Perhaps ADHD is a problem of not listening

Recently I reviewed my son’s high school essay on To Kill A Mockingbird. I was surprised and pleased to rediscover, or perhaps discover for the first time now that I was viewing it from the perspective of over 50 years of life experience, the profound wisdom of the book.

In one of the novel’s most famous quotes, Atticus tell his daughter Scout, “you never really understand a person until you consider things from his point of view, until you climb in his skin and walk around in it.”

I now understand this as a description of the essence of being human, namely the capacity to be curious about the meaning of another person’s behavior. Peter Fonagy, whose research has shown how the development of this capacity is intimately linked to healthy emotional development, argues, in a way analogous to Darwin’s description of attachment behavior, that this capacity has evolutionary significance, and is essential to survival. My book, Keeping Your Child in Mind, presents this research for a general audience, showing its application to parenting.

I wonder if our current epidemic of “ADHD” is related to having lost sight of this essential human quality.  The most common phrases I hear from parents who come to my office with concerns of problems of inattention and  impulsivity are, “he never listens,” followed by “tell me what to do to make him listen.”

Perhaps ADHD is a problem of not listening. But it is the adults who are not listening to each other. In our fast-paced, technology driven age, we rarely take the time to listen to each other, to put ourselves in another person’s skin.

When Scout comes home from her first day of school upset with the teacher, her father tells her, “she’s new too.” He is helping Scout to understand her teacher’s perhaps impatient behavior from a different point of view, to appreciate that the teacher herself may have been stressed and overwhelmed.

Recently parents of 4-year-old Sam, who was having problems of impulsivity in the classroom, spent a good portion of our visit expressing anger at his teacher, who they were convinced just didn’t like their child. But with a full hour, and a quiet space to tell the story, they came to recognize that just as they could get overwhelmed at times by their son’s behavior, so could the teacher be overwhelmed. Perhaps she felt defensive when the parents got angry, as she was trying her best in less than ideal classroom setting, with a low teacher: student ratio.

In turn, with the parents and teacher listening to each other and not behaving defensively, they could reach a new level of understanding of what set Sam off, and to develop strategies both at home and in school to help him to feel calm.

I wonder if the current epidemic of what we call “ADHD” represents a loss of this capacity to put ourselves in another person’s skin. I have had the pleasure of an email exchange with the New York Times journalist Alan Schwartz, whose multiple superb articles, most recently, “The Selling of ADHD,” have served to bring the subject to the forefront of public discourse. I am hopeful that he will help us to see the big picture, rather than to place blame.

I have wondered in conversation with him if the whole phenomenon of “ADHD” is itself a symptom of larger social ills, particularly in the education and health care systems as well as the medical education system. People, including parents, teachers, pediatricians and mental health professionals, are feeling overwhelmed and not heard.

The large scale medication of a whole generation of children has potential serious and profound long-term effects. These include the silencing of children whose symptoms represent complex underlying problems, as well as abuse of stimulant medication by high school and college students.

We will never go back to the slow pace depicted in the 1960 novel, where there are large expanses of time to listen. But we need to be very careful not to give it up completely. For it does take space and time to put yourself in another person’s skin. If that is the essence of what makes us human, we need to value that space and time.

Claudia M. Gold is a pediatrician who blogs at Child in Mind and is the author of Keeping Your Child in Mind.

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  • Suzi Q 38

    My son’s kindergarten teacher thought he had a huge hearing problem as well as ADHD.
    She wanted him to be evaluated and tested for such.

    My pride would not concede that my son had ADHD.
    I would only concede that he was a very active male, and as such, was very different than his older sister, who sat in most of her classes and listened with her hands folded.
    I teased the teacher with: “Did you think that both of our children would be the same??? Wouldn’t that be too good to be true?” Cry me a river.

    I also refused to get him on “the meds” for ADHD.
    Instead, I scaled back on my work schedule and volunteered in the classroom once a week. I could then get a sense of how my son acted and what I could do to get him to act in the desired behavior that the teacher wanted.

    It was hard for me to listen to the teacher say: “Andrew, you are not being nice, so GO sit on the RUG.”

    The “rug” was a “time out” area of sorts.

    I also had his hearing tested at one of the finest teaching hospitals.
    His hearing was just fine.

    The kindergarten teacher was also dismayed that my son could not “skip,” or gallop.”

    I told her I did not care, as he was a boy.

    Anyway, my helping out in the classroom made me see that my own son was a big PITA at times.

    I had to bribe him with special toys or outings, and I decided to go part time and spend more time with him.

    He got better and better with each passing year.
    Drugs are not always the answer.
    Boys are not girls and vice versa.
    If you can manage it, spend more time with these “difficult” children.

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