Against Impulsivity

Devon Price wrote a powerful article and book titled “Laziness Does Not Exist.” In these works, Price argues that the construct of “laziness” is not accurate or helpful. Laziness is defined as unwillingness to work, be productive, or use energy. Price argues that if someone is struggling to do these things, it is very likely not coming from a place of unwillingness but rather from a valid need for rest and/or a struggle with executive function or other skill sets that make these tasks hard. Since Price’s article and book, I have seen many activists, providers, and researchers engage in conversations about the need to acknowledge the very valid needs and struggles that may be contributing to someone’s limited energy or capacity for work, as well as the importance of rejecting the idea that our productivity is a measure of our worth. As a disabled, neurodivergent mental health provider myself, I am immensely grateful for Price’s work and the conversations that have been started as a result.

I was inspired by Price’s work and subsequent conversations around laziness to start a similar conversation about the concept of impulsivity. The aim of this blog post is to call into question how we conceptualize and define “impulsivity,” and to reconceptualize this in a way that is affirming of neurodiversity and disability.

Impulsivity is defined as the tendency to act without thinking. It is commonly associated with recklessness, irresponsibility, and lack of self-discipline. Impulsive behaviors are seen as those that occur without forethought, consideration of the consequences, or restraint. It is very frequently categorized as an issue in neurodivergent people. Mental health professionals often conceptualize the issue of impulsivity as a sign that individuals need to learn more self-control and emotion regulation. Many mental health professionals divide patients into two categories: those who are “overcontrolled,” who lack spontaneity and are rigid in their thoughts and behaviors and need to be taught more openness, and those who are “undercontrolled,” who lack restraint over their behaviors and need to be taught more regulation. Those who are “overcontrolled” are seen as having “too much restraint” and needing to learn to give themselves compassion, joy, and permission to express their feelings; those who are “undercontrolled” are seen as lacking restraint and needing to learn to delay gratification and behave in more respectable ways.

I would argue that this characterization of impulsivity, as well as this binary categorization of “overcontrolled” vs. “undercontrolled” individuals, is oversimplistic and misses the ways in which unmet needs, deprivation, and attempts at control and restraint may be at the root of what we consider impulsivity and undercontrol.

A relatively common example of this that I see in my work as a neurodiversity affirming eating disorder therapist is that individuals who frequently restrict their food intake are commonly labeled as “overcontrolled” (and therefore seen as having immense self-discipline and restraint), while those who binge eat are seen as “undercontrolled.” I have seen many people with binge eating disorder and bulimia characterized as impulsive by other mental health professionals. When these diagnoses co-occur with other forms of neurodivergence like ADHD or Borderline Personality Disorder, a person’s bingeing is often seen as evidence that they lack self-control or emotion regulation. People with binge eating disorder or bingeing behaviors are often taught “healthier” coping skills to utilize instead of bingeing. However, what this misses is that binge eating is a very common response to both physical and emotional restriction. When the body is deprived of key nutrients and/or adequate energy, or fears that it will be deprived of these, it will often respond by trying to take in those nutrients and energy in any way it sees feasible. In this sense, bingeing is actually an amazing survival strategy that helps our body to meet its needs. To me, this is the opposite of impulsivity. Even if people who binge eat do not themselves feel “in control” of the decision to do so, bingeing is often a very calculated decision that the body makes to avoid starvation. The solution to binge eating is to address restriction and deprivation, not to increase restriction and deprivation by instructing people to interfere with their body’s natural response to inadequate intake.

I believe that this shows up in many other ways as well. I frequently see ADHDers and other neurodivergent folks get labeled as “impulsive” due to behaviors like talking excessively, interrupting others, having emotional outbursts, and getting pulled into distractions easily. I feel that characterizing these behaviors as resulting from a “lack of regulation” misses the ways that ADHDers and other neurodivergent folks may be working extra hard to meet all of the demands and expectations required to live in a neuronormative society, such as masking, not stimming when they need to, tolerating sensory environments that are painful or uncomfortable, and pushing ourselves to perform workplace and household responsibilities that are immensely difficult for us. Categorizing neurodivergent folks as “impulsive” misses the ways that many of us are constantly restraining ourselves from living authentically and depriving ourselves of our needs for support and accommodations due to the potential for ableist consequences. As humans, we all have a limited amount of energy to expend performing the labor of accommodating others’ needs and doing things that are difficult and uncomfortable. It makes sense that if neurodivergent people are doing more of this labor to accommodate neuronormative people, there would be times when we would need a break. Behaviors that others see as “impulsive” may in actuality be resulting from our body and brain’s valid need for rest from the constant struggle of controlling and regulating ourselves. The solution, then, in my opinion, is not to teach us regulation and self-control skills but rather to ensure our needs are accommodated so that we do not need to expend so much energy conforming to a neuronormative world. 

Other behaviors deemed “impulsive” may be resulting from unmet needs or engaged in as a form of accommodation. Some ADHDers and other neurodivergent folks are deemed impulsive due to shopping excessively/buying more than they need. This may actually be done in order to minimize the stress of decision-making. Because many neurodivergent people experience a high degree of anxiety around making decisions, it may be easier to buy more of what we need in order to have more time to make a decision about what we like and want to use. Another behavior commonly seen as impulsive is talking excessively or oversharing. Because neurodivergent people are often not listened to or have their experiences dismissed, we may compensate by over-explaining or sharing more than necessary. 

The idea of “overcontrol” vs. “undercontrol” frequently comes up around the diagnosis of Borderline Personality Disorder. BPD is seen as a classic example of “undercontrol,” and the therapy most commonly recommended for it (traditional Dialectal Behavior Therapy rather than Radically Open Dialectal Behavior Therapy) aims to teach emotion regulation and distress tolerance skills. The goal is for people to be able to be able to restrain themselves from acting on their emotions, and instead to tolerate these emotions. While I am not opposed to teaching emotion regulation or distress tolerance skills (and I do know this is helpful for many people), I think viewing this as a primary goal is a mischaracterization and misunderstanding of the internal experience of many people with BPD. Many people diagnosed with BPD have experienced a high degree of invalidation and other forms of emotional abuse during their lifetimes; as a result, they have had to work harder and perform more labor in an attempt to be heard and responded to appropriately. People diagnosed with BPD have commonly been taught that the only way to be heard is to “scream louder,” or even that no matter how loud they scream, they will not be heard or understood by the significant people in their lives. It may not be accurate, then, to say that emotional outbursts, frantic efforts to avoid abandonment, and destructive behaviors like self-harm and suicide attempts result from undercontrol or impulsivity. Rather, these behaviors may result from the feeling that no other behaviors or communication would be effective in meeting the basic human need for emotional validation. Although these behaviors can and do have negative consequences, I do not feel that it is fair to say that these behaviors are being engaged in without forethought or consideration of the consequences. Like bingeing that occurs as a response to restriction, many of the behaviors that constitute BPD occur as a response to such frequent and significant emotional deprivation or abuse that it feels like there is no other option. Like bingeing, these behaviors are often the result of a calculation that one makes on the basis of their past and current lived experiences, even if this calculation is not done consciously.

Another area where I often see discourse around impulsivity come up is the topic of social media and digital spaces more generally. Many neurodivergent and other marginalized folks may find social media to be a more accessible way to connect with others who share similar identities and to engage in activism, especially in the past two years since the start of the pandemic. Because of this, neurodivergent folks may share personal details about their neurodivergence, their mental health histories, their sexual and gender identities, and the issues going on in their lives than neuronormative folks. In my clinical work and personal life, I have seen this type of communication categorized as “impulsive,” as “reckless,” as “irresponsible.” Of course, there can be negative consequences to sharing details of one’s personal life on social media. However, labeling this behavior as “impulsive” or other similar terms just because it has negative consequences dramatically downplays the ways in which engagement with social media and digital spaces can meet a real and valid need for connection. To me, it seems incredibly well thought-out, well planned, and responsible to have the thought process, “I am existing during a global pandemic that makes in-person connection hard, and I have marginalized identities that make it hard to find people who relate to my experiences in my geographic area. I’d like to share some of those identities on social media in hopes of building connection during a time of intense isolation.” Even if someone does not consciously have this thought process, we need to acknowledge the validity of people’s feelings that prompt them to post vulnerably on social media. 

I believe all of these ideas apply more broadly to the concept of “attention seeking” more broadly, which is another term that tends to show up in conversations around impulsivity. As humans, we all have a basic need for attention - i.e. being heard, seen, understood, listened to, and cared about. If this need is not being met, it then makes sense for our bodies and minds to find creative strategies to get this need met. Labeling the behaviors that one may engage in to meet this need as “impulsive” again feels like a misunderstanding of the need behind them. Again, I am not sure that there is much one can do that is more responsible or rational than trying to meet one’s basic needs for both physical and emotional survival. Of course, part of therapy and personal growth can involve learning less harmful and more constructive ways of meeting these needs. However, in my opinion, working with someone to meet those needs needs to be a priority over and above teaching someone more restraint or self-control.

I believe that the mental health field needs to have more conversations about what we mean by “impulsivity” and how we might become both more affirming of neurodivergence and understanding of our patients’ internal, subjective experiences by reconceptualizing this. To me, characterizing behaviors as “impulsive” is one way that we as professionals impose our understanding and experience of a patient’s behavior onto them rather than showing curiosity and openness to their internal experience and the feelings and needs driving these behaviors. Of course, some people may resonate with the term “impulsive” for their own lived experience, and it is important to validate this and empathize with this as well. However, I feel that we need to start with exploring people’s experiences and understanding where they are coming from rather than (impulsively) rushing to impose our own understandings or judgments. Ultimately neurodiversity affirming care means recognizing and honoring the expertise of each person on themself and their experience, and this should extend to behaviors our society defines as “impulsive” or “undercontrolled” as well.

Author: Shira Collings, MS, NCC (she/they) 

Shira is a pre-licensed counselor in the Philadelphia area. She primarily works with people with eating disorders, disordered eating, body image distress, and those breaking free from diet culture. As a neurodivergent diet culture dropout themself, they are especially passionate about supporting neurodivergent folx in finding freedom with food. Click here to learn more about their services.