Find out at fifty, or sixty, or sixty-six that you’re autistic, ADHD, or both, and the bookshop will helpfully hand you a list of everything that’s wrong with you. Most late-diagnosed adults could have written that list themselves. They’ve been reading drafts of it for decades, under other titles.
Late diagnosis rarely arrives on a clean slate. It tends to turn up after a long career of other names: anxiety, depression, burnout, a personality disorder, something with a Roman numeral in it. Mine was Bipolar II, for twenty years, until a clinician at sixty-six looked at the same evidence and read it differently. Autistic and ADHD, sharing one nervous system, the whole time.
What follows is the question I wish someone had asked me at the start, and why I’ve built a book around it.
The roadworthy that only lists the dents
Take your car in for a roadworthy and imagine the report that comes back. It lists every dent, every scratch, every rattle under the dash, with real care and an excellent clipboard. It notes the worrying noise the gearbox makes on cold mornings. It concludes that the vehicle is unsafe and recommends a lifelong management plan.
What it doesn’t mention is that you drove it in. That you’ve been driving it in every day for thirty years, without a manual, on roads designed for a different model, in weather nobody warned you about. The car, if anyone asked, would point out that it has been doing a remarkable job under the circumstances. Nobody asks the car.
That’s the deficit model applied to a late-diagnosed life. It counts the dents beautifully and leaves out the one fact that ought to dominate the report: you got here. The deficit model has never met a strength it couldn’t rename as a symptom. Intensity gets written up as instability, pattern-hunting as paranoia, and the crash after decades of masking as a mood disorder, when it was a nervous system that had been holding its breath for forty years and had, reasonably, run out of air.
What solution-focused therapy asks instead
Solution-Focused Brief Therapy grew out of the Brief Family Therapy Center in Milwaukee in the early 1980s, the work of Steve de Shazer, Insoo Kim Berg and their colleagues (de Shazer, 1985). Its founding move is almost rude in its simplicity. Instead of asking what’s wrong, it asks what’s already working, and how to do more of it.
The evidence is respectable and refreshingly unhyped. Kim’s (2008) meta-analysis found small but positive effects, and a later review of controlled outcome studies found it holding its own against established treatments for adult depression, often in fewer sessions (Gingerich & Peterson, 2013). Nobody is claiming miracles, which is a little ironic given that one of its best-known tools is called the miracle question.
For someone diagnosed late, four of its moves do most of the heavy lifting:
- Exceptions. When wasn’t the problem happening? Run backwards across a whole life, the question turns up decades of moments where things quietly worked and nobody logged them, because nobody knew they were worth logging.
- The coping question. Not “why are you struggling?” but “how on earth did you manage at all, for that long, without the name?” It’s the question that finds the competence hiding inside the wreckage.
- The miracle question. Imagine the problem vanished overnight: what’s the first small thing you’d notice in the morning? At sixty-six the answer is rarely a cure. It’s usually a quieter room and a good-enough Tuesday, which is a great deal more achievable than a cure and considerably cheaper.
- Scaling. On a scale of one to ten, where are you today, and what would one point higher look like? Not ten. One. Late is no barrier to a single point.
None of these needs you to have been born in the right decade for a diagnosis. They work on the life you actually have.
The grief is allowed
There’s a trap in all this cheerfulness, and the solution-focused crowd can fall straight into it. Finding out late is sad. Plain sad, the ordinary kind, the kind that sits at the kitchen table and doesn’t explain itself. You mourn the life that might have run differently if someone had caught it at six, or sixteen, or thirty-six.
That grief deserves its own chapter, and in MISREAD it gets one. What solution-focused work adds is a second question asked from inside the grief, gently: given all of that, how did you get this far? Because the fact you’re here at all, unnamed and unaided, is the strongest evidence you have that there’s something to build with.
Try this, in daylight
The exceptions exercise from the book, in miniature:
- Pick a time when you’re rested and it’s light outside. Never 3 a.m. Your brain at 3 a.m. is not on your side, and it will make a very persuasive case for the prosecution.
- Write down four times in the past year when something went better than you expected. Small counts. A phone call you made. A morning that ran smoothly.
- For each one, note what you were doing, where you were, who was there, and what the room was like.
- When the voice in your head says “anyone could have done that”, write the voice down too, then leave the item on the list. Australians call this tall-poppy syndrome. My answer to it is FIGJAM, which you’re welcome to look up, preferably not on the work computer.
Read the list back. Patterns show up quickly, and they’re usually about the room as much as the person. Mine certainly were. For decades the plan was to fix the man. What finally worked was moving to the mountains of Vietnam, and finding that a lot of what had been wrong with me for forty years simply stopped. The nervous system had been in the wrong building all along.
The book
MISREAD: Autism, ADHD, and the solution-focused way to build the life they said you’d missed goes live on Saturday 5 December, through all good online bookstores.
If Understanding AuDHD is the explainer, MISREAD is the front door. It’s half memoir, half method, and it’s written for people who got the news late, for the people who love them, and for clinicians who’d like a better question for the first session.
I can’t promise it will fix anything. It wasn’t written to. It was written to help you count what nobody counted, and the count tends to come out higher than you’d think.
References
de Shazer, S. (1985). Keys to solution in brief therapy. W. W. Norton.
Gingerich, W. J., & Peterson, L. T. (2013). Effectiveness of solution-focused brief therapy: A systematic qualitative review of controlled outcome studies. Research on Social Work Practice, 23(3), 266–283. https://doi.org/10.1177/1049731512470859
Kim, J. S. (2008). Examining the effectiveness of solution-focused brief therapy: A meta-analysis. Research on Social Work Practice, 18(2), 107–116. https://doi.org/10.1177/1049731507307807
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