ADHD Awareness Month, October, 2013

It is not exactly a “Hallmark Moment” to celebrate, having ADHD every day of your life. However, there are many ways that we can learn how ADHD affects individual people whom we know, and how we can be more patient and understanding so that we reap the benefits of their gifts.

This site, ADDitude, has many resources for any month of the year. In particular, though, there is an expert giving a free webinar, and I recommend it to anyone interested in this subject.

Dr. Brown’s book on ADHD and Executive Functions

His name is Thomas Brown, MD, and he’s written many excellent articles and books on recognizing and treating ADHD. You can listen to him via ADDitude’s website, http://www.additudemag.com/awarenesswebcasts.

October 16, 2013, 1PM EST
Exposing ADHD Myths: Science’s New Understanding of ADHD
with Thomas E. Brown, Ph.D.

In addition, this site is hosting many other intriguing talks, and has lots of articles and handouts that might help raise awareness of the issues facing people with limited attention, memory and executive function skills.

It is worthwhile to reduce the stigma, I think, especially within the school system. That doesn’t mean people with ADHD should be allowed to remain unconscious of their effects of their behavior on others, or be excused from doing their very best at any given moment. It means there needs to be a recognition of the condition, a plan in place to know what to do if that person is not able to perform at the moment, and a support system in place for making up work later on. Dr. Mel Levine referred to the first part as “demystification”.

I was stunned when meeting a 5th grader who was very ashamed of having ADHD. He thought it meant he was possibly mentally retarded. He was extremely worried that he would be pulled out of his regular class where his friends are, and put into the special education class. He wondered if it meant he had autism too.  He worried that he was unconsciously doing things that upset other people and he did not know about it! That’s a heavy psychic burden for a 10-year-old boy, especially one who is very active and talented in many, many areas. Interestingly, he had a lot of compassion for those kids who are in the special education class; he wondered if they had friends, or if they got in trouble for their “behaviors”. Somehow, though, he ingested all those negative messages about special education, and doubted his own version of reality. THAT is what I would like to help dispel. That’s where demystification comes in.

So, yes, I will be on some bandwagons, and I will be handing out some of ADDitude’s flyers. Viva demystification!

Gifted Adults Can Have ADHD Too

The Gifted Adult, by Mary-Elaine Jacobsen, Psy. D.  New York: Ballantine Books, 1999.

My motivation for reading this book was (1) personal – always nice to feel “gifted” and “special”; and (2) my consistent impression that the parents of the kids I work with are gifted, but may suffer from a case of ADHD or Strict Moral Upbringing or SBU (that’s my own acronym!) and feel their own unease coming out when they see their children struggling.

This book is incredibly pragmatic. It even includes a self-assessment that you can score.

But first of all, Ms. Jacobsen re-defines “intelligence”. Most adults grew up with the idea that IQ is a fixed number, and a fixed ability. Ms. Jacobsen widens the definition of intelligence to include several new facets – some that are a bit hard to define or quantify – but I think she does a good job.

She includes Gardner’s Multiple Intelligences (MI), critics be damned. While these are used a lot in elementary schools, they have not been seen as verifiable qualities that can be measured by most psychologists. Still, in an effort to help adults move past rigid ideas about their own intelligence, she includes questions on her survey to help them see new aspects of how they approach the world.

From there, she moves into the concepts of Intensity and Excitability, which she calls Gifted Traits (GT) (pp. 98-99). She includes descriptors for complexity and drive, too, which is necessary if you are going to get your ideas out in the world.

btw she loves acronyms, especially 2-letter acronyms.

The next section she calls Advanced Development (AD), which is quite nice in my opinion because she sees the desire to help others as a parted of the gifted personality. She loves making up “equations” such as:

AD = HV + MM + RA. These abbreviations stand for Advanced Development equals having a Humanistic Vision, a Mandated Mission, and a need to perform some Revolutionary Action.

All of these qualities of your interests, your proclivities, and your higher self are tabulated into your EvIQ, or Evolutionary IQ. She gets Evolutionary IQ from the notion of “evolve” – just as we evolve as a species, each individual evolves as we mature. We are able to have a vision and to take action once we are adults, in different ways than when we were born. Even if you like the idea of having a fixed IQ, you can see how you evolve your intellectual gifts into meaningful action through your work or your community involvement.

She really sees this definition of IQ as one that changes over time. After you’ve answered qustions on her survey, you tally up your scores in the areas of Multiple Intelligences, Gifted Traits, and Advanced Development, for a single score, which is your “current level of Evolutionary Intelligence” (p. 108).

And then what? Let’s assume that if you are reading this blog, you have a high EvIQ. J She has positive suggestions about meeting / confronting the usual criticisms you’ll receive – either from yourself or from others, such as, “Why don’t you slow down?” and, “You’re so sensitive and dramatic!”

I really like her section on Intensity (pp. 258 – 267). She has a chart that shows the differences between extremes of intense behavior, and a balanced version of the same energy:

Collapsed	Exaggerated	Balanced
Listless	Wired	Exhilarated by life
Numbers out with substances	Thrill seeker; addicted to excitement	Frequent peaks of experience
Dodges controversy; steers toward popular opinion	Intractable opinions; dominates conversations	Engaging conversationalist; comfortable with intense discussion
Substitutes mindless banter for in-depth conversation	Caustic; uses words as weapons	Articulate; stimulating
Deprecates self as laughingstock	Jokingly mocks and humiliates others	Joyous; congenial
Cold and remote	Doting and smothering	Warm and caring

She gives advice on how to reclaim your true self, your gifted self, and to seek balance to find joy and meaning in your world – but not by hiding your gifts, stifling yourself, or repressing others.

She ends the book with information about how you interact with others – relationships and finally your place in society. I expect for many people this last phase involved a sense of intuitive spirituality. Even if that sort of thing turns you off, it is important to know that those questions of the meaning of your life, and the legacy of your life, will be important as you continue along this journey. I hope everyone can find his or her gifts, see how the intention and willingness to change and improve can turn into reality, and how much our society needs you to share your gifts.

The “Myth” of ADHD?

The Myth of the ADD Myth

Review of The ADD Myth: How to Cultivate the Unique Gifts of Intense Personalities by Martha Burge (San Francisco: Conari Press, 2012)

Ms. Burge asks some provocative questions in this book, such as, “Intensity: Gift or Disorder?” While the word intensity here has a specific meaning, as described by Dr. Kazimierz Dabrowski as a particular giftedness, I appreciate her implication of how “intense” a person with ADHD can be. People with ADHD really are intense people; they feel intensely, they think intensely, they play intensely… and they fall apart intensely.

Ms. Burge, a life coach who practices in Southern California, has written this book to discuss the positive aspects of being intense in both the general and technical senses of the word. She writes compassionately about the people she has worked with who have a “deep sensitivity, a fullness of experience, a capacity for fantasy and creativity, and an intellectual curiosity” (p. xx), and who are not merely marred by attention problems.

She states that she developed her own theory of “intensities,” and then later discovered the work of Dr. Dabrowski, whose concepts described the same behaviors she had described. (See, for example, the Supporting the Emotional Needs of the Gifted (SENG) site for more information, or my blog post.) She came up with a great acronym for these different types of giftedness: SPICE. A person might be intensively Sensual, Psychomotor (Physical), Intellectual, Creative or Emotional. Generally, people who are gifted tend to be more “intense” in one of these 5 areas, and may have strong tendencies or talents in some of the other.

I want to point out that her approach may apply only to adults, and I am not sure all her ideas or suggestions can be used with children or adolescents. I have some criticisms of this book which mainly apply to how to help students function in a typical classroom setting.

A good point that she makes is that ADHD is “too common to be a disorder” (p. 18). There are many estimates of how many people have ADHD; I’ve seen research reports with 3%, 4%, 8%, 10% and even 15%. Over time, the numbers just keep creeping up. She poses a good question: “At what point do we look at a pattern of behaviors as within the normal range?” (pp. 18-19).

However, some points she makes are simply wrong. She claims that the National Institute of Mental Health (NIMH) estimates the number of people with autism is less than 1% of the population; their website states 2% (see http://www.nimh.nih.gov/news/science-news/2013/prevalence-of-parent-reported-autism.shtml). She states on p. 20 that “there are no objective tests that prove the existence of ADHD or any other psychiatric disorder,” but there are some biometric tests now for ADHD.  She skirts the issue of the efficacy of medication; she states that meditation can help most people – without using drugs. She has a section of her book, pp. 4 – 11, entitled “Medication Goes in Search of Patients” which has misleading information. She states that CHADD, Children and Adults with ADHD, was funded and founded by a big pharma company. She implies that they were set up to support giving out medications, as if all the other very helpful advice they offer is mere placebo. Yes, the pharmaceutical companies have something to gain by funding a resource like CHADD, but much of the information requires a lot of education even to understand whether or not your child has a disorder or disability. Frankly, I can’t think of anyone who would want to identify as having ADHD — how can she say that “the disorder seemed to go in search of patients” (p. 4)?

She throws in a very scary comment, that “the very same people,” i.e., doctors, who encourage parents to buy medications, are the ones who “will also tell you that stimulants are deadly” (p. 5). Hold on now! Of course abusing any substance is deadly! But death-by-overdose affects a very small percentage of patients, usually those with a pre-existing condition, and the medication is prescribed so that it will not be abused! Of course stimulants can be deadly, but so can hormone replacement therapy, aspirins, and sugary foods that lead to diabetes. It’s just not fair to scare people into ignoring a valid treatment, medication, just to serve your own pet theories. I distrust this kind of non-objectivity.

She calls meditation “the drug to end all drugs” (p. 52). Her approach to helping her adult clients includes meditation, mindfulness, and understanding some intellectual constructs, such as “the internal map of reality” (p. 46). It has been my experience to witness people with ADHD to be able to relax and focus only after they have taken medication to regulate their brains. I agree that meditation is wonderful and that developing a sense of your “inner voice” is an essential part of growing up and healing. But I do not think it is fair to tacitly discredit the use of medication. Some people can’t get to the state of being able to meditate until after they medicate. As with most conditions, every person is somewhere on the spectrum … some people have an “intense” case of ADHD, and many of those people when undiagnosed turn to drugs and alcohol to soothe or self-medicate – leading to an unproductive life of addiction and substance abuse.

As Burge points out, many people choose not to meditate, or believe they can’t meditate, because it takes too long – and a pill is a lot more convenient. I would ask her and all the anti-medication people out there – please leave room for both. If you can succeed without medication, great. But if you are a child or a young adult who is failing in school, you may be limiting your future choices if you can’t perform tasks that require focus, concentration and completion. There are minimum requirements to get into college, and we all know that earning a college degree is one of the most predictable ways to be financially secure as an adult.

While I respect a parent’s desire not to give medication to his or her child, I hope that parent is able to provide the time and energy to support that child – including sitting with them during a daily meditation period – to teach them how to utilize the non-medication tools of meditation, visualization, deep breathing, stretching, and developing an inner voice. My experience is that most 10-year-old boys who have ADHD – it’s not a myth – do not have the self awareness yet to benefit from this kind of training. Yet, they struggle and suffer and lose their self-esteem as they watch, mystified, their grades plummet and the respect of their teachers and peers diminish. That can cause permanent damage.

I used to think that ADHD was a myth, too. “We never heard of it when I was a kid in school!” Then, I walked into an elementary school classroom, where I hadn’t been in over 35 years, and saw a young man sitting backwards on a chair, his torso hanging over the back of the chair, his shoes off, as he attempted to work on a piece of paper with a pencil. He was not a myth. His disability was real. He didn’t want to be that way; he didn’t know why he felt like he was crawling out of his skin when forced to sit properly. He just couldn’t pay attention because he was physically – and yes, to use Dabrowski’s term, sensually – out of balance.

Twice Exceptional Learners Are “2E”

The term “2E” refers to being Exceptional, as in gifted, and Exceptional, as in having special learning needs. Many children who have learning differences/disabilities are also gifted, perhaps in math, the arts, or other areas.

A thought-provoking theory about giftedness is that these special traits or talents are “intensities”.  I like this description for many reasons, one being that it honors the basic abilities that most people have to create, to think mathematically, to understand literature, to relate on some level to the creation they are witnessing. For example, most people shudder at the thought of public performance, but they still love to hear music performed because they can appreciate the melodies, the interplay between the musicians, or some other aspect of the performance.

If you or your child has ADHD, and yet you can see areas of unexpressed talent, it may very well be that they are functioning at two different extremes. Because a lack of executive functions can impede productivity and follow-through, you or your child may not believe that you or he could be “gifted”. The common belief is that gifted only applies to academic subjects; people forget that dancers, designers, engineers, architects and so many other professions require creativity, novel approaches to problem solving, and a willingness to try many options (perseverance) until the most suitable solution is found.

Kazimierz Dabrowski, a Polish psychiatrist, developed this theory of human development, or “theory of personality.” One very nice book that details various aspects of intensities is Living with Intensity, edited by Susan Daniels & Michael M. Piechowski, Great Potential Press, 2009. Dabrowski’s theory has many fascinating insights into human development and what educational therapists call “temperament”. The most widely-known concept from his work is called “Over-Excitabilities,” or OEs. This term is an unfortunate translation of the Polish term nadpodbudliwos’c’ “superstimulatability” or “superexcitability” (p. 8). Dabrowski identifies five areas where a person might be intensely sensitive: psychomotor, sensual, intellectual, imaginational and/or emotional.

This book is a collection of works by psychologists, therapists and educators who apply Dabrowski’s concepts to behaviors in children, adolescents and adults. The articles range from the theoretical to the practical to the spiritual. Most of the authors imbue their texts with hopeful outcomes once their clients are liberated with the idea that they are gifted and worthy of appreciation. Many of their clients have experienced only the awkward parts of being gifted: being rejected for being “too intense”; not having peers to match their interests; feeling different but not knowing why; being depressed or anxious; and many other scenarios.

Seeing a person’s gift(s) in a more specific way can also be helpful in understanding his or her temperament. A person with an OE in the sensual realm, for example, may “catch details and may, for example, be captivated by the beauty of a glistening drop of oil floating and swirling across a rain puddle” (p. 40). Someone with a psychomotor OE may appear to be hyperactive, because they may like to move around a lot or use rapid speech. Chapter 3 of this book has wonderful suggestions on how to talk with a child about his or her gift, such as “You have wonderful enthusiasm and energy” or “Your curiosity fuels your intelligence.” There are also strategies listed for each type of OE.