EMDR and Counselling for ADHD: Addressing Years of Self-Blame

An adult ADHD diagnosis can explain difficulties with attention, organisation, time, impulse control and emotional regulation. It can also bring a different question into view: what do I do with the years before I understood what was happening?

ADHD & ADULTS

By Larissa Braga · April 2026 · Article 3 of 4

Part 3 of the ADHD Adult Series

For some adults, diagnosis brings relief. Experiences that had been interpreted as laziness, carelessness or lack of effort begin to make more sense.

Relief may sit alongside grief, anger or sadness. A diagnosis can offer a new explanation for the past, but it cannot change what happened or immediately undo the conclusions a person formed about themselves.

This article looks at the role counselling may play after diagnosis and considers where EMDR might fit when particular memories continue to carry distress. It is important to be clear from the beginning: EMDR is not an established treatment for the core symptoms of ADHD. The research specific to ADHD remains very limited.

This article is Part 3 of 4 in the ADHD Adult Series:
1. ADHD Diagnosis as an Adult: What Now?
2. How the Australian ADHD System Actually Works
3. EMDR and Counselling for ADHD: Addressing Years of Self-Blame (you are here)
4. ADHD at Work, in Relationships, and the Disclosure Question

The Emotional Meaning of Living Without an Explanation

ADHD is defined by patterns of inattention and/or hyperactivity and impulsivity that interfere with functioning. Its effects can extend well beyond concentration. Difficulties with organisation, working memory, task initiation and self-regulation can influence education, work, relationships and a person’s developing sense of self.

Emotion dysregulation is also common among adults with ADHD and can contribute to impairment. However, it is not part of the formal diagnostic criteria, and researchers continue to examine whether it is best understood as a central feature of ADHD, an associated difficulty or a partly separate dimension. A 2023 systematic review found meaningful associations between ADHD and difficulties with emotion regulation, while also noting that the available studies were limited and heterogeneous.

What matters clinically is not whether every person with ADHD has the same emotional experience. They do not. It is whether the person in front of us has lived through repeated experiences that have shaped how they understand themselves.

A child who is frequently corrected for forgetting instructions may begin to think, “I cannot get anything right.” An adult who repeatedly misses deadlines despite considerable effort may conclude, “I am unreliable.” Someone whose attention is misunderstood in relationships may come to believe, “I always disappoint people.”

These beliefs do not come from ADHD alone. They develop through the interaction between a person’s neurodevelopment, relationships, environment, opportunities, support and the meaning they make of what happens.

Painful Experiences Are Not All the Same

The language of “small-t trauma” is sometimes used informally to describe painful or repeated experiences that do not involve a catastrophic event. It can be a useful shorthand for some people, but it is not a formal diagnosis and can blur important distinctions.

Being criticised, excluded, misunderstood or repeatedly shamed can have a lasting emotional effect without necessarily meeting diagnostic definitions of trauma or post-traumatic stress disorder. The impact depends on the experience, the person, their developmental stage, the relationships around them and the support available at the time.

For an adult with ADHD, memories that remain distressing might include being humiliated by a teacher, repeatedly described as lazy, losing a job after struggling without support or experiencing conflict in an important relationship. The question is not whether an event is serious enough to earn a particular label. The question is whether the memory still becomes activated in the present and contributes to distress, avoidance or a painful belief about the self.

Where EMDR May Fit

EMDR stands for Eye Movement Desensitisation and Reprocessing. It is a structured psychotherapy developed by Francine Shapiro and is supported by substantial evidence for the treatment of post-traumatic stress disorder. The World Health Organization includes EMDR among the psychological interventions that should be considered for adults with PTSD.

EMDR uses an eight-phase approach that includes history taking, preparation, assessment, reprocessing, installation, body scan, closure and reevaluation. Reprocessing is only one part of the therapy. Before beginning it, the therapist considers the person’s history, current stability, coping capacity, supports, dissociation and readiness.

During reprocessing, the client briefly attends to aspects of a distressing memory while engaging in bilateral stimulation, often guided eye movements, alternating taps or tones. The client then notices what emerges. The therapist does not tell the client what the memory should mean or replace one belief with another.

EMDR was developed within the Adaptive Information Processing model, which proposes that some distressing experiences remain insufficiently processed and continue to be activated in the present. This is a clinical model, not a settled account of what happens in the brain. Several mechanisms have been studied, including working-memory taxation, changes in memory vividness and emotionality, orienting responses and processes shared with other trauma-focused therapies. No single explanation has been conclusively established.

What an EMDR Process May Involve

The process varies according to the person and the treatment plan, but it may include:

Understanding the broader history. The therapist and client explore current concerns, relevant experiences, strengths, supports and patterns that may connect the past with the present.
Preparing for reprocessing. This can include explaining the process, agreeing on ways to pause, strengthening grounding and ensuring the person can remain sufficiently present.
Identifying a target memory. The target is chosen collaboratively. It may be a specific event, such as being publicly criticised, rather than a broad period of life.
Assessing the memory. The client identifies an image, a negative cognition, a preferred positive cognition, emotions, physical sensations and the current level of disturbance.
Reprocessing with bilateral stimulation. The client notices the memory and the associations that emerge in short sets, with the therapist checking in between sets.
Completing and reviewing the work. The therapist attends to the preferred cognition, body responses, closure and reevaluation at a later session. Processing may continue across more than one appointment.

The memory is not erased. A possible outcome is that it feels less immediate or distressing and becomes connected with a broader, more adaptive understanding. Outcomes vary, and no ethical therapist can promise how a particular memory will change.

What the Research Says About EMDR and ADHD

This is the area where precision matters most.

A 2023 systematic review examined EMDR for people with neurodevelopmental disorders, including autism, intellectual disability, ADHD and tic disorders. It included 15 studies, 13 of which were case studies or case series. Across the included studies, PTSD symptoms generally reduced, but the authors concluded that the evidence was inconclusive because the research was small, varied and methodologically limited.

Very little of that evidence concerned ADHD specifically. Published ADHD reports have largely involved individual children with ADHD, adverse childhood experiences or PTSD. These reports may support further research, but they cannot establish that EMDR improves ADHD, executive functioning or emotion regulation in adults.

EMDR therefore should not be presented as a treatment for ADHD itself. Its established evidence base is for PTSD. For a person with ADHD, it may be considered when there is a clinically appropriate memory or trauma-related target, following careful assessment and shared decision-making.

This distinction does not make the emotional impact of living with ADHD less important. It means the treatment should be chosen for the difficulty being addressed, rather than because the person has an ADHD diagnosis.

From Fixed Conclusions to Greater Understanding

People sometimes arrive in therapy carrying conclusions such as:

“I am lazy.”
“I am incompetent.”
“I always let people down.”
“I am too much.”
“There is something wrong with me.”

Therapy does not need to replace these with slogans or insist on a more positive belief. It can help a person understand where the conclusions came from, whether they remain accurate, what they protected the person from and what was missing from the original understanding.

Over time, a more compassionate and complex perspective may become possible:

“I was struggling without the understanding or support I needed.”
“Some tasks are difficult for me, but difficulty is not the same as incapacity.”
“My actions have affected other people, and I can take responsibility without defining myself by my mistakes.”
“I do not need to become smaller to be accepted.”
“ADHD is part of my experience, but it does not explain everything about me.”

These are examples, not outcomes to impose. The language needs to belong to the person.

Where Counselling Fits

The Australian ADHD guideline recommends that adults be offered ADHD-specific cognitive-behavioural interventions. It also recognises the role of psychoeducation, environmental changes and other non-pharmacological supports. Medication, prescribed and monitored by an authorised medical practitioner, has the strongest evidence for reducing the core symptoms of ADHD, while psychological support may address functioning, distress, coping and self-concept.

Counselling can offer space to explore the meaning of a late diagnosis and the experiences surrounding it. Depending on the person’s needs and the counsellor’s training, this may include:

understanding the mixture of relief, grief, anger or uncertainty that can follow diagnosis
learning how ADHD may affect daily life without reducing every experience to ADHD
noticing patterns of self-criticism, avoidance or overcompensation
developing practical approaches to emotional regulation, communication and daily functioning
exploring the effect of ADHD within relationships, work and identity
supporting communication with medical and allied health professionals, with the client’s consent

A counsellor does not diagnose ADHD unless they hold a separate qualification and authority that allows them to do so. Counselling also does not replace medical assessment, prescribing or medication monitoring. Its role depends on the counsellor’s scope, competence and the needs of the client.

Frequently Asked Questions

What treatments have the strongest evidence for adults with ADHD?

Australian guidance recommends stimulant medication as the first medication option for most adults when it is suitable, with careful individual assessment, titration and monitoring. It also recommends ADHD-specific cognitive-behavioural interventions for adults. Treatment should be individualised and may include medication, psychological intervention, psychoeducation, environmental changes and practical support. There is no evidence that every adult needs the same combination.

What if anxiety or depression is also present?

Anxiety and depressive disorders commonly co-occur with ADHD, but similar symptoms can arise for different reasons. A comprehensive assessment considers the onset, duration and pattern of each difficulty, its functional impact and any other possible explanations. Treatment may need to address ADHD and a co-occurring condition together or in sequence. This decision belongs within an individual treatment plan.

Is EMDR safe for people with ADHD?

An ADHD diagnosis alone is not considered a reason to exclude someone from EMDR. However, it is not accurate to give a universal guarantee of safety or suitability. Readiness depends on the person’s current presentation, target problem, history, stability, dissociation, supports and capacity to remain engaged in the process. A trained EMDR therapist should assess these factors, explain potential discomfort and alternatives, adapt the process where appropriate and review consent throughout therapy.

Can EMDR treat ADHD symptoms?

There is currently insufficient evidence to support EMDR as a treatment for the core symptoms of ADHD. If EMDR is used with a person who has ADHD, it should be directed towards an appropriate distressing memory or trauma-related difficulty, not offered as a replacement for evidence-based ADHD care.

A More Careful Way of Looking Back

A diagnosis can change the way the past is understood. It may reveal that experiences once interpreted as personal failure were shaped by unmet needs, limited support or an environment that did not understand the person.

That new understanding does not remove responsibility, and it does not mean that ADHD explains every difficulty. It creates room for a fuller account. One that can include the effect on other people, the effort that remained unseen, the support that was missing and the strengths that also developed.

For some people, counselling provides enough space to explore this. For others, a particular memory may continue to feel present and emotionally charged, and EMDR may be worth considering after careful assessment.

The aim is not to rewrite the past. It is to understand its place in your life with greater clarity and compassion.

If You Would Like Support

If you are trying to understand how ADHD, past experiences and long-held beliefs have shaped your relationship with yourself, counselling can provide space to explore this without judgement or assumptions.

I offer ADHD-informed counselling and EMDR therapy for adults and young people aged 16 and over. Sessions are available in person in Billinudgel, in the Northern Rivers of NSW, and online across Australia. I work in English and Portuguese.

Sources and Further Reading

About the Author

Larissa Braga is a PACFA Clinical Counsellor and EMDR therapist based in Billinudgel, Northern Rivers NSW. She works with adults and young people aged 16 and over, with a particular interest in trauma, anxiety and ADHD. Larissa offers counselling and EMDR therapy in English and Portuguese, in person and via telehealth across Australia.