Accessibility View Close toolbar

ADHD as of the 20th century hysteria

The Hidden Life of Children

Sharon R. Kahn, Ph.D

[This article was originally published in the October 1999 issue of the Brooklyn Parent, a special pull-out section of the Bay News. SK]

The most memorable card my parents ever received from me showed a happy rhomboid figure on the cover, guilelessly exclaiming, "Mom, dad, remember all the times I drove you crazy?" When they opened it up, it insisted, "Well, I'm almost done now." Most parents who seek out the services of a psychotherapist are utterly incensed, experiencing only the first page of the total card, unable to feel within them the surety that they will all get through this.

At the end of our millennium, the usual reason that parents are driven crazy is the belief that their child, usually their son, is "too hyperactive." He never sits still, doesn't finish his homework, doesn't seem to focus well enough in school, interrupts the teacher, and seems to be driven twenty-four seven by a perpetual motor. And if the parent isn't driven crazy enough by this, then the teacher is complaining, advising the parent that their son has Attention Deficit Hyperactivity Disorder (ADHD) and needs Ritalin.

ADHD is a meaningless diagnosis, a label which piths children by their failures and tells you nothing about the child's personality, playfulness, vitality, intelligence, or creativity. Furthermore, this label tells you absolutely nothing about why the child is acting this way. Just like Tolstoy's unhappy families, ADHD children are all different in their hyperactivity. What they have in common is that they are acting out their problem in a behavioral fashion. This is actually quite an intelligent behavior. Adults pay attention to the acting out child, not the quiet, withdrawn window gazer. The acting out child experiences their moods as something foreign and as really "nasty" and through constant motion, the child can exorcise, excise, and exercise out the inner nastiness. Children's behavior occurs in a context, although the background may not be obvious to an adult. Parents are important others who regulate their child's earliest experiences and give meaning to them. Children who receive an ADHD diagnosis may merely be acting out that they need a lot more nurturant adult attention than they are receiving. Indeed, Peter Breggin, a psychiatrist, refers to hyperactivity not as ADHD but as DAD disorder--boys who need an increased dosage of fatherly interactive guidance.

ADHD behaviors are most likely to occur in loosely structured, boring situations, where children are required to make sustained effort and provided with minimal attention and reinforcement. Ours is a culture which demands at an increasingly early age that children sit quietly and share adult attention in large social settings. In earlier times, a boy who couldn't sit still in the class could still have a valued role in the schoolroom: his teacher could send him out to chop more wood for the classroom's heater, to draw some water from the well, to clap erasers or to erase the blackboard for her. At home, both girls and boys needed to attend to large-muscle chores before heading off to school. Indeed, given all that children used to do to ensure the survival of their family, sitting down in school for a few hours must have offered a great relief from their duties. The increased mechanization of our culture has left us with less use for our bodies and little useful muscular activities for our children to engage in. Before school, children are passively watching television. Recess, music, and art classes, which all offer active outlets for restless children, are still unknown luxuries for many of our public school children. Worse, outside of school, there are both real and feared hazards: many parents are afraid to let children play unsupervised in the street, to use the staircases in large apartment buildings, or to run to the store. Thus children are endlessly cooped up in small apartments, like Dalmatians fettered in a doghouse. In a culture where constructive muscular activities are rendered archaic, children are increasingly being labelled as disordered for wanting to use theirs regularly. Thus, the entire concept of ADHD may be ideologically influenced. Ideology abhors a vacuum. In our capitalistic society, it is a short walk down the path from a ideological influence to a psychiatric disorder, from a social disease to an individual weakness. Authorities urge parents to seek treatment for their ADHD children--especially psychotherapy and medication. Neither one is a panacea. Few children want to be in psychotherapy or pop pills--they fear it means they are crazy. Siblings and schoolmates are too happy to independently validate this fear. New fights start when the child is taunted, "Oh, you're cuckoo, you take medication." Taunts and threats are less motivators for seeking change than for perpetuating existing acting-out defenses. Medication does not prevent a child from being defiant or enhance social judgment. No tablet teaches new behavior; they serve to suppresses activity and thought processes. This, by itself, is not necessarily a terrible thing--medications can stop the distractions and help the child to focus on learning new behaviors and to discover more rewarding ways of getting attention, if simultaneously with the pills there is someone in their life who will teach them these new tricks. In our culture, that ends up falling under the purview of a psychotherapist.

Psychotherapists serve best when they can help parents to help their children to change and to teach their children new tricks. Change requires a new relationship between the child and the adults in his life. This is why discovering what the child does well is more useful than whacking the child upside down his head with his weaknesses. A child who is praised and admired for his real assets is a child motivated to learn. And then parents and teachers can begin to relax, sensing that the child is "almost done" at last.