By Tim Aiello, MA, LPC, NCC, ADHD-CCSP
Clinical Director, Myndset Therapeutics
Understanding Impulsivity in ADHD, Autism, and AuDHD
Impulsivity is a core feature of ADHD and often presents in Autism and AuDHD as well. It manifests as acting before thinking, difficulty delaying gratification, and struggling with emotional regulation (Barkley, 2023). In ADHD, impulsivity stems from executive function deficits, particularly in response inhibition and emotional self-regulation (Brown, 2022). Autistic individuals may also experience impulsivity, but it is often tied to sensory processing, intense emotional states, or difficulties in shifting attention (Murray et al., 2023).
In my own experience as an AuDHD therapist, impulsive thoughts can feel like tidal waves—uncontrollable and overpowering. I might send an email before thinking it through, blurt out an idea in a meeting before gauging its appropriateness, or buy something on impulse only to feel regret moments later. The aftermath of these actions can lead to intense guilt and shame, feeding into the cycle of negative self-perception. Understanding that impulsivity isn’t a personal failing but a neurological response has been a game-changer.
The Polyvagal Perspective on Impulsivity
Polyvagal Theory (PVT) helps explain why impulsive thoughts feel so powerful. Developed by Dr. Stephen Porges (2011), PVT outlines how our autonomic nervous system shifts between states of safety (ventral vagal), fight-or-flight (sympathetic), and shutdown (dorsal vagal).
For individuals with ADHD and Autism, the nervous system often remains dysregulated, leading to quick shifts into a fight-or-flight state. Impulsivity can be a nervous system-driven response to stress, uncertainty, or sensory overload (Dana, 2020). If our body perceives a threat—whether emotional, social, or sensory—it can trigger an impulsive reaction as a means of self-protection.
Powerful Techniques to Break Impulsive Thoughts
1. The STOP Method (Stop, Think, Operate, Process)
(Created by Tim Aiello, MA, LPC, NCC, ADHD-CCSP, ASDCS)
This technique was born from necessity—I needed a way to intervene before an impulsive action spiraled into regret.
Stop – Pause. Do nothing. Say “wait” out loud if necessary.
Think – Identify what’s happening. What triggered the impulsive thought? What is my nervous system doing?
Operate (Move) – Shift your state. Engage in deep breathing, stretch, or change environments.
Process – Reflect. Was this a fight-or-flight reaction? What would my regulated self choose to do?
Using this method has saved me from countless moments of impulsive regret.
2. Engage the Parasympathetic Nervous System (PVT Regulation)
Since impulsivity often arises from dysregulation, the key to stopping it is calming the nervous system. Research supports the following techniques:
Vagus Nerve Stimulation: Humming, singing, or gargling activates the vagus nerve and brings the body into a ventral vagal state (Porges, 2011).
Cold Exposure: Splashing cold water on the face or holding an ice cube can quickly shift nervous system states (Breit et al., 2018).
Deep Pressure Stimulation: Weighted blankets, tight hugs, or compression vests help regulate impulsive urges by calming sensory overload (McDowell et al., 2022).
3. The 5-Second Rule
Neuroscientist Mel Robbins (2017) popularized the 5-second rule, which aligns with executive function research. When an impulsive thought strikes, count backward: 5-4-3-2-1—Act Intentionally. This brief pause interrupts automatic responses and allows the prefrontal cortex to engage.
4. Create a Delay Strategy
Impulsivity thrives on immediacy. Creating a built-in delay weakens its power. Strategies include:
Setting a 24-hour rule before making non-urgent decisions (Barkley, 2023).
Writing down the thought instead of acting on it (Brown, 2022).
Using "if-then" statements: “If I still want this tomorrow, then I will reconsider.”
5. Self-Talk Reframing
Impulsivity often leads to guilt, but shame fuels more dysregulation. Reframing self-talk helps break this cycle:
Instead of “I messed up again.”, say “My nervous system reacted. I can course-correct.”
Instead of “Why am I like this?”, say “This is my brain’s way of responding to stress. What’s my next best step?”
Conclusion: Breaking Impulsivity Is a Process, Not Perfection
Impulsivity in ADHD, Autism, and AuDHD isn’t about willpower—it’s about nervous system regulation. When we apply techniques grounded in Polyvagal Theory, we interrupt the impulsivity cycle at its root.
Even as a therapist, I still have moments where an impulsive thought slips through before I can stop it. But what’s changed is my compassion for myself—understanding that my brain isn’t broken, just wired differently. By implementing these tools, we can shift from reactive impulsivity to mindful intentionality.
References
Barkley, R. A. (2023). Taking Charge of Adult ADHD (2nd ed.). Guilford Press.
Breit, S., Kupferberg, A., Rogler, G., & Hasler, G. (2018). Vagus nerve as modulator of the brain–gut axis in psychiatric and inflammatory disorders. Frontiers in Psychiatry, 9, 44. https://doi.org/10.3389/fpsyt.2018.00044
Brown, T. E. (2022). Smart but Stuck: Emotions in Teens and Adults with ADHD. Wiley.
Dana, D. (2020). The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation. Norton.
McDowell, C. P., Dishman, R. K., Gordon, B. R., & Herring, M. P. (2022). Physical activity and anxiety: A systematic review and meta-analysis of prospective cohort studies. American Journal of Preventive Medicine, 62(4), 601-610. https://doi.org/10.1016/j.amepre.2021.10.012
Murray, M., Trevisan, D. A., & McPartland, J. C. (2023). Autism and executive function: Neurocognitive underpinnings and implications for intervention. Neuroscience & Biobehavioral Reviews, 151, 105230. https://doi.org/10.1016/j.neubiorev.2023.105230
Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. Norton.
Robbins, M. (2017). The 5 Second Rule: Transform Your Life, Work, and Confidence with Everyday Courage. Savio Republic.
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