Suffer the Children

The case against labeling and medicating children, and effective alternatives for treating them

Why French Kids Don’t Have ADHD—Part 2

ADHD is a cultural construction.

     I appreciate Dr. Sarkis having the interest to respond to my article Why French Kids Don’t Have ADHD. The main point of my article was that there is no scientific evidence that ADHD is a real biological disorder. Medical scientists have not isolated a biological cause for ADHD, nor is there a laboratory test for it. ADHD is a social construction by a committee of psychiatrists who author the Diagnostic and Statistical Manual of Mental Disorders (DSM). Many of the authors of the DSM-4 (56% to be exact) have financial ties to pharmaceutical companies who stand to profit greatly from medicating children.

     In a previous construction of the DSM, the DSM-3, the authors constructed ADD as a disorder, but in the DSM-4 ADD no longer exists. It is certainly possible that ADHD will similarly disappear from future editions of the manual. I think it is important to realize that the DSM is an artifact of culture, and that not all cultures construct human problems and suffering in the same way.

     As I point out in another Psychology Today blog, ADHD: The Emperor’s New Diagnosis,"…the moniker ADHD merely describes a cluster of externally observed symptoms: the child often fidgets, makes careless mistakes in schoolwork, often loses his pencils, has difficulty waiting his turn, blurts out answers in class, and so forth. This is like defining diabetes as excessive urination, frequent thirst, lack of energy, and having sweet-smelling urine. Of course doctors do not define diabetes by these observable symptoms because diabetes has a well understood biological cause. Diabetes is a metabolic disorder of the pancreas being unable to produce sufficient insulin. But ADHD is defined only by externally observable symptoms.

    Dr. Sarkis and other readers may also be interested in my article, “Does ADHD Exist: A Reflection on Humberto Maturana” which appears on September 25, 2012 as a guest post on the blog of David Allen, M.D., Professor of Psychiatry at the University of Tennessee Health Science Center and author of three respected books on psychiatry.

     In my own work as a family therapist for twenty three years, I find that searching out the underlying cause of a child’s distractibility, inattentiveness, fidgetiness, etc. in the child’s social context (family, school and friends) is a safer and more effective way to help the child get over his problems than by dosing him with amphetamine drugs like Ritalin. As French psychiatrists found before me, diagnosing the child with ADHD does not help at all if one’s goal is to solve the child’s problem rather than mask his symptoms with potentially harmful drugs.

     Many parents are beginning to cotton on to the situation as well. As Bronwen Hruska explains, in her New York Times article of August 18, 2012, “Raising the Ritalin Generation”, the cause for a child’s antsy, disruptive behavior in the classroom may well be due to a social context factor like having a teacher who “doesn’t know what to do with boys.” Hruska also describes her shock when she read about the possible side effects of a medication her doctor said was safe for her son’s ADHD-like symptoms:

     “I learned that the formidable list of possible side effects included difficulty sleeping, dizziness, vomiting, loss of appetite, diarrhea, headache, numbness, irregular heartbeat, difficulty breathing, fever, hives, seizures, agitation, motor or verbal tics and depression. It can slow a child’s growth or weight gain. Most disturbing, it can cause sudden death, especially in children with heart defects or serious heart problems.”

     Recently, I discovered another interesting fact that might throw even more light on why French children have not been plagued by the ADHD epidemic in anything like the numbers of american children afflicted by it. French children are not exposed to TV screens nearly as much as children in the United States because they are protected from it. The French government has actually banned French television programs designed for children under three-years-old.

     Young French children are sometimes exposed to TV programs on foreign channels, but now those channels must warn parents of the negative developmental effects of television watching. This kind of programming now issues the following warning to French parents, “Watching television can slow the development of children under the age of three, even when it involves channels aimed specifically at them.” The warning is based on a ruling by the French High Audiovisual Council: “Television viewing hurts the development of children under 3 years old and poses a certain number of risks, encouraging passivity, slow language acquisition, over-excitability, troubles with sleep and concentration, as well as dependence on screens.”

     As mental health professionals seeking clarity in our thinking and ever new ways to help our clients, we must be aware of ourselves as living and working within a cultural context. Stepping outside of our own context to see how other cultures construct human problems helps us become more aware of what is natural and what is cultural. While I appreciate Dr. Sarkis' reference to Moliere, certainly he describes certain annoying behaviors in children. But the construct "ADHD" did not exist at the time he was writing his plays. Diabetes is a biological illness that occurs in nature. Based on what medical science knows today, ADHD is a cultural construction that attempts to explain certain behaviors, the causes of which are not understood.

     As for the study Dr. Sarkis quotes by Faraone, et al (the et al includes Dr. Joseph Biederman of Harvard), a comment someone posted on my original article about this particular piece of research says it all:

When I took a look at the cited article by Faraone et al, the last name in the list of authors (who is commonly the one responsible for garnering funding for the research) rang a bell. Joseph Biederman of Harvard Medical has gained some notoriety for his research funding. If you're interested to see who paid for this research published in 2003, take a look at the New York Times:

http://www.nytimes.com/2009/03/28/health/policy/28subpoena.html

and

http://www.nytimes.com/2008/06/08/us/08conflict.html

 

Copyright © Marilyn Wedge, Ph.D. 2012

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Marilyn Wedge, Ph.D., is a family therapist and the author of Suffer the Children: The Case Against Labeling and Medicating and an Effective Alternative.

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