ADHD – The how, what and why….and what now?

I am told that September has been nominated as an Autism and ADHD month. My blog is an offering to those unfortunate children whose anxiety is demonised because of ignorance about this so called “disorder”.

Thousands of kids in US are labelled  as ADHD kids everyday. Their lives are torn apart by the diagnosis that teachers, parents, doctors impose on them. The stigma will carry with them throughout life. 90% of the world production of Ritalin is consumed in US, which often leads me to wonder if US kids are somehow more disabled and diseased than the kids in the rest of the world? That assumption doesn’t seem right, so then, is there something wrong with parents, teachers, doctors in this country that mercilessly subject the innocence of childhood to such extreme measures?

US has essentially been a youthful state, as well as a state that worships youthfulness. One has to take a look at statistics related to plastic surgery, and it will be clear that growing old doesn’t seem to have the allure that it has in other parts of the world. Old is bad.

I don’t think its the age that is a matter of derision in this society. It is the helplessness, weakness, incapacity and related vulnerability associated with age that is the cause of derision. It is not ok to be vulnerable. Vulnerability is not tolerated, in fact anything vulnerable is attacked and annhilated. US is a state where only the fittest will survive and thrive. The old, and the kids, are vulnerable. So childhood seems to be a distinctive disease here. So bad is this disease that the state has to pass laws to protect the children! Without the laws, the children would be in danger !

According to Lacan, it is the repressed that gives rise to the unconscious, the incestuous which gives rise to the taboo, and it is the underlying aggression, and derision felt against age, and childhood, that gives rise to our laws which protect the children, and the old. On its own, the society would annhilate these extremities of life.

ADHD is a typical “disorder” that lends credence to my assertion. There is no such thing as ADHD.  ADHD is a hollow construct. It is a name given to a condition that does not really exist the way it is understood and treated. My opinions may seem extreme to some of my readers, but bear with me as we explore the developmental origins of this “disorder” and uncover the problems that lead to this adjustment problem encountered by many a tender psyche.

Before we start discussing the origins of this problem, lets discuss some statistics that will help throw some more light on the nature of this “disorder.” I grew up in India and lived there till I was 26. I then lived in Dubai for the next 9 years and then moved to Australia in 1995. We moved to US in late 1998.

Up until 1995, I had never heard the term ADHD. After 1995, I heard the term in passing, but it didnt really concern me until I moved to US in 1998 where it was the buzzword everyone was using. It wasn’t that there were no naughty kids in India or in Dubai. But out of 1000s of acquaintances, friends, and  a very very large extended family on both sides of my marriage, when I look back I can see two kids who could have qualified for this diagnosis.  At that time, though, the mothers of both children had accepted the flaws in their mothering, and attempted to change their behaviors. One of them invited her parents more often so the kids could be looked after the grandparents who had much more patience. The other one, realizing her own inadequacies, had sent her son to a boarding school. No other kid I have met in the last 50 years of my life over the two continents, has exhibited any signs of ADHD.  Australia was pretty much the same, although the prevalence of ADHD, and diagnosis was a little more common there.

US, though, was a different ballgame altogether. I found here kids who were clearly much more hyperactive, and more often than I would like it, they were diagnosed with ADHD and put on Ritalin. I was amazed to read that 90% of the world’s Ritalin was consumed by the kids in US, which didn’t really make them any better because the “disorder” though muted by medication, raised its ugly head in other areas of their life.  This different in the nature of children, almost the difference in “quality” of childhood shocked me to no end, and I spent a great deal of time trying to figure out what was going on beneath the rampant diagnosis of these ADHD kids, their diagnosis and their medications. Along this time, I had some ADHD kids as clients as well, and my work with them and their parents shed some light on the phenomenon called ADHD. My son’s best friend is labelled with ADHD and is doused with medication. His mother revealed that he was more focussed with medication, and was able to get good grades. Here are my thoughts and my own analysis of the malaise that seems to threaten the future of our kids, and hence the future of United States.

United States is a capitilistic country where financial and material dreams come true. People have opportunities of making a lot of money. A LOT. The stars in their eyes induce them to work like crazy. US may be the only country in the entire world where an annual leave of 10 days a year is the norm.  In addition to such a atrocious policy on annual leave, maternity leave is 45 days! This is absolutely horrific and shameful. Everywhere in the world, maternity leave is usually from 3-8 months, and then father’s can get paternity  leave for another 3-8 months. The family structures in the rest of the world are much more cohesive than in US.  In India, for example, our extended family comes in to help. The grandparents on either side of the family will live with the couple, and will take turns to care for the baby/grandchild till the baby is at least 2 years old. As all developmental theories posit, child development for the first 2 years is extremely crucial, and leaves a lasting impression on the child’s life. This development, during the first two years of infancy, becomes the cornerstone of adult life. Since family systems are not as cohesive in US, no such luxury is affordable to an American woman. Single parenting makes it even worse. A woman returning to work after 45 days is often forced to put the baby in the public childcare system, where quality of care can range from mediocre to downrightly terrible. Nothing can substitute a mother, not even grandmothers. But grandmothers are the nearest substitute that there could exist. The infants are thus wrenched from their mother within 45 days, and expected to fend for themselves, at least emotionally ! In the absence of the mother, the infant becomes extremely anxious, fearing annhilation.  Gee…..I’d say separating a mother from a child within 45 days, with not real mother substitute except a sterile crib…to me that is real child abuse, and oppression of women !!!

ADHD is a specific anxiety disorder that is diagnosed primarily in little children, although adults may also carry the symptoms. However, the symptoms are first experienced as a child, the anxiety becoming entrenched in the psyche. The Diagnostics Statistical Manual (DSM-IV-TR), the bible of mental health disorders, defines ADHD as a “persistent pattern of inattention and or hyperactivity-impulsivity that is more frequently displayed and severe than is typically observed in individuals at a comparable level of development.” In addition to these, there are other criteria

I have repeated the story about mother-child non-duality and symbiosis  so many times in the past that we would all be better off for not repeating those discussions. For new readers who would like to read up on this discussion, last few blogs (viz Disconnection and Sex, The Othering of the Mother,  The Dynamic Dance of Non Duality and Separation) may provide a refresher on this subject. To recap, the mother and child initially exist in the harmonic symbiotic unity that needs to be gradually reduced. In normal circumstances, the primal non duality leads to gradual duality and separation, as the infant slowly learns to see himself or herself as being separate from the mother. A gradual and paced out separation, leads to a gradually emergent sense of I and Thou. Slowly the child lets go of the parent and becomes its own being.

Any abrupt rupture to this  non duality, before the infant has had time to acclimatise himself to the inevitable duality, causes intense anxiety that is almost like a death anxiety. Unlikethe adult, the infant depends on its survival on its mother. Removal of mother spells disater, leading to a perception of certain death. A part of its existence – the omnipotent part that allows it to continue living – is non accessible. This intense anxiety causes the infant to become survival oriented and the pace of growth is hurried. Its defences are prematurely developed, and become contorted because his psyche is not ready to unfold those defenses yet but has to hurry through. This distorts the psyche, and also leads to extreme annhilation anxiety.  Since the child’s neurological development continues well into the fifth year,  it is not difficult to imagine that neurological development gets distorted under the stress of premature development and inadequate mothering.

When I explain this concept – that ADHD is a phenomenon of inadequate mothering – most mothers become defensive and try to give me examples of the love they have for their children. The term inadequate mothering doesn’t necessarily mean the mother itself is bad, or neglectful or abusive. It just means that the child perceives the mothering to be inadequate, for whatever reason. And its the child’s perception that causes him or her to develop those defenses. A parallel ecample may be  a malnourished child. The mother of such a child may be genuinely neglectful, but she it is also possible that she may be making all kinds of foods for the child, but the child doesn’t eat for whatever reason – he may be angry at the mother, he may stuff himself with candy and soda, he may have some inherent deficiency or may simply not like the food that the mother cooks. So he would become malnourished. Whatever the reason, the end result is a child who is not being fed. An inadequate mother is similar to the above mother. For whatever reason, her child perceives a premature separation from her which causes the child very extreme levels annhilation anxiety and consequential distress. Because the young infant doesn’t have the resiliance and the psychic infrastructure to mediate this anxiety, it becomes etched on the psyche, often on the soma (body) as well.

Thus the biology of the child – the neural structure, the blood vessels, the cellular structure, are crafted in a certain way as a response to the felt absence of the mother. That being so, it isn’t difficult to guess the nature of the best treatment for such children. The treatment consists of mothering the child well, compensating for the deficits that the tender psyche had experienced during infancy. That natural calming gradually reduces and eventually eliminates ADHD completely, as the body chemistry changes in response to the treatment However, because we do not understand the tender psyche, and its needs, because we are so far removed from the experiences of an infant, we try to measure the infants responses against our own responses, forgetting that we have become resiliant in the smithy of life’s daily experience. The infant, on the other hand, is simply a blob in comparasion, kinda like unset cement on which life leaves its footprints.

So what does ADHD medication do ? It “calms” the child’s neurology. What does “calming” mean? How do you think calming is achieved ? It is achieved by numbing. Neurons are numbed into submission by medication, which of course reduces anxiety. But you can imagine all else it does while the medication is there. It inhibits proper development, it acclimatizes the brain, creating tolerances for such medications, and it generally impedes growth. The effects are less pronounced in adults, because adult brains are more resiliant, but the blob like brains of infants, that really haven’t fully formed yet, is “trained” by medication. Small wonder that most of these kids become manic depressives, or bipolar, when and if the medication is discontinued. The body/brain has not learnt to exist without the medication, it has no innate ability to calm itself. Like mitochondria, the medication becomes a lifelong necessity.

I mentioned that my son’s friend is labelled with ADHD. The family is from the the Middle East. There are three boys in the family, only a few years older than the child in question. It turned out that the mother worked a graveyard shift. She had been thus employed before her pregnancy, and continued with her job after the pregnancy leave was over.  She slept during the day, and worked during the night. When she was available to the child, I presume her time was divided between the three kids. Although she loved him dearly, obviously she was rarely available to the child since his birth. Her husband has a business, and although he is home more frequently, there is a culturally mandated distance between fathers and sons. The distance between father and son  is necessary – as Lacan will tell you – but the necessity of the distance is a taboo against anincestuous nature of the mother-child relationship. When there is lack of symbiosis, when the incenstuousness of the mother is no longer a threat, the distance serves to exacerbate the separation, and lack of connection. One can imagine how anxious this child, whose mother was never present in is life the way she was meant to be, would be. On one occasion, he came for a sleepover to my house. It was his first in his 12 year life. However, by 10:00pm, his anxiety got the better of him, and I had to take him back to his home. He was unable to withstand the separation from home, and family, beyond that point. The child  was entering latency at the time, and during this stage, there is a backward pull. The  tender psyche knows that it will soon have to relinquish the mother, home, comfort, security, so there is a resistance to any separation from all the nurturing aspects. My own son had suddenly started clinging to me with intensity that had been uncharacteristic of him before. So everytime this mom discussed her son’s problems with me, I would ask her to take it easy on her job, spend more time with the kid, build a connection to help him overcome his “ADHD”.  But when I said that, she would look at me strangely because she expected me to tell her that he needed to change his medication, perhaps he needed to exercise more, go our more, change his friends, play volleyball, or meditate. All those things can help manage symptoms, like medication does, but the underlying problem remains, and there will be no long term progress. One has to work at the root of the problem to alleviate and eliminate a problem of annhilation anxiety. These behavioral and medical solutions are simply like band-aids. They help a little, but they don’t have any long term effect. She continued working these extremely demanding hours that necessitated her complete absence from the child’s life  because, you see, in her mind it was the kid who had a problem, not her or her family. This is the common misconception parents will have – they do not wish to accept that the problem may lie in the home, and their own behaviors, or in the family situation. But as one can see – it was a problem in the quality of the mother-son relationship. Her son longed for the feminine containment. All children are essentially born anxious, and fearful. It is the mother that acts like a receptacle, a bucket that contains the anxiety of the child, processes that anxiety, leaving the child calm, rested and free of anxiety. One can say the child outsources the anxiety to the mother, and dumps it *in* her. In the absence of such a receptacle, there is no one available to handle that anxiety. The child is prematurely forced to handle that anxiety on its own, even though it is not equipped to handle it. This leads to stress, that causes a permanent change in biology of the infant and child.  What can the medication do except disconnect the brain from the biology ? In other words, even though the body remains disturbed and anxious, the brain is not allowed to “know” that there is distress in the body. The medication numbs the anxiety-carrying neurons, abandoning the body, and parts of the brain that are terrorized by the thought of having “lost” the mother prematurely. Since the medication helped him focus, and appear normal, and get good grades, the medication became a preferred medium for healing of this child.  But grades at school are, and should always be, subservient to long term health. If a child had cancer, would his parents ignore that and harp on good grades? So how come parents forget that their child has developmental issues, and only focus on grades ? It appears that we believe that good grades are an end to themselves, that somehow psychological health is unimportant. Unfortunately, that is not so. Psychological health is equally, if not more important than medical health. Academic achievement and success in life is empirically proven to be a consequence of psychological health. The pharmaceutical companies dictate and shape our beliefs about medications by churning out these medications, but of course the companies are motivated by financial gain, and we follow their mantra, focusing only on the financial future of our children, whereas its their overall happiness that really matters in the long run.

We have begun to owe our allegiances to materialistic gods. The Self, the centre of our existence,  the internal god that is given to us to guide our existence and lead us to wisdom, health and happiness, is drugged and is relegated to the dungeons of repression, with severe consequences for the emerging adult.

I have many many many examples like these around me, and in each case, the common theme has been the unavailability of the mother – for whatever reasons.

If your child is diagnosed with ADHD, do yourself and your kid a favor – develop empathic relationship with the child, spend more time with the child, be more patient, and loving, cuddle up, spend as much time with the child as you possibly can, feed it with love and togetherness, promote unity, instead of separation, so that the right brain – the healing brain – may become activated, strengthened, and more involved. Of course if you can’t do that, or don’t have time to do that, take the kid to a psychologist who can “mother” him well. Most psychodynamically, psychoanalytically or analytically oriented therapists and psychologists will do exactly that. I guarantee the symptoms of ADHD can be managed, perhaps even eliminated. Your child is precious, he deserves a chance at living a “normal” life….

Edited on 10/9/2012 : Pills to Help in School….

2 responses to “ADHD – The how, what and why….and what now?”

  1. My son is on a time released RX cause he does not eat when he is on his medication. it wears away around lunch then 30 mins later the other half kicks in and lasts until 2:45. It is one pill in the morning taken at 7:30 and by 8 he is ready for school. I had the same issues with my son in his daycare, when they refused to watch him. Then when Kindergarten started I had him tested and on RX (only for the second half of kindergarten cause my ex doesnt believe children should be on pills) So when the time released RX was offered to work around school hours I gave it to my son. It made my ex shut up and he has been a perfect honor roll student ever since. My son is now going into the 2nd grade. I hope this will make you and the school happy. But to be on the safe side call up the superintendent of the county school board. You should be able to call his office and make an appointment,also on the phone ask for the county school board lawyer phone number. The lawyer should be able to inform you of all legal grounds based upon the schools in your state. Use your public chain of command.

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