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People in High Places have ADHD, as do People Who Struggle Mightily

People in high places have ADHD, for example, Daniel Koh, the Chief of Staff for the Mayor of Boston.

But it is also true that people who struggle mightily just to get by often have ADHD.  This condition can associated with greatness or with abject despair and failure.

As many of you know, I have long advocated a strength-based approach to the diagnosis and treatment of ADHD.  In just the past 10 days two things happened that bear upon this matter.

Before I discuss those two items, let me quickly clarify what I mean by the strength-based approach, for readers who may not be familiar with my position.  As I see it, the medical model is skewed entirely toward pathology, toward what’s wrong, what’s sick, what’s in need of bing fixed.  This is in keeping with the medical model.  You don’t go to the doctor to talk about how well you feel; you go when you are sick.

But when it comes to the mind, it is dangerous to assign a diagnosis that only highlights the deficits.  That’s because we identify with our minds.  If you tell a person they have a sick kidney, that’s one thing, because people do not identify with their kidneys (unless they are psychotic!).  However, of you tell a person he has a sick mind, he feels totally diminished, as if you have just told him he, himself, is sick, in toto.

That’s why, when it comes to the mind, it is so important to mention strengths along with weaknesses, not to sugar coat the bad news, but to give a full and accurate picture.  Every mind has strengths and weaknesses.  It is important to mention both.  For example, Abraham Lincoln, perhaps our greatest president. suffered from episodes of major depression.  Yet we do not think only of depression when we think of Lincoln.  Winston Churchill, winner of the Nobel Prize for Literature and arguably the foremost statesman of the 20th Century, suffered from major depression, substance abuse, dyslexia, as well as a hint of bi-polar disorder.  Yet when we think of Churchill we do not first label him as mentally ill.

In the case of ADHD, it is especially important that we  who diagnose and treat it search out each person’s strengths, as well as their challenges.  When we do that, we get the best results, and we avoid instilling the pernicious disabilities of shame, fear, and a feeling of being defective.

Now to the two items I want to comment on.  First, a distinguished professor of psychology came to my office to take me to task for overstating the positives associated with ADHD.  She told me that I risk making parents feel guilty if their kids struggle, and making the kids themselves feel they have somehow failed even when they are doing their best.

I completely agree with that psychologist, and I want to make it clear that ADHD can be utterly crippling.  ADHD is over-represented in the ranks of the prison population, the addicted, the unemployed, the depressed, the marginalized, and the people who commit suicide.  ADHD can be a terrible curse.  And when it is, no one, certainly not parents, is to blame.  Please do not misunderstand me.  I know how bad ADHD can be.  And I feel nothing but respect for the heroic parents who hang in there trying their best to help their child deal with it and survive.

The second item relates to Daniel Koh.  In the Nov. 3 issue of the Boston Globe, Linda Matchan wrote an article about Mr. Koh that recounted his struggle and ultimate victory in living with ADHD.  To quote the article:

His mother kept the house quiet while he did his homework. His father sat with him when he read. “My parents refused to accept that I was not destined to do good things in life,” he said.
But someone else believed in him too, the teacher Koh calls “Mr. Hutch” — his seventh- grade adviser, Bob Hutchings.

“He would sit with me and make sure my work was organized. He gave me hope that I was a smart guy.”

Hutchings, who still teaches at the Pike School, says he suspected that Koh might have had an attention deficit disorder. He also saw him as “lovable” and impressive.

“He had this huge personality, and in fact I called him ‘the Mayor’ in seventh grade,” Hutchings said.

“The fact that he is now the mayor’s chief of staff is just a hoot to me.”

Among many points I could make here, I want to be sure not to imply that the kids who succeed have good parents and teachers, while the kids who struggle and fail have bad parents and teachers.  Far more goes into it than that.  As the psychologist who visited me correctly pointed out, the best parenting, teaching, and ancillary help in the world sometimes leads to less than wonderful, and sometimes pretty miserable, outcomes.

On the other hand, almost every success story I’ve seen, and I’ve seen many, includes parents who care and a Mr. Hutch, someone who believes in the student no matter what.  In the case of John Irving, who barely survived Phillips Exeter Academy and is now one of the world’s great novelist, it was his parents and his wrestling coach, Ted Seabrooke.  And for Daniel Koh it was Mr. Hutch.

One day we will be able to help every person of every age who struggles with ADHD.  In the meantime, we need to look for the strengths these people invariably have, and then, as Daniel Koh’s parents did and Mr. Hutch did, do all we can to develop them while never losing faith in the person we love or care about.

At the same time, we need to be ever so careful not to cast stones at the caregivers of the individuals who are not thriving.  Blaming these heroic people is beyond ignorant, it is cruel, hurtful, and deeply destructive.

We need, all of us, to work together, to believe in the power of positive human connection, and to keep at it, no matter what.

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