Attention deficit hyperactivity disorder is a battleground of biological psychiatry and its opponents. The latter challenge the assumption of the former that most mental health disorders including ADHD are rooted in biology. Some even claim that certain disorders such as ADHD do not exist. The truth lies in the middle whereby the brains of individuals genetically predisposed to certain mental disorders transact with certain environmental factors resulting in chemical or other imbalance in the brain that manifests as a mental disorder. Not all behavioral disorders occur because of traumatic stress in the past or adverse environment in the present. These factors can abet mental disorder, but cannot entirely cause it.
Hanif Kureishi, in Art of Distraction (February 19th, 2012 edition of the New York Times), challenged the very idea of ADHD. He wrote that "some distractions are constructive and some are destructive" and left to their own devices distracted children will find “some competence” and liberate their minds from destructive distractions to create a beautiful world. But the idea that a child should be left alone to discover "some competence" which every child will find as the author did is Panglossian. The destructive distractions are referred by physicians a ‘condition’ to acknowledge that they need attention. Just as names do not reflect the entire essence of a being, but are necessary to identify and refer, ‘condition’ in medicine identifies and refers to a constellation of weaknesses that cause dis-ease or dys-function. I wish every child could creatively harvest his mind during the lapses of concentration as Hanif Quereshi did, but in reality many children are so distracted that they lose track of even the most mundane tasks of daily living. And some become disruptive and destructive. The physician thinks "about and deals with an individual's history, circumstances and reactions'" and the child's strengths and weaknesses and gives a name, as all names are given, to facilitate dialogue. The names in psychology are the product of years of deliberation by a panel of experts and field trials.
Human mind is a product of biology. A significant body of research has shown that children are born with innate temperaments, strengths and weaknesses. Although environment and experience transact with this biology, fostering strengths or weaknesses as the case may be, they cannot erase it. Even resilience is influenced by biology. Many conditions of the mind, such as schizophrenia and depression and even creative and destructive distraction have been shown to have genetic underpinnings. Thus, although not entirely deterministic, biology is one of the ugliest realities of psychology.
Unlike physics there are no absolutes in medicine. Educated guesses are made on the basis of empirical evidence. Usually a battery of interventions is recommended, of which medication is just one component. Although Ritalin has become a whipping boy on the block, its use has been validated by hundreds of scientific studies over a number of years. Its use harnesses the creative energy of some children preventing it from dissipating in the fugue of distraction and clamor of disruption. I agree that some interruptions are worth having if they create a space for something to work in the fertile unconscious. But to leave those that intrude on others' space and land on barren recesses of the unconscious sliding in the abyss of self destruction amounts to neglect. Yes, it is a question of values - whether to leave a child alone to figure it out or to assist a child who cannot figure it out to figure it out by creating the right conditions and circumstances. No, it is not a question of tying a child's hands to prevent him from touching his genitals but to liberate his mind from destructive distractions so that he can create a beautiful world with his hands.
Hanif Kureishi, in Art of Distraction (February 19th, 2012 edition of the New York Times), challenged the very idea of ADHD. He wrote that "some distractions are constructive and some are destructive" and left to their own devices distracted children will find “some competence” and liberate their minds from destructive distractions to create a beautiful world. But the idea that a child should be left alone to discover "some competence" which every child will find as the author did is Panglossian. The destructive distractions are referred by physicians a ‘condition’ to acknowledge that they need attention. Just as names do not reflect the entire essence of a being, but are necessary to identify and refer, ‘condition’ in medicine identifies and refers to a constellation of weaknesses that cause dis-ease or dys-function. I wish every child could creatively harvest his mind during the lapses of concentration as Hanif Quereshi did, but in reality many children are so distracted that they lose track of even the most mundane tasks of daily living. And some become disruptive and destructive. The physician thinks "about and deals with an individual's history, circumstances and reactions'" and the child's strengths and weaknesses and gives a name, as all names are given, to facilitate dialogue. The names in psychology are the product of years of deliberation by a panel of experts and field trials.
Human mind is a product of biology. A significant body of research has shown that children are born with innate temperaments, strengths and weaknesses. Although environment and experience transact with this biology, fostering strengths or weaknesses as the case may be, they cannot erase it. Even resilience is influenced by biology. Many conditions of the mind, such as schizophrenia and depression and even creative and destructive distraction have been shown to have genetic underpinnings. Thus, although not entirely deterministic, biology is one of the ugliest realities of psychology.
Unlike physics there are no absolutes in medicine. Educated guesses are made on the basis of empirical evidence. Usually a battery of interventions is recommended, of which medication is just one component. Although Ritalin has become a whipping boy on the block, its use has been validated by hundreds of scientific studies over a number of years. Its use harnesses the creative energy of some children preventing it from dissipating in the fugue of distraction and clamor of disruption. I agree that some interruptions are worth having if they create a space for something to work in the fertile unconscious. But to leave those that intrude on others' space and land on barren recesses of the unconscious sliding in the abyss of self destruction amounts to neglect. Yes, it is a question of values - whether to leave a child alone to figure it out or to assist a child who cannot figure it out to figure it out by creating the right conditions and circumstances. No, it is not a question of tying a child's hands to prevent him from touching his genitals but to liberate his mind from destructive distractions so that he can create a beautiful world with his hands.
