Psychology and Theology: ADD/ADHD

         

          Attention Deficit Disorder (ADD) and its counterpart Attention Deficit Hyperactivity Disorder (ADHD) are two behavioral disorders that have experienced a marked increase in prevalence among youth and adults over the last several years.  It is a relatively new mental health issue with the first modern-day diagnosis believed to have occurred in the early 1970s.  However, one report has that ADD was recognized by a British clinician as early as 1902.  Interestingly enough, this clinician did not use the term ADD, but rather a term called “Defect of Moral Control.”  Unfortunately, one source does state that this English clinician began believing that behavioral issues had an organic component to them and that he renounced his stand that parenting styles and other external factors play a role in the development of ADD…and that’s too bad. The Bible is very clear regarding behavior and its origins and its proper method to alter it, and it’s got nothing to do with heredity and other sources that are out of one’s control.

            I find this topic extremely interesting since I was in counseling myself once, and the therapist I was meeting with was a Christian counselor.  It only took until our second meeting together that she began believing I was suffering from ADD/ADHD.  She wanted me to consult a specialist in the disorder to be evaluated.  I can remember going to this counselor for a very specific issue and why it was that I was having trouble with it.  She asked me questions and inquired about many different things and came to the conclusion that I must have ADD.

            Here’s the problem.  Now mind you, I wanted to know why I was having problems in my life with a particular issue, but at the suggestion that I potentially had ADD, I was able to say to myself, That’s why I do such and such…because I have ADD.  I can remember feeling vindicated from all of the wrong I had been doing with respect to my issue because, after all, I couldn’t help it.  I had a mental disorder that caused me to have a tendency to do the things I did.  Well, carry the argument further…God created me that way, with this disorder, how can He hold me responsible for my actions?  He made me to have brown hair…I can’t help that.  He created me to struggle with ADD, therefore God understands because I can’t help that either…right?  Wrong!  Here again is an example of taking away somebody’s personal accountability for their actions before God and replacing it with excuses for sinful behaviors.  The non-judgmental musing of psychology and counseling are to blame for the proliferation of sinful behaviors that the world just excuses away so readily and easily that the sinner is often pitied as though he were the victim.

            The 4th edition of the Diagnostic and Statistics Manual (DSM-IV) is the guidebook for the mental health community in displaying the criteria for ADD/ADHD among all the rest of the psychological disorders.  ADD/ADHD is described as follows:  “OFTEN fails to give close attention to details; OFTEN has difficulty sustaining attention; OFTEN does not seem to listen; OFTEN does not follow through on instructions; OFTEN has difficulty being organized; OFTEN avoids dislikes or tasks that require sustained mental effort; OFTEN loses things; OFTEN is easily distracted; OFTEN is forgetful; OFTEN fidgets or squirms; OFTEN leaves seat when should remain there; OFTEN runs or climbs; OFTEN has difficulty playing quietly; OFTEN “on the go;” OFTEN talks excessively; OFTEN blurts out answers; OFTEN has difficulty awaiting turn; OFTEN interrupts others (DSM-IV, pg92)”

            Here’s my first concern about this disorder…and I highlighted it…OFTEN.  This means that of the 18 criteria (ADD/ADHD combined), some or all may not be present in the individual all the time.  Which means that when they aren’t present, the person is doing what they should be doing and what is appropriate for that setting at that time.  If I’m not always paying attention to detail, it simply means that sometimes I am.  Which means, and you can argue this point with me if you wish, that when I’m not paying attention to details it is simply because I don’t want to, rather than because I can’t.  Since I sometimes do what’s right and expected of me, it proves I have the ability within me to do that.  So any time I act in ways that are inappropriate, it’s because I choose to act in a manner I prefer at that time, in that setting.

            For example, just Google “Michael Phelps ADD/ADHD” and read how he has battled and overcome his ADD and how it may have actually helped him in the past couple of Olympic games because one of the features of people with ADD/ADHD is that they have incredible ability to focus on what they enjoy.  But again, a contradiction.  On the one hand the DSM-IV claims ADD people fail to give attention to details (something crucial to a world-class athlete who must be precise in all his training and competing.)  On the other hand you have the ADD research that says they can focus incredibly on tasks they find stimulating and exciting.  So which is it…can they focus or can’t they?  If you read between the lines you can see that these people have the ability to focus, but pick and choose when they will use their ability based mainly on doing it when it suits them.

            When I was 19, I was enrolled at CCRI.  I attended classes sporadically but made sure I was at all tennis practices.  I won tennis matches left and right and received All New England honors but didn’t earn one single credit and flunked out.  Did I have ADD as a young adult like my counselor thought?  Well, if I’m honest with you I can say that I just found tennis to be more FUN than challenging myself intellectually.  Is that a mental disorder or a sign of someone who is immature and undisciplined with misplaced priorities?  I had no constraints and no one to be accountable to and I ran with it.  Incidentally, I was academically ineligible the next year and was banned from the team…and I had no one else to blame.

            Another concern I have with the legitimacy of ADD is that, by their own admission, the DSM-IV states, “There are no laboratory tests, neurological assessments, or attentional assessments that have been established as diagnostic in the clinical assessment of ADD/ADHD” (DSM-IV, pg 88-89), and “There are no physical features associated with ADD/ADHD” (DSM-IV, pg 89).  When there are no physical findings, it lends itself to reason that what clinicians and parents are dealing with are behavioral issues.  Look at the criteria, they’re all behavioral observations that are wholly subjective.  Their isn’t even a guideline for what is normal versus abnormal in these observations.  If you place a “normal” inner-city teen in a classroom and evaluate him against an Amish girl, you can see how subjective judgments can be skewed.

            Let me give you two more incriminating statements from the Manual.  First, the DSM-IV claims that, “usually the disorder is first diagnosed during the elementary school years, when school adjustment is compromised” (pg 90).  Well sure, I can see that.  What do we find at this age level, around 6-7 years old?  We find children possibly leaving homes with very permissive parents and now all of a sudden these children are constrained by rules, people telling them how and when to do things and there are expectations placed on the child that they have never before experienced.  When these children are used to moving from one thing to the next without any kind of structure, you better believe it will take a major adjustment to sit still and follow directions.  But again, these same children have the “ability” to sit in front of a television set and become experts at the latest video games.  They don’t lack the ability to learn in the classroom, it’s just not as much fun for them…so they OFTEN won’t try.

            The final point that I believe makes ADD/ADHD suspect in nature is the finding by the research cited by the DSM-IV that says “ADD/ADHD has been found to be more common in the first-degree biological relatives of children with ADD/ADHD than in the general population” (pg 90).  Following in the footsteps of the English clinician, these researchers are leaning toward a possible genetic link to ADD/ADHD.  But if it’s prevalent in generations in the same family, all these generations are growing up and learning from the previous generation.  If they all displayed characteristics of ADD/ADHD, then that’s all the children learn as normal and will eventually just pass that behavior on to the children they ultimately raise.  So…does parenting, or the lack thereof cause the behavioral problems that the scientific world wants to call ADD/ADHD?  Probably it does to some extent, but who wants to be told a child is behaving a particular way because you were too permissive with them and didn’t take the time necessary to discipline your child at a young age so they would learn to be respectful at church, to listen to the preacher or teacher, and to remain seated and quiet while others are talking.

            As much as I have studied the disorders during my time in graduate school, I have to say without an inkling of a doubt, that ADD/ADHD have the most holes in their criteria, assessments, and overall construct.  I wish I had time to debunk everything about ADD/ADHD against the Bible and conventional human reason, but I lack the time and resources to do so.  But I am including an article that does just that…it blows ADD/ADHD out of the water.  This gentleman uses a lot of Scripture and it’s a fascinating read.  Here’s the link: http://www.psychologydebunked.com/documents/Dobson ADD.pdf

            Next week will conclude this series with a look at drug therapy and the dangers therein.  I will try to put forth Biblical options to drug therapy and what God has to say about treating depression and treating behavioral issues found in ADD/ADHD.  Following next week’s article, I will begin a run of articles covering various aspects of the marital relationship.  I want to focus on the husband and wife dynamic touching on areas of communication, emotional intimacy, how to fight the right way, and eventually look at marriages in trouble and with a type of therapy called “Hope Focused Therapy.”  I hope these next several weeks after the conclusion of this current series next week will be a blessing to some of you.  Again, I encourage your feedback and criticism anytime by leaving a comment.

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