Attention Deficit Disorder: Practical Coping Methods - part 2 ppsx

2.3.3 Manipulation 2.3.3.1 ADD Without Hyperactivity ADD individuals can be excellent manipulators, however, again, this is due to their extreme fear of someone getting angry at them. Also, because of their guilt they don’t tend to ask for what they want in a straightforward manner and therefore have to manipulate the situation to get it. Finally, there are classic issues of self-esteem in this group. Since they believe they don’t deserve anything anyway, they rely on manipulation to get what they need rather than asking anyone for anything. These individuals are also very secretive for the same reasons. 2.3.3.2 ADHD Manipulation is a means to get what they want and often a game or sport to see how far they can shift and move people. There tends to be a need for dom- inance due to the low self-esteem that is a consequence of symptoms of the disorder, and a consistent need to prove themselves better than others. Due to their need to be right and to their rigid way of thinking, they are forced to manipulate others to bend to their will as they do not see any other alterna- tives. They also have no idea or capacity, due to the loss of the frontal pro- cesses, of how to negotiate or bargain. 2.3.4 Reading and Math Problems 2.3.4.1 ADD Without Hyperactivity Reading or math problems are generally due to an inattention to the whole, which is characterized as a spatial problem, not a learning disability. This means that the ADD individual has difficulty developing phonemic skills of approaching words and learning language as they cannot sound it out and then put it together as a whole. Often there are mispronunciations and the ten- dency to memorize words. Bright individuals typically start off reading quite well, however, as things become more complex, the words get longer and they can no longer memorize the word. Reading begins to falter. As a result, they read less and the problem becomes worse due to lack of interest. Typically, these individuals mispronounce words and see a word differently; a word such as “heir” is seen as “hair.” Math skills also present problems when there is a spatial component, such as adding in one’s head, which requires a visual–spa- tial whole. Geometry poses a specific problem for the same reason. 2.3.4.2 ADHD Reading and math problems exist due to the presence of a true learning dis- ability and an inability to learn from one’s mistakes and to use information as feedback. Research indicates that there is a difference in the brains of the ADHD individual that results in learning problems. © 1999 by CRC Press LLC 0-8493-????-?/97/$0.00+$.50 © 1997 by CRC Press LLC 3 Looking at ADD Without Hyperactivity 3.1 What is it? ADD without hyperactivity is that true sustained attention disorder, one that describes an individual as dreamy, out to lunch, and not always operating on all four pistons. These are the individuals who have more conversations with themselves than with anyone else. ADD without hyperactivity tends to involve more of the parietal areas of the brain, as well as some of the subcor- tical areas. The frontal or logic processes, however, are intact. Thus, these individuals have difficulty understanding or “getting it,” but once they do, they can use it and can truly rely on logic to function as well as they do. Skills of logical reasoning and ability to analyze a situation are the assets they are missing to figure out and survive in a world that is constantly confusing to them. ADD without hyperactivity is the less serious of the two subtypes of ADD and not always recognizable. Thus, this disorder is often overlooked. This can be seen in the child, adolescent, or adult who does not cause problems but, instead, just about fades into the woodwork. They don’t bother anyone or call attention to themselves, and, if they are bright, they will be able to compensate to the degree that they can perform within the work or school setting to an adequate level. Performance generally will not match their abil- ities. It will, however, suffice and they manage to get by. The key issue about this disorder is that they “get by.” They don’t maximize themselves and they don’t operate to the level of their potential but they perform adequately. 3.2 What to look for These individuals are hidden and not easily seen, noticed, or understood. Very often, adults who are diagnosed complain that they were working with © 1999 by CRC Press LLC 1 0-8493-????-?/97/$0.00+$.50 © 1997 by CRC Press LLC 4 Over-Focused Subtype of ADD Without Hyperactivity 4.1 Defining the Over-Focused Subtype There is a subtype of ADD without hyperactivity that can look like a combi- nation of ADD without hyperactivity and ADHD. The two disorders are gen- erally seen as separate, and we do not sustain the belief that there is a combination of ADD without hyperactivity and ADHD, but rather that there is a subtype of ADD without hyperactivity. The reason this is described as a subtype of ADD without hyperactivity, is that the clinical picture — how the brain operates — shows ADD without hyperactivity. The frontal processes are highly intact. Problems seen in an evaluation are information processing, distractibility, slow cognitive speed and all of the symptoms characteristic of ADD without hyperactivity. So the symptoms of the disorder fit the classic pattern of an attention disorder with- out hyperactivity, but they look hyperactive from what we call a behavioral pattern — their behavior appears to be that of an individual with the classic pattern of an attention disorder with hyperactivity. This is why professionals in the field arrived at this combination disorder; it explains why both types of symptoms are seen in one person. In light of how the brain takes in information and the clear differences between the two disorders, it seems virtually impossible to have such a com- bination disorder exist. The two disorders use different biochemical systems and to have an effect on different structures in the brain. It does not make sense that a combination disorder would exist when the two disorders appear so different in nature. Regardless, a certain subtype emerged in chil- dren and adults diagnosed with ADD without hyperactivity. The group of individuals had similar characteristics that seemed to have a more severe attention disorder and also have more severe emotional and behavior prob- lems both at home and at school. They were also more susceptible to having other issues such as allergies, tics, asthma, and eating and sleeping problems. Overall, they seemed “fragile.” They appeared highly sensitive, very over- © 1999 by CRC Press LLC 0-8493-????-?/97/$0.00+$.50 © 1997 by CRC Press LLC 5 ADHD Revisited 5.1 Where Do We See It? This is a more severe disorder than ADD and therefore makes up a smaller percentage of the overall population. In following the medical model, the more severe the disorder the less it exists in the population. The common cold is generally thought of as a milder illness and it happens very often. There are billions of colds occurring every day as opposed to something like strokes and heart attacks (although unfortunately they, too, are becoming far too common). Strokes and heart attacks represent a more severe disorder and so are seen less often than the common cold. ADHD is often seen in the criminal population but is less visible in a private-practice clientele. ADHD individu- als have difficulties in maintaining employment and, as a result, have neither medical insurance nor a stable income. These individuals are impacted by symptoms of the attentional disorder to the degree that their lives do not recover. Their lives can become a series of endless failures, more trials and tribulations. 5.2 A Severe Disorder This disorder is pervasive and involves more of the areas of the brain that are not operating as they should. Thus, these individuals may miss information, not be able to grasp information, or may become confused. Once they do manage to comprehend, they don’t know how to use it. Frontal processes are nonfunctioning, and, therefore, the integrative processes are disabled. They can’t understand pieces of information, they don’t see the whole picture, nor do they think of the consequences of their behavior. The inhibition system is disabled and there is no stop sign. So they want what they want when they want it and they want it now. They operate out of the inappropriate because there is no appropriate regulation. They have no “stop” for the emotions © 1999 by CRC Press LLC . with © 1999 by CRC Press LLC 1 0-8 49 3-? ?? ?-? /97/$0.00+$.50 © 1997 by CRC Press LLC 4 Over-Focused Subtype of ADD Without Hyperactivity 4.1 Defining the Over-Focused Subtype There is a subtype. requires a visual–spa- tial whole. Geometry poses a specific problem for the same reason. 2. 3.4 .2 ADHD Reading and math problems exist due to the presence of a true learning dis- ability and an inability. by CRC Press LLC 0-8 49 3-? ?? ?-? /97/$0.00+$.50 © 1997 by CRC Press LLC 3 Looking at ADD Without Hyperactivity 3.1 What is it? ADD without hyperactivity is that true sustained attention disorder,