(Introducing a Major New strategies Etiologic Concept and Drug-free Treatment Approach)
There is an epidemic of 'ADHD' afoot. Legions of children line up daily at school for their 'drug fix.' But, are there instances of attention deficit, distractibility and hyperactive conduct that do not call for medication? I think so and show so. The incidence of neuro-ADHD to social-ADHD (SIH) is 1/25...
The diagnosis of ‘Attention Deficit Hyperactivity Disorder’ (ADHD) has mushroomed in recent years and most overactive, distractible children are nowadays likely to be placed on a stimulant drug. Is this a reflection of long overdue case-finding? Is it good treatment? My research says, respectively, yes and no...
Case 1: A schoolchild finds it difficult to sit still, can hardly concentrate and attend to the task at hand and is constantly reacting to every little thing going on. Marks are poor, conduct aggravating. It doesn’t take long for a smart teacher to boil such behavior down to the medical-psychological trio of hyperactivity, distractibility and short attention span. A light turns on in her head, “Eureka! This must be ADHD.” A trip to the family doctor is quickly, almost routinely, set up – for Ritalin.
The teacher in this scenario has a 25 to 1 chance of being wrong. The reason is that a hitherto unrecognized clinical entity accounts for the vast bulk of hyperactivity connected with distractibility and other behavioural and educational problems. This new strategies brand of 'hyperactivity' shares almost identical subjective symptoms and objective signs with standard ADHD, but most importantly, it is not biological or genetic – it is a social-psychological disorder carrying with it absolutely no brain malfunction. A number of logical alternatives to reflexively routine drug tteatment thus flow from its correct diagnosis. As family doctors and pediatricians write most of the prescriptions for stimulants, they should be fully aware of Socially Induced Hyperactivity or ‘SIH’ as I call it. SIH is generated via a unique biphasic social-family mechanism. This newly-discovered source of hyperactivity is ecological. It stems from outside the child; a ubiquitous self-reinforcing process incubates in the family and spreads to infect the child’s wider social milieu. The school is usually a major, if often innocent, player. Nursed along by selected case examples, the biphasic mechanism can be explained nicely with two key diagrams:
PHASE 1, anxiety induction: A mother (M) and father (F) are in quietly hostile disagreement (+ / -) with each other. They no longer are talking about some key issues that are also important to their child. Such a two-person covert conflict is termed asplit social field. While failing to speak directly with one another, each parent separately does so with their child, who in turn covertly relays the adverse message on to the other parent (arrows). Back and forth it goes. This three-person setup is called aSplit Field Relayer System or SF:RS. A dysfunctional family triangle, it perversely entraps all three of the actors. But most importantly, the SF:RS induces structured anxiety in the child-relayer who is depicted above with hair standing on end and labelled with a big ‘A’ for anxiety. PHASE 2: Anxiety converts to hyperactivity if a child is caught in more than one SF:RS. This easily happens when a parent is at covert odds with a teacher—or any other significant person outside the immediate family. Suppose, a child whose parents are separated, is in temporary protective care … then, as the number of care-giving persons (P) increases, so does the number of potential split social fields between them (1, 2, 3…n). For a child at the nexus, the intensity of hyperactivity goes up (as the original induced anxiety diminishes) in proportion to the number of entrapping split fields. Write inhyperactivity with a large ‘H!’ This augmented setup, involving a few to numerous noxious triangles, is termed Multiple Split Fields (MSFs).
