ADHD Terminology
The behaviours described as Attention Deficit Hyperactivity Disorder (ADHD), Attention Deficit Disorder (ADD) and Hyperkinetic Disorder (HKD) were mentioned in literature over the centuries. Historical mentions of ADHD include Shakespeare who called it, in Henry VIII, a “malady of attention.”
150 years ago, modern psychology saw these as moral disorders or “morbid defects of moral control.” This was when the Attention Deficit Disorder terminology started evolving.
The next stage was to describe the “moral disorder” as symptoms of brain disorder or “Postencephalitic Behaviour Disorder” because of behaviour changes in survivors of encephalitis. This morphed into “Minimal Brain Damage.” Since many of the children had not suffered a brain trauma from either a disease or a blow to the head, the terminology evolved to “minimal brain dysfunction” or MBD.
As George Bernard Shaw said, “England and America are two countries separated by a common language. “In America children were “hyperactive,” but over the other side of the pond they were “hyperkinetic.”
To clarify the evolving confusion in terminology, terminological taxonomy of symptoms developed. In the United States, it was the Diagnostic and Statistical Manual of Mental Disorders (DSM), while in Europe another, but similar system, the Classification of Mental & Behavioural Disorders (ICD) was preferred.
In the long history of science, when a subject begins with basic terminology, which later becomes confusing, this is a sign of not realising something fundamental. After systematising the terminological flora, and restoring order, everyone breathes a sigh of relief. If more terminological weeds then sprout up again, this suggests basic flaws in reasoning are still somewhere in the background.
Probably the major flaw is the assumption that a DSM classification suggests a disease. What the ADHD classification is in reality is a syndrome of behavior, decided on by opinions in a committee of the American Psychiatric Association, and thus not a scientifically established fact.
Sometimes the specialists in a field, in their eagerness, do not see the obvious. Two such “emperor’s new clothes” scenarios are a result of the search after 1 (one) cause for ADHD, ADD and HKD.
Fundamental in research, but unfortunately not taught much, is the concept of analysing research methods for possible paradigm traps. These happen when researchers are so stuck in their paradigms that they are unable to realise that their methods and interpretations are functions of their paradigm perceptions and not of reality. The results of the research are facts, but the interpretations of these facts are subject to the researchers’ paradigms, or worse, paradigm blindness.
For example, there are distinct functional and structural difference between brains of children, with ADHD and after many years of medication, compared to brains of children without ADHD and no medication. That is established fact. The conclusion, so often published, with the assumption there is a difference in the brains of non-medicated ADHD compared with brains of non-medicated, non-ADHD children, is nonsense. There is no proof of this. To make that statement requires other tests; namely non-ADHD children should be medicated for some years and compared with ADHD children who have never been medicated.
The research most likely shows the damage Ritalin, and the other Schedule II stimulant drug, given to ADHD diagnosed children does to a developing child’s brain.
A red flag-waving is the increase in numbers of children diagnosed with this condition. There appears to be an epidemic. This is worse in the United States than in Europe by a factor of 10. There are 10 times as many ADHD diagnosed children per 1000 children in the United States than in Europe. Figures bandied about in medical journals now make claims such as 8-12% of children worldwide are suffering from this “disorder.”
If 8% to 12% of children worldwide can be diagnosed as “suffering” from disorders as ADHD, ADD or HKD, then there must surely be a “disorder” in the diagnosis. Such a large percentage suggests this “disorder” is within the normal variation of healthy children.
Another red flag is this “chemical imbalance in the brain” and “it's genetic.” These statements might sound reasonable to a researcher isolated from the real world in his or her ivory tower. In the real world epidemics caused by genes do not happen over a generation or two, with exceptions to populations exposed to nuclear radiation, as in Hiroshima and today in Iraq and Afghanistan (caused by bombs with depleted uranium).
The “chemical imbalance cause” hypothesis has some fact behind it. There are imbalances in the neurotransmitter systems in the brain of people with ADHD, anxiety, depression, etc. Medicating however merely masks the symptoms. The source of the imbalance is ignored. The drugs work by causing a further imbalance in the brain, and in response to this, the brain slows down. This is not even an attempt at establishing and curing the underlying cause.
The problem is not THAT there is an imbalance, but WHY there is an imbalance. Stress, anxiety, abuse emotional or physical, frustrations, medical conditions such as hyperthyroidism, hypoglycemia and lead poisoning can all cause this.
The origin of the “chemical imbalance cause” idea is not in science, but in philosophy. It is a question of the brain and the mind. Science deals with the material aspects of our reality. Science cannot deal with our immaterial reality. The brain is an example of the material, while the mind and consciousness are examples of the immaterial. What comes first, the state of mind such as depression or the chemical imbalance? Is the chemical imbalance a response to the depression? The cause of the symptom or the symptom?
For ADHD, Cognitive Behavioural Therapy, is as effective, 3 years after treatment, as is medicating for 3 years, although the medicated patient is still not cured. Medication does not cure ADHD and has to be taken daily as long as the “condition” is there, but Cognitive Behavioral Therapy does have a lasting effect. Medication works on the brain, while Cognitive Behavioral Therapy works with the mind.
The thought of anything immaterial is anathema in Western society today. Yet we deal with concepts we do not understand on a daily basis. Engineers and scientists make basic calculations daily such as F=ma (force=mass x acceleration). Science still does not know what mass is. There are only hypotheses to explain it. Scientists used the concept of gravity without understanding what it was. Our Standard Model of the structure of matter stands or falls on our hypotheses on mass, it is so fundamental, yet we still do not know what it is.
This is not as strange as it may first seem, to use a concept we do not understand. When we weigh ourselves we do not measure our mass. We measure the result of the effect of our mass. Since we do not know what mass is and cannot measure mass itself, we do the best we can, and accept it.
Those who have ADHD symptoms because of allergies do not have ADHD, but allergies.
Those who have ADHD symptoms because of lead poisoning do not have ADHD, but lead poisoning.
Those who have ADHD symptoms because of lead poisoning do not have ADHD, but lead poisoning.
Those who have ADHD because are anxious do not have ADHD, but have anxiety.
The list is long, but finally we come to people who have a hyperkinetic or hyperactive and distractible personality. If we can get beyond seeing this as a disorder, then we can adapt our attitude to accept and support these people, many of whom are creative and gifted.
The disorder is more prominent in the western society than in other cultures, possibly because we are less flexible in the West. School is inflexible. A child who learns by moving, feely, touchy, has to sit still and is not allowed to fidget. A fidgeting hyperactive (hyperkinetic) child is able to focus. Without focus fidgeting, the child concentrates on not fidgeting and is oblivious to the lesson.
Anxiety is the next step, as the child tries to control their movements while still too immature to have learned coping skills. The inner turmoil and sitting still makes it almost impossible to learn or remember what the teacher said in class.
The child, who was healthy and intelligent to start with, now falls behind with lessons and develops a learning disability. This causes frustration to on top of the existing anxiety. Is it strange that so many children are diagnosed as ADHD in the West?
One example may suffice. A child who needs to learn kinaesthetically, but has to sit still while the class is learning the alphabet, can become dyslexic. This is not because there is anything wrong with the child’s brain. The symbols drawn on the blackboard do not make sense and the child cannot internalise them without movement. If that child can move while learning, and act out the letters, then the internalising can take place.
Maybe the ADHD and HKD disorders are symptoms of ADD or Absurd Diagnostic Disorder.
150 years ago, modern psychology saw these as moral disorders or “morbid defects of moral control.” This was when the Attention Deficit Disorder terminology started evolving.
The next stage was to describe the “moral disorder” as symptoms of brain disorder or “Postencephalitic Behaviour Disorder” because of behaviour changes in survivors of encephalitis. This morphed into “Minimal Brain Damage.” Since many of the children had not suffered a brain trauma from either a disease or a blow to the head, the terminology evolved to “minimal brain dysfunction” or MBD.
As George Bernard Shaw said, “England and America are two countries separated by a common language. “In America children were “hyperactive,” but over the other side of the pond they were “hyperkinetic.”
To clarify the evolving confusion in terminology, terminological taxonomy of symptoms developed. In the United States, it was the Diagnostic and Statistical Manual of Mental Disorders (DSM), while in Europe another, but similar system, the Classification of Mental & Behavioural Disorders (ICD) was preferred.
In the long history of science, when a subject begins with basic terminology, which later becomes confusing, this is a sign of not realising something fundamental. After systematising the terminological flora, and restoring order, everyone breathes a sigh of relief. If more terminological weeds then sprout up again, this suggests basic flaws in reasoning are still somewhere in the background.
Probably the major flaw is the assumption that a DSM classification suggests a disease. What the ADHD classification is in reality is a syndrome of behavior, decided on by opinions in a committee of the American Psychiatric Association, and thus not a scientifically established fact.
Sometimes the specialists in a field, in their eagerness, do not see the obvious. Two such “emperor’s new clothes” scenarios are a result of the search after 1 (one) cause for ADHD, ADD and HKD.
Fundamental in research, but unfortunately not taught much, is the concept of analysing research methods for possible paradigm traps. These happen when researchers are so stuck in their paradigms that they are unable to realise that their methods and interpretations are functions of their paradigm perceptions and not of reality. The results of the research are facts, but the interpretations of these facts are subject to the researchers’ paradigms, or worse, paradigm blindness.
For example, there are distinct functional and structural difference between brains of children, with ADHD and after many years of medication, compared to brains of children without ADHD and no medication. That is established fact. The conclusion, so often published, with the assumption there is a difference in the brains of non-medicated ADHD compared with brains of non-medicated, non-ADHD children, is nonsense. There is no proof of this. To make that statement requires other tests; namely non-ADHD children should be medicated for some years and compared with ADHD children who have never been medicated.
The research most likely shows the damage Ritalin, and the other Schedule II stimulant drug, given to ADHD diagnosed children does to a developing child’s brain.
A red flag-waving is the increase in numbers of children diagnosed with this condition. There appears to be an epidemic. This is worse in the United States than in Europe by a factor of 10. There are 10 times as many ADHD diagnosed children per 1000 children in the United States than in Europe. Figures bandied about in medical journals now make claims such as 8-12% of children worldwide are suffering from this “disorder.”
If 8% to 12% of children worldwide can be diagnosed as “suffering” from disorders as ADHD, ADD or HKD, then there must surely be a “disorder” in the diagnosis. Such a large percentage suggests this “disorder” is within the normal variation of healthy children.
Another red flag is this “chemical imbalance in the brain” and “it's genetic.” These statements might sound reasonable to a researcher isolated from the real world in his or her ivory tower. In the real world epidemics caused by genes do not happen over a generation or two, with exceptions to populations exposed to nuclear radiation, as in Hiroshima and today in Iraq and Afghanistan (caused by bombs with depleted uranium).
The “chemical imbalance cause” hypothesis has some fact behind it. There are imbalances in the neurotransmitter systems in the brain of people with ADHD, anxiety, depression, etc. Medicating however merely masks the symptoms. The source of the imbalance is ignored. The drugs work by causing a further imbalance in the brain, and in response to this, the brain slows down. This is not even an attempt at establishing and curing the underlying cause.
The problem is not THAT there is an imbalance, but WHY there is an imbalance. Stress, anxiety, abuse emotional or physical, frustrations, medical conditions such as hyperthyroidism, hypoglycemia and lead poisoning can all cause this.
The origin of the “chemical imbalance cause” idea is not in science, but in philosophy. It is a question of the brain and the mind. Science deals with the material aspects of our reality. Science cannot deal with our immaterial reality. The brain is an example of the material, while the mind and consciousness are examples of the immaterial. What comes first, the state of mind such as depression or the chemical imbalance? Is the chemical imbalance a response to the depression? The cause of the symptom or the symptom?
For ADHD, Cognitive Behavioural Therapy, is as effective, 3 years after treatment, as is medicating for 3 years, although the medicated patient is still not cured. Medication does not cure ADHD and has to be taken daily as long as the “condition” is there, but Cognitive Behavioral Therapy does have a lasting effect. Medication works on the brain, while Cognitive Behavioral Therapy works with the mind.
The thought of anything immaterial is anathema in Western society today. Yet we deal with concepts we do not understand on a daily basis. Engineers and scientists make basic calculations daily such as F=ma (force=mass x acceleration). Science still does not know what mass is. There are only hypotheses to explain it. Scientists used the concept of gravity without understanding what it was. Our Standard Model of the structure of matter stands or falls on our hypotheses on mass, it is so fundamental, yet we still do not know what it is.
This is not as strange as it may first seem, to use a concept we do not understand. When we weigh ourselves we do not measure our mass. We measure the result of the effect of our mass. Since we do not know what mass is and cannot measure mass itself, we do the best we can, and accept it.
Treating the mind, through Cognitive Behavioural Therapy or Neuro Linguistic Programming cures hyperactivity or controls through better self-awareness and coping skills, for both child and parent. Medication does not and carries with it serious and unpleasant side effects. Why not then try what works.
Those who have ADHD symptoms because of allergies do not have ADHD, but allergies.
Those who have ADHD symptoms because of lead poisoning do not have ADHD, but lead poisoning.
Those who have ADHD symptoms because of lead poisoning do not have ADHD, but lead poisoning.
Those who have ADHD because are anxious do not have ADHD, but have anxiety.
The list is long, but finally we come to people who have a hyperkinetic or hyperactive and distractible personality. If we can get beyond seeing this as a disorder, then we can adapt our attitude to accept and support these people, many of whom are creative and gifted.
The disorder is more prominent in the western society than in other cultures, possibly because we are less flexible in the West. School is inflexible. A child who learns by moving, feely, touchy, has to sit still and is not allowed to fidget. A fidgeting hyperactive (hyperkinetic) child is able to focus. Without focus fidgeting, the child concentrates on not fidgeting and is oblivious to the lesson.
Anxiety is the next step, as the child tries to control their movements while still too immature to have learned coping skills. The inner turmoil and sitting still makes it almost impossible to learn or remember what the teacher said in class.
The child, who was healthy and intelligent to start with, now falls behind with lessons and develops a learning disability. This causes frustration to on top of the existing anxiety. Is it strange that so many children are diagnosed as ADHD in the West?
One example may suffice. A child who needs to learn kinaesthetically, but has to sit still while the class is learning the alphabet, can become dyslexic. This is not because there is anything wrong with the child’s brain. The symbols drawn on the blackboard do not make sense and the child cannot internalise them without movement. If that child can move while learning, and act out the letters, then the internalising can take place.
Maybe the ADHD and HKD disorders are symptoms of ADD or Absurd Diagnostic Disorder.
Labels: ADD, ADHD, attention deficit, HKD, hyperactive, hyperactivity, hyperkinetic, inattention
posted by abacusteam at
September 02, 2008
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