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This discussion focuses on a two-year psychoanalytic treatment case of a college student diagnosed with attention deficit hyperactivity disorder (ADHD) presented by a psychoanalytic training institute candidate. The complex clinical presentation of individuals with ADHD symptoms, attunement of the analyst to unconscious processes, and competent supervision that provides the analyst with opportunities to explore the intersection of these factors serve as a context for the ensuing discussion. The discussion highlights how the importance of the therapeutic climate, the analyst’s recognition of the pervasiveness of shame among individuals with ADHD symptoms, and the use of transference are key contributors to the success of the treatment.