S2E44: ADHD, Trauma & Reclaiming Self-Trust + guest Karen Dwyer-Tesoriero

Julie Legg speaks with psychotherapist Karen Dwyer-Tesoriero, who specialises in adult ADHD, complex trauma, and attachment. With over 25 years in social work and psychotherapy, Karen brings both professional expertise and lived experience to the conversation after discovering her own ADHD later in life through her son’s diagnosis.

Together, they discuss powerful overlap between ADHD and trauma, particularly how negative childhood messaging can evolve into legacy burdens that shape adult identity, attachment styles, perfectionism, and people-pleasing. Karen unpacks how rejection sensitivity can be mislabelled as personality disorder, how masking impacts women especially, and how internalised “I’m not good enough” narratives quietly drive anxiety and depression.

Key Points from the Episode:

• Discovering ADHD later in life through a child’s diagnosis
• Masking in women and the “talks too much” childhood narrative
• ADHD and complex trauma: where they overlap
• Rejection sensitivity vs borderline personality misdiagnosis
• How negative childhood messages become “legacy burdens”
• Perfectionism and people-pleasing as trauma responses
• Attachment styles in ADHD relationships
• The role of nervous system regulation in healing
• Using EMDR and Internal Family Systems to untangle beliefs
• Why “normal” and “perfect” don’t actually exist
• Building evidence for “I am good enough”
• A daily mantra: Dare to believe in yourself

Links:

• WEBSITE: https://www.kdtesorierolcsw.net/
• INSTAGRAM: https://www.instagram.com/kdtesorierolcsw
• FACEBOOK: https://www.facebook.com/kdtesorierolcsw.net/ 
• LINKEDIN: https://www.linkedin.com/in/karen-dwyer-tesoriero-lcsw-emdr-certified-411316a1/

Thanks for listening. 

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Transcript

KAREN: Afraid that their emotions are too much. They were afraid that they're too much. And that's part of those negative messages they get about being too much, not being lovable. So that those messages get carried into the complex trauma because they're carrying it with them. It's living in their body. And then they're looking for signs in their adult lives that like, oh, see, that's confirming that negative belief about myself that I have. That's reaffirming it. So, it must be true when it's not true. It's part of the ADHD that lends itself to the trauma.

JULIE: Welcome to Season 2 of ADHDifference. I'm your host, Julie Legg, ADHD advocate, author of The Missing Piece (a woman's guide to understanding, diagnosing, and living with ADHD), and an unapologetic doer of many things. This season, we're turning up the volume with a global lineup of brilliant guests bringing their lived experiences, insights, research, strategies, and resources. And of course, along with a healthy dose of humour and humility. Whether you're neurodivergent yourself or just curious, there's something here for every curious brain. Let's dive in. Today I'm joined by Karen Dwyer-Tesoriero, a psychotherapist who specializes in adult mental health, ADHD, and complex trauma. Karen has spent more than 25 years working in the field, including early work in the New York City Child Welfare System, where she was supporting families experiencing intergenerational trauma long before it was widely named or understood. Through her son's ADHD journey, Karen discovered her own ADHD later in life, a realization that helped reframe so much of her past and the patterns she'd seen in others. Today, her work focuses on helping people undo negative self-talk and limiting beliefs that hold them back from being fully themselves, particularly those shaped by ADHD, trauma, and attachment. In this episode, we're talking about the messages we inherit, the voices we internalize, and what it looks like to gently reclaim self-trust and authenticity. Welcome to the show, Karen. Thank you so much for having me today. [That's great. I can't wait.] We've got lots to cover today. Yes. So, we'll start with because you've spent over 25 years working in social work and psychotherapy, and it was through your son's ADHD journey that you discovered your own. Can you take us back to that moment of realization and what suddenly started to make sense about your own experience? 

KAREN: So he went through his evaluations and you know it came back he had ADHD medications, things like that. And so I was looking up how to support him. He was older. Well, the first time he got diagnosed with ADHD, he was about six or seven, but then he didn't want to try medications and we didn't do medications until he was in high school and we started it at that point. So, the more I started researching about the medications, of course, online, Dr. Google, and a lot of these different ADHD assessments came up and the more that I took these assessments, first of all, I scored off the charts as a severe ADHD, the inattentive type. And then just the more and more I researched it and the more and more I was like, "Hey, this is something I do and this is related to ADHD that my family members like, oh, that makes so much sense now." So, that's kind of how my own journey started. And I really started learning what does it look like? What does masking look like? Especially for women and girls, because that is huge. And the more I was able to relate it to clients that I work with that I was like, "Oh, this is what I'm seeing now. This makes sense now." And I started doing psychoed with them and they started getting tested. So, it's just been a journey. It's just been an amazing journey. And it is at times difficult. It impacts on my relationships, sometimes it impacts on my work, but there's a part of me that can't imagine being any other way. So, I don't I'm like, "Wow, what is it like to not have music playing in the back of your head all the time?" Like, I'm very curious about more you know, neurotypical people as opposed to people with ADHD. Like, it's just it the differences are just fascinating to me. 

JULIE: Aren't they just. And I've often wondered what would it be like to have one thought, right? Really? It's impossible. Or to have nothing in your brain, you know, just thinking nothing. I just thinking what a strange situation that would be. It would be eerily quiet. 

KAREN: I would think we were one day sitting at dinner and it was the four of us. So, me and my son with ADHD and my partner and my other son without ADHD. And a plane flew overhead and I just started rambling. I'm like, I wonder where it's going. I wonder where it came from. I wonder where are they going to be okay? Like what airport are they going to? And I had all these thoughts and my son with ADHD chimed in and he was like, "And what about this and what about that?" And the neurotypicals in the group just sat there like, "Is this what your brain does?" And I was like, "Yeah." I was like, "I'm thinking about the plane and I'm thinking about dinner and I'm thinking about cleaning." Like everything was going on at one time and they just sat there laughing. They're like, "I can't imagine that happening." And then sometimes like we'll be doing something. I'll just start dancing or singing a song and I make up songs and they're like, "What is wrong with you?" And I'm like, "It's my ADHD. It's just taking over right now." 

JULIE: But it's nice now to have a language for it, isn't it? To say, "Ah, that's what it is. That makes perfect sense." Whereas before bit of self-doubt creeps in, you know, why am I so different? 

KAREN: It was actually interesting because sometimes when I find myself spiraling and having that hard time to get motivated to do something or like I know I have an like today was the perfect day. I knew I had you at today at our time set and I was like but I want to do this and I want to do that. So it gave me the structure to be like okay let's go do all those other things before we get on our call. So sometimes when I don't have that it I just could sit all day and now that they know they're like "Okay what do you need to get done today?" Let they help me prioritize what I have to do this way I could get stuff done because sometimes it's just it doesn't happen. 

JULIE: I understand. I really do. How did discovering your ADHD later in life change the way you understood your past personally and in a on a professional basis? 

KAREN: That's actually interesting because it like it shed so much light on so many different things. I realize a lot of my experiences from when I was younger were now related to ADHD, like the different parts that I remember. One thing is I always got in trouble for talking in class. Like every teacher on every report card, "great student talks too much." Great. Like that was the common theme of my childhood. And one teacher turned, I was in first grade, told my mom "We could put her next to the wall and the wall's going to start answering her. Like she could talk to anybody and we put her next to the shiest kids and they start talking to her. Like we got to get the talking under control." But I realized now that was part of my impulsivity. That was part of that. So it still plays in. And I still think of all the times I got in trouble for talking. And now that I'm a therapist, I'm like, I get paid to talk. I found a job where they'll pay me to talk to people. This is awesome. So it does, it did work, but I also recognized the masking that I would do at different points and how hard that was. Like looking back in that and now doing the work that I do, I try and have empathy. Looking at it from an internal family systems point, I try and have empathy for that part of me that had to do that. And now I don't mask it as much anymore. I tell people, I'm open about it. I talk about it because it has been life-changing discovering it and going forward with it. And I'm not medicated. I don't, I'm not on medications for it, but it's it impacts on how I do my work, how I schedule my time with my clients because I need that consistency of the schedule in order to do the work that I do. 

JULIE: We're going to be piecing in a bit around trauma in today's conversation. So early in your career, you were working with the New York City Child Welfare System with families experiencing intergenerational trauma and CPTSD often before those terms were actually even really widely understood. So looking back now, how would you see ADHD and trauma or trauma overlapping in the families you were working with? 

KAREN: Oh, I see it overlap not just in my early foster care experiences working in child welfare, but I see it in adults now. I see it in my practice now where people come in and have ADHD, but also have the complex trauma. And we do a lot of work around that. Like what was that like? Because a lot of them have similar experiences to me where they were diagnosed later. They're trying medications now and they're recognizing you know back in the day... and when I say back in the day keep in mind I only entered the field only enter the field 30 years ago in the 1995 1996 time frame, that's when I started. ADHD at that point was very little was known about it what we were told about it is kids are going to grow out of it kids grow out of it like they no adults have ADHD no we just mask it really well that's what was going on there. And so I see it not just in those early days of my work, but I see it now in my practice with people. And what we know is what happens is these kids with ADHD, and I'm using kids specifically, they internalize negative messages about themselves of they're not good enough, they're stupid, like all these negative messages in part because of what teachers have told them, in part because of what other classmates have told them and classroom bullies have told them, but in part what their parents have told them of "Why can't you be like your sibling? Why do you have to be this way?" Or some parents don't know how to emotionally regulate their children who have ADHD. They don't know how to co-regulate and to stay in the moment themselves to stay calm. And so they come up with their child and meet their child's high emotional level. And it just all of that causes the complex PTSD that now I'm treating as adults here in the room present day because it all plays out. And when we internalize those negative messages about ourselves in internal family systems theory, we call them legacy burdens. We carry them with us into adulthood and into our adult relationships of "I'm not good enough. I'm not lovable." And then that plays into borderline personality disorder dissociation. So it really does come full circle in our mental health as adults now. And when I think about specifically the child welfare stuff, I wish I knew then what I knew now because I would have been able to help those people a lot more, but right out of the gate, I was out of college. I didn't have the experiences I had. I didn't have the training. And what's more important is neuroscience was different back then. We, no one ever talked about neuroscience and how this all plays in. Nobody looked at it. And now it's everywhere, especially in the therapy world when we do our trainings and stuff. It's all about how the mind and the brain and the body are all connected to each other. 

JULIE: You're right though, there's been a bit of catch up required, hasn't there with between the studies and the research, more open conversations, a better understanding now brings us to this point where you're seeing so much of it in your work. But it's ever evolving I guess what I'm trying to say. How do you think ADHD traits, how can they be misunderstood or mislabeled when trauma is part of the picture? 

KAREN: That is so interesting. That's a great question and I love talking about this stuff. So with ADHD, one of the symptoms of it is rejection sensitivity disorder that could very much look like borderline personality. So those two things they kind of look alike. We know borderline there are certain studies out there that say that borderline personality is a hereditary trait but we know more than anything it's born out of trauma and complex trauma and relationship trauma. So what borderline is it's an intense fear of rejection or abandonment whether real or perceived. So, somebody's going away or the fear that somebody might go away or that they might say something where they're going to stop liking me and they're not going to want to be with me anymore and I'm afraid of that. So, that's a really quick overview of borderline. It's a little bit more complicated than that, but it looks like rejection sensitivity disorder because kids are afraid of that. They're afraid that their emotions are too much. They're afraid that they're too much. And that's part of those negative messages they get about being too much, not being lovable. So that those messages get carried into the complex trauma because they're carrying it with them. It's living in their body and then they're looking for signs in their adult lives that like, oh, see, that's confirming that negative belief about myself that I have. That's reaffirming it. So, it must be true when it's not true. It's part of the ADHD that lends itself to the trauma. The other thing that happens in childhood, kids with ADHD, especially the hyperactive type, they might be all excitable. They might be fidgety. The kids in their classes may not like them. Or they might like be like, "Why can't you sit still? Like, you're too fidgety. You're too this. You're too that." Whatever the too much is, whatever that that language is, that child carries that with them. So, they might be like, "I don't know how to make friends" like friendships or relationships get impacted by that and then they carry those messages through. So, it's a really complicated process of this neurobiology that's going on in our systems from the ADHD itself and the lack of dopamine to all of these negative messages and how are we internalizing them and then how is that getting reinforced. 

JULIE: We've been talking a lot about these negative messages and a core part of your work is helping people navigate them or undo them I guess the messages they receive from others or you know, really that comes internalized as you said as truth. What kinds of beliefs do you think or do you most often see holding adults with ADHD back? 

KAREN: A lot of times it's "I'm not good enough. I'm unlovable." Especially the I'm not good enough because that lends itself to people pleasing. And here's the thing with people pleasing and the other part of that is also perfectionism. What is perfect for one person may not be perfect for somebody else. So for instance, if you are a people-pleaser who wants to be perfect, to be perfect for your boss, you might have to be on call all the time. You might have to work till 10, 11 o'clock at night. To your partner, being perfect is being there and being at the house after work and being present in that moment. So those are two opposing views of what perfect is. So how do you navigate that? Now you're stuck with this. I need to be good enough. I need to be perfect. I need to people please. But now I have these two opposing views of what perfect is and I can't satisfy both. I must not be good enough. That's kind of like a process of how these negative messages continue. And the more they think, I'm not good enough, the more perfect they have to feel. So, it really does spiral into depression and into anxiety because you can't possibly be perfect for everybody at every given moment. And then how do you rationalize that? And part of what I do with people is one to recognize there is no such thing as perfect. There's no such thing in this world as perfect. There's no such thing as normal. Those two things don't exist. They're made up words. So, what's normal for one person is not going to be normal for somebody else. And that is perfectly okay. Those differences are what make the world beautiful. Those differences are what make each one of us unique. And we want you to be different. We want you to be your own person. So, that's kind of the broad picture of that. 

JULIE: Oh, that's lovely. This next question, you've probably answered it, but I will ask you in case there's something else we can also tap in, but I love that saying it's there's no such thing as normal, give it a rest. Difference is everywhere and it's great and it should be celebrated. So awareness is really powerful but it's often not enough by itself. And with your work with clients, what helps people begin to loosen the grip of negative self-talk and start relating to themselves with more compassion? 

KAREN: One of the things I ask I ask my clients is what do you want to believe about yourself? What is it that you want to believe? And usually it'll be the positive of I am good enough. I am lovable. So then one of the things that I ask people is so what evidence do you have to support that? What evidence in your life do you have to show that you are lovable and that you are good enough? Like where give me an example of a time where you felt that? And sometimes people struggle with that. And so then I will call out things that I've known that they done or circumstances or stories that they've told me and I'll be like, well, let's look at that. Like did that feel good enough? Did that feel like you were loved in that moment? And so we'll pull from there. And then also what I do is I have some training in internal family systems. So I'll pull some internal family systems in. I'm going to do some polyagal work because what happens is this stuff gets activated in our bodies and we feel the bodily sensations. So I want to know what are those sensations? Where are you feeling that and where are you carrying that? Because when you start to feel that outside of our work together that means that that's getting activated. So what do we have to do to kind of check in with that part that gets activated? So we'll do some exercises around that and then eventually we'll get to the point where we actually do EMDR work in order to help people move away from those negative cognitions that they have about themselves and move into the positive. We want people to really have a good sense of who they are as people and to really believe in themselves. Wow, that's a really powerful question to ask. Why do you think you are worthy of your self statement? 

JULIE: It's really difficult too because I think inside we know how hard we try and how hard we work at things but there's not always a great evidence flow history behind us saying yes we've mastered every relationship that we've been in and we've been wonderful but we know that we actually could be the best partners we just haven't been with the right one or understood our brains enough to follow that through to find that joy. Oh, so complex, isn't it, Karen? 

KAREN: It really is. And often what we're striving for is good enough. Like we want people if they can't get to like, okay, I feel good about myself. Let's get to a part where we feel good enough about ourselves. Like, and it's interesting because if I ask people, name something positive about yourself, they will often like struggle with that. And I'm like, well, what would your partner say? What would your kids say? What would your boss say about you? What are those things about you that are intrinsically about you? Like your character, your being? I don't want to know about like, "Oh well, I have a Louis Vuitton handbag or I have Christian Louis Vuitton shoes." Those things don't matter. I want to know, are you caring? Are you kind? When did you feel that you were being kind? Let's look at that because we're going to pull that going forward into the rest of our work together.

JULIE: It's wonderful to have folk like yourselves that can work with those of us that really need assistance at times because it can be too much to even begin to untangle when we try and do it ourselves. Yeah. And having different perspectives and being asked questions and drawing out this information that's within us. Sometimes it's just impossible to do by yourself because you'll be drawing out the wrong things or asking yourself the wrong question. So, good work. 

KAREN: Exactly. And especially for people with ADHD because they carry so much of this and they may not feel good enough. Some people with ADHD, they're not good students. They don't get because think of that. Think of that. Think about how hard that is to sit in a classroom, especially these days for six, seven hours and being asked to focus on math, being focused on science, being focus, and if you're not interested in that, your mind is going to go everywhere. You're going to be tapping on the desk, you're going to be talking to your friend, and then you get labeled as you're being disruptive, you're being this, you're being that. And we need environments where kids with ADHD in particular, their ADHD is embraced. No one ever told me when I went to school and was talking too much, no one ever turned around and said, "That's going to be a great gift when you get older because you're going to help all these different people." No one ever said that to me. It was always negative about it. Most people with ADHD, they're either entrepreneurs as adults. They work in fast-paced medical environments like EMS, nurses, ICU staff. We couldn't survive without those people. Those people are the real heroes. And a lot of them have ADHD. Cops, firemen, they all have ADHD. So many of them because they're not going to sit behind a desk. They're not going to do paperwork and computer work. It's too boring for them. So, let's celebrate what ADHD is and how does it help us? How can we be successful with having this diversity of our brains when we could really embrace it and make it work for us? 

JULIE: Absolutely. Yeah. With regards to attachment styles, how do they show up in adults with ADHD particularly in relationship boundaries and self-worth? 

KAREN: So that is such a complicated question. So again, attachment styles form in childhood. So if your child who has ADHD and you're getting all these negative messages, you might have an anxious attachment style. And so what that would look like is I want and this happens I will share the story. This happened with my own son. He would be in school. He would be unmedicated with ADHD and he would be getting in touch in trouble with the teacher. And so what would happen is he knew when he got home, I'm going to get in trouble with mom and dad. So he would like the anxiety would kick in and he would start to spiral of "Please don't call my mom. I'm going to get in trouble," and then his behavior he would escalate his behavior. So now the teacher's like, "Oh, we're definitely calling your mom now." And like this would escalate and then he would get even more in that anxiety part of it. So, he would get anxious about coming home. And before we knew what was going on, of course, he got in trouble. Now, as he got older, we were like, "All right, what are we going to do differently? How can we have handled that situation better?" Like, "What did you need to feel supported? And what does the school need to know about you so that they could support you?" And it was a much different picture once we all got on board with it because we were able to support him. But attachment style could be anxious attachment style. They could even become an avoidant attachment style, which would be like, I don't even want to get in a relationship right now. I'm so afraid I'm going to get hurt. I'm not even just going to get in any relationship because they're not safe. And then that carries into adulthood because if you're in an avoidant attachment style, you're going to avoid intimate relationships with partners, you're going to sabotage those relationships. If you have an anxious attachment style, that goes back to that borderline stuff I was talking about earlier because I want to be in a relationship with you, but I'm afraid you're going to leave and I'm gonna act out because I'm going to be anxious that you're going to leave. And it's a constant battle back and forth. So, it plays out in so many different ways. And that's why finding a therapist who knows about ADHD, understands how it's related to trauma, and then how it plays out into adulthood, it it's such a powerful experience if you could work with someone like that. 

JULIE: Karen, you've mentioned anxious and avoidance um attachments. Yeah. What other types of attachment styles are there? 

KAREN: There's anxious, there's avoidant, and then there's anxious-avoidant, which is the two together. So sometimes that's referred to as disorganized attachment style. So there's usually three. And then of course there's a secure attachment style, which very few people statistically actually have. Usually people fall into the anxious attachment style realm. 

JULIE: Thank you. Thank you for clarifying that. Interesting. At this stage of your work, what's feeling really meaningful or energizing for you right now? 

KAREN: The work you're doing right now, what is energizing? Oh, that is so interesting. I am in the process of changing my whole business. So I am moving a little bit away from the one-to-one model and I'm working more with people doing EMDR intensives in regard to childhood trauma, in regard to adverse childhood experiences. So I am moving more in that direction where we could do really intense work on a one-to-one basis. So usually it's 5 hours in a day, sometimes over the course of two days and we do the work that way. And we're using one target with EMDR and we're really like going through the whole EMDR eight-phase process in order to kind of help people. I'm also doing podcast. I am developing some courses. So, I am really in this incredible transition that I can't wait to see. I started writing a book. So yeah, I'm in like this whole transition phase right now in my career. I'm still seeing clients one-on- one, but I have a lot of other projects that I'm working on right now. 

JULIE: That sounds very exciting. And don't we love having multiple projects to work on that gets our passions and our interests just get all overflowing again, which is really exciting. So, really glad. 

KAREN: And we get hyper-fixated. And that's the part that I'm at right now is the hyperfixation part. There's only so many hours in the day, isn't there? And I'm sure I squeeze every minute out of every hour as best I can. I do I and I try and schedule myself so that I know like okay like tomorrow I have my clients and I have to incorporate some movement and I want to do some cooking so that I'm eating healthy like so I'm really trying to like balance it all and it's tough. It is a tough balance but it's so important especially for people with ADHD that we're getting enough sleep that we're practicing self-care. We're incorporating movement into our bodies for no other reason than one, it releases the dopamine and two, it just helps keep us focused when we do have to do work. 

JULIE: Karen, if there's one reframe or a practice that you find yourself returning to again and again with ADHD clients or yourself when stuck in self-criticism, what would it be? 

KAREN: So, I have a sign behind me and I keep it visible on my shelf behind me. It's a mantra that I do. So, what I do every day is I take a couple of deep breaths and I check in with my body and what am I feeling in my body while I'm breathing and I repeat to myself every day, 'dare to believe in yourself.' Because every day it's a new possibility to try something new and be something new. So if you just believe in yourself, you'll be able to accomplish whatever you want to accomplish. So that is my mantra to myself. Dare to believe in yourself today. Try something new. Step out of that comfort zone. How does one start to dare to believe in themselves? It's looking at what you've done in the past and where you've been successful because we want to pull from the strength that you did then and apply it to whatever it is now. So like I said, I want to start writing a book. I started doing an outline and stuff like that. So, I'm using I looked at it like what have I done in the past? And I've been complimented on different writings that I've done professionally in the past, things for courts, for child welfare thing reports that I've had to write for other clients like I've taken that and been like, "Oh, I've gotten compliments on my writing in the past. Maybe I can do this." So, I don't know where it's going to go. It might be self-published on Amazon. Maybe I'll try and get it with the publisher. I don't know yet. But I'm really trying to look at that and dare to believe myself and every day spend a couple of minutes just writing on it and nurturing it and recognizing like it's okay if it's not perfect today. I'll get there eventually, but I just got to keep believing in myself. So, I keep going with it and don't give up on it. 

JULIE: And for someone who's listening who's only just realizing that ADHD and trauma may have shaped their inner voice and someone who's beginning to question the stories they've believed about themselves, what would you most want them to hear? 

KAREN: What I this is important if you in internal family systems which is a the therapeutic modality when we look at that we call that a legacy burden. And what that means is that that messaging was instilled by somebody else based on their own experiences. It may have nothing to do with who you are as a person. And so part of my work with people when we have that or we were witnessing that is we want to put some space there between who you are in your self-led space versus what someone else told you were because they that's their experiences. That doesn't mean you have to internalize that. And using internal family systems, EMDR, that's how we help move past that. Very interesting. You're so right. Even in general conversation, people do project their own fears, their own hopes and dreams, their own perspectives, and it's not necessarily to do with you personally, it's protecting their own. So very important to remember and I think that's wonderful. I'll share from my own experience like there have been times where I'll be like I'm going to go do this and throughout my life and someone will be like you can't do that and now as an adult my favorite thing is like watch me. Hold my coffee and watch me I'm going to go do it now because you told me I can't. So, you know, whether that's part of my oppositional defiant disorder, part of my ADHD, or whatever that is, but I'm not going to let you tell me I can't do something until I try it and I exhaust everything that I can in it. And then I'll be like, "Oh, I can't do that." But what if I do do it? And that's that dare to believe in yourself because it's always possible. 

JULIE: That's wonderful. And these barriers, I think almost we can't see barriers unless we've proven to ourselves that there is one. And even then we'll try and go over it or around it or under it. But for someone else to tell us that doesn't quite cut the mustard as the saying goes. Karen, you've been absolutely wonderful to chat to today and I really appreciate your time on the show. Your links to your consultancy and other bits and pieces will be in the show notes so listeners will be able to find you and learn and read more. [Thank you so much. This has been great.]