Designing Environments That Support Self-Regulation in ADHD

For years, ADHD (Attention-Deficit/Hyperactivity Disorder) has been explained mainly as an attention problem: difficulty concentrating, sustaining focus, or completing tasks. However, this explanation is incomplete.

Russell A. Barkley, one of the most influential voices in contemporary ADHD research, has emphasized for decades a central point: the core of ADHD is not attention, but self-regulation. Within this, emotional dysregulation has held a fundamental clinical role since the earliest writings, even though it has been minimized in modern diagnostic manuals.

ADHD as a Disorder of Self-Control

At the beginning of the twentieth century, children were already described who, in addition to distractibility, showed low frustration tolerance, marked irritability, and rapid, intense emotional reactions. These features were part of the clinical understanding of ADHD for decades.

Barkley explains it clearly: ADHD should be understood as a developmental disorder of self-control. When we observe attention alone, the clinical picture fragments. When we observe self-regulation—cognitive, behavioral, and emotional—the disorder becomes clinically coherent.

In other words, when we look only at attention, we understand little.When we consider self-regulation, ADHD makes sense.

Emotional Dysregulation and Executive Functions

From this perspective, emotional dysregulation is not a matter of “oversensitivity” or a character flaw. It is a deficit in emotional executive functions.

Functionally, it involves difficulty:

• inhibiting impulsive emotional responses,

• modulating the intensity of feelings,

• sustaining goal-directed emotional states,

• and emotionally recovering after intense activation.

Emotion here is understood as self-regulated behavior, integrated into the same executive systems that support planning, inhibition, and behavioral control. The central challenge is not emotion itself, but emotional inhibition.

The Environment as a Modulator of Self-Regulation

From a neuropsychological perspective, Barkley links these difficulties to networks that include the prefrontal cortex and the anterior cingulate cortex—areas highly sensitive to context. Overstimulating or excessively demanding environments increase the inhibitory load of a system that already operates with a reduced regulatory margin. Regulating environments, in contrast, free up executive resources.

This is where the evidence on contact with nature takes on clinical importance. Research shows that natural environments reduce physiological stress, decrease excessive activation, and facilitate the restoration of attention and emotional regulation. Nature captures attention without demanding it. It supports without overwhelming.

Space Design as a Clinical Intervention

For this reason, at Instituto Clínico González & Talavera the design of the physical space reflects a clear clinical intention: to create environments that support emotional and attentional regulation. Wood, natural light, and greenery convey safety and a sense of containment. The body perceives it before the mind names it.

Patients often report feeling calmer even before the session begins. This response has a clear neurophysiological basis: when the environment regulates, the nervous system responds.

Designing regulating spaces is not an aesthetic detail. It is a form of care grounded in science.

Nature is not a luxury. It is a tool for inclusion and mental health.

Supporting individuals with ADHD means understanding that self-regulation is built in a relationship. In many cases, that relationship begins before the first word. It begins with the space.