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An old fashioned approach to the problem of ADHD

I recently attended a community event at the Young Israel of KGH entitled: Understanding ADHD (Attention Deficit Hyperactivity Disorder) Strategies That Turn Struggles into Strengths in Children and Adults”. The free seminar, attended by about 100 people, was given by Rabbi and psychologist, Yitzchak Goldberg, PH.D and psychiatrist, Dr. Barry Holzer, MD. Much helpful information was conveyed to the audience as well as assurance that much can be done to turn around children who are afflicted. The event was written up very thoroughly by Suzie Garber in the 102nd edition of the Queens Jewish Link.

The DSM (Diagnostic and Statistical Manual for Mental Disorders) first wrote about a malady resembling ADHD in 1968. The event speakers pointed out and indeed the statistics bear out, that the frequency of diagnosis for ADHD is steadily increasing. From the CDC (Center for Disease Control):

Approximately 11% of children 4-17 years of age (6.4 million) have been diagnosed with ADHD as of 2011.

The percentage of children with an ADHD diagnosis continues to increase, from 7.8% in 2003 to 9.5% in 2007 and to 11.0% in 2011.

Rates of ADHD diagnosis increased an average of 3% per year from 1997 to 2006 and an average of approximately 5% per year from 2003 to 2011.

Boys (13.2%) were more likely than girls (5.6%) to have ever been diagnosed with ADHD. (this fact to be dealt with later)

While I am not a mental health practitioner, the subject of mental health has intrigued me almost all of my adult life. When I was a young man I found myself having difficulty adjusting to the modern world because I was brought up in a household largely dominated by Jewish Orthodoxy with an Eastern European Shtetle ethos. From the age of 23, I spent 5 years in a support group trying to make sense out of the modern world. I was never an ADHD child but being that when I was a child I didn’t have a strong focus on secular studies in school, as an adult I grew to feel a certain empathy toward the ADHD condition. I have no degrees to back up my impression of what the disorder is about but because my orientation from childhood is from another culture, namely the Shtetle, I have an unconventional approach that makes me question what the mental health scholarship on the subject, is based on.

First, let us ask, why indeed is the condition of ADHD on an upward trajectory? The speakers at the event acknowledged that those having the disorder seem to break out of the syndrome when they are engaged in pursuits that interest them. It would then seem strange that the mental health profession seem to imply that ADHD is a neurological disorder. Yes, it’s true that we’ve heard of idiot savants who can’t tie their shoes but are whizzes at math or prodigies on the piano but those cases are so extreme that they easily lend themselves to an understanding of some mysterious circuitry of the brain. There are those on the other extreme, such as conservative radio host, Michael Savage, who infamously said that ADHD is just a spoiled brat syndrome. Between those two extremes, I think the truth is somewhere in the middle. No doubt it is a real disorder and there is much suffering to the children and families of those afflicted but I question the biological nature of the malady because doctors are not able to source it biologically and the condition seems to have contradictory behaviors.

The advice given at the event was to give praise to such children whenever possible, being firm with consequences towards bad behavior and making sure that children with such disorders do not get positive reinforcement for doing bad things, such as being kicked out of class from a class they don’t enjoy anyway. They suggested volunteer work especially for these children because it tends to focus them on something constructive and gives them a sense of identity. They very wisely pointed out that girls are often naturally associated with volunteer work, as is the nature of girls and women to be nurturers, and this may explain the higher incidence of the syndrome among boys. Dr. Holzer even seemed to tie in the subject of youth falling off ’the derech’ which was surprising to me in how he seemed to concede that the disorder is not just a brain circuitry issue but more having to do with philosophical choices and having a meaning of life. Yes, I see it more as a philosophical-choice disorder that such a child rejects the priorities that society has laid out for him or her. He also said that concomitant with the disorder is the phenomenon that these children lack internal motivation, hence they act out in ways that are self destructive and anti social.

Recently, in the news there was a shocking case of 2, 12 year old girls who attempted to kill their friend by stabbing her 19 times, a friend with whom they had had sleep overs and played together. The reason for this most bizarre act was explained by the girls as having to do with ‘Slender Man’, a fictional internet bogey man whom they were greatly and irrationally influenced by. They said that Slender Man demanded that they kill their friend, for otherwise their own families would be hurt. To me, Slender Man is the metaphor of our times; children without parental engagement and presence. When I was growing up under the strict and distinct tutelage of my parents and the clear ideals of what they stood for, there was no room for a Slender Man. ADHD is a modern disorder and was not even diagnosed until 1968! To this I ask, was the condition camouflaged by other mental disorders or is it that modern life especially after the ‘helter skelter’ life from the 60’s perhaps brought on this new unfocused state in children (and in some adults)? Was there ADHD in the Shtetle?”

I think that parents should convey more of their beliefs and feelings about life than is currently manifested by today’s parenting roles. Parents should not just be enforcers of standards, disciplinarians and chauffeurs to the children’s extra curricular activities. Children deserve much more than that. It says in the Torah “Vesheenantum Levanecha” (and you shall teach your children) implying that there is an expected conveyance of culture and teaching from parents to children. Children need to see how parents deal with life’s conflicts and philosophical choices. American or modern life is trying to sanitize the human experience and parents are to some extent appearing robotic and lacking human emotions to their children. This is even reminiscent of the fake German society prior to Hitler’s ascent which wanted to squeeze out the humanity from the human experience. German culture was about excelling in sports, science and select art and literature as long as they conveyed life as beautiful. But religion and real life is much more than that and negative emotions such as frustrations and conflicts also need to expressed as long as they are within certain bounds. How else are children to learn how to deal with life’s travails? In my opinion, the lack of role modeling is at the center of the epidemic of problematic behavior such as ADHD.

A ‘potch’ on the tush of a young child is now considered corporal punishment and I’m not saying that it is necessary to discipline children that way but now parents are not even supposed to convey emotionally that they are disappointed with children’s bad behavior. Time-outs and “consequences” talk, take the emotions out of human communications and I think that this method of parenting is producing more directionless children which manifests itself in all sorts of behavioral problems. It is said, that because children are less in contact with dust or dirt in our homes due to cleaning efficiency and children washing their hands with antimicrobial soaps, we’re losing our immunity towards natural pathogens thus paradoxically developing allergies that we’re trying so hard to avoid. So it can also be said, that because we want to control our emotions and passions and shield them from our children we leave them in a state of spiritual sterility. Hence they are not able to form a natural array of emotions and are unable to deal with life in a meaningful way.

I don’t have children of my own but I have offered my time and energy to my nieces and nephews as well as to my siblings. I feel that I have made a difference in their lives. What I learned from my old fashioned parents and what I feel compelled to convey to anyone willing to listen, is that we have to give of ourselves, in the form of our thoughts feelings and presence because that is the biggest gift one can give another, apart from enabling life itself. The reason I am convinced that there wasn’t the high incidence of ADHD in the Shtetle is because the family was united in quest of spirit and survival and the meaning of life was palpable to every child.

In today’s world everyone is doing their own thing; children are busy with studying and parents are busy making a living but there still needs to be family time. What it should not amount to is just a race of reaching a higher standard of living and perfecting our children in outdoing and outsmarting the neighbors’ children in whichever way. I feel that modern life is lacking the very flavor of life and lacks the nourishment to our children for them to feel appreciated and with a sense of family and purpose to life itself. Yes, I’m saying that even in doing such a lofty practice such as parents going to a shiur should not become obsessional and at the expense of not being close to your children. Everything in life has its place and measure.

Medication may have to be the gold standard for treating ADHD but I feel that society can do much to prepare children not to become ADHD to begin with. I think that if we truly teach our children as the Torah instructs us to do and as our heritage for thousands of years demonstrated, that we could add on a richer spiritual and emotional life to our children. Too bad there isn’t the respect for age old wisdom that we purport to believe in. I’m totally impressed by modern technology but I don’t want us to forget that our souls are still human and need nurturing.

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