By Dr. David Keirsey
Something is wrong with the idea of attention deficit. Not just a little wrong, but terribly wrong, and, as it turns out at the turn of the century, tragically wrong. Tragic because it gives the appearance of legitimacy to the practice of prescribing stimulant narcotics for children who are said to be short on attention.
During the 1950s the practice of experimental narcotherapy for so-called “hyperactivity” came into vogue. The drugs of choice were amphetamines such as Benzadrine and Dexedrine, and in the late 1950s, methylphenidate (Ritalin), and pemoline (Cylert). At first only the extremely active boys got zapped with stimulants, maybe one or two per school. But since only a few psychologists complained about this questionable practice, and since the “special education” movement was growing rapidly, more and more teachers demanded that somebody else should be held responsible to put a stop to disruptive behavior in the classroom.
During the 1960s and afterwards only the corrective counselors trained and experienced in the methods of Dreikurs, Erickson, and Glasser knew how to control disruptive behavior in the classroom. Not knowing this, parents turned to those local medics who claimed they could control disruptive behavior with drugs. These medics, knowing that activity level could be dampened with drugs that act on the brain, started experimenting with brain-disabling drugs. They’re still experimenting, but they have multiplied exponentially because the practice is so easy and so lucrative. Now there are millions of kids being drugged, whereas there were only thousands in the 1950s.
Tragically, a kid doesn’t have to be disruptive to get his brain disabled. All that need be done is for someone—teacher, principal, nurse, counselor—to tell the parent that her boy doesn’t have enough attention to succeed in school. In the face of such news parents may go a local medic who will “verify” that her son may afflicted with “attention deficit.”
Now, what makes the teacher think the child doesn’t have enough attention? Notice that this isn’t a disruptive child, so the teacher’s not busy with him trying to stop him from getting out of his seat so often and wandering around, or from making noises and motions that bother the teacher and the other kids. This kid stays in his seat and doesn’t bother anybody. What he doesn’t do that bothers the teacher is his assignments, or if he does them, he’s sloppy and slow about it. She knows what he doesn’t do, but not what he does do. Indeed, nobody knows what he does because, unlike the disruptive child, he doesn’t call attention to himself.
Now any skilled corrective counselor can chat with the kid and find out what such a child does with his time. I did this for around twenty years and then trained my staff and my students to do this for another ten or so years. I also handled all cases of chronic disruption referred to me when I was in practice such that the disruption stopped and productive behavior started and continued. I also trained my staff and my students to do likewise. Spare me the nonsense that nothing can be done about either sloppy school work or disruptive classroom behavior. Any counselor practiced in the methods of Dreikurs, Erickson or Glasser can do a lot about both, and even the so-called “cognitive-behavioral” counselors of late can handle these rather simple cases. And make no mistake about it, these are simple cases compared to the other kinds of things kids can do at home and school that even these well practiced counselors are hard put to deal with. My advice to medics, since they have only brain-disabling drugs to offer, is to tend to their own business and refer these cases to those corrective counselors who know what to do.
A Disparity of Agendas
The point is that the child who is sloppy or slow in pursuing the teacher’s aims is not short on attention, as is claimed, but is long on attending to his own aims. What we have here is a disparity of agendas. It is silly to suppose that the reason a kid pays little on no attention to someone else’s agenda is because he doesn’t have enough attention to pay. Attention isn’t something that one “has.” Rather it is something that one “pays.” Unless we’re sleeping, we cannot not pay attention to something, whether the something is present or absent. Everybody is paying attention to something all of the time. Now in the case of the disruptive kid it should be obvious that he’s paying a lot of attention to his own agenda. It’s a mistake to say he hasn’t enough attention to succeed in school. It’s just that his attention is focused on things of no interest to the teacher.
Indeed, it is likely that both “Attention Deficit” and “Attention Deficit Hyperactive” children are long on attention, belying the attention deficit part of this phony “disorder,” and leaving only hyperactivity. If there’s no attention deficit in either hyperactive or non-hyperactive children, then there’s no attention deficit disorder.
The question arises, is the not very active child who ignores the teacher’s agenda distractable like the very active child, who also ignores the teacher’s agenda? But the question is unanswerable because nobody checks up on what such a child is paying attention to. I think it rather unlikely that kids who do sloppy or slow schoolwork are distractible. In any case they’re hardly distracted from their lessons because they aren’t attracted to them in the first place. And nobody knows what’s going on in their heads because nobody bothers to find out. No, these kids are just doing their own thing and don’t care to do those definitely unfun things their teacher wants them to do.
A Disparity of Interests
Now why do some kids pursue their own agendas rather than the teacher’s? One answer I find more useful than others is that what the teacher requires the kids to do is not fun to do, which is to say it doesn’t interest them. Most of the kids, even though schoolwork isn’t much fun, want to please the teacher, so they do as they are told, if only halfheartedly and with some annoyance. But some of them are not only disinterested in schoolwork, they are also disinterested in the teacher.
It’s a matter of temperament. Though none of the kids can figure out what good it does them to do their schoolwork, those endowed with a certain temperament resist doing that sort of work because it bores them. This has been true as long as this sort of kid has been sent to school and told to obey the teacher. These are what Plato called the “Artisans,” what Aristotle called the “Hedonics,” what Galen called the “Sanguines,” and what Myers called the “Sensory Perceptives.” As far as these kids are concerned there’s no point of doing things that aren’t fun or of no immediate use. They’re what I call “concrete utilitarians,” this because they’re concrete in speech and utilitarian in pursuing their interests. And I figure that they’re about 40% of the school population, at least in elementary schools (about half of them drop out of school when they get to the ninth grade).
Since there are so many of them attending elementary schools, how come only about 5% are turned over to the tender mercies of medics? One reason is that lots of parents aren’t taken in by the educators and the medics and simply decline the invitation to have their kid drugged.
But what about the rest? Here the teacher makes a whopping difference. Most teachers are smart enough to figure out how to get their pupils interested in pleasing them so they’ll go along with doing their assignments. They don’t have a problem with wandering attention because they know how to engage the intentions of their pupils. Too bad, but those kids whose temperament is unsuited to school routines, the Artisans, are not at all easy to train to take on these routine demands of school life. So some of the teachers are hard put to deal with such kids.
Before World War II these kids were not a problem. If they didn’t do their assignments they were not promoted. By the way, two of my classmates were two years older than me, while three of them were three years older than me, all five superb athletes when they got to high school. But after WWII schooling became a very serious matter and those children that displayed little interest in school work were regarded with grave concern. Holding them back would no longer do.
The Myth of Attention Deficit
To understand how the myth of attention deficit came about, it’s instructive to look carefully at its source. I refer to the Diagnostic and Statistical Manual of Mental Disorders. The idea cropped up in its third edition and was finalized in the fourth edition. Let’s have a look at what the “criteria” for making the “diagnosis” of “attention deficit disorder” in the fourth edition.
First, it must be said that this particular “disorder” is rather peculiar. The contention is that the symptoms of the disorder cause the disorder. This is said very pointedly in the section on “Attention Deficit Hyperactivity Disorder,” so we must conclude that the writers meant to say it. As far as I can tell this is the only “disorder” among hundreds in which the “impairment” is “caused” by the “symptoms” of the “impairment.” This is peculiar, to say the least, in an ostensibly “scientific” document.
Notice that inattention is a negative concept, that is, something not done. The claim is that those with impaired attention fail to attend to things like directives, speakers, accuracy, equipment, daily activities, exerting mental effort, and organizing tasks. But what is not done cannot be observed and can only be inferred. If, for example, a directive is not carried out, then it can only be inferred that the directee failed to carry out the director’s command. But it can also be inferred that the directee did not intend to obey it and so did not fail. The same holds for the rest of the list of so-called “causes” of impaired attention. Just because a kid seems not to listen to a speaker can either be because he does listen but gives the impression of not doing so, or because he really doesn’t listen because he doesn’t care to, or yet because he has his mind on something else and is therefore oblivious to what the speaker says. Take the last item on the list, failure to “organize tasks.” Now, what if the seemingly inattentive kid has no interest in an assigned task, which, by the way, is usually the case? Why would he bother to “organize” it? As far as the kid is concerned let it lie unattended and get on to more interesting pursuits.
The Big Switch
Having only assumed that disruptive kids were also impaired in attention, that is, “can’t pay attention” to anything for long, the writers of DSM IV appended another assumption, that impaired attention may be independent of disruptiveness. Some kids, they claimed, could be deficient in attention without being disruptive. Since it was quite apparent that stimulant narcotics could decrease the amount of disruption, perhaps it could also increase the amount of attention. Voila! The market for stimulants suddenly expanded from a mere one case per school of five hundred to twenty five cases per school of five hundred, that is, a jump from .2% to 5% of the school population. By the 1990s over million kids were on stimulants (mostly Ritalin), while in the 1960s there were only thousands.
Megabucks had entered the scene for makers, dispensers, and prescribers of stimulants, with parental, educational, and governmental approval to boot!
Now, making zombies out of disruptive kids was already an evil practice. But to add several million victims just because they did sloppy school work was a great big switch. Alas! Just as money had fueled the expansion of illegal cocaine traffic, so too had it fueled the expansion of legal methylphenidate traffic. The irony of this enormous expansion is that both drugs are narcotics which are indistinguishable in their effects on the person who takes them. Addicts can’t tell the difference!
As a kind of poetic justice, many youths who in the 1990s were required to but didn’t want to take Ritalin, began selling the drugs prescribed to them to other youths who did want to take Ritalin. From being victims of pill pushers they themselves become pill pushers, at the same time saving themselves from the (concealed) consequences of long term use of Ritalin—1) brain atrophy, 2) loss of motor control, 3) stunted growth, and 4) low self-esteem.
Think of this problem as a matter of orders that are not obeyed. The teacher orders kids that don’t do their work, don’t stay put, or don’t keep quiet, to get to work, stay put, and keep quiet. The so-called “attention deficit” kid obeys the order to stay put and keep quiet, but disobeys the order to get to work. The so-called “hyperactive” kid disobeys all three orders, so he gets more attention from the teacher than all the other kids. The point is that both “inattentives” and “hyperactives” are disobedient, and that will not do. Disobedience in school must not be tolerated. Since punitive measures fail to increase obedience, and the medics claim they know what’s wrong, give them over to the medics. This is the “final solution.”
Who’s to Blame?
Some behavioral scientists—anthropologists, biologists, philologists, psychologists, sociologists—are inclined to blame the medics for this blatant drug abuse, even calling them “pill pushers.” But this is unfair, because medics are no more to blame than the educators and parents who bring their children to the medics for a quick fix. After all, medics, like educators and parents, are not even close to being corrective counselors, and, as laymen, are not students of behavior of any kind, and certainly not students of misbehavior. Nor are they students of the methods that have been developed to correct misbehavior since the 1950s. They don’t know that disobedience at school is easily corrected by corrective counselors who know what they’re doing.
Medics, of course, study anatomy, physiology, pharmacology, and surgery, which is to say, medical practice. And once in practice they are hard put to keep up with the steady advances in medical practice. They can hardly be expected to take the long hard journey to become corrective counselors after taking the long hard journey to become medical practicioners. For that matter, only some clinical psychologists and some marriage, family, and child counselors actually become proficient in the methods of corrective intervention, such as practiced by Dreikurs, Erickson, and Glasser. The other methods are largely useless in dealing with chronic disobedience.
Let’s face it, nobody’s to blame for the final solution. And the evil practice won’t end, not at least in the foreseeable future. One reason it won’t end soon is that drugging disobedient kids is but a small part of the practice of drugging anybody that is said to be “afflicted” with a “mental disorder”—all get drugged. Witness, for instance, the fantastic increase in the use of Prozac for the so-called “mental disorders.” The other reason is that all but the disobedient kids profit from the evil practice. The makers, dispensers, and prescribers get lots of money, while the parents and teachers get relieved of responsibility. Maybe by the middle of the 21st century the final solution will be recognized for what it is, a very evil practice, and so will end. In the meantime parents and educators are wise to steer clear of the medics, whose “cure is worse than the disease” even though the medics who engage in the evil practice have sworn to “do no harm.”
ABOUT THE AUTHOR
A clinical psychologist for nearly half a century, Dr. Keirsey began dealing with youthful mischief in 1950 as a counselor at a reform school for delinquent boys. He then worked as a corrective counselor in public schools for 18 years, during which time he collected a large repertoire of corrective counseling methods. He followed this practice with 11 years as a professor of the behavioral sciences (California State University Fullerton) training graduate students in the technology of corrective counseling at home and school. Since 1982 he has been writing books and articles on varieties of temperament, varieties of interpersonal disorders, and varieties of intelligent behavior. Over two million copies of his 1978 book Please Understand Me (rewritten in 1998) are in print.
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