The THRIVE Center for Emerging Young Adults

 

Beyond Medication: The Heart Of Working With ADHD

The "how" of what we do refers to the heart that we bring to creating relationships with these kids. It is not technique but relationship that makes the biggest difference in our ability to transform people's lives.”

By Rick Silver, MD

Excerpted from a presentation to educators in the Association of Independent Maryland Schools (AIMS)

With your indulgence, I’d to wax philosophic for a few moments. It’s important to discuss not only WHAT we do, but HOW we do it. I want to make a plea that the most important change that we can make is not in the techniques that we bring to bear in the classroom or the treatment room; but rather in ourselves as instruments of learning and healing.

The “how” of what we do refers to the heart that we bring to creating relationships with these kids. It is not technique but relationship that makes the biggest difference in our ability to transform people’s lives.

So what do we need to consider regarding our relationships with ADHD children? Most importantly, we need to understand these are very complex children whose functional problems go well beyond not being able to focus.

ADHD can ultimately be a life changing condition – for the child and for the family – and with serious challenges not just in the primary and secondary educational settings, but through the course of the person’s life. Challenges and failures occur frequently and repeatedly in the realms of academic performance, social interactions, family life, self-esteem, emotional stability and, as adults, in their ability to form enduring relationships, to find and keep employment that is satisfying and to maintain financial stability. Problems with substance abuse, the law, divorce and all manner of losses, setbacks and disappointments plague the life of the adult with ADHD far more than those of us with more cognitively and emotionally typical brains.

We as educators and mental health professionals have an important responsibility to try and alter these outcomes for the better. And if we are to make a lasting, positive difference in these kids’ lives, we need to begin by understanding the world as seen through their eyes – how they process and experience the world.

This is a world where, despite a passion to learn, a child is unable to stay focused on the assigned task – and where, because of this repeated failure to perform, and no matter how intelligent or eager, they begin to see themselves as failures from early on. A world where impulse, not control, reigns – so that appropriate social behavior is hard to master and social hurts, not rewards, become the norm for interacting with peers. A world where senses and emotions are hard to control, so that inside your body and mind exists a confusing, unsettled hurricane of experience. A world where time doesn’t travel in straight lines, so that planning and remembering and organizing are as foreign as sight is to a person with no vision. A world where well-meaning teachers and parents and friends and doctors criticize and demand and even mock, but rarely understand what the world of an ADHD kid is really like from the inside.

This work is about believing in them, no matter how difficult the challenges that they might present to us.”

If we are to make a difference for these kids, we need to begin to understand the breadth and depth and color of their experience. We must move well beyond our notion of the “rightness” of the developmentally typical world; and place ourselves in a cognitive and emotional world where the rules are turned upside down, or sideways or all over – but are certainly not linear and predictable.

And they must become for us not just children seen through the lens of checklists and reports and grades, but rather through the lens of our hearts – hearts that allows us to appreciate the complexity and richness of their minds, emotions and spirits. Hearts that move us to use our understanding to shape relationships rooted in caring, creativity, hopefulness and love. Hearts that commit to the journey of guiding and of interpreting the cognitive culture of the developmentally typical world to the language of the ADHD brain.Hearts that can see beyond the struggling, frustrating, puzzling child before us today to the proud, powerful and passionate adult that will blossom if given the chance.

As my wife has said: “This work is about believing in them, no matter how difficult the challenges that they might present to us.”

This is hard work, this believing in the possible -- not for the faint of heart or those uncomfortable working outside the bounds of standard treatment or educational practices. This work demands patience, creativity, self-reflection, commitment to our own growth and a willingness to engage ourselves whole-heartedly and without reserve in the gift of transforming the lives of these very unique, wonderful children.

It is truly work that moves us beyond who we are today and has us reach for a future where greatness – both the children’s and our own – is possible.