Meme of the week: the carnival

Existential broil

We know that one of the most common features adhd is insomnia, particularly difficulty falling asleep. And amazingly, though estimates suggest that 50%+ of those with adhd suffer from insomnia across the span of their life… it doesn’t show up anywhere in the diagnostic criteria for the condition. As a result, having suffered for years with insomnia has no impact on the way in which the medical community interprets your symptomology. And further, in all the years of working with clients with adhd, I have yet to hear of a single instance where a doctor or psychiatrist inquired into their patients’ sleep prior to it becoming more of an emergency situation. I am not a doctor, but… I’m pretty sure sleep is an important component of overall health? 

But the phenomenon described in the tweet above is a story I hear on a daily basis in my practice. It goes something like this: the client is bone tired, they struggle to get through their nightly pre-bedtime routine, they turn out the light, get into bed, and close their eyes ready to sleep the sleep of angels. Most folks who get to this point then seamlessly drift from conscious awareness into the first stage of sleep. But 50%+ of those with adhd? That’s when the carnival begins.

The idea of the carnival was introduced to me by a client some years ago, and I think it’s the perfect name for this phenomenon. The carnival is the experience that this week’s meme of the week describes: when the lights are out and your home is quiet… the carnival starts. I’ve added a video below that I think is a good representation of what I’m describing here.

The mood of the carnival is ominous. Clients tell me that the content of their thoughts and the emotional tenor of the carnival is existentially heavy. What does that mean? It means that when we are in bed at the end of a long day we are both fatigued and undefended against the thoughts and emotional states, because we are without our work, without other people, without text and video and sound. In short, at that moment we are without the techniques we have in our day to day that keep the most difficult content in our lives and the world at bay. That moment when we lay our heads down in the dark and the quiet, we are at the disposal of any difficult thought or feeling without a way of not thinking that thought or feeling that feeling.

It is very common that in this state, as the tweet notes, that we “broil in existential dread or replay every mistake we’ve ever made”. Why? Why these thoughts and feelings and this time? The truth is that broiling in existential dread is a possibility on any day at any time. But broiling in existential dread can be combated, and we do it every single day. How is that done? It’s done by being engaged—focused, attentive, enmeshed—in your life. Let me repeat that: we maintain an appropriate distance from existential dread—one’s own death, the death of loved ones, fear of isolation, fear of illness, making difficult decisions, and discerning if anything you do makes a bit of god damn difference to you or the people around you or anyone for that matter—by engaging in activities of all kinds that keep us deeply enough occupied to inhibit our thinking and feeling in the existential broil.

This is the reason that folks with adhd speak with such terror when discussing the concept of boredom. Boredom is simply the experience of being disengaged—unfocused, inattentive, and unmoored—in one’s life and, as a result… the carousel of the haunted carnival starts up, announcing that all thoughts and emotions have access to you and demand your attention.

One final note: I mentioned above the concept of “appropriate distance from existential dread.” The word “appropriate” is doing a lot of heavy lifting here. I am an existential psychotherapist, which means I a person who spends his days talking with clients about the existential difficulties that produce difficult outcomes. But I do not believe or think it healthy to spend one’s days in the existential broil. It is important to square up to the realities of life: death, illness, responsibility, isolation, and meaning. But when the carnival comes to town and refuses to leave… that’s not existential courage but existential torture.