"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/     Connect with Cathy Rashidian: ReadySetChoose.com Resources: Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist Instructions https://add.org/wp-content/uploads/2015/03/adhd-questionnaire-ASRS111.pdf