7 days ago

Why Knowing Isn't Doing: Adult ADHD Through a CBT Lens | Dr. Russell Ramsay

"I know what I need to do, but I don't trust that I'll do it when I need to do it."

If that sentence lands, this conversation is for you.

In this episode of Refined Leadership: ADHD Lens, I sit down with Dr. Russell Ramsay, one of the leading voices in adult ADHD and Cognitive Behavioral Therapy. We talk about his new book, Once I Get Started, and the cognitive theme he believes runs beneath much of adult ADHD: self-mistrust.

This is not a productivity conversation. It is a conversation about what actually happens between knowing what to do and doing it — and why that gap shows up so often for capable, high-performing professionals.

What we explore:

Self-mistrust as a possible central cognitive theme of adult ADHD, and how it shapes self-worth, decisions, and follow-through
Why ADHD is better understood as a performance problem than a knowledge problem
Motivation as an emotion, and why deadline pressure stops being a sustainable strategy
Self-regulatory efficacy: why some people disengage early, and what protects against it
How thoughts, feelings, and behaviors operate as a braided cord rather than a linear chain
People-pleasing, social capital, and why ADHD professionals may overestimate their relational debts
Procrastivity, or productive procrastination — when it is adaptive, and when it is avoidance
Taskidermy tasks: the items that keep reappearing on your to-do list without moving forward
The SAP Method: Specific, Actionable, Pivot Points for getting unstuck
How CBT for adult ADHD differs from CBT for depression or anxiety, and why the implementation focus matters
Masking, intentional self-presentation, and the difference between coping and concealment

This episode offers language for patterns that often go unnamed at work — and a more grounded way to think about why standard advice keeps falling short.

About Dr. Russell Ramsay: Dr. Russell Ramsay is a psychologist who specializes in the assessment and psychosocial treatment of adult ADHD. He has lectured internationally, published widely, and authored six books on adult ADHD, including his most recent, Once I Get Started. He is a CHADD Hall of Fame inductee.

Pre-order Once I Get Started by Russell Ramsay, Ph.D.: https://www.penguinrandomhouse.com/books/783710/once-i-get-started-by-russell-ramsay-phd/