ADD/ADHD: What You Say Is What You Get

                                     Randy W. Green, Ph.D.         
                 Ridicule often checks what is absurd, and fully as often, smothers that which is noble. .                                                    Sir Walter Scott (1771-1832)

                                       The privilege of a lifetime is being who you are. 
                                                     Joseph Campbell (1904-1987)

There is no question that both children and adults who exhibit characteristics identified by the labels, “Attention Deficit Disorder” or “Attention Deficit/Hyperactivity Disorder” (ADD/ADHD) lead challenging lives when those characteristics fail to serve them in ways held as important within our society.  So providing opportunities for them to live more satisfying and rewarding lives is certainly warranted.  What is at issue here are some of the assumptions that are made about these individuals and subsequently, the way ADD/ADHD is addressed when providing those opportunities.  Some specific questions to consider are:

  • 1- How specifically does classifying these observed ADD/ADHD characteristics as a “disorder” affect those “diagnosed?”
  • 2- Does labeling a “difference” as a “disease” or neurochemical “deficiency” more directly lead to changes that are beneficial?
  • 3- If we were to assume all behaviors are useful in some context, how can we extract what already works in the lives of these people and teach them to utilize those skills in situations that are typically challenging to them?

The pejorative nature of the diagnoses, ADD/ADHD, implies to peers, parents and educators that those “diagnosed” are inferior in some way. Typically, the diagnoses derive from characteristics such as:
1- Becoming easily distracted; 2- Having difficulty organizing and planning tasks; 3- Acting impulsively, that is, responding suddenly, unexpectedly, such as when interrupting others who are speaking; making sudden decisions regarding their behavior that seem to lack deliberation or planning, and so forth; 4- Maintaining attention at a task for short periods of time unless they find the task “interesting”, 5- Acting impatiently when otherwise having to wait for something to occur, ; 6- Daydreaming ; 7- Acting without considering the consequences of those actions and, 8- Preferring  to process information more readily using the visual channel than auditory.  Since most teaching is presented auditorily, they may have difficulty reading or converting spoken words into the concepts necessary to understanding a particular subject.
As ADD/ADHD is regarded within the framework of the problem state—that is, as a “disorder”, the first step is generally to “test” for it and find out if someone “has it.”  If the tests prove positive, a variety of “treatments” are recommended, the most common of which is central nervous system (CNS) stimulant medication, though there are several non-medical treatments that are often utilized as well.  
What is addressed with stimulant medication is the chemical activity occurring within the brain.  ADD/ADHD is thought to result from insufficient neurological arousal.  Several of the chemicals which control or regulate brain activity are called, “neuro-transmitters” and include: serotonin, norepinephrine, and dopamine.  Increased levels of these neuro- transmitters affect our ability to shift attention from a more open state of awareness, characteristic of ADD/ADHD people, where attending to many details in the environment at the same time occurs; to a focused state, the goal of any treatment regimen for ADD/ADHD, in which attention is directed at a single task or event for extended periods in order to achieve a purposeful outcome.
In administering stimulant medication, the assumption is that ADD/ADHD results from low levels of the neurotransmitter, “dopamine” in the brain.  Drugs such as, “Ritalin”, the most widely-used central nervous system stimulant, increase dopamine levels, causing a shift to more focused attention. 
Though drug intervention is the most widely accepted treatment for ADD/ADHD, there are some inherent difficulties with relying on stimulant medication to boost dopamine levels as the primary ADD/ADHD intervention:
 1- As most drugs, CNS stimulants such as “Ritalin” come
     with certain unpleasant side-effects, not the least of which
     is a between-dose “slippage” manifested as a return of the so-
     called symptoms.  Recently, this has been addressed with a
     “Ritalin patch”, a new form of drug delivery in which the
     dosage administration is more constant thus, largely
     circumventing this between-dose phenomenon.
  2- Many parents object to long-term usage of CNS stimulant
     medication for their children.  This in light of some research
     that profound changes in brain chemistry may result from
     long-term usage of medications such as Ritalin.  Moreover,
     Thom Hartmann in his book, “Attention Deficit Disorder:  A 
     Different Perception”, suggested that since dopamine
     disorders in old age are at the root of Parkinson’s disease,
     and Ritalin affects dopamine levels, there has been some
     concern expressed that long-term usage of Ritalin may lead
     to negative side-effects in old age.
  3- People naturally shift attention from focused to open states
      of awareness as a function of frontal lobe brain activity inter-
      acting with the social environment of the individual.  Since the
      purpose of Ritalin and other CNS stimulants is to force a kind
      of focused attention, that is, attention to a narrow range of
      activity for an extended period of time, such drugs used long-
      term can inhibit a person’s ability to shift between these two
      attention states.  This could cause difficulty for someone
      when a situation calls for an open awareness of their
      environment such as when driving, hiking, playing a sport.
   4- As described by Thom Hartmann, author of many books on
      ADD/ADHD, in dozens of opiate studies in the past century,
      people who used narcotics for extended periods became
      more sensitive to pain.  It is hypothesized that the brain could
      react in a similar fashion to long-term use of stimulants that
      increase dopamine levels, followed by withdrawal from those
      drugs.  When dopamine levels in the brain are low, suggesting
      ADHD, and stimulant medications are administered, the brain’s
      “compensating mechanism” activates to rid the body of the
      excess dopamine. Then when such a drug is discontinued, as the
      person’s natural level of dopamine would be very low, it’s
      possible (but not confirmed) that an individual could manifest
      more ADD/ADHD symptoms than prior to the course of
      medication treatment.
The relationship between neurochemical activity in the brain and human behavior is well documented.  Recently, Dr. Daniel J. Siegel, author of, “The Developing Mind”, indicated that interpersonal experiences, such as perceiving and responding to social situations, shape brain development.  He believes the brain circuits responsible for perception in social situations are the same or tightly linked to those that regulate bodily states, modulate emotions; and organize memory and the capacity for interpersonal communication.  Much of this has to do with how genes are expressed, which then produce chemicals for neural network development that ultimately shape responses. But to simplify: the beliefs you have about your ability to perform in a certain way such as being successful in your activities – which, among other places, stem from interactions with teachers, parents and peers-- are directly related to neurochemical changes in the brain that contribute to its development; without the use of stimulant medication as a catalyst.  In this way, words are a form of “neuro-transmission.”  Actually, all communication is a neuro-transmitter!
These beliefs are “held” within your body in a specific manner.  You may recall that all experience first shows up in the body at the neuromuscular level, expressed as postural shifts, micro-muscular movements, breathing changes, eye-accessing cues (or the path they follow to retrieve inform-ation), all known as the “somatic form.” This form is wrapped around the powerful stories, beliefs and attitudes or “myths” we live by.  Verbal feedback such as diagnoses, criticism and disapproval; or compliments, acknowledgements and acceptance is first perceived somatically. Accordingly, the way we communicate helps shape the way our minds develop and is reflected in how we manifest ourselves—through our bodies-- in the world. 
So how does the way ADD/ADHD is addressed relate to the somatic form someone holds?  Human experience is either organized around what is possible, a positive form; or problems, the negative form.  When you consider the world from the “filter set” of problem solving, what you find are problems!  In traditional psychotherapy, the task is often to “make things better” by finding out “what’s not working.”  Surely, you know of some people who think this way.
When we label children as having a “disorder” such as ADD/ADHD, thereby operating within the framework of the problem state, the words we use are mainly pejorative and hurtful.  And the belief held is often one of being incapable of succeeding-- even in therapies with the best of intentions, since those therapies still maintain the underlying premise that someone is “disordered” in some fashion and requires “treatment.”  So these people conduct their lives from within a negative framework or the “problem state.”  Therefore, it’s not surprising that kids diagnosed with ADD/ADHD may experience shame, believing that they are judged harshly by adults, ridiculed by peers, incapable of performing tasks or getting organized, and that everyone is evaluating them negatively.
First and foremost, they hold this negative, at times, shameful experience of themselves somatically in an inhibitory fashion. Their lives seem filled with insurmountable problems, as the framework of their experiences is one in which they constantly sort for what is wrong.  A by-product of this lifestyle frequently is “isolation.” This is particularly difficult for children and adolescents for whom the social imperative is to fit-in – be connected to the group. Then, considering Siegel’s position that the “mind” develops from the interaction between neuro- physiological processes and inter-personal experiences, it is not surprising that children and adolescents who become isolated or absent healthy interpersonal experiences, grow up harboring resentment, insecurity with peers; and fail at tasks and relationships. 
Meanwhile, on the inside, where ADD/ADHD is often treated, brain chemicals appropriate to this negative state are released, such as those which impact stress levels, increase blood pressure and cholesterol, adversely affect the immune system; and even place severe strain on the heart.  So in addition to compromising a child or adolescent’s self-esteem, living with constant negativity can be hazardous to their health.  Interestingly, according to Joseph Chilton Pearce, among others, recent heart research has revealed that the heart may control and govern the neurochemistry of the brain through hormonal and other forms of communication between these vital organs.  So there is a cascade of pernicious events that can occur inside to those who perceive they are being classified and treated in ways that are highly demoralizing.  In effect, “What you say… is what you get.”
In contrast, what if instead those identified with ADD/ADHD characteristics were regarded from an entirely different framework?  By teaching these individuals to organize their perceptions and responses from a state of “possibility”so they notice for the things that are working in their lives, they begin to saturate their brains with a different set of chemicals—a positive “neuro-cocktail”, so-to-speak.  As Dr. Siegel implies, positive interpersonal experiences have a special organizing role in determining how the brain operates.  In effect, each time ADD/ADHD individuals sort information so they notice for what’s working in their lives and communi-cate with others, their brains continue to build the capacity to use positive neuro-chemicals more efficiently and effectively over time, extending and enhancing the effect as they do.  Edward Hallowell, M.D., and John Ratey, M.D., in, “Delivered from Distraction”, offered some insights into how ADD can be explained to children in ways that support high self-esteem.  Reframing it as a set of skills or a “gift”, they compared the ADD child’s brain to a race car with a turbocharged engine, but with brakes that require some attention so they work more effectively.  In one touching exchange, when a child asked if he will “have ADD for the rest of his life”, they responded, “If you’re lucky.”
So living life by responding to your perceptions of the world from a positive, self-enhancing position of what is working can produce a different set of outcomes. These responses are, too, first held within the body but as a totally different somatic form.  What is essential is to help those classified with ADD/ADHD discover ways they are extraordinary by uncovering their fascinations and interests, then identifying the “somatic form” they hold at such times. The feedback they receive, naturally, will be in relation to this way of operating or highly positive.  This, in turn, tends to sustain or reinforce that somatic form in a recursive loop, where one leads to the other.
Of paramount importance here is another difference between the way ADD/ADHD is traditionally addressed and the position herein described. The usual response to ADD/ADHD is to get someone to change in ways that are considered appropriate to the demands of our society.  In contrast, this approach, based upon the “Mythogenic Self® Process, developed by Dr. Joseph Riggio, teaches people to establish and hold a form within them that is changeless!  This is a singular position, held within the body, from which a person is ready to perform at his/her best! Once someone locates and learns to maintain this position, there is nothing outside that individual which needs to be present in order to catalyze a change process.  In effect, that person is standing in the center of his or her own life experiencing a sense of completeness; one in which “desire” replaces “need” as life shows up.  So in the process, as an ADD/ADHD individual becomes able to sustain this position and the opportunity to learn something becomes available, “learning” becomes a desire—not a dreaded chore!
To further clarify this, another of my presentations, “ADD/ADHD: A Change Of Focus”, introduced the idea that by attending to the somatic form or how experience occurs within the body, a person can learn to identify his “center.” The “center”is this place of changelessness inside where you notice your body coming to rest. It is the position you hold within your body when you are experiencing your fascinations, interests, stories and characters that have attracted you in some way.  In short, like this, you are operating from that singular position from which you live your life true to your self without compromise, both on your own and in connection with others.  At your “center” you are most aware of who you are and who you are becoming.  It is the balance point from which you create perceptions of the world external to you as well as influence the perceptions of others, rather than allowing the world to determine—through negative labeling, for example—who you are.  And this is an essential ingredient for staying connected verses isolating oneself.  As Siegel also implies, staying connected to others stimulates creative exchanges with others.  ADD/ADHD people, like all humans, need a creative, productive outlet to increase stimulation and feel fulfilled.
Once you have taught those classified with ADD/ADHD to identify this way of being, the task becomes teaching them to hold that form when engaging in tasks—i.e., learning, working, relating to others—that were previously challenging!  Then holding a somatic form in which they are “changeless”, what can evolve as life “shows up” are the ways they learn to organize their time and space in order to experience more satisfying and rewarding lives. 
                   Ridicule often checks what is absurd, and fully as often, smothers that which is noble.    .                       Sir Walter Scott (1771-1832) The privilege of a lifetime is being who you are.Joseph Campbell (1904-1987)