So it turns out, after me getting very irritated with a therapist, that I have ADHD. And I've been talking to other femaleish persons about this. It's apparently a definite and very common problem; the initial diagnosis for people seen as female is usually anxiety, or depression, or sometimes bipolar. It often takes quite some time to get a proper diagnosis.
The meds actually are helping a bit. But I just feel frustrated. It was very clear that the initial person they had me seeing didn't believe me when I said that it wasn't anxiety. It was clear that the process she was going on was to try to guide me to understanding how my underlying anxiety and distorted thinking were causing my inability to focus, so we could work on that in therapy. If it had been before, at a time when I wasn't so confident and had a decent idea of what I was looking at and was confident in my ability to just refuse to do anxiety treatment again, it wouldn't have helped at all. And we'd likely have ended up going down the same route of trying to dig deeper and deeper to find the root of my anxiety
Some of my prior noncompliance symptoms were probably also ADHD related. Some of it's stuff like repeatedly losing homework from therapy or forgetting it. Therapists generally treated this like some sort of resistance to therapy specifically. Some of it might be just trying to explore my anxieties around certain issues. Turns out the answer "I don't know, I just can't get my brain to do that!" was actually the right one. But again, that's not an ok answer in therapy.