ADD, ADHD, or Lack of Boundaries?

The prevalence of ADD and its hyperactive counterpart ADHD is astounding. The Centers for Disease Control CDC estimate the morbidity of ADHD in this country to be:

  • Percent of children 5-17 years of age ever diagnosed with ADHD: 10.2% (2012-2014).
  • Percent of boys 5-17 years of age ever diagnosed with ADHD: 14.1% (2012-2014).
  • Percent of girls 5-17 years of age ever diagnosed with ADHD: 6.2% (2012-2014).

Even more alarming is the growing trend to diagnose children, ages 2 – 5 with a behavioral disorder such as ADD and / or ADHD and utilize treatment methodologies such as a medication as a means for pharmaceutical control of many symptoms that are simply childlike in nature.

As a clinical psychotherapist, practicing with children for more than 15 years, I have come to know the face of ADD and ADHD personally. However, my journey with ADD and ADHD did not start within a clinical laboratory, or within the confines of my psychotherapy practice. Instead, it started with a difficult transition in primary school, where teachers were apt to have me evaluated, medicated, and treated in a manner that would somehow have me labeled as different from my peers. Was this due to my innate love of learning versus my innate need to fit within the 80/20 box offered by traditional educational settings. While a personal journey in many respects, I cannot help but reflect on the journey that was, examining the problems that many children face in conjunction with the problems their over-stressed and oftentimes over-worked adult caretakers face in light of bringing up the next generation.

As a doctor, treating children with ADHD, it is imperative to set clear clinical boundaries. While medication may help in some instances, it oftentimes leads to only a placebo effect. It may control some of the behaviors some of the time, but lasting change is only learned through learning one’s strengths, confronting one’s deficits, and utilizing one’s learned strengths as a means to overcome their perceived deficits. As a child, I was lucky enough to work with a behaviorist, who taught my mother methods of communicating, that not only honored the strengths I had, but also taught valuable skills of looking while I listened, focusing on one task at a time, and giving me time to use my active imagination to dream life forward. While difficult to imagine, giving children time to actively explore their world and dream about their future outside of some prescribed educational, medical, or statistically sound box, it is this very act of dreaming that allows children to tap into their natural capacity for growth, and find ways to see the flowers in the meadow that their adult counterparts often remain blinded of.

Advice from the doctor.

  1. Help your child develop a focusing habit. Engaging in activities such as sports, martial arts, and increased physical activities will help your child immensely in their journey to develop focus, sustain focus, and burn off excess energy.
  2. Work with a therapist. Your child’s symptoms do not exist in a vacuum. It is imperative you work with your child’s therapist to develop appropriate behavioral skills, and implement these skills within your life. Boundaries within the family is the only way your child will learn to successfully navigate problematic behaviors within other contexts such as school, work, and social settings.
  3. Listen to your children. They know what they are going through. No medication will help them to learn of their emotional state. It is up to you as parents to help them learn about, navigate, and find appropriate ways to handle situational distress. It may be difficult, but it will be well worth it in the end. Your child must learn effective ways to handle their emotional states, not repress them through pharmacological means. While many of the medications do not have addictive qualities, if they miss the valuable lessons offered by emotional states during their formative years, suppression and repression become the norm, and are often elicited by later maladaptive behaviors such as addictions.
  4. Try alternative approaches. Biofeedback and neural feedback have been shown to have great efficacy in the treatment of ADHD symptoms. It assist children to develop hyper-focus, and can dramatically affect their neural development and capacity to control internal disregulation common to anxiety, depressive, and attention deficit states.

Dr. Tom


Center for Disease Control (2015). National Center for Health Statistics.

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