Inside Out, Outside In

What we bring to the world, and what it brings to us

Coping with ADHD

How a young man and his mother are managing a path to success

Gene Beresin, M.D., M.A., Peter Braaten, and Ellen Braaten, Ph.D

 

Introduction (Gene)

We could have called this story “Conquering ADHD,” but that would have been a lie – more likely, too much of a fairy tale.

Most kids who have Attention Deficit Hyperactivity Disorder (ADHD) and problems with organization (“executive functioning”) live with it their whole life. Like our personalities, strengths and weakness and even illnesses or physical problems we develop, we find ways – hopefully healthy ways, to work and live with them. At times, we might laugh at ourselves when we trip or blunder. Hopefully we do not scream or blame ourselves excessively, though this is very common and easy to do. And if persistent we just might find a path to succeed, like Peter did.

But what is success in this world of inborn traits, genetic vulnerabilities, or wiring problems like ADHD? What does it look like? And what can we write that will inspire hope?

Because there is hope!

Peter has an incredible story well told in the Clay Center Podcast “Living with ADHD.” And the unique feature of an accompanying podcast (See the Link at the bottom of the blog) is that it included Peter and his mom, Ellen Braaten, PhD, Chief Child Neuropsychologist at MGH, and Steve Schlozman,MS, Associate Director of the Clay Center and Peter’s doctor.

In this post, Peter and Ellen will elaborate on what the podcast touched on, but from the angle of what it takes to grow and thrive, despite this particular adversity. This is really the heart of resilience.

So, let’s hear from Peter and Ellen.

Peter, now 20, is tackling ADHD in his own way. As in every psychological problem we all have to find out what works for us. Because what works for one person is not necessarily what works for all. There are no magic bullets. No platitudes. No simplistic answers.

Not to be a spoiler, I will be one anyway.

Peter is going to tell us:

• His need to understand and reflect on how ADHD affected him and this required nurturing self-reflection and awareness of his strengths and weaknesses

• His struggle with the lack of understanding by those around him, especially adults

• Why ADHD was tough on his self-esteem

• His seeking coaching rather than tutoring to set him on the right path with tasks

• How he had to find the right approach that worked for him

• Some advice for parents

Ellen will describe:

• Being a professional is useless with your own kids. No matter how much you know, at your core you are a mom like any other mom

• You can’t make your kid do what you want, no matter how much you think you know what is best. You guide, try and then let your kid find his own path

• Fasten your seatbelt and enjoy the ride (well, not the fights, but the growth that will come with your faith and trust in your son)

So much for spoiling. Here’s what they can tell us.

Peter:

One of the most difficult things for me about being diagnosed with ADHD (especially at such an early age) was understanding this as a helpful push in the right direction. It was very hard for me to appreciate what a “diagnosis” means. Does it just mean a guide for treatment? Well, that might be fine for a doctor, but in my experience it is not good guide for others. In some ways, it significantly influences the ways others view you. Some understand what it means, while others don’t – some adults around me did not even believe it exists or just seemed to disregard it.

Context is what I find difficult with this diagnosis. I It is really something that affects every aspect of your life, which is why it is so hard for other people (teachers, parents, etc.) to understand what it means for an individual to have ADHD. A diagnosis in itself does not inform others around you what tasks are easy or difficult. It does not differentiate effort levels. So for me, some activities have been pretty easy to accomplish, while others are very hard, if not impossible, without some kind of coaching. And the amount of energy that it takes me to do different projects is highly variable. But only I know this, and a teacher, parent, friend might not know what I am going through – they are not living my life.

We live in a world where results are everything. Too often I have been told to just “try harder.” Well, ‘trying hard’ just doesn't cut it anymore –it is not so simple if you have ADHD, and especially if you have problems with organization in some tasks. I have gotten in trouble more times than days I’ve lived on this planet because I complete 85% of an assignment, task, or any kind of job. And then when I just cannot do the rest, others around get angry, frustrated, or don’t understand. And worse, I get really down on myself!

So what lowers my self-esteem?

A few of the most frustrating things to hear are: “Peter, you have the ability to do the work, why are you getting this grade’ or ‘why aren’t the assignments coming in?” The worst is when a teacher has the perception that you are not giving any effort in class or homework (usually because assignments are missing or it is hard to look like you are paying attention in class).

For the first time in my life (I recently turned 20) I am gaining awareness about how I study, how much wait time I need to answer a question without an impulse answer, how I need to listen to music when writing papers (even silence is distracting to me), how ‘later’ does not actually exist, how procrastination manifests itself into my daily life.

What has really paid dividends to my academic success is something called academic coaching. The most important aspect of this coaching concept is accountability. There is someone whom I really like and respect expecting results from me (goals of which I set for myself, not dictated by my parents) and I genuinely want to achieve those results and make myself proud.

I was never really quite ok with the concept of school and it was not until withdrawing from college at the last possible day that I realized how everything was in my control. It may take me twice as long to get the same grade as someone else in a class, but that is just the price to pay for hard work and success.

Ellen:

Unfortunately, my knowledge as a child psychologist wasn’t all that helpful when it came to parenting a child with ADHD. I was just as frustrated as any other parent when I watched my son struggle with things that I thought should have been easier for him. There are no quick fixes for the problems that are part of an ADHD diagnosis; problems such as disorganization, slow speed of processing, poor attention, trouble sitting still, getting started on homework are hard to define and need individualized treatment. That kind of treatment is hard to find – and rarely found within the public school system.

Many professionals still have misconceptions about the diagnosis – i.e., it’s over-diagnosed, doesn’t exist, or can be overcome with will power. But even knowing that it can’t be overcome without will power...somehow....when you’re helping your 4th grader with his homework and he can’t even start, you think to yourself, why can’t he just pick up the pencil and get it done!

That kind of thinking isn’t helpful for anyone. If Peter could have picked up the pencil and gotten it done he would have. While this type of thinking is partly motivated by frustration it is also motivated by a desire to see your child succeed – by an almost wish that if you could say what he needs or should do the behavior would magically happen. At the same time, yelling works to some extent. In fact, when Peter was in middle school I remember saying to him, “Peter we need to come up with a different way of helping you get your homework done other than yelling at you every night” and he said, “Well, yelling works!” Unfortunately, it doesn’t feel good for either party and does nothing to teach the strategies that would actually help a child get the work done more efficiently next time.

If I could change some things about Peter’s life, I’d have done a better job at finding a more appropriate match between his learning style and the school environment. We lived in a great suburban town with a well-ranked school system when Peter was growing up but it wasn’t really a great environment for him. Ironically, helping kids find the right school environment is part of what I do! This just shows how hard it is to find the right kind of support. The current school culture talks about individual differences and learning styles but I find that it’s the exceptional school that is able to put that into practice. Luckily, I feel Peter is finally in an academic setting where he is well-matched to his learning style and ready to take advantage of what is offered. That is also a key issue in his success.

I’ve learned more from Peter about living with a disability than anything I’ve ever learned in a book, just as I learn from the families and kids I see every day. In many ways, Peter is far more knowledgeable about himself than many other kids his age who have had a smoother ride. I’ve observed this in the kids I’ve worked with over the years – kids who successfully negotiated life while dealing with disabilities are able to better handle the inevitable bumps in the road in life than other kids who haven’t.

Thus, my advice to other parents is to enjoy the ride, wherever it takes you and be open to the possibility that the child who struggles most may also be the one who has the most to teach you – and the one who may eventually surprise you in ways you never expected.

 Peter:

I am currently taking classes from a community college and getting straight A’s. I hope to raise my GPA and transfer back to a four year institution. Looking on to the future I hope to continue to develop academic confidence, as well as my spiritual fulfillment.

My final advice to parents living through what I lived through (as a child) is to have patience and truly listen to what their kid needs and not press their own agenda. We all work at our pace and develop at our own rate.

Summary (Gene):

Living with ADHD is no fun for the kid or the parent. What we see here is that Peter and Ellen’s success came from understanding just how ADHD affected Peter in a unique manner, and how he had to embrace a way of coping with it in ways that were effective for him. Not everything works for everyone.

Both Peter and Ellen reveal that there is not only hope for coping with ADHD, but as painful and difficult as it has been for each of them, sometimes we need to face adversity to become stronger.

We all have our rough spots – our vulnerabilities. Maybe by facing them directly and honestly makes us stronger.

A version of this post originally appeared and was written by the authors (Beresin, E. Braaten and P. Braaten) on WBUR’s CommonHealth on August 18, 2014.

For the accompanying PODCAST, please visit: www.mghclaycenter.org

 

Eugene Beresin, M.D., is Professor of Psychiatry at Harvard Medical School.

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