No, there is no such thing as ADHD. Somewhere along the line we have lost the understanding that kids come in all shapes and sizes. Some kids are active, some are quiet; some kids are dreamers, others are daring; some kids are dramatic, others are observers; some impulsive, others reserved; some leaders, others followers; some athletic, others thinkers. Where did we ever get the notion that kids should all be one way?
Parents these days are subject to pediatric "experts" who proclaim that kids should follow some prescribed rates of physical, mental, and emotional growth. If they deviate from the "mean," then there is a problem. Parents are intimidated and worry that there is something wrong with their babies. Every child matures in his own way, in his own time. Every child is different. We need to throw away all the bell curves of "normal," you know—developmental milestones. Parents worry if Johnny is a happy breast-feeding pudge-ball, heavier than his appointed weight; or crawls differently; or isn’t walking yet; or isn’t talking at his appointed hour; or still isn’t toilet trained (very few make it to adulthood without getting toilet trained). There are experts at every turn, such as those who proclaim knowledge that a pudgy baby will create fat cells that will create weight problems for life, which is nonsense. Parents, leave these poor kids alone and enjoy them. Raise them well, you know, with boundaries and love.
Apparently, differences mean that we should make children conform to the idea that there is some ‘normal’ that all kids should be. If they’re active give them amphetamines; if they’re moody give them Prozac; for fears, give them benzodiazepines; and while we’re at it, lets give them antipsychotics, or Lithium and other mood stabilizing drugs. What in the world are we doing?
My focus is on the interplay of temperament and trauma to demonstrate how the fiction of ADHD took hold in the first place. Dr. Peter Breggin and others have addressed the issue of giving amphetamines to children with compelling clarity. (see a “Towards a Ban on Psychiatrically Diagnosing and Drugging Children”).
Every single person is absolutely unique. No two of us are alike. Even identical twins are not the same. We all have our unique constellation of temperament. I want to emphasize that by temperament, we are talking about inborn temperamental styles, not pathology. (See “The Nature-Nurture Question—The role of ‘Nature’ comes from our genetic temperament. Our temperament digests our parental nurture all the way through our development.” Together they create the varied and wonderful scope of human personality. Our cortical imagination, oriented by our temperament, writes a specific and nuanced character world in each of us, which is as unique as our fingerprints. And so it is with nature and nurture for all of us. Our temperaments differ; our salient environments differ; our parents, our culture, and the happenstances of our lives differ. The specific qualities of our parents, brothers, sisters, aunts, uncles, teachers, friends, girlfriends, boyfriends, and the moment-to-moment experience of our lives are all unpredictably alive. Our adult character is created out of all of these forces and is absolutely unique. No two snowflakes are alike, but we are all snowflakes. And we all form the same way.
To understand ADHD, we need to look at differences in temperament, as well as the degree of responsiveness, abuse, and deprivation that is digested into our plays of consciousness. A typical child, often a boy, may have an active temperament. One can readily tell whether a child is active or passive. Active children sit and walk and climb early in childhood. They take off at the beach. The active child is naturally physical, physically expressive, and action-oriented. He is oriented to active, muscular, good aggression. In the context of good-enough loving, the active child, identifying with his active strength, operates as a take-charge doer. (The passive child is not oriented by muscular, good aggression. In basic orientation, he is more absorbed elsewhere. He tends to be off day-dreaming. The passive child depends more on someone else to provide shelter from the storm. He identifies as the recipient of action rather than as a doer.)
The next temperamental attribute is that our active child tends to be an externalizer, rather than an internalizer. What does this mean? The orientation of an externalizer is to look outward. With good enough loving, he feels secure with love from others. In the context of deprivation and abuse, he is predisposed and oriented to feel attacked or criticized by others. He locates the source of attack, hatred, or criticism as coming from a person outside of him. For example, from a legacy of shaming abuse, an externalizer experiences being actively shamed by a person outside of him and will react to it. His orientation is as a blamer. As such, he would be inclined to blame and fight with others. (An internalizer will carry a source of loving internally. In the absence of good-enough loving, instead of blaming and fighting, he will attack himself. It would be manifest as self hate. “I’m bad; I’m inadequate, I’m stupid, I’m ugly,” etc. In the context of shaming abuse, an internalizer, would feel ashamed.)
Our active child would tend to be more narcissistically inclined than echoistically oriented. His orientation is to operate from his sense of self, as opposed to an echoist who operates from the point of view of other people. In the context of deprivation and abuse, his “me” orientation focuses on himself as the injured party and isn’t as centered on thinking of others. He is furious and outraged at slights and injuries directed at him from others. He leads with an exposed nerve and indignantly feels, How dare you treat me this way?
And finally this child tends to more of a participant and less of an observer. A participant is naturally oriented to be immersed in and emotionally involved in activities. He easily and naturally engages through feeling. (The natural orientation of an observer, on the other hand, is to process at a distance, rather than be immersed in the feeling relatedness of the scenario of the play. An observer tends toward thinking, caution, circumspection, reticence, and figuring things out.)
So what do we have? An active, externalizing, narcissistic, and participatory child. Remember, there are no pejoratives associated with these qualities. This type of constellation generates the attributes of leaders and athletes. In many cultures these children are valued rather than devalued. They grow up to be fun energetic people. They may show behaviors that get them called ADHD, but they are normal kids. They are easily bored, need to run around a lot, and may have short attention spans, except when they are interested. These actually are stereotypical boys. They can be fidgety and impulsive and may concentrate poorly, but there is nothing wrong with them.
In the context of deprivation and abuse they may be prone to spin out of control. They may act out more and blame and fight. This may be a signal that something is problematic in the family and needs to be attended to. Many families don’t like to hear this, but the attention deficit may mean that the parents are giving insufficient loving attention to the child.
What is called ADHD in general is merely one part of the constellation of temperaments that make up the human condition. Even within this group, temperaments will vary. No two children are the same. And the specifics of deprivation and abuse vary with every child. Not only that, there are many other issues that can be very misleading. I give one example in “How Do Our Children get Misdiagnosed with So-Called ADHD?" Certainly symptoms present themselves, but they need to be correctly understood. All of these children need to be properly evaluated to understand what they need. It might be help for the family. It might be a more open classroom. It might be to help teachers be better teachers. But one thing is for sure: There is no brain condition that generates some disease called ADHD, and none has ever been demonstrated. And no child should be given amphetamines.
Robert A. Berezin is the author of “Psychotherapy of Character, the Play of Consciousness in the Theater of the Brain”