Ep 74: ADHD & Trauma: The Hidden Connection with Cristal Sampson

🧠 ADHD & Trauma: The Hidden Connection with Cristal Sampson, Yale PMHNP

In this powerful episode, Cristal Sampson shares expert insights on the often-overlooked connection between ADHD and trauma, drawing from her experience as a Yale-trained psychiatric nurse practitioner and founder of Spirit Clinic.

📌 Key Topics:

• Understanding Big T vs Little T trauma
• How childhood experiences shape ADHD symptoms
• The science behind EMDR therapy
• Breaking the cycle of emotional boxing
• Practical strategies for genuine rest and healing
• Navigating parent-child trauma dynamics

🗣️ Featured Quote: "The trauma of being left can be a catalyst for ADHD symptoms - whether it's big T trauma of physical absence or little t trauma of emotional unavailability." - Crystal Sampson

👤 About Our Guest: Cristal Sampson is a board-certified Psychiatric-Mental Health Nurse Practitioner (PMHNP-BC) and founder of Spirit Clinic. Yale-educated, she specializes in anxiety, trauma, mood disorders, and the intersection of ADHD and trauma, bringing a unique focus on presence and attunement to her practice.

🔗 Connect with Cristal:

• Website: spiritclinic.com
• Instagram: @cristsamp
• YouTube: @cristsamp
• TikTok: @spiritclinic
  
  

💡 Remember: Healing starts with presence. Your coping mechanisms served a purpose - now it's time to discover what serves you today.

🔗 Useful Links Mentioned: 

Learn more about private coaching: https://learntothrivewithadhd.com/services/

Free Resources: https://learntothrivewithadhd.com/freeresources/ 

Website: https://www.learntothrivewithadhd.com/ 

LinkTree: https://linktr.ee/learntothrivewithadhd 

Instagram: https://www.instagram.com/learntothrivewithadhd/ 

Facebook: https://www.facebook.com/learntothrivewithadhd/

#adhdtrauma #mentalhealth #traumahealing #adhdsupport #mentalhealthawareness #adhdcommunity

Click here for full show notes.

CLICK HERE for more resources. We're on this journey together!

Transcript

All right. Welcome back, everybody. I am so excited today to present to you Crystal Sampson. And she I'm going to let you introduce yourself with all your credentials. She is a former client. That was just a model client. As far as like as soon as we got your time management under control, you were like, easy, breezy, breezy. But, yeah, go ahead and introduce yourself.

Yes. So my name is Crystal Sampson, and I work as a psychiatric nurse practitioner seeing patients and Connecticut and New York. I'm a Yale School of Nursing graduate. And. Yeah, former client of yours definitely found myself in need of some executive functioning coaching. And I often recommend your services and services like yours for patients who both have of course, who have ADHD or even just, you know, executive functioning difficulties sans ADHD diagnosis.

You know, because I feel like almost everyone can benefit from some of that sort of work. That is a very good point that I think a lot of people don't know. Is everyone can be, you know, higher or lower in certain executive functions. And it doesn't mean that you have ADHD because you are. And so that's that's that's a very good point to bring up.

But something that I've been wanting to talk to you about is trauma, which is just a heavy subject, but can be. Yeah. So. So I'm just going to let you lead the way. We've been having a little bit of a conversation before. I know I have, you know, experience. I've heard about like big trauma and little trauma, and I've definitely experienced both.

And I do feel like for looking at myself and looking at, like, friends around me, that, you know, things from our childhood could continue to affect us if we don't handle them properly. And I just I guess we're here today to talk about, like, what does that look like, handling it properly? Like, what is the prevalence of trauma amongst people with ADHD?

Like, what's, what's your knowledge on the subject? Yeah, I mean, yeah, you brought up a ton of points. Gosh, there's, there's so much. Well, how can I start with a definition that I really like from Kathleen Wheeler? She is also a psychiatric nurse, nurse practitioner. She is a scholar, a professor at the University of Fairfield. I believe as of present day.

And in one of her books that I have, one of her textbooks she defines as an event or series of events that overwhelm an individual ability to cope and or significantly disrupts their physical, emotional, social or spiritual well-being. And I really like this definition because to me, it highlights just how broad of a definition and trauma is, right?

Just how all encompassing it can be. The definition of trauma pretty much leaves no one out. Right. Because if you if you look at it, you can certainly see ways in which what you've experienced could constitute the trauma. You talk about big T trauma versus little t o big tree, big T trauma. I suppose that would relate to things that appear to seem obvious, right, so to speak.

Right. So so, you know, catastrophic events. Right. Experiencing natural disaster abuses of of any and all kinds inflicted upon a person you know could could qualify as big T trauma. But I you mentioned executive executive functioning and how it sort of exists on a spectrum. I would say that the so-called big T little t trauma also happens in degrees, right?

Because I would say a big T trauma is witnessing any one of the so-called, you know, big T traumas witnessing, just witnessing. Right. You know, it's not it's not even happening to you, but just bearing witness to it can be absolutely traumatizing enough to be, you know, considered big T or at least affect you like any other big teachable moment.

So, yeah, so it's it's a matter of degrees. Little T trauma. I that to me is the most profound. One of the more important ways to define trauma a little t is pretty much the one that's like, inescapable, right? Like, it's almost like a like you're not. Everyone has had a little t trauma. The most potent to me and most common is actually like the trauma of emotional neglect.

Emotional neglect from early caregivers is a so-called little t trauma. As in, like, no one's talking about it. No one's an uproar. No one's like, trying to give you emergency services for it. However, the impact can be incredibly long lasting and incredibly pervasive. Little T traumas, if you ask me. Traumas, trauma, pain is pain. Suffering is suffering. But you know, these kinds of trauma you often see like play out in relationship and that would be relationship to self and all that entails.

Right. Relationships to your behaviors even that I would consider that a part of relationship to self, relationship to your thoughts, relationship to your emotions, all of it. Relationship to solve everything that comes under that umbrella. Relationship to others. You see that a lot. You see that play a lot in relationship to others in thoughts. I've had patients that like present quite well, right?

Like everything seems to be going fine. Like they're they're like picture perfect model of a person. Everything looks good like great career, like, you know, they're on time, they're organized. They, you know, pay their visits on time. Everything looks good. They look good. Well presented. And then like you hear about how their relationship is with their like, spouse or partner and it's like, whoa, like this is different person, something is happening.

Something is happening. Yeah. So, so yeah, I see the relationship as being very incredibly sensitive to these little traumas, these traumas of of emotional neglect, emotional unavailability, which, you know, accumulate over time. You know, a lot of us have had caregivers in childhood who first and foremost were emotionally unavailable to themselves. And, you know, therefore, it's it's it's it's an impossibility for them to spontaneously give the sort of attention and availability that we need as children.

These this and the emotional aspect of child rearing is so important. It's a part of what literally helps us ground and center like, even though I'm talking even as infants, like our caregivers ability to self-regulate and to self attend to what's going on in their internal world has an impact on us. If they're unable to do that, we feel that earlier.

If they aren't able to do that now, you become a safe landing space. You're safe. You're my protector. I can be here with you. Right? So, yeah, so, so incredibly pervasive, incredibly ubiquitous. I would even say that's like the biggest reason for any and all of us to work on our own selves is because, you know, the things that we sort of leave behind or, you know, try not to look out or try to bottle up or, you know, box away, it has an impact on us.

And that thus has an impact on others, especially the vulnerable ones in society. Right? The young ones, the ones that look up to us. I also, you know, I call that sort of thing like, you know, the traumas that need our healing attention. You know, I it's a little radioactive. And by that I mean, you know, a lot of us we tend to have these experiences that are incredibly, incredibly, incredibly painful.

And we we box them up and we try to some them in the far corner closet of our mind and, you know, hope that that is enough to kind of like keep us away from it and just back into the real world, back in to real time in our lives. But it's radioactive like it's like warm, warm from the closet.

Right. And in what ways is it radioactive? Like I mentioned, it's radioactive in the ways that it affects our relationships to everything self world in others. It's so interesting that use that term, boxing it out because that's the way I always used to put it, is like you would box it up and put it away and I would always kind of like put on this front that like everything is fine, everything's okay.

You guys just get your stuff together and, you know, when I would watch other people, rightly so, struggle, I'm like, No, you just you just put that stuff away and and move on, soldier up. And then I realized as time went on that like, then those boxes start to rot. yes. Is that is so okay, so the thing about the boxing it up, you know in this case or coping mechanisms in all cases which I would consider that a coping mechanisms of a coping mechanism of yours, the boxing up the the feelings and things is that there was a time in which that worked.

There was a time and a place in which that was the answer in the environment in which that solution was born is the only environment in which that solution works. The issue becomes one where you leave the environment that created that coping mechanism that we start to have issues, right? That's when we start to have problems. Something that what that worked and was a solution and seemed reliable and helped us and helped us survive and helps us cope becomes a toxic right outside of that environment.

So so yeah, when it comes to things like boxing things up and any other coping mechanism, I always my first thing that I tell my patients is to view these ways of being first and foremost through a lens of gratitude because they saved us, man. Like they saved us. Their problem now, right now that we're autonomous and we're adults and we're accountable and responsible and we're, you know, we've we've got the autonomy.

It's an issue and we're all in the house. It's an issue, but it was a 100% a savior. I mean, it was the thing that saved us. So always with gratitude, I try to approach those behaviors first and then look into how we can begin to swap those behaviors out for for healthier mechanisms. Not so valid eating and makes so much sense because I look at my teenagers now and I see them try to deal with their emotions and sometimes they're they're just coming at them.

So fast and they don't even understand why they're upset. And so they're they're kind of unable to, like, suss them out and deal with them. And I remember feeling that as a teenager, and that's when that tactic of boxing it up and putting it away was useful when I was a teenager, when I didn't know any other way to handle it.

And then I carried it into thirties, my thirties, like I just kept it going and then it caused like depression and anxiety and things like that because I didn't have somebody smart like you to tell me this no longer works for you. But you know, you it sounds like it was kind of telling you it wasn't working. It was just a matter of like, I don't know what else to do.

So, you know, that's what good therapy can do, right? It can give you other ways to cope with the stressors. So I'm glad that you even, you know, got to the point where you understood that that wasn't working for you anymore. Many of us live a whole life perish and never get rid of that sort of thing. So guffaw, you know, and it's funny because I had an experience where my husband had just a lot of he went into anaphylactic shock at one point because he got bit by an ants, which we didn't even know he was allergic to ants like there were he had to go into the emergency room for another thing.

There was like all these I was joking at the time, like he just keeps trying to die this month. Like, and my friend's like, How are you dealing with that? And I'm like, I'm fine. And she's like, She she was smart enough to go. That's an odd response. And she's like, You're fine. And I'm like, Yeah, I'm fine.

And and it I don't know if in the moment I realized it or if it took me a little bit or if it was maybe her questioning me a little bit where I'm like, there's that same coping mechanism of like, box it up, soldier on, you know, to just deal with it. And I was like, okay, that's that's not a normal response to what I've been dealing with.

And that's that's just good information at that time. But I appreciate having that friend that was like, are you sure you're fine? But I had expressed to Crystal before the call that I had written in a college type setting about a, you know, traumatic thing in my life. And it kind of set me on a spiral for a week.

And you were telling me about writing and how that how that could have been better helpful than just writing that one paper that one time. Yes, I was loosely recalling an Andrew Huberman episode in which he spoke about with the healing powers of writing and, you know, and the so-called healing powers of writing comes from research that was actually done, I believe, on college students, where they were tasked to write about incredibly traumatic experience.

And the research found that day one of writing was the worse was the worse, the worse, the worse, the worse, most painful, most discomfort, you know, just terrible. Right? And so when we feel that way, the natural response is to want to back away from that feeling and from the material causing that feeling. However, what the research showed that the very next day they had the students write again, and then they noticed that their responses were much more muted than the first day.

And then I believe it was by the third day, people started to actually gain insight. People started to actually have an an understanding that perhaps they weren't able to have before because they never were able to look at the source material, you know, from which you can gain insight. And then, you know, you know, some healing actually begun once you, you know, are consistent and you have this consecutive writing.

But most of us don't get past like a day one experience like that, right? So we would never know that, you know, behind that day two and three and so on, that there can actually be, you know, a potential transformation of our response to that same traumatic material. Yeah, I love hearing that. That is such an action item to take away from this to, you know, maybe with the help of your therapist or whatever it might be with some support going through that writing exercise.

But yeah, that's I love hearing that. Another thing I brought up that I have been interested in, it's actually on my Not Now list. I have a now Not Now list for my time management and it's been on my not now list to look into MDR. And I loved hearing your positive feedback on that. Can you explain to people what that is?

my gosh, can I? It's so complicated. Well, it's like slightly mysterious in there as well. That's what I told my patients when I introduced it, which I'm not a specialist in EMDR. As a psychiatric nurse practitioner, I mainly provide medication management. And and there are some sort of, you know, what I call, like processing therapy in which, you know, we sort of like explore, you know, through curiosity and questioning and like create quality listening.

We can we can get somewhere, but if we need specialized care, go to a specialist. So EMDR stands for Eye Movement Desensitization reprocessing. It is a therapy specifically created to treat traumatic stress of any and all kinds, really. And. WHEREAS, there are other therapies that can be modified to focus on trauma, EMDR is like it's the one it was made for.

This. The thing that I most love about this therapy is that the risk of reach composition is much, much lower than traditional talk therapy. I was telling Mande, right. So in a traditional talk therapy session, if you are wanting to get at the traumatic material, you just have to state it out loud to the therapist and consequently to your own ears.

And even just hearing about the traumatic material can elicit and does for many people, elicit traumatic stress responses that can then negatively impact you. Like you mentioned before, with the writing for for four days, four weeks. So with EMDR, the material, the traumatic material is targeted in this particular way that sort of takes your conscious thinking out of it right, Because the body keeps the score.

So this stuff is in there, right? It's in the subconscious, it's in the body, it's accessible. You don't need to talk about it, to access it and to treat it and to potentially heal it. Right? So EMDR, EMDR does that and it does it through the first two letters of that acronym, the Eye movement. Eye Movement. It just it's a placeholder for any bilateral stimulation, right?

So that can be and you may have heard of this or the listeners that could be, you know, tapping alternately on your own thigh. That can be the back and forth eye movement and any sort of bilateral stimulation in this way. And the desensitization, I mean, traumatic stress, I mean, that is a sensitivity heightening state. So there's desensitization that happens and there's reprocessing that happens.

That's kind of to me a part of the mystery. But but but yeah, it's it's an incredible, incredible therapy. Studies have shown that especially like early on in a traumatic event, if you can get EMDR treatment, your chances of improving like improving as in like no more PTSD is quite high, right? So I'm thinking, you know, like a, you know, a traumatic loss or, you know, like a like a traumatic accident or, you know, like if you can get in to an and you're a therapist quickly, you can actually stand a chance of like eliminating that diagnosis.

And then for the rest of us who have, like accumulated little traumas, that that could still absolutely be targeted by EMDR, you know, I would say give it a try. It's so exceptional. I love the EMDR. I'm so glad. It's so good to hear. Now, how is that different? Or maybe it's just a form of but what about NLP neuro linguistic programing?

So I'm actually not terribly versed in an LP. Okay, maybe you can share a little bit with us. I was just reading this morning all about trauma as you do. Yes, we do. But they definitely brought that up towards the last bit of what I was reading. I think it was in the Body Keeps the Score. I was reading a summary of that and they were talking about it.

And I simply I know as much as you do, I've only heard of it. I, I know it's a thing. I just didn't know exactly what that was. And I just made a mental note to, like, look into it and see perhaps this is my son. I need to look into it as well, because it's always good to have an option of therapies to recommend to patients.

So I I'll have to do my due diligence and look into this therapy as well. Thank you. Well, something that I know I experience and a lot of my clients experience and I'm curious if this is tied to having past traumas, but an inability to soothe yourself, an inability to rest, guess that type of thing, what would you say to that?

How do we learn to do that? That is such a wonderful question. That's so good. I would say to Russ I'm just making a note so that I make sure I can get back to, to this. I would say the sort of ties into my theory about how trauma can be potentially a catalyst for a person to begin to experience ADHD symptoms in their life.

And my sort of theory is that there's a trauma of being left that to me seems to affect or influence like ADHD or ADHD symptoms. And that trauma of being left can be a big T trauma of being loved or a little T trauma of being left. And when you say being left, you mean like abandoned left any of it.

So big T trauma being left. B your early caregivers are totally drug addicted and they're not in the house, are not available. They are not there. You are left in that way. Little t trauma of being left and this is so common could be the fact that you are like a gifted kid, a bright kid, and like your parents are like, you got it left.

Right? So there are, there are so many levels and degrees of being left there can even you know, this one is harder to talk about because what do you do? How do you solve it? How do you prevent it? But like, even like you're busy parents, like leaving for work all the time out of the house for hours and hours and, you know, and then they get home and they just want to relax and they're tired and they don't really have a lot of time to, you know, deal with what you've got going on.

That's a version of being left and that can absolutely, you know, be a traumatic experience. So this goes also. But I feel like this ties in to what I mentioned at the top of the, you know, podcast is needing needing to be around our people, our early caregivers, like sort of bartering, borrowing their calm as kids. Here's another way that we're left super anxious parents, super depressed parents, or even moderately anxious and depressed.

That's a form of leaving, not being present is a form of leaving is a form of of abandonment. It's hard to talk about because it is so common. And again, it's feeling of what do I do? I have to go to work, what do I do? I have to think about the future. Well, if you can imbibe your life with a bit more presence, that is going to help a lot.

ADHD is pretty common and so are these traumas of being left in all of the levels of T. Right. So I really do. I see a bit of a correlation there. And so, yes, rust, rust, that deep rust and that deep self-soothing seems to me to be like coming from like the parent child connection, like the DB, like I need to soothe.

I can't quite get it because we didn't quite have it or have it consistently. Now what to do about it? I would say what to do. I would say there's a lot of healing in being present. There's a lot of destruction and not being present and there's a lot of healing in being present. So the more that we we can be where our bodies are, the better able we are to begin to rest and to soothe.

But the more that that we are here and we are there, we are where we were when things happened to us. We are where we want to be, where, you know, anywhere but here is going to make it hard to rest and soothe. So come back here, find some sort of security, comfort, safety here, however you might find it.

And often it's like the simple things that can help us feel calm and safe and grounded where we are. And that could be anything from like having your favorite like super soft blanket or your favorite super soft socks. This I hear this a lot. And like, like treatment for like ADHD and autism is like these, like all strategies you can think of that help you to feel safe, calm no matter how crazy or what have you like, do it and make it personal, right?

Make it personal. One of the ways that I sort of engage rest is is meditation. I know that can be really, really tough for many people. Any bit of meditation works, you know, that's meditation right there, right? Anything that once again brings you where your body is, is going to be present and can be meditative and can help sort of be the groundwork for that, you know, good deep breaths and soul soothing, soothing that you're looking for.

And presence is such a problem these days, especially with cell phones and things like that. Like when are we ever truly present? It's so, yeah, it's my presence is a problem. But again, the presence is a solution. The problem are all the things that take from the present moment. How do we do it? There are some questions where the answer is question How do you do it?

You do it like it's like yoga. So sometimes when you get to sort of distilled to the core, I've had these sort of conversations a lot with patients is like, Well, how do I, how do I we start getting closer and closer to are to a core of the answer. And then we like hit this thing where you don't go any further.

There are no other answers besides turning that question into like a period and taking like the question piece off the front. And that's your answer. So, so it's it's trying is practicing. It's doing the the the what is it to try and to practice is to do so just try and practice and you're doing it by virtue of trying and practicing.

So so unfortunately like, but like that's kind of the answer. And I know a lot of us, like, we kind of want it to be like bigger, grander, more profound. But I think there's a lot of profundity in simplicity. I mean, I think it shows itself, even just in what I said before about, you know, the answer being in the question.

So I would say that's how you kind of have to try to practice. Yeah, I was doing that research this morning and there was so much about de-stressing and I was asking that question, How how do I de-stress? And I was going through kind of like all, all of the like confusion about it really. But I love your answer.

Like we just have to try things and see, see what works for us. At the end of the day, that's that's the only step forward is the trying of the things we can gain. Knowledge and knowledge is power and important, pivotal. But nothing is going to substitute the trying. Yeah. So what if we are at the stage where we are parents who now have older kids or we are the kids of of the parents and maybe we were the parent that wasn't as present as we would have liked to have been or maybe we had parents somewhere in its present as we needed.

Yeah. What what do we do now? See, I like to think of my work as, like being at an intersection between, like the psychiatric and the spiritual and that question of what do we do now that we've discovered that some past events are very actively influencing our lives are behaviors, our personalities, our choices, our decisions, our relationships. Now, what do we do that immediately?

Gets me thinking about some more spiritual solutions. And what is that to me? Like? The spiritual is the personal. So it's like something that unites us. You can't necessarily get like a universal answer to. To me, that's something that like you must discover something that no amount of external information is going to give you. I think this is where the road of information kind of like stops, like the bus stops here and now you get off the bus of information and you go explore.

I think that's the spiritual aspect. I think that's where you go with that question of what do I do now? Because what Mande does now, a crystal does now, maybe different things. Maybe what you do now is advocacy. Maybe that's what fills you. Maybe that's the thing that helps you now finally begin to feel soothing and rest. Maybe the thing I do is go no contact.

And that's the thing that finally gets me to feel depressed and self-soothing. That's that's that's how I see it. There is. Yeah. There is only so far that general information can take you. The rest is yours and it is mine. And as the listeners. Yeah, I love that. I love that. All right. Well I've been wanting, I say the right people and the resources to come into your life at the right time and this has been perfect timing for this conversation and it's been a long time coming.

I know we've been talking about this for, what, a year or two? I know, but it's done this. Yeah, I feel the perfection to thank you so much for inviting me and for asking me again. I, I appreciate you. I appreciate your time and your platform. Thank you so much, Mande. I appreciate you and the work that you do.

Is there anywhere that you would like people to reach out to you? Sure. You can visit my website www.spiritclinic.com And I've got I've got a YouTube, I've got a Tik. I mean, I have the accounts, so I'll, you know, give them that, give you those links and. And perhaps you could put it in show notes or.

Sure, I will do that. Thank you so much, Krystal. We appreciate you. Thank you. All right.