Mike Rucker, Ph.D.

Interview with Kirsten Milliken about Treating ADHD with Play

Kirsten Milliken | Treating ADHD with Play

Dr. Kirsten Milliken was always destined for a path less conventional. Her early “bad girl” behavior of staying up late to read, coupled with being labeled a “gifted student,” was a prelude to a later diagnosis of ADHD—a condition marked by a vivid imagination, distractibility, and a quest for motivation in traditional settings.

With a Ph.D. in psychology, Dr. Milliken turned her ADHD challenges into a field of study, uncovering the transformative power of playfulness in managing ADHD’s neurochemical influence. Her groundbreaking work led to the founding of her company and the publication of PLAYDHD, which advocates for a playful approach to overcoming the hurdles of ADHD. Her work exemplifies that with creativity and play, challenges can become opportunities for growth and enjoyment.


1) How do you define “play” in the context of successfully navigating ADHD, and why is it particularly effective for adults with this condition?

Play, for me, encompasses any activity that brings joy. Play is really anything that makes you feel happy. For example, for me, play is engaging in conversation with others (because I find conversations fun). Each unique dialogue sparks my curiosity. In fact, for me, curiosity itself is a gateway to playful experiences. An activity like writing, where curiosity is at play in finding the perfect words, brings me joy, so I personally would call that play. Beyond these personal examples, play can manifest in more traditional forms, such as games or dancing. There really is a broad spectrum of what play can mean, and it is unique to each person’s specific preferences. Some forms of play are more audacious- like singing in front of an audience or doing parkour.  Others are more subdued, like drawing, or doing research.

For adults with ADHD, recognizing how our brains light up with engagement during play—contrasting sharply with the frustration felt in its absence—is crucial. This distinction is particularly vital in contexts like education or some work environments, where traditional settings often clash with the ADHD brain’s need for stimulation and interaction. ADHD’s challenges mainly emerge from environments demanding prolonged focus and quiet, which do not align with the natural inclinations of an ADHD brain- unless we are super interested in what we are working on.

Reflecting on my own schooling, the issues commonly associated with ADHD were mitigated by learning environments that encouraged freedom and engagement. I was fortunate to be in an open classroom environment where I had the autonomy to engage dynamically with my surroundings.  I could sit quietly in a beanbag chair and work on a project until I felt I needed to move.  Then I could play the piano or swing on a rope in the classroom.  This would help me to refocus so I could get back to “work.” Such experiences underscore the importance of adapting environments to harness the ADHD brain’s potential (rather than constraining it within traditional structures).

2) Given the societal misconceptions about play and adulthood, what challenges do adults with ADHD face in incorporating more play into their lives, and how can they overcome these obstacles?

Societal norms often discourage play, instead pushing for “seriousness” and “hard” work, especially from middle school onwards. This mindset permeates into our professional lives, where the notion of play at work is often dismissed. This unfortunately can have a negative impact on productivity and engagement, particularly for those with ADHD. Reflecting on my personal experience as a telemarketer (one of my first jobs), enjoyable social interactions with someone I sat next to significantly boosted the performance for both of us.  Celebrating our sales and bantering between calls was playful. When our manager separated us, our performance tanked. From that experience, it became clear to me early on that fostering an environment where play and work coexist can lead to remarkable outcomes. This is crucial for individuals with ADHD, whose brains thrive on engagement and suffer in its absence.

So, how do you challenge the societal perception that adulthood and play are not mutually exclusive? Overcoming these challenges requires a reevaluation of what constitutes productivity and success, both personally and within our workplaces. By recognizing the cognitive and emotional benefits of play—such as increased dopamine levels (which enhance focus, motivation, and organization)—adults with ADHD can advocate for and create spaces where play and work are not at odds, but instead are complementary. This mindset shift, while potentially easier said than done, can lead to a more fulfilling and effective approach to work and life for adults with ADHD.

Strategies for integrating play into our lives and work include focusing on the process rather than the outcome, incorporating novelty into our approach, and allowing for personal expression, even in small, unconventional ways. It’s about making tasks enjoyable and engaging, leveraging our innate preferences and interests to maintain focus and drive. For example, approaching work tasks with a mindset geared toward finding creative and enjoyable methods of completion can transform an experience from being a chore to a playful engagement. Ultimately, it’s about balancing structure with flexibility, creating an environment where play is not just permitted, but encouraged.

3) You advocate for a playful approach to work and one’s personal life. What considerations should individuals keep in mind as they look to strike a balance between playfulness and productivity, especially for those with the type of ADHD that results in anxiety and/or guilt if they perceive that they are compromising their responsibilities?

By integrating enjoyment into achieving goals—be it personal, family-related, or professional—there’s little room for guilt when both ‘enjoying the task’ and ‘meeting objectives’ are in alignment. This often involves communicating with those around us, like spouses or employers, to demonstrate that what might appear to them as merely trying to have fun is actually a productive path toward achieving shared goals.

Addressing the misconceptions around play and productivity is crucial, especially in professional or family settings where traditional views on work ethics may prevail. It’s about showcasing the effectiveness of a playful approach, emphasizing that goals are being met or even exceeded. For individuals with ADHD, this dual focus not only leverages their innate strengths, but also aligns with their need for engaging activities that help to stimulate focus and motivation.

Achieving this at a personal level involves a shift in mindset to recognize and honor our unique needs and processes. At work, again, it may require explaining your approach to others, framing the outcome as a measure of success (rather than a focus on the process). Recognizing that feedback or criticism about the process often comes from a place of misunderstanding (rather than a reflection of our true capabilities) can help ease the burden of guilt and/or anxiety.

Key strategies include preplanning how to integrate play into tasks, setting clear goals (and sharing them when appropriate), and anticipating potential challenges. This proactive approach can mitigate feelings of anxiety and guilt by ensuring a balance that respects our needs while fulfilling expected responsibilities. Additionally, owning our actions and openly communicating when we veer off course can strengthen relationships and self-acceptance, acknowledging that missteps are part of the process rather than indicators of failure.

4) In your book “PLAYDHD: Permission to Play,” you also explore the importance of mindfulness. What are some practical steps people with ADHD can take to integrate mindfulness into their daily routines without feeling overwhelmed?

Mindfulness ( often misconceived as synonymous with meditation) isn’t limited to sitting still in silence—a concept I find as appealing as the thought of sticking a needle in my eye. My approach to mindfulness emphasizes activity and interaction over traditional meditation. For instance, in a presentation series I conducted in Kuwait, we practiced mindfulness through movement (e.g., walking in sync to a rhythm, closely following another person with your hand on the next person’s back). These exercises ensured that practicing mindfulness was a shared, dynamic experience rather than a solitary, boring one.

I advocate for active mindfulness, where engaging the body through walking, movement, or even drawing in adult coloring books serves as a vehicle for calming the mind. These activities don’t just occupy the body; they allow the mind a quiet space to breathe and operate beyond the constant influx of stimuli.

A crucial step in active mindfulness is consciously avoiding reaching for screens during downtime. The challenge isn’t just to avoid digital devices but to gradually extend the time we spend disengaged from them (starting from maybe just ten minutes at a time to potentially half the day or more). The aim is to reconnect with our environment and allow our brains the space to create and reflect, rather than continuously consume.

I also suggest mini personal retreats. Imagine giving yourself the gift of a full day off from screens and incoming stimuli, allowing your mind the liberty to wander, create, and reset. Such practices can profoundly impact our mental state, offering a respite that many find transformative. This concept of mindfulness isn’t just about self-imposed silence or solitude but about creating opportunities for our minds to rest and regenerate in the absence of external inputs.

5) For someone just beginning to explore the intersection of play and ADHD management, what are the first steps you recommend taking?

The journey starts with introspection and experimentation. Reflect on moments you genuinely felt engaged in play and how it impacted your mental state and productivity. Understanding the contrast between when you have been deeply engaged and when you have been disengaged. This exercise can guide you where to begin with experimentation.

To then begin experimenting, consider incorporating small changes to introduce playfulness into your daily activities. For instance, try doing homework in unconventional settings like a bathtub—not only does it make the task less mundane, but it also leaves you with a humorous story to share, potentially doubling the joy you get from the experience. In a corporate environment, simple actions like sitting on the floor or introducing playful desk accessories can subtly shift your mood. Even personal adjustments, such as wearing your favorite outfit, can inject a sense of playfulness into your day.

Another tactic is preparing a menu of playful activities tailored to different settings (e.g., home, work, or school). Start with actions that easily blend into your current environment, then gradually expand to more creative expressions as you become more comfortable. Remember, the goal is to activate your brain in enjoyable ways without feeling self-conscious or needing to explain your choices (unless sharing is something you actively choose to do).

One memorable example from my experience involved a military veteran who chose to do an interview with me while in a handstand position. Though only practical for part of the conversation, this unique approach brought joy to us both and highlighted the unpredictability and delight of human interactions. Such moments underscore the essence of play: transforming ordinary experiences into memorable ones without fear of judgment.

Start with balancing self-awareness with creativity, allowing yourself permission to weave play into the fabric of your everyday life. Embrace small changes, celebrate the joy they bring, and then gradually open up to more significant shifts in how you view and integrate play into your personal and work life. Have FUN!

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