Wednesday, July 17, 2013

The Missing "I" in ADHD.

ADHD, Attention Deficit Hyperactivity Disorder is the most commonly diagnosed psychiatric disorder in children effecting approximately 5% of all children.  The rates among children with autism are cited to be over 50% (Leyfer et al, 2006) and in my experience, children with other developmental disabilities have a much higher rate of ADHD as well. 

The symptoms of ADHD are well known:
  • High rates of distractability, inattentiveness and inability to focus or concentrate
  • Hyperactivity that can include motor (fidgetiness) and hyperverbosity (chatterbox)
  • Impulsivity, both verbal and physical (aggression)
The last symptom, impulsivity, doesn't get credit in the ADHD title, however.  Shouldn't it be ADHID?  My advocacy for the missing "I" is due to the frequent incidence that I've found in how challenging (frustrating, maddening, crazy making, choose your descriptor) impulsivity is. 

Kids blurting out how much they "hate" their parents, siblings, family members and teachers.  Death threats, rarely meant, but in our current world in need of stern attention, inadvertently reinforcing the behavior to boot.  Physical aggression against family, peers etc.  These are the behaviors that try parents' patience to the hilt - and so many parents end up over-responding and thus adding to the inadvertent reinforcement of what is, essentially, just a symptom of ADHD.  One test, by the way (not infallible) of whether the impulsivity is really based in ADHD is whether the child has remorse afterwards when calm.  We like remorse for bad behavior. 

So, for those of you with kids with ADHD, remember, those really challenging behaviors that make you want to tear your hair out - could they be the result of the missing "I?"  It's worth keeping in mind. 

Thursday, July 11, 2013

Emotional Muscle Memory

Athletes hone their expertise through repetitive practice to reinforce what we call muscle memory.  Over and over they will throw, run, jump, catch, swim and with good coaching learn the subtleties of how to excel in their sport.  This is true for kids as well as professionals.  When my now adult son was involved in Kung Fu beginning in early elementary school, he was quite motivated and practiced his moves repeatedly until he was fluid with the movements and techniques and earned great praise from his sensei.  The focus children - and even adults - learn in working on their physical muscle memory serves them well.  (I keep on threatening to again take golf lessons to fulfill my dream of a 200 + yard drive from the tee.)

So why do we not have the same level of focus, concentration and repetition in the area of emotions, relationships and families? 

So many of us have histories filled with trauma and great emotional pain, losses that mightily weigh on our ability to cope.  These wounds result in emotional callousing and maladaptive behaviors that can so easily sabotage our own mental stability, our marriages and our relationships with our children and families.  So why not consider the reparative work in the same way we consider athletic conditioning that results in muscle memory?  We need and deserve to have coaching - whether from a professional, friend or loved one - that help us consider alternatives to the emotional patterns that we have adopted as a result of our histories. 

An example of the need for emotional "muscle" memory has to do with a number of couple's I've been seeing lately where the wives are in great pain about the emotional distance they experience from their husbands.  These men, quite successful, have come from families where there was lots of "dysfunction" such as addicted parents, distant and self absorbed parents who were uninvolved in their childrens' lives etc.  Part of what these guys are struggling with is how to create emotional closeness with their wives and kids, something they had virtually no training to do in their own families of origin.  We meet, we discuss how to get involved, things their wives can do to support their emotional involvement with the family etc. and then comes the hard part.  Practice.  It can be tedious, frustrating and the results can be slow to be seen - too slow for some.  What I'm encouraging these folks to remember is that it took years and years of "bad" emotional habits to result in their current patterns of emotional distancing.  So too it will take lots and lots of practice, gains and losses to create the emotional "muscle" memory of a new way of engaging in their relationship with their families. 

My encouragement  is to consider life a series of "training" opportunities.  Find a mentor, a coach, therapist, friend or trusted ally to help you polish and improve your emotional "style" of interacting.  Consider different strategies.  Try them, not just once or twice, but until you have some familiarity with them and then integrate whatever works into your emotional repertoire.  Work hard - as hard as you might work if you took tennis lessons, or as hard as you would support your kid to work if he or she took tennis lessons.  Create new emotional "muscle" memory to improve your game.