A Psychiatric look at ADHD with Dr. Nesrin Abuata

Dr. Diana Mercado-Marmarosh: [00:00:00] Come join me May 1st through the sixth, so that you can rest, rediscover your strengths, reconnect yourself and those physicians like you who are ready to leave, work at work and re-energize. This is the invitation for you. 2023 your year. Join me in Costa Rica in this really amazing, non-judgmental, intimate decision community.

I am gonna show you how to rest and how to recharge. Let's transform your brain up so that you can start to dream the life that you always wanted this year in 2020. I can't wait to learn all about what kind of year you're gonna have after this conference. Take care. Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective.

I am Dr. Deanna Mecado Mar. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now. See it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life. In the past two years, I've come to realize that unlearning some of my beliefs.

And some of my habits were just as important as learning the new set of skills. Well, hello. Hello. I am so excited to be sharing with you a very nice friend, colleague that I've been chatting with before we started, and I probably should have just hit record because that conversation was amazing already.

But I am so excited that she's here. She. All the things. And so hopefully I'm not gonna mess up her name. We practiced, but I'm gonna try. So, Ms. Reen Abk she is actually a family medicine physician. She's a psychiatrist, but she's an integrative addiction psychiatrist. Yoga instructor, Reiki energy healer, and the list goes on and on and on and on.

And guess what? She's an amazing person with adhd. Oh my god, I found the unicorn. Right? Sounds crazy. But as you guys know, we tend to be multi-passionate and multi curious, and we are lifelong learners. And so I am so excited to have her here today because she's gonna talk to us about the relationship that A D H D and trauma can have.

And I was just explaining to her that, you know, the more and more that I look into it that's why now I'm actually getting. I didn't tell her, but I'm working towards getting my certification also for trauma so that I can in further integrate into my course because I, I try to be very careful with my teaching because I don't want you to feel like, you know, everything I'm saying is exactly one size fits all.

There's not such thing, and I want you to try all the tools and walk away with the ones that make the most sense. But I am so excited to have her here. I would love for her to share a little bit about her story and then she can tell us a few things about trauma or anything she wants to tell us. I'm so excited.

Dr. Nesrin Abuata: So thank you Diana, for having me. I just as you said, I got training in, I'm a family medicine doc, a psychiatrist, and I feel like my life story, the overarching theme is all about integration and how do we connect the mind and the body. I am originally from Israel. I was born there, grew up there, and then I came out here from my medical training.

If you've ever been to Israel or heard on the news, we're always unfortunately making it on the news. There's a lot of trauma and. Trauma, big T trauma or small T trauma. So Big T trauma is things that are obvious that everybody sees it on the news and they're small Ty trauma, that it's the experience of what you undergo that puts your nervous system at a risk and not feeling safe.

That's a small ttra, so having grown up in that kind of place, I was just telling Diana as we started, when you're a fish swimming in the water, you don't know that you're in the water until you step out of it. And my growing up, I grew up in, in a lot of trauma without knowing it or understanding it. what you would think of as abnormal here because it's not everyday kind of life over there.

Growing up it was ki part of my life, and as I was going through med school and training and putting on a different lens, I began to see things differently. I began to tap into different sensations in my body and that's when I made the B Mind body connection and. . The trauma really lives in the body because we talk, we tend talk about mental health and psychiatry as in these are your thoughts, these are your experiences, but we don't bring the body into it.

And I learned that you can't separate the bind and the body. The trauma lives there. That's where what I call the crime scene happened. And you have to go back to the crime scene with tools, but you need to go back if you want to have that kind of openness. And healing in your mind. And so that's kind of how my path started.

So really, I feel like I was born for this role in a way given my path. And somewhere along my training, I felt like bringing in mindfulness and yoga. And yoga does. They, we always talk about linking the mind and the body. That's how I added, I call it the psychospiritual. So that you combine both the spirituality and the mental health and then you brain yoga and the body and so you don't separate.

So I tend to think of things like if you have a hair braid, you know, you braid and it's three strands. And so there is the mind, and then there's the body, and there is the spirit or spirituality and you braid it together and trauma. Changes the nervous system and impacts us in so many different ways that we don't want to just have one.

The more tools you have, the better you're equipped to address every part of you. Because before we started recording, I sang Diana about being in relationship with things and shamanism in different parts of shamanism. We're always talking about how can we be in relationship and as physicians when we are getting training, as medical students, we're always thought that the central.

Thing to any practice that you do is your relationship with your patient. You can have the best treatment plan, the best surgical intervention, the best techniques, but if you do not have that relationship with your patient, you are, you're basically on shaky ground. So bringing in, again, all these tools to help reinforce and healing the different aspects of our relationships with ourselves internally, but also external.

It's kind of where my path basically has been. So it's windy, but in a way it integrates. We talk about also being an integrative psychiatrist because integrative means that, again, we look at the whole picture, mind, body, medicine and soul. The food that we eat, the relationships that we have, the communities that we belong to, the histories that we come from, the land that we live on.

So it's multifaceted in that. And over time I've come to think of addiction as lack of connection. So when I hear people talking about addiction and I treat addiction, I'm always listening for where the disconnection happened. Because where the disconnection happened, the trauma happened, and that's where addiction rushed in.

Wow. That's

Dr. Diana Mercado-Marmarosh: such an incredible insight. And you know, I think because I'm thinking just like you are thinking, I people say that I'm more flex or less or whatever, when people are telling me that, you know, oh, that they're smoking or that they're drinking, or that they're doing cocaine or they're doing this or that, or whatever.

And, and when I ask them, well, how did. How does that help you? Like does it help you to concentrate? Does it help you to not feel numb? Like, like does it help you sleep? They're looking at me like I'm crazy because I'm asking them, how does it help you? Because obviously we're not doing something just to do it, and nobody says, oh, can I sign up for more pain?

Please. It, it must be helping them in some way. You know, just like, you know, when people with anemia come in and they're like, well, I'm, I'm wanting to eat the, the dirt. Like, what's wrong with me? And you're like, well, yeah, there's iron in there. Yeah, of course you're wanting to eat the dirt. And so it's so good that you pointed that out that addiction can be the lack of a connection to something.

And sometimes it could be like you're going for the cocaine because you don't have enough dopamine, or you're trying to also fill in a void. Maybe you were neglected and then you realize that food or this or that would fill in. Void. Right. And And it's so good that you have been able to use all your experiences, like they say, to really not just treat the body, not just treat the mind, not just treat the spirit right, but to put 'em all together, like as a human being, , and to really like see it from that angle.

Like, man, that's amazing. And, and like you said, sometimes you have to go through stuff yourself, unfortunately, like your pain becomes your progress or your, your speaking gigs, so to say, right? Mm-hmm. because you understand it and, and you can then turn around and, and say it, and, and it's like you can finish that other person's thought, thoughts, because again, you, you understand it.

Can you, can you, If you want to share, you don't have to. Can you tell me when you realized that you, yourself also had a d H D? Did that happen during childhood or was it like an adulthood?

Dr. Nesrin Abuata: No, it didn't happen during childhood. And again, it's when you also come from minority groups, which I do come from minority group.

There's not enough awareness about mental health and there's not seeking of mental health. And I didn't realize it up until the end of my psychiatry residency. So I was about done with residency, about to. And I was, when you're high functioning, which I was very high functioning, it didn't call for any assessment.

And so I, I functioned, I got everything done. It took a lot of effort, but I got it done. So, but if something would take somebody 50% of the effort, it would take me 150%. But I got so used to doing that all through my life that that was not new. And it wasn't until I began actually practicing that. People were sitting across from me with the patients and somehow when I was sitting with them listening to their stories, something clicked in my mind.

So somewhere between the end of my residency and at the beginning of my actual practice, I realized their blind spots were my blind spots. So a lot of times in A D H D, we were just talking about that before we got on the recording, you have time blindness you miss certain things and conversations.

You miss certain things with the order, the emotional overwhelm seems to be out of proportion to what is going on. All these things, but you're so steeped in that kinda like that we're talking about the fish in the water, you know, recognize that not everybody else is in that water. Yeah, so I would say the window to my understanding myself was through self-awareness.

And why did it? Why it happen at that time? I am not sure. Was it because I was ready? Was it because I was out of residency and all that pressure that comes on you? Maybe that's my guess. But I learned from that, that the window to anything is a self-awareness because then things change once you become self-aware.

And that's why I always ask my patients when I meet with them, if they know what's your motivation for change? What changed? What did you learn? And if they don't have the answer, that's okay, but I'm always putting my finger on the. Where is this leading? What are you learning as you go? Because I was have, one of my journeys on self-reflection and self-realization happened was that window somehow opened and once it did, I was able to change things.

Dr. Diana Mercado-Marmarosh: Yeah, self-awareness. It, it's the first thing that I, I always keep telling people if you're not, Then there's nothing you can do after that , because again, like you said, you're not even aware, you're swimming in in the, in the water. You're not even aware of that. So how can you then do something with it, right?

Mm-hmm. . And so, yes. From awareness, then you can move on to like processing it or realizing, yes, I, I'm gonna take an action or not, or realizing I'm going to regroup or what, what is the next things you have to do? Mm-hmm. , but. I'm so glad that you had that insight because I don't know if you would've had that insight if, if it would've made a difference again, because you would've kept doing it, and that's the thing.

And then if people, that's the theme, right? Like people don't realize how hard you're working because you make it seem so easy. So everybody else's who's looking in, but they don't realize that they're hanging on by sticks because you, maybe because you are in the, in, in the passion of it that you keep going it because it, it's aligned with you.

Dr. Nesrin Abuata: You know, the other thing too that I've. Reflected on, but I also work with children, adolescents. Our sense of identity starts from when we are, when we're very young and who we are, and it gets formed in school and with classmates and in families and communities. And along with that comes our executive functioning, understanding the world and a child in classroom who misses some of the instructions but doesn't wanna get in trouble and falls behind and then starts.

Developmentally, they will start blaming themselves when they're the age group of elementary school. It's very what we call ego systo. So if something bad happens outside, that means something is bad with me. Instead of thinking, okay, what else is going on? And so a level of a six or seven year old cannot explain to you, I was not able to understand the instructions because I got distracted.

And so you start picking up these, I think of them as rocks of your identity. You know, you put 'em in a backpack of who you are and you start picking it. So then by the time you're older and then somebody comes and tells you, do you have awareness of what's going on? You're so attached and fused with your backpack with the rocks.

What are you talking about? The backpack is so sewed into me. I can't take it off. And that's, that's a hard thing. It takes time. So, Diagnosis is the beginning with the awareness. But it takes time to unpack all these patterns in the brain because there are pathways, and these pathways will are well worn out with thinking over and over.

So these thoughts of, I am not good enough having the imposter syndrome, I am not gonna succeed. Nobody's gonna believe me, I can't do it. They come a lot of times from such a young age that you have to travel back to that age to undo. Along with skills and therapy and all sorts of stuff too. So awareness is the beginning, but there's a whole lot of path behind it too,

Dr. Diana Mercado-Marmarosh: you know?

Yeah. And that's why I constantly keep telling people that coaching is about one of many things, right? That you need to use all the tools, like you need to use therapy, you need to use cognitive therapy. You need to use systems like people helping you. You need. Use meds like you need to exercise, like it's one of many things and you shouldn't do it one thing only and and help it happen.

Right? And, and like you said, like when, when you love your parents so much and you want to do the best that you can at school, You're gonna work really hard unaware that you might just miss the mark because you didn't have all the tools. But, but you're doing it because of your impassion with that.

Like you said, you think it's your, it's you, there's no other thing but you. And, and so I remember like when we were finally in. In the US and my dad like had to come and sit down because when my mom would come and sit down in the teacher's classroom, like I wouldn't be quiet. I would still be like, I would do my work and I'd be running around screaming and like I was done.

Like, and they, and she would be like, well give her more work. And they would give me more work and I would do the work and then like, because I would keep doing the work, they'd be like, Well, forget it. We're just gonna skip her grade and we're just gonna skip her grade. And we're just, and so my dad would come and sit down and not until my dad was sitting there, like, I would be like, okay, I'll sit I don't wanna spanking in the middle of the classroom.

Like, you know, and, and, but because like you, we were talking about machismo and different things before, like, you know, my dad was like, Why am I missing work for this little girl to like, you know, I'm gonna give her a spanking here at the middle of the class. And I was like that. That was like, again, maybe traumatic, like right.

Traumatic that, oh my God, I'm gonna get a huge spanking. So that's what like, Shut me up to sit down and be quiet. But it was because I was fearing that he was gonna give me spanking and I was gonna be embarrassed, right? Mm-hmm. And, and so it's not like my A D H D got it got taken away from me. Like I, I was just having to react to the environment based on what was going

Dr. Nesrin Abuata: on.

Yeah. And in a, you know, in a perspective, when we look at the world, Through the lens of a six or seven year old, you're small, you're not big you're not in control. There's all these authority figures between teachers and parents. It doesn't mean the parents are gonna spank you, but there's that threat.

The nervous system perceives it as I'm not safe and what I need to do to stay safe in the context of, oh, I'm not doing what I'm supposed to be doing. It's already my fault. So that is a form of. And that becomes internalized. And then we carry that sense of shame with us and then shame. When it takes over the brain, we no longer have language to describe it.

It becomes stored in the body. And that's where when I keep talking about the mind and the body connection, then when I go back to the roots of the shame, we have to go back to the body to unpack it. Yes.

Dr. Diana Mercado-Marmarosh: You're so right. I hadn't told anybody about my diagnosis about A D H D because I was in such shame, and then when it was pointed out to me, A D H D was just a circumstance that you could decide what you wanted.

It was like saying that the sky was blue or it was saying like, I had high blood pressure, or I had cancer, or I had anything else and that I, what I made it mean was up to me. And I was like, well, no way. Like why would I wanna shame myself? Why would I wanna think like that did not. Take a while for me to process and to realize and, and of course now I feel like I'm speaking from a healed wound or healing wound, not a bleeding out he imaging wound.

Right. Because at that point I, like you said, I didn't have the language, I didn't have the connection, and I remember like multiple people asking me questions about feelings and I. What do you want from me? Like , there was no words because I was so used to putting all those things aside because maybe it was too scary to like sit in the shame or sit in the embarrassment, or it might paralyze me and not help me to do whatever needed to be done in order for me to go forward or do X, Y, and Z.

Dr. Nesrin Abuata: And you bring up a good point about how. . We learn how to be with our feelings from a very young age. When our parents can model it for us, when they can sit with us with the difficult feelings. When we're small feelings, feel like they're huge and we can't manage them, we can't digest them. Having parents that can parent and they can model it for you and digest it for you and make it small enough they can manage it, then you're able to connect with the feeling and be present with it and express it without getting overwhelmed, not being able to, or not getting help.

That is a form of trauma. The nervous system can't tell the difference between what's true and what's true. That's why the business the movie industry makes a lot of money because you sit in front of a TV screen and in your brain, when you watch somebody fall off the horse, you fell off the horse.

And so imagine when you're a child and, and even as adults, your nervous system sees that. It doesn't know what's true or not. And so if the nervous system picks up, this is dangerous. It has to react in. Really, the nervous system has limited pathways of how it can react. The first way it's gonna be fight or flight.

That's the first basic one. If there's a danger, can I fight it off or do I run? If not, then can I freeze? Can I play possum? Because the danger will pass away. Maybe they'll ignore me if I'm quiet. And then if that doesn't go away and the person is still undergoing the threat, then we end up with that last one that you said, that paralysis, that shutting down, that numbing, and the nervous system keeps moving between these three until we've processed it and healed it and integrated.

And imagine being six years old, you're not gonna be able to do all these. And that's where the parent or the therapist or adults helps you manage too, because part of an executive function, and you mentioned that too, is emotional regulat. And I think executive functional skills should be taught to all kids in school, but we don't do that.

And then you add a D H D, it's even harder to access emotional regulation skills. And also people with A D H D are more, they might, I always have a suspicion that people feel their emotions a lot stronger and deeper and more intensely than somebody else. And so the skills are really important to. So if somebody gets mad or angry, they'll say it goes from zero to five.

But with a D H D, the intensity is really high. So that's gonna take a lot more skills and a lot more intensity to calm it down too. And then you add to a trauma and then trauma intensifies because of the way the brain is also processing what happened too. Yeah.

Dr. Diana Mercado-Marmarosh: So I would you just describe exactly is like rejection, sensitivity, dysphoria.

Right. And so, The difference between that is that with a d h, adhd, like you said, it goes straight into the amygdala , and it goes straight there. And it doesn't like have that two second delay with the with the prefrontal cortex like most people do. And, and, and that's why you, it looks like, what the hell?

It just happened. Like what? And then five minutes later you're like, back to your peachy self and they're wondering what happened. Because they're so short-lived, like sometimes less than two hours. It's not like enough to say like, this is like anxiety, or this is like depression, or this is a mood disorder, which they can all coincide of course.

But in general, again, if you're not even aware of that, How can you begin to unpack it and how can you begin to, and it's so interesting, like when I ask my clients like, okay, can you describe like everything you love about yourself and can you describe everything you hate about yourself? Like every time they describe everything about everything they hate about themselves, it's all about their A D H D tendencies and, and they don't realize that it's.

Their character flaws, but it's their A D H D. And when you point it out to them, they're like, oh. And so it's such an, like, like you said, you, you internalize it like it's you and it's you all along and you don't realize, yeah, it starts and ends with you, but if you don't have an awareness, you cannot modify it.

But

Dr. Nesrin Abuata: then you add the layer of trauma where in trauma, the person to whom the trauma happened is unfortunately a. And in that kind of context, the victim gets blamed already. And it's very common for people that undergo trauma to have survivor guilt, to blame themselves in general, regardless of what age it happens as adults, as children.

And it happens because as children, it happens because the brain, like a, like I was saying, it's ego dystonic. Meaning that the belief goes with who they think they are because a child cannot believe. Let's just say their caregiver is abusing them, whether it be physical, emotional, or neglect, the child cannot come to accept such a horrible idea that the person that I have to rely on for my life.

Can kill me is hurting me. That kind of idea or belief results in the child feeling disconnected, and we are born and wired for connection. Connection equals our survival. It doesn't matter what kind of connection it is. Ideally we want a nurturing war mutual connection, but if it's a poor connection, any kind of connection, our nervous system will seek it out, that it will adapt our beliefs to actually make the connection work.

So that means that I cannot. in order to make the connection alive with the parent. As a child, I can't believe that the parent is bad because then who wants to have a connection with the parent? That's bad. But you can live with a thought about yourself. Something is bad with me. I am bad, but it's okay to be in connection with my parent.

And you can take that into adulthood again, when a trauma happens for an adults, no matter what it is, the survivors a lot of. They blame themselves that I cause it. What happened? It must be on me. Because alternative is to believe that really you were not in control of what happened, and to believe that you were not in control of what happened.

That's a very scary place to be at, and that is that kind of lack of connection. Connection to the self because connection to the self gives a sense of power and empowerment and voice, and in trauma, that source of agency and empowerment and voice is taken away. Unfortu. ,

Dr. Diana Mercado-Marmarosh: what are some things that you think.

Tools to help them to start or to even like identify if they, there's, they're being in the victim phase or if they can help themselves to process this trauma, like you said, the trauma store stored in the body.

Dr. Nesrin Abuata: I would say it depends on what phase the person in, because I was telling, talking to you about being in the fight or flight phase, in the freeze phase or in the collapse phase, in the fight or flight phase.

You can process things and you can notice. Because your heart rate is gonna be up. You might have tension in your bodies. You might have more thoughts of anger being animosity against other people, getting into fights, fight or flight. You can notice it. Or other people can now comes in the piece of awareness.

Can you learn to tap into what stage of trauma level you're in? And that starts with the body, noticing your body, noticing the tension, noticing a heart racing with anxiety attacks, noticing are you having back pain? Are you having headaches? Are you having shortness of breath? These sorts of things cue you into, okay, I might be in my fight or flight response.

My body is in that kind of trauma. The other one that I was talking about, the freeze part. That's where somebody feels, they tell you, I feel paralyzed. I feel like I can't take action or socially, it becomes what we call fawning. Fawning is when we're talking, Diana, I tell you what I think, I, I know what you want to hear, so I can't show you who I am because it's not safe and I had to find, I have to hide myself.

Finding is I fake it in front of you with the belief that hopefully, if you like me enough, we're gonna be. You know a lot of people because the fight or fight, we're not fighting every day. We're not arguing every day. It's not that common per se, but the fawning is there a lot. And then the last stage is the the numbness part.

And that's where somebody says, I can't connect to my fear. People cannot even tell me they're not in touch with their feelings. That's when they tell me, I just feel blah. And that's when I begin to wonder and to ask and to kind of bring in the awareness. Are you feeling numb? You can't feel, and then I ask, can you track your body?

Are you aware of your body in space and time? Are you in touch with your toes, with your feet, with the hold of your body? A lot of times in trauma, especially when it's chronic and for a long time, people are in their head having left their. So how to tap into the trauma so you can do something out. Like I said, you start with the body and you see what the sensations are and follow that.

Sometimes you might be able to start it on your own, but a lot of times you can need the help of somebody, like a therapist or a coach or a trusted loved one. It's hard to face it alone because it overwhelms the nervous system.

Dr. Diana Mercado-Marmarosh: Yeah. You bring in such amazing points, like, yeah, this is amazing. Oh my God.

Yeah. I'm like, my brain is going like amazing. Like I'm big of all kinds of things like I wanna have you at like I do. And I'm just like, okay, slow down. But it's amazing because again, when you start to see the connections, you cannot unsee the connections. And like you said, if you just work through each area of it.

It just opens you up to stop carrying all that heavy little rocks that you didn't even know you kept putting in there and put putting in there and, and you don't realize how easier it would be if you just unpacked those rocks that what got us here. And we're, we're trying to go. We don't need all that.

Like if you can learn or unlearn and so much of the unlearning, I feel like this is what I keep saying in my course. We get taught first, do everything for your patient. And, and I say, the day that I realized I was the most important patient in the room was the day that I realized that if I wasn't okay, but if I wasn't taking care of my mind, my body, my spirit, everyth.

Then I, I was just gonna come and then my patient was gonna get me at 20%. They were not gonna get me at like 50, 60, 80% because I wasn't the first patient in the room. And, and so that was such like a mind shift for me. And then that's when I started realizing, okay, so it does start an end with me, but I'm gonna need a lot of help

Dr. Nesrin Abuata: No, but you bring up a good point about how in healthcare, The message that's propagated as we get training as physicians, that the patient comes first and you are expected to run on empty, empty tank, even from our training. And imagine then growing up in an environment where the connection with the caregiver was poor whether that be actual physical outright abuse, but a lot of times the most common from abuse is neglect.

And so when you grow up in that kind of environment and that kind of connect, And caretaking where you are neglected and in that child's mind to take care of things and make the connection work, then the child has to become the caretaker. That child has to fill in all the gaps in order for the relationship to work.

In their mind, it doesn't make sense because adult will do whatever they wanna do, but in the child's mind, I can fix it, right? It's on me to do it. If things are not going right, I caused it. I am the beginning and the end of it. Just what you're saying in a dysfunctional. And so then you bring that to becoming professional caregivers.

We put ourselves last, we run on empty, and in a way, we perpetrate the same form of self neglect in these sorts of growing up young relationships. Professionally. I don't think our patients want us to self neglect. I don't think our patients want us to harm ourselves. I think that's the last thing they want.

They want a doctor who. Fully present with them, fully connected. My patients, I can tell when I walk into a room that they care about me because they ask me, how are you And I, I won't go details. I say, I'm okay, but I can tell they care about us as humans and we're not there. Talk about ourselves, but they do care about us.

And so what kind of message do we send them when we come into the room and we are running on. They already struggle with the relationships and patterns and trauma. Well, they have run on empty too. And so then you have two people with that sort of background, an internal attachment system with trauma and neglect, and in a way we're not helping each other out.

So how do you learn to heal inside so that they can, you can run on a full tank and energetically people can feel that, patients can feel how their doctors are doing. They might not say any. But we as people can tune in, we're intuitive. We're intuitive human

Dr. Diana Mercado-Marmarosh: being. Yes. So much to that. Again, like my brain is just like going like, oh my God, amazing.

I could share like 10,000 stories about what you just said and, and, you know, giving us ourselves permission, like you said, to have those conversations with candid conversations. Like you'd be surprised how many times I told the. I know you're not making the list cuz I didn't make my own list either. But I guarantee you that if you do X, Y, and Z and I'm gonna see you back the next week cuz I want you to tell me that you did X, Y, and Z.

What a difference it makes. And they just look at me and I'm like, I know because I was doing it too. But when you start putting yourself first again, the ripple effect that happens, and again, I'm not talking about like putting yourself and I tell them, You are in self neglect if you're not in self-care.

And I didn't even know what self-care was before. And and it sounds such cliche-ish because most people are like, oh, she probably means she's over there on the golf course and getting her nails done. And no, I mean, like eating sleepy baby, like the basic ADLs of, of life. Right. And, and when I say that out loud, they look at me and I'm like, yes.

That is self neglect. It is because you're not aware that you need your basic things and you don't, and again, it goes back to like maybe you're a mother and you just think you do all that first, or you've been, you are a physician and you've been told you're patient first, or you are the oldest one. And so you think you, you have the responsibility, like all these things that we again, get to reinterpret and then.

Ooh, I can see how that could have been traumatic or I, I am taking on somebody else's idea of what. Ideal for me, . And again, I didn't make the plan. They just told me this was the plan. And so you were well and told that this is what's going on. Right. And yeah. Wow. I mean, so many insights that you're giving and so many amazing pros.

So, Do you take do you do coaching? Do you do consulting? Do you, do you just see your patients in the psychiatry addictive treatment? Or what are, what are the things that you how can people find you? Because I'm sure they're gonna be like, oh my God, I can't wait to talk to her. She's

Dr. Nesrin Abuata: amazing.

Yeah. I do different things. I have my own private practice and so I see, I see patients there as patients. And then I also work at Addiction Center too. And then I also do provide coaching and. And I do teach, I have like classes online too. My website is my first, I'll type that in the, in the link here.

But my website is my first and last name, md.com. So N E S I N A B U A T A md.com. And so you can find me there, you can reach to me there. I have a YouTube channel. I have a podcast too. Yeah,

Dr. Diana Mercado-Marmarosh: tell us all of those so that they can

Dr. Nesrin Abuata: find. So my podcast is actually called My Grandmother's Blessings, and it's very, it's, it's kind of like 10, 15 minute short stories that are meant to inspire people to reflect.

So I bring a story, I bring an experience, and then ask the question so that you can internally reflect going back again to that self-awareness and awakening inside. And I love that podcast because I loved my grandma. I was very close to her and she helped. in a way. We were talking about the adult that sits with you through your feelings and processing and teaching you and digesting things for you.

And my grandma was that, and I hope that everybody listening to this can identify having that person or that source of love, because that can be from our pets that can ground us and help us emotionally regulate. So I was inspired by my grandma, so I called them my grandmother's and then blessings because kinda like you're saying how you go through stuff and the difficulty can become your medicine, it can become your wisdom.

So my hope with these stories that I share are, can you be inspired? Can you learn something? Can you reflect? And so you can, if you type it on Google, you can find it. So that, and then my YouTube channel is also under my name, Rin Abu, and also my website. And then I have a Facebook group Under Mind Alchemy, which is the name of my clinic.

And I called my, my clinic that because I really believe in mindful transformation. Amazing.

Dr. Diana Mercado-Marmarosh: So as you know, people listen to us have a D H D, and sometimes they tap out, although they shouldn't have tapped out because this is an amazing episode. But if they did, because we have wondering mine, what would you want them to take away if they just started listening?

Right.

Dr. Nesrin Abuata: Two words that come up. Three. Well, three words, self-acceptance, self-awareness, and embodiment. Know when you are breathing, can you feed your body. These are the three words, because if you can build that kind of building block, then you can process through things.

Dr. Diana Mercado-Marmarosh: Awesome. And the last question I always ask people, What do you hope to see yourself for fun in the next three years?

Dr. Nesrin Abuata: I would like to be able to do these what do you call them? They're like, they're trapeze. You can be doing the trapeze in the air. But you have to have a lot of core strength. And I've been working on my body and then we always talk about A D H D to me, you have to be in your body. It's the, this is the most healing thing.

So I've been challenging my body, so if I can build enough strength to be doing trapeze in the air, that's what I would like to be doing for fun. It's

Dr. Diana Mercado-Marmarosh: amazing. The reason I ask that question is because like when we go back to dopamine and fun is a fastest way to tap into dopamine, right? And so if you are doing something for fun, you're definitely refilling your cup and you're definitely gonna step up to whatever comes your way because you are in the fun mode.

I love that question. Awesome. Well, it was such a pleasure to have you and I can't wait to continue to interact with you and I'm sure I'm gonna. Beg and pray that you come and be one of our guest coaches in my program because I think we all can benefit again from that connection. And yeah, I'm already thinking of 10,000 things that I want to do.

So this is amazing, right? This is our A D H D. We can just feel the energy and the energy guides us there. So thank you again for for coming. It was such a delightful convers.

Dr. Nesrin Abuata: Oh, thank you for having me, and I hope that when people are listening, they're building these awareness and just, you know, never start with one question and then see what leads you.

Dr. Diana Mercado-Marmarosh: Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website@hdlivecoach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.