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Categories: 2012, February
by Mark Bertin, MD
“I was putting so much pressure on myself, and my son Stephan.
He has ADHD. We’ve tried so many different things to get him to
listen. And we go to my mother-in-law’s, and there’s this
look she gives me. It’s like, without saying a word, she’s
staring me down. I know what she’s thinking—honey, do
something and get your monster under control. Or it might be in a
restaurant, not that we really go anymore. Everyone is watching, and I
get so angry at myself for even trying to go out for a meal. And
I’m angry at Stephan. I’m doing everything I can,
don’t they all realize?”
* * *
The list of biologically driven, ADHD-related behaviors parents blame
themselves for is long. Something happens—a shove on the
playground, or a social rejection—and a visceral reaction starts.
I should have known this was going to happen, why didn’t I do
something? It’s often amplified when parents do not fully
comprehend or believe the biology of ADHD. Or maybe they do, but their
spouse doesn’t. If you cannot see ADHD as a medical condition,
it’s easy to assume the persistent behavior is
My kid does not get invited to parties anymore. They don’t
seem to have any close friends. My spouse feels I should be doing
something different with the children. My parents think I should be
stricter. My friends think I should be more lenient. Their teacher
thinks I am too indulgent. Their other teacher feels I should motivate
them. For each of these ADHD-driven thoughts, a twinge or a deluge
of self-doubt may follow. Am I doing the right thing?
You’re trying to make a change, and there may be a practical
step to take. But the hectoring, often abusive voice of judgment may
linger. You’re not good enough, you have to work harder, if only
you were a better parent. If only I was a better person or you were or
he was, then everything would be different. Or you think about your
family. If you were a more motivated child, or if you were the kind of
dad who spends more time with his kids.
We are frequently led to assume that we find happiness only when we
get our act together, reach some state of perfection and answer the
voices. Instead, we can notice those voices for what they are, a
combination of what we actually hear from the world and our own inner
commentaries. And then instead of taking it all at face value, we can
train ourselves toward a more compassionate, insightful way of
When we are driven by an endless sense of letting ourselves down, or
letting down our families, our boss, or whomever else, we exhaust our
mental resources and make unskilled decisions. When we begin to notice
the voice of judgment, we can begin to let it go. Thanks for the
feedback, I’ll take it under consideration, I did everything I
A subtle (or less-than-subtle) inner message criticizes every move,
never satisfied. I messed up again, I should have done that better.
I’ll never get it right. Or it constantly compares everything to
what it “should” be. Do I have the job I should, the
house I should, the kids I should, or even the spouse I should?
Perhaps one day you’re hanging out on a blanket at a picnic,
and someone playing Frisbee accidently steps in your food. Looking up,
you see one of your closest friends—and you smile and shrug it
off. But if you look up and see someone you don’t like, or
don’t trust at all, what then? It’s the same accident, but
instead you become annoyed.
Typically, we don’t treat ourselves like we treat our friends.
You’re playing Frisbee and accidently step in your boss’s
food. Immediately, you are flooded with a pile of thoughts, feelings,
body sensations. Maybe your stomach flips, your palms sweat. You might
have reflexive thoughts about yourself. How careless. Fool. Why
weren’t you more careful? All without nearly the patience or
grace you would have had for your closest friend, a moment ago. Driven
by these unconscious, negative judgments, where does your behavior go?
What might you say or do? How clear would you be in your next
Aware of their influence, you might notice when they arise—and
choose not to listen. By cultivating for yourself the attitude
you’d have toward a close friend, and by giving yourself a break,
you may discover something new. I messed up, and I’m sorry. What
is my next step?
LIFE, OF COURSE, IS NOT ALWAYS A
PICNIC. You’re on an airplane and your eight-year-old son
throws an epic tantrum, legs flailing and ear splitting screams. He
doesn’t want any of the meal choices available, only grilled
cheese, which is not on the menu at thirty thousand feet. A situation
difficult enough to manage on its own… and then your own mental
habits add fuel to the fire. You may imagine the entire plane staring
you down, be ashamed you’re causing a scene, or simply denigrate
yourself for not knowing how to solve a situation that doesn’t in
fact have a perfect answer.
None of us are at our best when overly influenced by these voices of
judgment and inadequacy. So instead, in the midst of the mental
conflagration you can pause and aim to give yourself a break. Take a few
breaths while privately acknowledging that you’re striving to stay
calm and to find an answer, whatever it may look like from the outside.
What would you advise your best friend dealing with the same
Or maybe you’re an adult with ADHD. You’re rushing to
pick up your child from an after-school program. Late once again,
you’re anticipating polite condescension from the staff waiting
for you to arrive. Or perhaps you’re picturing your spouse’s
anger or your child sitting on the bench outside alone and resigned,
waiting for you. Maybe there’s a bill you suddenly realize
required payment last week, or a project not quite on time when you told
your boss you wouldn’t run behind again. Subtly or not so subtly,
the internal dialogue begins—you should know better, you blew it
Left unattended the feelings perpetuate themselves, reactions like
self-blame, shutting down, or lashing out, and they limit the
possibility of change. You’re not intentionally doing anything
wrong. You have ADHD and on a neurological level it is difficult to
manage time and to keep organized. You’ve been working on your own
and maybe with a therapist or an ADHD coach. Perhaps you and your
significant other have started to discuss better communication or
household logistics. Maybe none of that has happened but you’re
moving internally, mustering your resolve. You’re doing your best
and not even vaguely giving yourself the type of pep talk you would give
your closest friend. That sounds like an awful experience, you’ve
already accomplished so much, look how far you’ve come.
You’ll do better next time.
And what about those other voices lambasting you for your supposed
failings? If someone else was whispering in your ear, providing an
ongoing critique of your life, how would you handle that? You’d
likely turn away, dismiss the person as unhelpful, and move on. You can
practice the same in life: Observing those inner patterns, recognizing
them. The thoughts may not go away, but you train yourself to pay them
far less attention—to notice them and walk away.
Maybe none of those situations apply, and you’re a school
administrator at a table across from two scared and angry parents.
You’ve lost six staff members and twenty percent of your special
education budget to cuts. You’ve spent your entire career trying
your best to help and something isn’t working for their child. You
have the same immediate goal as these parents, even though you
don’t agree with everything they say. And, in fact, your own child
is failing algebra or you have a sick relative or maybe you just
didn’t sleep at all the night before and aren’t feeling as
sharp as usual.
Whether you’re the parent, the administrator, or an adult with
ADHD, being compassionate doesn’t mean becoming a doormat for the
world. You can entirely disagree with someone’s actions and still
recognize their basic humanity—and then choose to firmly take a
stand for yourself. Similarly, giving yourself the benefit of the doubt
doesn’t require letting go of reality or pretending it is okay
that you left your child waiting.
The practice of compassion often breaks entrenched patterns in our
lives, ones that fuel negative self-talk and reactivity, anger and
anxiety, and all the rest. Routines that seem fixed and unchangeable,
ways that we relate to ourselves, to our children and to the world, are
more malleable than they usually appear. While always aiming to make
changes that take care of ourselves and our families we can remember
that everyone is struggling in some way.
Muddied by an impending sense that we’re about to fail, losing
track of the fact that we’re all simply trying our best, we limit
ourselves, our children, and anyone else we encounter. By pausing and
choosing a broader point of view, we start entirely new habits. We
increase the odds of finding not only compassion and happiness, but also
far more skillful solutions to the problems we face day-to-day.
Responding with compassion
Much as we do with ourselves, we can love our children
unconditionally and not be fully empathetic of their challenges. Without
liking the fact that they have ADHD, without giving up on a desire for
change, compassion implies unguarded empathy that recognizes the entire
experience of a struggling child. Our own fear, frustration,
embarrassment, and countless other emotions cloud our perspective. We
love our children but really, really wish they could just get it
Our interactions may be clouded by another voice of judgment. We may
not quite fully accept that beneath the surface of academic struggle or
misbehavior is a child trying his or her best to succeed. The child
would just as soon have an easy time of it, but is getting in his or her
own way because of poor executive function—the child’s brain
isn’t allowing the child to behave his or her best. An overall
sense that the child “should” act differently or behave
“better” impacts our communication and the decisions we make
about everything, from how to manage an argument to treatment
ADHD is a deficit in certain cognitive skills, not a character flaw.
We can empathize with a child’s inner struggle without giving up
on teaching skills, trying to modify behavior, and expecting long-term
progress. We can acknowledge our own challenges as parents, and feel
sadness, frustration, anxiety or anything else without reflecting back
the intensity of these emotions onto our children.
Never losing sight of our long-term goals, all we can do is offer
skillful support, day after day, without blaming anyone for what is
nothing more or less than a chronic medical condition. A focus on
compassion may intuitively lead to more emphasis on praise and reward,
both vital for children with ADHD. Fully taking a child’s
perspective equally recognizes the value of setting limits and
consistent discipline, approaching rules and boundaries with a clear
understanding that they support healthy development. It also means
accepting our children as they are—with plenty of strengths and
flaws like everyone else—and then doing everything we can so that
tomorrow, or in a year, or a decade from now they have what they need to
thrive on their own.
Compassion often influences decision making. Children with ADHD have
a developmental delay in executive function as concrete as a language
disorder or a physical disability. Yet somehow there is often an
assumption that ADHD is more ephemeral, that a child could choose to be
different through effort alone. Empathizing with ADHD, even when it may
not fit our picture of how family life “should” be, we may
decide to change how we run a household, how we emphasize consistency in
schedules, or how we respond when angry. Compulsively upholding routines
or pausing before responding quietly when upset may not be our natural
style, yet we recognize the needs of our children and modify our own
In any moment, we can attempt to put ourselves in the shoes of our
children. In spite of intensive support at home and school, or maybe a
plan involving behavioral therapy and various complementary
interventions, a child continues to act out. But think: What is it like
to fight your own biochemical tendencies, moment to moment? Would we
ever say to a child with asthma, “Now go to school and pull
yourself together, stop wheezing already!” Perhaps balancing a
universal desire to avoid unneeded medications against the bare facts:
What are the actual potential side effects and benefits, as opposed to
fears or misconceptions? Not prejudging the situation, not advocating
for or against any particular choice, but taking into account the
perspective of a struggling, individual child.
So, your child, having been asked eight times to play Frisbee on the
other side of the yard, steps on your picnic lunch. Pausing to respond
instead of lashing out, what is your most skillful reaction? Your
frustration, anger, and uncertainty about what the guests will have left
to eat are all real. But from there, which perspective do you take? Do
you lash out reactively, or impose layers of blame on an already
difficult situation? Or, instead, do you respond with the compassion
you’d show your closest friend?
Anthony Rostain, MD, MA, on the years of transition to adulthood
interview by Susan Buningh, MRE
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