The number of psychological disorders, particularly among children, seems to be growing within our Western societies by the day. This phenomenon has left us scratching our heads. Currently, there seem to be two ways of explaining and treating psychological disorders such as ADD (Attention Deficit Disorder). Some would say these disorders are diseases that people catch similar to catching the flu, simply a bad stroke of luck. Others would say these disorders are genetic and these people were always destined to be anxious, or depressed, or obnoxious, or defiant. In particular, people point to the fact that it is common for ADD to be multi-generational as a justification for it being a genetic disorder. In either case, treatment of these disorders usually involves seeking to control an individual’s behaviour. At school or within the family, rewards and punishments are the methods of control most often applied. If such methods prove unsatisfactory, pharmaceutical drugs, such as psycho-stimulants, may also be utilized to help control the behaviour.
As a society, we seem desperate to limit any behaviours that are considered abnormal, whether our own behaviours or that of others. While adults have choices about how they seek to control a psychological disorder they struggle with, children often have little choice about how such a disorder is managed. Sadly, the control measures employed appear to be more for the benefit of those adults who interact with the child than for the benefit of the child themselves.
In a recent article of mine, I discussed the behaviours of children with ADHD (Attention-Deficit/Hyperactivity Disorder) and noted we may have much to learn from these children. Though dramatic to us, the behaviours of children with ADD or ADHD may highlight issues within our society we would rather ignore. Perhaps the increased sensitivity of children with ADD or ADHD to the world around them is not something to repress but to pay close attention to. What are these children telling us? What if their increased sensitivity is not the problem but rather our inability to respond? As the physician and author, Dr Gabor Maté writes,
“Sensitivity is transmuted into suffering and disorders only when the world is unable to heed the exquisitely tuned physiological and psychic response of the individual.”
An online search for information regarding ADD and ADHD reveals that diagnosis of and treatment options for these disorders are broadly discussed, while the causes are barely mentioned. If any information regarding possible causes is given, it is usually a cursory sentence. This is not out of keeping with a common societal misconception that to name or label something is to have explained it. A label is not an explanation. A name may help describe particular traits or behaviours; however, a name does not tell us anything about why these behaviours occur. Seeking to control symptoms with little understanding as to what is causing these symptoms is highly unlikely to solve the issues long-term. The key question we need to ask is: “what are the underlying factors causing these symptoms?”
When thinking about the term “attention-deficit” we must ask, what are these children struggling to pay attention to? Many parents are hugely concerned about their child’s inability to maintain attention in situations where they have deemed it necessary for their child to focus. Yet they miss the fact that their child can maintain attention in situations where their interest is captured. There is a relational component to this attention-deficit in that it is often directed towards unchosen authority figures such as parents and teachers. We must ask the question, what is happening in these relationships that are causing these reactions?
It is also worth considering that the comorbid disorders of ADD are largely relational problems. The most prevalent comorbid disorder is Oppositional Defiant Disorder (54–67%), followed by Conduct Disorder (20–56%) and Anxiety Disorder (25%). It has been argued that the behaviours exhibited by those with such disorders are simply the products of their genes, but this is not necessarily accurate. Behaviours can be learned as much as inherited or may be reactions to things a child experiences in their world. Seeing as it is the parents who usually have the most influence on their child, we must look at the parent-child relationship, in our quest for understanding and treating disorders such as ADD.
There may also be other things about the parent-child relationship which contribute to ADD. Things that happened which shouldn’t have happened, such as physical, sexual, or emotional abuse, and things that should have happened which didn’t happen, such as attachment.
When children are subject to abuse, their body responds by going into “survival mode”. This means either going into an immobilized and disassociated state or a defiant state. These are both states where the child seeks to regain some sort of control in their lives. By disengaging with the world around them, they are expressing their distrust in adults, who they may rightly perceive to be irrational and erratic. By showing defiance, they are trying to regain control. The child knows they will likely get a reaction out of whoever they are being defiant towards, the main thing is to gain adult attention. Knowing they have the power to cause an adult to “lose control” and become angry is a coping mechanism for the child. How else can they deal with the large power disparity between themselves and the adult? Although in reality, the cause of the adult’s erratic behaviour was the adult’s inability to self-regulate rather than the actions of the child.
We are born yearning attachment, and we will continue to seek it out if we do not receive it in our childhood. For those with ADD, this lack of attachment may manifest itself in the form of attention-seeking behaviour as described above as well as anxiety. A child can only learn to regulate their emotions if they have a close, healthy bond with a stable adult, who can model how to self-regulate emotions. A child that does not have self-regulated emotions modelled to them by the parent will seek external ways of regulating emotions. This inability to self-regulate seems to be a large factor in the association of ADD and similar disorders with drug addiction.
“The understanding of relationship is infinitely more important than the search for any plan of action.” -Jiddu Krishnamurti
If we are to understand our relationships with children we must seek to engage with them in a way that makes them feel secure and valued. For a child to be engaged they cannot be in a defensive mode. If they are in an immobilized or disassociated state, or in a fight or flight mode due to fear, they are not in a relationally safe position. We must be willing to ask ourselves if the child’s reactions are from a place of survival instinct rather than because they are “disobedient”. So why not instead start from a place of curiosity? Why not seek to discover what is actually causing the symptoms of ADD? Certainly, the task for the parent is daunting, possibly even frightening. To do so means to admit to the parts you have played in creating the problem. It will also mean looking into the parent’s own past and seeking to understand the origins of their own behaviours. As the parents start on this journey there may still be many challenges as the child may continue to act in ways they wish for or understand. Perhaps there will even be times they have no idea what to do next. But any parent who wants a meaningful relationship with their child and who truly wants to help must start from a place of curiosity.
Then the aim shifts from controlling the child to repairing and deepening a relationship with the child. Achieving this aim requires introspection on the part of the parent, something far harder than simply labelling their child. This introspection is particularly hard in this day and age because for many people “normal” human existence means living at a hectic pace and within tense relationships. However, hard does not mean unachievable or undesirable.
To have any hope of long-term solutions for ADD/ADHD, we should be asking: what is actually causing the symptoms? If the root of these disorders is indeed relational experiences, then we must dare to become more inquisitive about ourselves and our children; recognize the needs of our children, especially their need for attachment; and show humility as we try to reconnect with our children.
Disclaimer: I am not a medical professional, and my comments should be read with this in mind. I am grateful for the work of Dr Gabor Maté. His books and talks have been incredibly helpful in researching this topic.