Conditions such as ADHD and autistic spectrum traits are increasingly recognized among children but the problems that such people face as adults are less commonly appreciated. Many clients present with traits of ADHD and the autistic spectrum (these often occurring together) but such characteristics may not be recognized by psychotherapists, psychologists, counselors or psychiatrists. As a result, the clients are not given the understanding or assistance they need and deserve. Much time and effort may be wasted on a spurious search for psychodynamic reasons for problems that are essentially rooted in neurobiology. Another frequent and adverse outcome is the relegation of the client to a diagnosis of "borderline personality disorder".

This book outlines what happens in the brain of the person with ADHD, how this affects behavior, emotion, thought processes, and regulation of impulses and how these affect other people. Those with ADHD are often driven to be argumentative, are prone to depression, anxiety, sensation-seeking and addictions. Such traits are not entirely psychodynamically driven but reflect the insufficiently aroused brain seeking stimulation, novelty, and pleasure. The picture presented by people with ADHD of their childhood or current environment may express honestly held but extremely subjective perceptions that are distorted by their own brain states and challenging behaviors.

Several other conditions that are frequently missed by psychotherapists are also addressed. The "porous personality" and the "prey-predator dynamic", which play a significant role in recurrent self-harm, are described for the first time.

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