Once considered a childhood condition, ADHD is now increasingly recognised among adults, many of whom have built entire careers while quietly battling exhaustion, self-doubt, and the pressure to “keep up.” As awareness grows, so does the need for grounded, clinically-informed guidance.

Neuropsychologist Gabriel Rafi, who has spent over a decade practising in Paris, London and Dubai, specialises in understanding the cognitive and emotional profiles behind behaviours that often go unnoticed. His work spans ADHD, high IQ assessments, anxiety, and the complex ways these traits interact in real life. Through his clinical practice and organisational workshops, he helps individuals make sense of their minds and helps companies understand the diverse brains within their teams.

In this conversation, Gabriel breaks down the nuances of adult ADHD, the dangers of self-diagnosis, and why compassion, structure and mutual adaptation are key to supporting neurodivergent employees. From childhood masking to workplace burnout, he offers a rare, deeply insightful lens into how ADHD evolves and how people can learn not only to cope, but to thrive.

1 – Many adults struggle to recognise their own ADHD symptoms. In your practice across Paris, London and Dubai, what are the most common signs people overlook and why do so many adults seek an assessment only later in life?

Most adults are, to some extent, aware of their own symptoms – difficulty concentrating, frequent errors, forgetting important details – yet many hesitate to acknowledge them, as doing so can feel like a blow to their pride. More often than not, it is the concerns voiced by those around them that finally prompt them to seek an assessment and confront the possibility of a diagnosis. Awareness is also growing, and in today’s society such conditions are far more common than we tend to imagine.

2 – Building rapport with neurodivergent clients is a craft. How do you create a safe, open environment for ADHD clients who may struggle with trust, attention, or emotional regulation during sessions?

Being understood is fundamental to building a trusting relationship. As with any neurodivergent profile, the most important step is to truly understand the person and how they function. I take time to provide psychoeducation – explaining, for example, what ADHD is – to all my clients with ADHD so they can better understand themselves: what stems from their specific profile and what is simply part of their personality. This helps them let go of guilt or shame and begin to rebuild their self-confidence.

3 – You’ve helped clients across three major cities with very different cultures. Have you noticed differences in how ADHD presents, or how people interpret their symptoms, in Paris versus London versus Dubai?

In Dubai and London, I’ve noticed a strong pressure to succeed, which often creates heightened anxiety as people try to compensate for any difficulties they may have with attention In France, the experience of ADHD is quite different: although awareness is steadily increasing, the condition has long been misunderstood or minimized, leaving many individuals feeling guilty, ashamed, or simply ‘not enough’ without understanding why. By contrast, the UAE is now seeing a significant rise in awareness and open discussion around ADHD, with more people seeking assessments and support than ever before. The UK, however, recognized and studied ADHD much earlier than both France and the UAE, which has contributed to a better-established diagnostic culture and a broader public understanding of neurodiversity.

4 – As ADHD becomes more widely discussed online, many people try to self-diagnose. What do you see as the risks of auto-diagnosis, and how can individuals tell when it’s time to seek a professional evaluation?

An assessment must be carried out in a clinical setting – never online. Only a psychiatrist or a neuropsychologist is qualified to diagnose ADHD. Self-diagnosis is not reliable, as untreated ADHD often leads to additional difficulties over time, such as anxiety or low self-confidence. ADHD is a neurodevelopmental disorder, and it must be evaluated by a trained professional who is specifically qualified in this field.

5 – You specialise in both ADHD and high IQ assessments. How does the combination of ADHD and high cognitive potential present differently from “classic” ADHD profiles?

ADHD and IQ are not connected. A person can have a high IQ without ADHD, and likewise, someone can have ADHD without having a high IQ. However, individuals with a high IQ often experience difficulties with focus because their attention is strongly influenced by motivation and interest. When a high IQ is combined with ADHD, maintaining concentration typically becomes even more challenging.

6 – How do the symptoms evolve with age, and what does ADHD actually look like in a 35-year-old professional versus a 10-year-old child?

A child with ADHD is not fully aware of their difficulties. They try to please adults, feel proud of themselves, and often hide their struggles. Around the age of 10, they begin to realize that something is different, which can lead to a significant drop in self-confidence. During adolescence, they typically don’t want to hear about their challenges and resist making efforts, so they avoid duties and responsibilities. It is usually around 17 that they become mature enough to understand that they need guidance in order to perform and succeed, and this is when they are more likely to accept a diagnosis. Without proper support in adulthood, they may develop anxiety and low self-esteem, feeling increasingly vulnerable. Even if they try to use compensatory strategies to succeed at work and at home, the effort becomes exhausting – and eventually overwhelming.

7 – Do you recall and client testimonials/case studies that have stayed with you? 

I remember a patient who was a young woman with severe ADHD. She made frequent mistakes and was repeatedly dismissed from every company she worked for. She refused to disclose her diagnosis to colleagues or HR because she was terrified of being labelled as the ‘stupid one.’ The main goal was to help her acknowledge that she has ADHD and that it wasn’t her fault. This would allow her to talk more openly about her diagnosis and avoid being judged for things that are beyond her performance or skills.

8 – In your workshops, you talk about recognising cognitive and emotional patterns within teams. What are some signs that a company might unknowingly have neurodivergent employees who feel unsupported or under-stimulated?

Managers should have a deeper understanding of their employees’ true profiles, yet many focus solely on performance and output. It is very common for neurodivergent employees to suffer from unfair decisions simply because of limited communication and a lack of understanding of how they function.

9 – One theme you emphasise is “mutual adaptation”– adjusting communication, environment and leadership styles. Could you share a real-life example of how this transformed a team’s dynamic or productivity?

A clear example of mutual adaptation comes from a team where an employee with ADHD was seen as disorganised, which created tension. After we worked together, the manager adopted clearer, more structured communication, and the employee implemented simple tools to organise tasks and share their needs more openly. Within weeks, the dynamic improved: fewer misunderstandings, better performance, and a more positive atmosphere. What started as an adjustment for one person ultimately enhanced clarity and productivity for the entire team.

10 – From a mental-health perspective, what early indicators should leaders look for to spot stress, disengagement or burnout in neurodivergent employees, before it escalates into crisis?

For neurodivergent employees, early signs of stress or burnout often appear long before a crisis – but leaders need to know what to look for. Subtle indicators include a sudden drop in focus or work quality, increased procrastination, missed deadlines, or a noticeable rise in selfdoubt. You may also see withdrawal from meetings, avoiding communication, or becoming unusually reactive to feedback. Another key signal is overcompensation: employees who start working longer hours or double-checking everything to hide their struggles. This often means they are already overwhelmed. The most important step for leaders is to stay attentive to changes in behaviour rather than personality. When something feels ‘different’, it usually is – and checking in early, with curiosity and empathy, can prevent burnout and protect the employee’s well-being.”