Thursday, April 4, 2013
Once More on Attention Deficit Disorder
Yes, there are diminishing numbers of us therapists dealing with patients; most of us are dealing drugs because we don’t know what else to do. We do not recognize patients’ inner lives; maybe because we do not acknowledge our own. This is my third piece on ADD, and I hope the last. A major article on ADD appears in today’s NY Times (April 1, 2013. Front page). It states that there are more and more cases of ADD among children…..one in five, to be exact. Two thirds of those with ADD diagnosis are given drugs to help out. They get stimulants such as Ritalin, or they get repressants such as Prozac and other serotonin enhancers (keeping more of it active in the synapse).
So what is going on? If I were to say to them that their brains (children) are too active because of birth trauma and life in the womb, I would be judged a bit bonkers. So I will say it: imprints due to early trauma activate the system to help in repression. And as the brain evolves the top level cortex is also activated to deal with the imprint. The brain is busy, busy, dealing with the pain and has a hard time dealing with or focusing on one thing. The input from inside is too much. And when there is stimulation from the outside, from school tasks and homework assignments, it meets up with a very active brain which says, “Whoa there. Stop the input. I have too much going on inside to listen to what you ask for. It is overwhelming.” But if there is no recognition of history, and by the way, recognition is also cognition, then ADD can never be understood.
If we do not understand that there is a history that remains in the brain and agitates us, then ADD is a mystery. It does not have to be. So why do the professionals offer downers and uppers? Because there are two ways to deal with brain activation. Either we soup up the top level neo-cortex to get stronger in its efforts to shut down pain, or we start at the bottom and use painkillers to hold down the pain from coming up. Both work at two ends to deal with the source of the agitation: imprinted pain. The kids are distracted because so much is already going on inside. They have to deal with that first because it is a primary source and cannot be ignored; and since there is no recognition of inner life, all that is left are drugs. The input is so strong and so diverse without any specific scenes that can be attached to it that it remains a vague entity that leaves some professionals feeling it is a mysterious force, that ADD. Why, by the way, do we offer stimulants to enhance the work of the top level cortex? Because it has been over-occupied by engraved pain and it needs help; more neurons to offer its shoulder. Enter stimulants. Those stimulants do activate the entire brain; only the upper part, the thalamus and neo-cortex. That is why they improve focus; the cortex is stronger now; it has had help. Not a word about why kids need stimulants when they are already over-stimulated. The drug companies are active here encouraging more and more drugs. What most drugs do is make up for deficits in our own ability to produce them. More tranquilizers because we can no longer manufacture serotonin (the key ingredient in tranquilizers), or in ADD the cortex is suffused by internal input, taxing it immensely, and so we need outside help to make it stronger and more active.
This attitude is exemplified by Dr. William Graf, pediatric neurologist At Yale University, who says he is floored by the numbers of cases. The American Psychological Association has decided to change the diagnosis, which they believe is a “brain disease.” This “disease” impairs impulse control and other factors so that the Association wants to widen the diagnosis to enable more people to be treated. And how will they be treated? By medication, of course. If we do not understand how pain is installed in the system and endures then all we can do is medicate, leaving an entire generation of ‘zombies.” Why on earth is it so difficult to understand that we are victims of our childhood? Are all of us professionals so estranged from it that it remains a mystery? You mean none of us can look back and realize that there was no love there? Maybe we cannot because our parents wanted smart kids and we filled the bill, (not at all my case) never realizing it was conditional love.
My mother was psychotic and so there was no expectation that I would be anything, so I could not develop a defense nor a profession that I could use as a defense. That came decades later, but I was ADD to the maximum and had the worse grades possible in school. I know what it is and was. So much tumult was going on inside from my immediate environment that focusing on one thing was impossible. I have relived that early life and the birth trauma, being given away right after birth to others that there is no doubt what was inside me. Every teacher wrote “nervous” on my report card. I remember, why can’t others? Maybe they fulfilled what the parents expected. I don’t know but it is a mystery why it early pain is ignored.
You know, ADD is also called the hyperactivity disorder. (ADD HD: Hyperactive Disorder) Of course, the kid is agitated out of his mind, driven by agony inside. We want her to focus on 18ths century art and she is drowning in misery. The drug director, T.R. Frieden, also sees medication as key, only we must not abuse it. And how do we do that? Stop so many prescriptions.
The drug officials will publish a new list of what constitutes ADD in the next month. Will it be behavior, in the thrall of the behaviorists, or will it be about feeling? I leave you to answer.
Subscribe to:
Post Comments (Atom)
It seems that many professionals in the area suffer from the same phenomenon as ADD and for what they purport to nurture others without understanding why... "why" they must find symptomatic and genetic explanations. That they would be victims of ADD rhymes too bad by their own "professionalism" filling the task to explain the cause of ADD.
ReplyDeleteWhen their questions fall outside the scope of their own explanations will their brains spins even faster.
Now it has become a "brain disease" and serenity lies in the cognitive quest for intellectual response as a defense against the question of why!
Frank
"Why on earth is it so difficult to understand that we are victims of our childhood?... Maybe we cannot because our parents wanted smart kids and we filled the bill, (not at all my case) never realizing it was conditional love."
ReplyDeleteIt is so true! How could we realize it was conditional love? We have been raised to become the knights in the shining armour, the "perfect winners". There was never freewill, so there is no longer a Self inside of us. We have become the expectations of the others and we do no longer know what we want and who we are, but we'll avoid questioning that. As long as the society and family congratulates us for our "performance", we will take it for granted; we'll accept the surrogate because this is all we have ever had in life. To question ourselves is unbearable, it means our life has been stolen from us, that we are nothing for the others and lost from ourselves, that we have to start it all over again: it is just too much. We are in a perfect trap, as we do not see the grating.
I am one of these persons who have never stopped fulfilling the expectations of the parents. Since I can remember my father have told me how much they love me, how lucky I am with such a family that would do anything for me, how grateful should I be. Rejection as a child was unbearable (I’ve felt it like total rejection as soon as I had made a step out of the way) and guilt was the preferred weapon to keep me in the leash. To question the "good intentions" of my father has always been taboo. Everything was for my own sake (actually I have just fulfilled his neurotic endless needs). I guess the final defence is to accept it all, burry the pain and say "yeah, they are probably right". Even now I have moments when the doubt is killing me… the parents are sometimes good people in pain, unconsciously hurting the child. This game is very subtle, there is no clear evidence of mistreat, you have been raised like this, there is no reference to clear you up.
I’ve got out of the pattern when my husband rejected me and I had no job and nowhere to run to. As I couldn’t act out, I've got depressed and luckily I've discovered PT. That would have never happened to me if my life would have stayed steady in the spotlight. That is why, I think, it is very difficult for a zombie to come back to life without an exterior punch. I still wonder what effect would have had on me to read about PT while still armoured with defences. Maybe the way to convince the cognitive neurotics with no feeling access is indeed with a mathematic description of PT, it’s their own language.
Anna
So very well put, Anna. art
Delete“Anonymous” speaking ;-)
ReplyDeleteDear Dr. Janov: Please stop trying to wake up the masses to the real problems of ADD. I am filthy rich from investments in pharmaceutical companies and your silly research could seriously damage my profits. I live luxuriantly and would die if I ever had to actually work for a living, honestly. Me and my “friends have the population sufficiently doped up with sex and TV, and do not appreciate your meddling and threatening our comfort zone here. Integrity is vastly over-rated. Why don’t you join the dark dside with the rest of the sell outs on our payrolls and become filthy rich, albeit , with no integrity, of course. Membership has its privileges ;-)
OK, so I jest a little. I had heard Primal therapists did not have a sense of humor, so I thought I would find out for sure. But on the serious side, there is also another reason why ADD is becoming more pronounced and far more common. And believe me, its true.
As a society, we have become far more ruthless and cruel. Everywhere there is more pressure exerted on young and old alike. We are all becoming more dysfunctional by the day. And kids are becoming monsters, because if mom and dad are real influential, and often they are, then they back and justify their kid’s disruptive behavior, making it impossible for teachers to actually teach.
My parents were not as bad as yours, by any means, but they both were mildly retarded, undetected by most people. But when you live with them and compare, you start to see it all. My father got a proper diagnosis when he had his mild stroke in 2007. The Doc said he was of the opinion that my father had suffered from some sort of illness his entire life and that I would probably be surprised. I did not blink, know what I mean? The Doc was right. My mother died a complete mental wreck. What she was, was quite obvious after she was physically dead. She was mentally dead many years ago. She died just last year.
If we do not put on the brakes and bring back some decency to life of the collective whole, one need not worry about primal pain. We will not be around that long. There is a boiling cauldron of pain, roaring with bubbles. Pain only grows and multiples. It does not diminish. Don’t take my word for it, though. Just hang around another 5 years and be amazed ;-)
Apollo: I am already amazed art
DeleteHi Apollo,
DeleteMy folks are getting old, my Mum has dimentia, in a care home; my Dad amazingly at the age of 84 carries on regardless; zooming around in his Sports Smart car. If a doctor told me he had always been 'retarded' I also would not blink. Though my Dad has always been a master of 'appearances' and has managed to present an image of himself not true to the facts. His area of expertise is 'sales and marketing'.
Many people say (hard as it may be) that when our parents die it releases us from the burden of their repressions. I hope you can move on and recover from your parents hold on your life.
There's a myth that the Romans poisoned themselves with lead from their water pipes; I don't know if this is true. There's some evidence that 18th C women and men poisoned themselves with lead oxide powder on their faces. . .
When repression puts such an emphasis on 'appearances', health takes the back seat. If the quasi scientists and their 'corporations' can make a buck out of it along the way then they will. I'm not convinced this is a 'conscious conspiracy'. I wish it were because then you could identify the culprits and put a stop to it. What actually seems to be happening is a gradual and inexorable slide into a global society of appearances. All is catered for through the eyes now. . .
How few people have a life where their hands grapple with the means of production and survival? Through the hands we can better form relationships with our environment. Now we just use our fingertips to press buttons and divert electrical signals to the main control centre, waiting, mouths open, for the next feeding pellet.
A blind man's hands tell him the truth better than a sighted man's eyes.
Through the eyes we are deceived by appearances.
'Read the Label' used to be understood to mean the eyes and the neocortex were working to protect the organism from poisoning or overdose. What does it mean now?
Paul G.
Greetings Paul!
DeleteHere is a funny incident. I offered a guy who lived across from me as a kid, 4 years younger than men, who did not learn to talk much till 5. I needed help cleaning out our house that my mother, an extreme hoarder, left in a disaster of epic proportions. My parents suspected something wrong with him back then in the 60s. He came to help. What a mistake. The army did not like him and neither did I. It turned out he had almost every identical trait my father had, almost as if the 2 were Siamese twins. Spooky. All the defense, thin skin, lying, pretending, acting, trying to be something they are not and can never be. Always terrified that someone is going to figure them out. That is funny, because a fair number do see through them, they just don't know it. I would say that they are so identical that evidently, retardation leaves so few options intellectually and emotionally that they come out pretty much the same. The less you have to work with, the less range you have in potential. I have nothing to do with this guy anymore.
But as for intent of "doctors" (so called) and pharmaceutical profit makers, I like what Jan sort of suggested. We thought that talk therapy was bad. But compared to drug therapy, we will mourn the day we lost talk therapy ;-)
Sure, pain makes the thinking process a little dull and confusing, but it still has some ability. Bu as to intentions, consider that those who worship profit, to the exclusion of any other consideration like integrity and caring, have lost all feeling and humanity. They are doing fine and enjoying their ill gained profits, but are oblivious to the harm they cause.
My suspicion is that it takes quite a bit of repression (a form of effort) to ignore the suffering. so it is not without consequence and that some choose to expend all that energy to remain in denial, indicates to me that they do know what they are doing.
Our world gets nastier by the day and this is so obvious that anyone that can ignore or deny it is expending fantastic amounts of energy to remain blind like that. The paradox is that feeling is the best antidote or inoculation against refusing to see suffering.
but the more primal pain, the less chance there is of them coming to recognize PT. That is how I tend to see it. Another paradox, it also takes great effort to maintain some humanity and caring, because if you get your teeth knocked in every time you care, it will take strong effort not to let it get to you and harden you. Pain is like a virus, in that it makes you more or tries to make you more dull and less feeling and sensitive. Ain't life grant, my friend? ;-)
Paul: we define normal by our ability to act normal. in the age of behaviorism, appearances is all that matters. It's all we measure. it's we CAN measure.
Delete...but do we cure the homosexual by forcing him to pretend to be straight? Do we cure the "loser" by making him terrified of what other people think? And do we cure the childless by making them have children that they never truly wanted nor could love?
Alas - appearances can be so pitifully blind (I'm ranting!).
Hi Andrew,
DeleteRant on, rant on.
Apollo, it is weird sometimes how certain 'types' appear on the conveyor belt of life to 'remind' us of our 'inheritance'.
I don't know whether it is fortunate or unfortunate but I studied personality type for years and have found myself in the unenviable position of having typed myself as a perfectionist. Realising that most people do not approve of such labelling (many on this blog no doubt and least of all Mr. Scrutinizer himself). I have therefore 'dumbed down' what I learned, ie: I try hard not to label others for fear of being accused of having a problem with blame.
Nevertheless, as a perfectionist type I have learned to take pride in my critical faculty. Consequently when certain 'types' keep re-appearing in my life I now know better than to label them and of course I know not to engage in any collaborative ventures with them either.
In particular for me there is a 'type' exactly like my father and older brother. The "Tyrannical Buffoon". . . These are absolutely the nicest of people in the social sphere. Brilliant sense of humour, friendly, affable and on the face of it, attractive and approachable. The epitome of 'well adapted'.
Until you try 'co-operating' with them. . .
Paul G.
From Bad to Worse
ReplyDeleteLike an introduction of a new smartphone, the American Psychiatric Association will soon announce its DSM 5, the latest Diagnostic and Statistical Manual of Mental Disorders; the bible of the psychiatric profession. One of the expected consequences is that the new stigmatizing categories allow the pharmaceutical industry to follow up with new miracle drugs in an over-simplified, less thought-consuming marketing. Willing, profit hungry, psychiatrists will against embarrasing, perfectly legal, reimbursements promote anti-psychotic drugs in the different categories, they have established, in DSM 5.
Seen from our position in 2013, the Big Brother-tyranny, in George Orwell’s “1984”, were more than satirical fiction. However, we can just imagine what Orwell might have invented of futuristic horror fiction from knowing that 6,4 million American school-age children, now receive the diagnosis of Attention Deficit Hyperactivity Disorder.
Speaking in Orwellian terms, today the “Ministry of Plenty” and the “Ministry of Love” are satisfied knowing that the pharmaceutical industry is reaping net benefits of, at least, USD 14.600 million a year on anti-psychotic drugs alone. In this task, the industry is being supported by an multitude of respected, professional psychiatrists, many of whom it has turned from talk-therapy to drug-therapy in order to make 150 USD for three 15-minute medication visits, compared with 90 USD for a 45-minute talk therapy session.
An average psychiatrist treated earlier 50/60 patients in once - or twice-weekly talk-therapy sessions. Now many psychiatrists treat as an average 1200 people in mostly 12/15 minute visits for prescription adjustments that are months apart. Then, he knew his patients inner lives better than he knew his wife’s, now, he cannot remember their names. Then, at least his ambition was to help his patients become happy and fulfilled, now, it is just to keep them going.
As long as marketing is fulfilling our real needs and is supplying us with improved quality of life with no hidden disadvantages, marketing is a blessing. However, marketing manage by calculating forces often create habits, which in the long term may be disastrous like tobacco, anti-psychotic drugs and sugar, just to mention 3 of the segments where the wrong side of marketing has been used in a ruthless way.
If just a fraction of the marketing resources, being put into quick fixes and fast satisfactions, had been put into a feeling therapy aimed at reliving repressed pain, we had now had universal access to information that an alternative to the present Orwellian situation actually exists.
Jan Johnsson,
- who was lucky enough to be an ADHD-case when the pharmaceutical industry and the psychiatric Corps still had not invented this category; my epilepsy and the Primal Principle “saved” me.
An email comment:
ReplyDeleteEsteemed Dr. Janov,
I am always fascinated by your reflections and read them carefully. As a med-legal editor, I tend to read narrative text with a different set of filters than most people do – which cause me to notice typographical errors (a/k/a Printer’s Gremlins in days long past). I believe that one such Printer’s Gremlin appears in this post. See the bright green highlighted sentence below. I believe that you meant to write, “Those stimulants do not activate the entire brain...” There are a few other diffuse scattered typos, a few of which I’ve also highlighted in yellow; but only this one really concerns me, as some readers might not “supply” the needed “not” which could lead to confusion.
By the way, I am one of those ADD patients, having been diagnosed in my early fifties, nearly a decade ago. My own psychopharmacological story is complex and I suspect that you simply haven’t the time for any dilation on that matter (although I would be happy to do so). I do feel that your perspective makes a great deal of sense – and given the obvious greed and malicious history of Big Pharma, there is no need to discuss that aspect at all.
I am wondering if you have heard/read the thoughts of Dr. Gabor Mate, a Vancouver-based physician who specializes in addiction, ADD/ADHD, and issues of child development. I often think of his writings/lectures (widely available via YouTube) when I read your “Reflections.”
Dr. Mate correctly views the purely “medical model” approach (read “medication model”) to treatment as one-dimensional and essentially missing the boat, as you do. He points to developmental (including pre-natal, of course) history as a key element of concern – one which seems to be almost methodically overlooked by the medical establishment. And I’m now thinking of Alice Miller, who (in at least one of her writings, and I suspect elsewhere), wrote, “Today, I share the opinion of Arthur Janov who always affirmed, that primal therapy without the assistance of a well informed and compassionate therapist can be very dangerous. (cf. his homepage). In addition, I think that it contains (1) a contradiction in itself by reactivating a situation of which one want to get rid of and (2) a perpetuation of the violence directed toward oneself.”
I am going to keep this email short, and conclude by predicting that the days of ignoring developmental (including prenatal) history are grinding to an end. With all the new brain imaging tools that are becoming available, I would not be one bit surprised to find that during the coming decade, we will have ipso facto evidence to support what clinicians like you, Dr. Mate, Dr. Miller, and others, have been saying.
Thank you for your courage, perseverance, resilience, and commitment to relieving human suffering.
Gary: I know and I sent the request to change it but it got lost in the shuffle. Dr Mate We do communicate so yes, I know about him. Alice came to my house in France to know more about Primal Therapy.
Deletethanks so much for the letter. We shall start research soon to seek out more answers. art
As the possibilities to gain and to spread information are growing
ReplyDeletewe get more and more prone to do gossip and be influenced by it.
Gossip is mobilising our troops and - our therapies.
First move is the polarisation using propaganda - diagnose and labeling...
Then the persecution gets more invasive and explicit - medication, surgery...
Yesterday my brother who lives abroad and i shared some photos by email. Most were made by the river... Later that day i felt to comment his photographies by sms and while doing it i suddenly realised why he loves the river... and hates the traffic jam... etc. I felt excited and immediately shared the "eureka" moment with him. I did refrain to explain him why... and he didn't ask... yet...
but what a GOSSIP!
And it was not enough for me, i have to share it here.
Gossip is seeking attention.
But it doesn't really connect people.
Some serious stuff lies behind it.
There must be a book somewhere about the role of gossip
in human civilisation...
gossip for war, for peace, to buy, to sell...
Hi Art,
ReplyDeletethe 9 year old son of my nephew has ADD. And my nephew and his wife are thinking now of either give him medication, i.e. make him a zomby, or give him to a boarding house, which is also not preferable. Since I was once a patient of you and know how good the therapy at the center is, do you have some kind of treatment for ADD children at the center in the German language? If not, what would you suggest to do?
Thanks for your answer.
Albert Kastl
No German here but I would always question the diagnosis. I cannot tell much because I am not there and I cannot legally give advice. Sorry. But look again at diagnosis with another doctor. art
DeleteHaving always been a hyperactive child with limited abilities to focus and concentrate in school I was labeled dumb. My father reinforced this with my siblings as I was also the " identified patient," black sheep and the one they could all look at and say is crazy. Alot for any child to cope with is an understatement. One of my insights through the course of therapy was understanding on the 2nd line why I was driving everyone nuts with my manic behavior as a kid. The reason being I was also very sad and my defense of rushing around was literally trying to run away from the feeling that I simply was not loved. Having resolved whatever amount of this primal pain that I could in therapy and a limited amount of the 1st line component, I have discovered the abilities I lacked in childhood. I can focus and concentrate on whatever tasks I apply myself to with much greater ease. I do have to get up and walk away from the computer while teaching myself graphic design for example because of my "busy" brain but now later in life at least, I have learned how to study a subject which I never could before.
ReplyDeleteAnonymous: great . art
ReplyDelete