A PHYSIOLOGICALLY-EXPANDED APPLICATION OF THE BIOPSYCHO-SOCIAL MODEL WHEN SPECIFICALLY APPLIED TO ADHD WHEN WORKING WITH CLIENTS IN SEXUAL AND ROMANTIC RELATIONSHIPS

Originally proposed in 1977 by George Engel as an improvement to the biomedical model, the widely accepted, traditional view of the biopsychosocial model stipulates that well-being includes the effects of psychological, behavioral, physiological, and social dimensions. The application of physiology in this model is too-often limited to the basic ideas taught in a high school or college general biology class. When viewed from the modern conceptual understanding of the brain and mind, the traditional bio-psycho-social model presents a simplistic, 1950’s conceptualization that fails to include the complex interactions of neurochemistry and the nuanced implications of neurophysiological differences when compared to neurotypicality. The shortcomings of this simplistic model become apparent when working with clients in sexual and romantic relationships where one or both of the partners has attention deficit hyperactivity disorder (ADHD). People who suffer from the executive dysfunction of ADHD are held hostage by the demands of a world that was not created with them in mind and are doomed to failure by the very world that expects them to capitulate to its social and cultural norms and structured time demands. When combined with ADHD stereotypes and prejudices within the mental health and medical communities, the simplistic, traditional, time-honored medical and psychotherapy “treatments” for ADHD—especially as they pertain to relationships—present as if they were created by neurotypicals for a complex inner world they have never experienced and cannot understand, and can best be summed up with the statements “there’s a pill for that” and “just put it on a list”. This paper challenges the traditional, deficit-focused view of ADHD in the biopsychosocial model based on the current understanding of neurochemistry, and neurophysiology, especially as it applies to psychosexual therapists working with ADHD clients in sexual and romantic relationships.