today for a free consultation to learn how ACT can help you stop battling your brain and start living by your values. Get unstuck for good with Brilla.
