ADD and the musical mind

March 5, 2007 at 03:11 AM · Is medication neccessary to bring people with this trait to a functioning state, or can individuals be allowed to remain as they are? What are the benefits of each option? I'm concerned that wrongful medication can stifle the creative process, which at times may be unconventional or unorthodox.

Replies (100)

March 5, 2007 at 03:30 AM · Hi Emily,

I have a sixteen year old student who has ADD. He does not use any medication (his mother's choice) but drinks coffee...the lesser evil... which seems to help him focus.


March 5, 2007 at 04:41 AM · Greetings,

>Is medication neccessary to bring people with this trait to a functioning state,

not remotely. Nutrition is primary in most cases. Sugar is the main culprit although the list of chemicals and their combinatiosn we now absorb in our food is so extensive and scary we should be shouting form the rooftops.

The condition and all its other variations does not even have a reliable test. Its usually some kind of questionaire administered by anyone that includes quesitons like `Is your child childish? (sic) Another typical `indicator` is something like `does not pay attention in class.` Aside from the obvious problem that a lot of taechers are completely boring ot young children , as is school environment, what is being increasingly taught to teachers is that the child -is paying attention- A great dela of attention. Its just simply to what the child is interested in and is often an indicator of more than a fair share of intelligence. Too often we judge children behaviour inrelation to ours instea dof asking where they are going or why.

thus the issues of ADD type conditions and their supposed medicinal treatemnt has become one of the most spurious self inflcited wounds humanity has inflicted on itself in the twentieth century. Probably a lot to do with the multi million dollar profits for the Ritalin manufacturers. A drug which aside from pacifying kids to a zombie state often has serious side effects and has shown no increase in academic performance from its victims.

The number of people who genuinly need some kind of medication for mental problems of any kind in order to lead a normal life is relatiovely small. It would be a crime to deny their existence or stigmatize them in any way. But the greater crime has been the profit led brainwashing of even the most intelligent people into the belive that a clearly specified condition exists (ADD etc) and the only way of looking at the problem is the degre e of intervention with drugs.



March 5, 2007 at 05:14 AM · On a semi-relevant note, if you have ADD look for signs of other things. Many people with Bipolar Disorder etc. are misdiagnosed with ADD because the symptoms are the same during the mania stage.

My wife had been diagnosed with ADD when she actually had cyclothemia, and the ADD medication actually just made her cyclothemia worse.

Always bothersome.

March 5, 2007 at 05:38 AM · Some consider Asperger's to be merely the stronger end of the ADD spectrum.

March 5, 2007 at 05:54 AM · From Stephen Brivati

"Nutrition is primary in most cases. Sugar is the main culprit although the list of chemicals and their combinatiosn we now absorb in our food is so extensive and scary we should be shouting form the rooftops.

The condition and all its other variations does not even have a reliable test. Its usually some kind of questionaire administered by anyone that includes quesitons like `Is your child childish?"

I have adult ADD, and methylphenidate (generic Ritalin) helps me a lot to focus and be more effective when I can't maintain my physical regimen. (The alternative medication is amphetamines.) What are the known side effects of methylphenidate?

I agree about ADD having become a catchall diagnosis when it comes to kids who actually just need more exercise and better supervision. There are definitive diagnostic tests and criteria for ADHD, but it's very often diagnosed by unqualified people.

Do you have any actual data about sugar and ADD, specifically sucrose? I ask, because the glycemic index of sucrose is much lower (around 55%)than bread, rice, potatoes, carrots, and honey. What is the mechanism by which sucrose contributes to ADD?

Also, can you give some examples where nutritional programs have been successfully used to control ADD? I'm interested, because I don't like taking drugs of any kind. If I can work out for a couple of hours a day, running and doing martial arts, my concentration and effectiveness is much better, but time is in short supply these days. I have to choose among developing a side business, studying, practicing, working out, and eating and sleeping.

March 5, 2007 at 06:45 AM · Greetings,

I`ll get back to you on the data stuff as I can-cmpletley snowed under at the moment. The most immediate suggestion I have is that if you haven`t already explored it, work on the diet factor yourself. There is a very good plan at

Not only doe sthis guy know his stuff food wise he is one of the world`s leading experts on the drug aspect and how to get off them (as far as is possible- as you know , some people just don`t have a choice).

The studies I am familiar with tend not to separate refined sugar from other additives. A lot of them can be found listed in `John Robbins` book `Reclaim Your Health.` There is also a book about Ritalin extant which explodes the myths that Ritalin is safe for children and the reasons why. I`ll tyr to get the name for you. As an adult you are much more able to handle the side effects. Kids is a whole diffenret ball game.

As far as sugar goes, I study nutrition and its effect on the body from a TMC, macrobiotic and Ayurvedic perspective in which sugar is way off the end of the scale and that is where it takes the balance of mind and body. Additives, drugs and the like belong in the same part of the spectrum.

I have no trouble controlling being pi polar through diet working with a nutritionist familiar with this area. I also know and frequently meet people constantly striving to adjust their mental state through slight variations in dosages of drugs. They are only only partialy successful and when I ask about diet they suggets that becuase they take the medication they can `lead a relatively normal life@ which means they drink (liquid sugar) consume ice cream and pizza like everyone else.

The hard reality is you can`t . The universe dealt you the cards your`re holding and you learn to control things relative to yourself. It is both tough and inspiring at the same time.



PS I know where uyou are coming from with the glycemic index but it can be a very misleading tool. Food combining tends to skew that around. (infact, even working on your food combining can be a major factor in controlling the iossue). It also misleads some people into rejecting certain kinds of food as `fattening` such a sbread and potatoes whereas the actual problem is in the refining and chemical additives. Whole grain bread is just a marvel!

March 5, 2007 at 01:23 PM · Sometimes there is a great deal of focus on a particular problem, and it suddenly becomes an epidemic.

A high energy level (i.e., hyperactivity, physically and mentally) is randomized in the population; some people have a lot of it, some just a little. But when it reaches a point of intensity and crosses a line and starts to interfere with learning and other important life activities, we start looking for reasons.

ADD and ADHD represent a biological imbalance in the system which upsets the physical and mental energy system. There's too much energy for the system to handle. It's like putting a jet engine in a Volkswagen. It affects everything from sleep to attention span.

Unfortunately, ADD (and ADHD) has become the diagnosis of choice (the "soup of the day") in today's world. The definition has been stretched to include almost any kind of overactivity (or even, paradoxically, underactivity). We read it into every kind of problem. As a result, people with other problems (or no problems other than an inherently high activity level) are often misdiagnosed as having ADD or ADHD. However, some people with genuine ADD and ADHD often get misdiagnosed as having something else, so it can work both ways.

Successful treatment (whether it is medication, nutrition, counseling, or changes in lifestyle) re-establishes the balance in the system. The idea is NOT to drug someone up, but to restore an energy balance so that the person can function with their full capabilities.

Hope that helps clarify it.

Cordially, Sandy

March 5, 2007 at 01:57 PM · i hold the view that if we clean up the diet (cut off all sodas, sugared or diet or whatever, deep fried junk food) and media exposure to the kid (TV and internet), and the obsessive parents stop consuming coffee and other stimulants like fish and start to take some responsibility like trying to learn to be a parent, 99% of the diagnoses will disappear. it is now a mix bag of disorders stemming from social, behavioral and physiological etiologies.

there is attention deficit because the disorder is that everyone is drugged.

March 5, 2007 at 01:43 PM · What I discovered for myself was that music gave me an orderly clothesline of events which I could use to model my other behavior and in fact, after I began to learn music at age 7 my ADD began to be more manageable--not much but any improvement is a help. I got through school without drugs because there was not a lot of pharmacological help in the 50's and 60's. Now of course, I have to cope with the depression that comes along foer the ride with ADD.

March 5, 2007 at 02:19 PM · My brother has ADD, and none of the medications help him (they do not help everyone). He is also quite careful with his diet, and that does not help him either. I know that there are coping strategies that a therapist can teach an ADD sufferer.

BTW, as far as I am aware, Aspergers is on the autism spectrum and not the ADD spectrum. It is a very different problem from ADD.

March 5, 2007 at 02:46 PM · that is precisely my point, that add or adhd or whatever is not just a dx of choice, but a dx of convenience and fashion. it is a way for the diagnosticians to say: i have no idea, but for labelling sake, let me just put something down.

it serves as a waste basket for conditions that are excluded from other conditions.

within the basket, because of the different etiologies, it is not surprising that one or two approaches will not work for everyone.

there is a dog trainer guy on tv with a show. he does not drug his out of coontrol clients into proper behavior. he tries to understand them. this guy will make a great president.

March 5, 2007 at 03:04 PM · al ku - you really ought to read some of the material on some of the websites about ADD and ADHD before stating that it is a dx of choice for people who do not fit into any other niche. It has some very clear symptoms; I know because my brother has them (very disorganized and distractable, unable to follow through on things he starts). While he has other issues, he clearly fits into the ADD category and recognizes it. I agree that it is is unprofessional for practitioners to categorize some as ADD or ADHD if they do not fit the bill, but for many the dx is certainly valid.

March 5, 2007 at 03:19 PM · tom, as i said to you via the email, currently it is a dx by symptoms/behavior, but not verifiable by scan or blood test. therefore, it opens the door wide for false positives and negatives. on a person to person basis, it is possible that 2 persons present with similar symptoms but from different causes end up with the same label and the same treatment. isn't that what we are seeing?

in addition, add/adhd is still very poorly understood simply because the brain is the last frontier and will remain to be last frontier. comparatively, the medical science barely knows anything about the brain as compared to other organ systems. just having the label of add/adhd really does not mean much because no one currently really truely understands what is going on in the brain on an individual to individual basis.

March 5, 2007 at 03:18 PM · I have an 8 year old daughter who about 2 years ago I thought she had ADD. She had attention problems and out of control behaviors. I took her to an allergy specialist because we had just found out that my husband was allergic to certain foods (wheat). When they did a spectrum of food allergy tests they came up with a whole list of foods that she is sensitive too.. Corn being one of them.. cornstarch, corn syrup.. which is in EVERYTHING.

When I pulled her off of everything she was allergic too... 4 days later I had my little girl back.. She can now stand a half hour violin lesson and is doing really well in school.

I am not saying that there aren't kids and adults out there with true ADHD... but it makes me think about the allergies and maybe there are a few kids with them. I know of a couple more kids with the corn allergy.

Let me tell you with the food allergy and having another daughter with diabetes (type 1) we are the healthiest eating family in the neighborhood : )

Take care


March 5, 2007 at 03:29 PM · i am afraid to imagine how many kids out there are put on the trendy meds simply because the adults around have not taken the time and thought to sort things out, as illustrated by jodi's experience. pretty scary. more scary if it is your own kid.

i know of many kids whose hydration comes solely from sugared soda. it will be a miracle if they do not jump up and down the sofa when you come home.

March 5, 2007 at 05:05 PM · Hi, all: As I said (above), unfortunately ADD (& ADHD) is often overdiagnosed (as is clinical depression). ADD certainly does exist. But as in everything else, the key is a careful and accurate diagnosis.


March 5, 2007 at 05:24 PM · 99% of all people have ADD. The other 1% are lying.

In the 60s it was frontal Lobotomy, in the 70s it was Valium and 'ludes, in the 80's it was ADD, in the 90s it was Depression and ADD and in the 2000s it is ADD/ADHA/ADDAHDA etc and Impotence. (Have you noticed that depresson is getting less press and less diagnosis among children, now that the popular drug is implicated in suicide?).

In the 22nd century we'll just end it all and make robots.

March 5, 2007 at 05:53 PM · Hi Emily,

I'm glad you brought this up, because I've been very curious about related issues since being diagnosed with ADD myself last year as an adult. I have tried two different medications; one (Strattera) doesn't work for me at all, another one (Focalin) does seem to help, but is not a cure-all on its own. And in my case, caffeine is worse than useless: it makes me anxious and irritable without helping me focus.

I think that from the point of view of this website, a lot of what's been discussed in this thread so far is a distraction: issues such as the general appropriateness of the diagnosis and the appropriateness of different kinds of therapy for different individuals are really best left to the clinicians, patients, and their parents.

The people who have said that it can be an unclear diagnosis, prone to both false positives and false negatives are correct, but I think what that means is that we're all waiting for more research for the picture to become clearer. Definitely, investigating things like diet, blood sugar, and food allergies, is a good idea and can help some people, but the results in any individual case aren't generalizable and the techniques probably aren't at a music teacher's disposal in any case.

All that being said, I think there are a few things that help people with my subtype, which is called "inattentive" (and presents quite differently from the stereotypical "hyperkinetic boy bouncing off the walls in a classroom setting" that characterized popular conceptions of ADHD in the 80's and 90's).

1. Written practice logs and lesson plans are essential. I just started keeping one as an adult (post-ADD diagnosis), and I could kick myself for not having done that when I was a student. The amount of time I wasted in inefficient practice because I just didn't remember from one day to the next what I was supposed to be doing is sobering.

2. Conscious effort has to and should be made at memorizing pieces.

3. Establishing habits is important. Take Laurie's 21 days to establish a habit seriously. The key here is to not have to think about trivial stuff like "where is my pencil" or "where is my practice log." It should always just be in the same place and used the same way.

One positive aspect of ADD is supposed to be heightened creativity, but too often that creativity is frittered away in time spent looking for that lost metronome, piece of music, or little scrap of paper where the time for the next lesson was written.

My bias is that ADDers don't have a lot of bandwidth and really can't try to pay attention to a million things at once without having a meltdown. If medication, diet changes, cognitive therapy, a written practice log (or any or all of the above) can free up their attention in order for it to be applied to the creative aspect of making music, then that's all to the good.

March 5, 2007 at 06:44 PM · karen, that is a sensible perspective. i wonder if you feel comfortable discussing in retrospect if your diagnosis was made later in life (recently) or you have developed an adult onset subtype?

i have noted previously that you have received education from some of the most competitive academic institutions of the world and if the add had any effect on you back then, since you mentioned the mix of creativity and disorganization.


March 5, 2007 at 07:35 PM · I have Attention Surplus Syndrome, meaning I pay too much attention. The first symptom was when I demanded a microscope as a kid.

March 5, 2007 at 07:28 PM · Al, I've discussed that with my doctors and it's a good question and hard to answer. I think to some extent I did well in school because school provided the external structure I needed. I started having more trouble in graduate school, and even more in the work world, when I needed to organize myself and no one was going to do it for me.

Looking back I think there were certain signs in school when I was an adolescent at least. One factor I think that played a role in my not being diagnosed until adulthood is that I was a quiet girl who didn't cause trouble. Back then the stereotypical ADDer was a hyperactive boy who couldn't sit still long enough at his desk to listen to the teacher. Boys were diagnosed at a rate more than twice that of girls. Nowadays the thinking is that the condition manifests itself differently in the majority of girls--in spaceyness, forgetfulness, absent-mindedness. That is, in lack of attention. Also, ADD is independent of IQ. I have a high IQ and I used that to compensate pretty well for a lot of years. But for most of us, the time comes sooner or later when talent alone is not enough. I think that time comes a lot sooner in music than it does in academic work.

Halowell and Ratey have written some good books that touch on ADD and creativity, one is called _Delivered from Distraction_. In that book, the authors interview some high-functioning ADD adults and try to get at how they succeed both because of and in spite of their different brain wiring (the CEO of Jet Blue is one of their interviewees).

Overall I think this "focus on the positive" approach is good. It's helpful for a person who has it to think of it as "different" brain wiring rather than as "bad" brain wiring. You feel better about yourself and it gives you hope. Halowell himself has ADD but doesn't take medication because, he says, it doesn't help him. And he's done a lot of good work.

But my own experience is that while focusing on the positive and creative is good, it isn't enough for me to actually get the job done. The treatment, including medication, helps too.

March 5, 2007 at 08:23 PM · thank you for the candor and insight, very refreshing and enlightening.

March 5, 2007 at 08:41 PM · Greetings,

Karen. thanks for your great writing. I think it is vital to focus on the psoitve that comes up in this issue in particular the creativity.

One area where I beg to differ is the suggetsion taht such things are best left to doctors or parents. My reasons for this are as follows.

1) Doctors have virtually no training in nutrition.I think Harvard has a mandatory one hour class. Yet the whole structure and fucntion of the body is governed from momernt to moment by what we put in it.

2) They are highly trained (or not) in thinking in terms of matchign a discrete chemical/drug to a syptom without assesisng the condition of or effetc on the whole body. Of not asking what is going on emotionally and so on.

Of course there are superb doctors who have recognized these issues but they are not the norm.

The public then follows the instituionalized belief that doctors automatically heal (there is research from situations in which odctors have been unavaliable for extneded periods and public helath has actually improved) and does not pay attention to what is going on in the world around us.

The majority of parents are not like yourself. They are unable to face the scary challenges of our degraded food and lifestyle which has , in the big picture, come to threaten the existence of the planet itself. The clearest example I can think of to support this assertion is the blind acceptance of several million parents (that figure must be correct becaus eof the number of kids involved) of putitng their kids on Ritalin base don the advice of doctors who often follow the primary research on the benifits of Ritalin for children which were actually falsified and the peprertrator served a prison sentence for that crime which went largely unreported...

Although it is fairly hard to isolate a single cause for thes ekidns of issiues it is not hard to be informed about the thousands of additives in our food or the massive dosages of sugar the westerm world absorbs on a dialy basis. Once one begins absorbing the data about consumption of poisons and stimulants the body is not designed to handle the correlations between that and the massive increase in 'unmaneagable" or "passive' children is all too clear. Just as an example, I have observed many thousands of elemenatry school children very closely over the last sizteen years. Those with learning dififuclties, violent behaviour, of ADD type symptoms have absolutely consistently had mouthfuls of metal to the point where little is left of their original teeth in many cases.

I do think one can make very powerful "generalizations' such as those presented in mmore holstic oriented medical traditions. Since they have proven to be highly reliable they are not, in my opinion classificable with the rather negative connatation og generlization.

I am not suggetsing it is true in your case, but I have often found that when people say they are follwoing a whole grain diet (for example) or cutitng out additives and it didn"t wrk , a closer examination reveals that they are still eating a great dela of the ubiquituous sugars and chemicals which are present in virtually everything we are sold outside the strictest helath food lables.Cheers,


March 6, 2007 at 03:52 AM · al ku, could you elaborate?

"...stop consuming coffee and other stimulants like fish..."

So it's the fish then, is it?

March 6, 2007 at 04:15 AM · Greetings,

yes. Especially dipped in coffee.

Haven`t you heard of Carpuchino?



March 6, 2007 at 04:37 AM · i meant to say, stop drinking the fish for the dioxins and mercury:)

March 6, 2007 at 05:52 AM · Greetings,

an interesting article



March 6, 2007 at 06:13 AM · How does treating hyperactive kids with stimulants work anyway? Do they become so hyper they can't move? Do they just stick where you put them vibrating so fast you can't see it?

March 6, 2007 at 06:49 AM · Al, no one should drink fish. This is an unacceptable way to serve any species, be it freshwater or saltwater.

March 6, 2007 at 06:46 AM · Greetings,

Jim, if you put two together in a room would the vibrations cancel each other out?



March 6, 2007 at 06:48 AM · Jim, I'm surprised you don't know more about this. People who are naturally wired as though they are on speed will have an opposite reaction when taking this type of stimulant. I don't understand why, but I know that if I took speed, I would probably sit still for a long time.

I don't understand why people would want to take speed. What's so big about picking the carpet for hours on end, or scribbling through entire pads of paper in one sitting? Although, I suppose it would be good for arrowhead hunting.

March 6, 2007 at 10:42 AM · Your problem isn't ADD. Your problem is you're delusional. Your delusion is that picking the carpet for hours on end, or scribbling through entire pads of paper in one sitting isn't normal. It's just that it's too taboo to discuss, or show on TV. Sander, am I right? Or do I have ADD too?

March 6, 2007 at 12:24 PM · OK, Jim, just take a deep breath and relax. For some strange reason, ritalin (and/or other stimulants when used properly) have a paradoxical effect on hyperactivity. It ain't my area of expertise, but my understanding is that it stimulates parts of the brain that control the overactivity, thereby creating the opposite of what you'd expect.

As far as violin playing or any intellectual activity, the real damage that ADD does is to wreck havoc with one's attention span by shortening it and making the person easily distractable. As a way of compensating, many hyperactive people learn to concentrate more intensely, so that this makes up for the brevity of their attention to any one thing. I think that those of you touched by this problem probably find yourselves doing that.

Anyway, it is indeed an area with lots of publicity, lots of different viewpoints (especially as to treatment), and indeed not yet enough definitive research.

Part of the problem with research in this type of problem is that the diagnosis is not always made specifically enough, so that clinical samples include people with some similar symptoms but who may not actually have ADD.

For example, in one of my areas of work over the last 30 years (motivated underachievement), the characteristics of some classic types of underachievers are similar to individuals with mild ADD. These individuals often end up getting treated with medication or nutrition (or whatever) - treatments that have absolutely no impact - when in fact the underachievement and distractability is due to personality factors that can be treated successfully with the appropriate counseling method.

If I may be self-serving for a moment, I've co-authored 2 books on the subject ("The Psychology of Underachievement," and "Could Do Better: Why Children Underachieve and What To Do About It" - both by Harvey Mandel and me, and both published by Wiley & Sons).

Pardon the commercial. And what does all this have to do with violin playing, anyway?

Cordially, Sandy

March 6, 2007 at 12:57 PM · During my stint as a school teacher I had one girl student with ADD. She was in grade 3.

She was given to screaming out F-ing Bitch! at the top of her lung capacity at the slightest imagined look from one of her peers. I started to wonder if she was the subject of some sort of secret conspiracy from the other students.

One day, this ADD student hit the absolute roof. She turned in the blink of an eye into a raging monster. A very strong one. I had to physically hold her down. She was going to kill someone (or try to).

She escaped from my grasp, grabbed the blackboard duster (in the schools in my area these are big, heavy things with the soft pad glued to a big slab of hardwood). I then saw the most amazing thing, quite unbelievable in one so young. She stepped back quickly, carefully raised the duster right back over her head, arched her back, took very very careful aim at one of the other student's heads, and catapulted it at her target with the most amazing concentration of physical force and mental will I have ever seen in a human being. She used every ounce of energy in her to launch that duster with lethal force!

It shot across the room like a ballistic missile but missed the target (a student's head) by inches. If it had hit, there would have been an emergency ambulance case for sure, if not worse.

That was it for that student. She was out of my class. I felt like I had failed, but I decided that I was not going to put the other students (and myself) to such risk.

That was a rough school. A lot of the kids were probably teasing her. The last time I saw her she looked happy enough, quietly playing by herself outside class, the class teacher trying to persuade her from the door to come back into class.

March 6, 2007 at 01:57 PM · children are not good listeners but great imitators. good chance her language came from home.

if things do not work out, there is always American Idol.

March 6, 2007 at 08:25 PM · Greeetings,

al, that"s interesting. My main focus of teaching is via storytelling. I have found children to be the rgeatest listeners in the world. Its adults who just pretend to lsiten a lot of the time,



March 6, 2007 at 09:03 PM · buri, you are a good storyteller and most are not:)

the underpriviledged kids around me learn more effectively via deed than word.

March 7, 2007 at 04:05 AM · I read back over many of the posts in this thread. Picking up on what Buri was talking about, I noticed that the particular school that I was talking about seemed to have a terrible tradition of the kids eating junk for their lunch. It really stood out in my mind.

In walking to the staffroom to partake of my own lunch, I would often be accosted by my students and their friends, wishing to regale me with various jokes and stories which I tried to patiently listen to before making excuses and continuing on my way (I needed a cup of tea!).

It used to distress me to see that their lunch that they were chewing on as they spoke to me was very often junk. Worse than junk! Things like a paper bag full of green and red sugary snakes. That was their lunch (do Americans have gum arabic-and-sugar snakes?). Actually, I remember noting that I had not seen a single healthy lunch being eaten all the many many days I worked there. I think the healthiest lunch I saw being nibbled at by a student was a big block of those dried egg noodles. Maybe I didn't look carefully enough, but I saw enough to feel sorrow for those kids. Every now and then I would attempt a bit of a brief lecture on good eating habits during class.

What made it worse was that I liked the lady who ran the tuckshop (the canteen). She was pretty much the most normal adult in the whole school. If I'd been a tough idealist, I should have had stern words with her. Wouldn't have worked, though. That school was in the absolute grip of the community/parents.

March 7, 2007 at 04:36 AM · It seems like gummy bears turn you into one kind of zombie, and granola turns you into a different kind of zombie.

March 7, 2007 at 04:39 AM · something to do with Pooh perhaps?

March 7, 2007 at 05:47 AM · Pooh pooh, pe doo (in a dotted rhythm).

March 7, 2007 at 06:26 AM · Greetings,

now that brings back memories. Pity the young who ended up with Britney...



March 7, 2007 at 12:17 PM · To get back to ADD and music students, one other comment I'd like to add, also based on personal experience, is that many ADDers tend to come across as thin-skinned and sensitive to criticism. This is certainly something they need to work on on their own, but I don't think the responsibility rests entirely with them.

The reason I say this is that in my experience ADDers tend to be criticized a lot, just in day-to-day life as they are trying to go about their business: for losing things, for forgetting things, for not paying attention, for getting off-topic and introducing perceived non-sequiturs into conversation. After a while, with ADD, you start to feel that the first thing anyone says to you is going to be something negative, something you have to watch, be careful of, or change about yourself.

In a violin lesson situation, of course, those kinds of topics (advice, corrections, etc.) are ostensibly part of the point of the experience, and actually helpful, but for a student used to a backdrop of regular, daily criticism and negativity from any and all comers, such finer distinctions may not stand out as anything special or useful.

So I think the ADD lesson needs to stay affirming and positive, and the criticism constructive and specific. I'm not saying that there's any place for empty praise, but it's also not helpful to be personally gruff and stingy with compliments. These people get very few of those in the rest of their lives either.

March 7, 2007 at 02:08 PM · Karen:

You're right about sensitivity to criticism in people with ADD. This is also true for numerous other kinds of problems (learning disabilities, various medical problems, etc.), especially if the problem has not been diagnosed and the person does not understand the specific nature of the problem and that it does not reflect on one's intelligence or general competence.

As far as the art of giving criticisms to people sensitive to receiving them, I have found that one effect way is to first praise them on some aspect of their performance. "I liked how you bowed this passage here..." (etc.) Then have them do it again, pointing out the good things about it so that they can recognize it and revel in it. Usually, they'll smile when they hear it.

Then say, "OK, let's see how we can make it better. May I make a suggestion?" And give a suggestion of what they should do differently, and not tell them what they did "wrong" or what you didn't like.

I'm sure that you and any other experienced teacher does something like that already with students sensitive to criticism. But, what the heck, I thought I'd throw in my two cents worth.

Cordially, Sandy

March 7, 2007 at 03:04 PM · In general, I try to find as many times to ask "do you know what you did right?" as "do you know what went wrong?" Surprisingly, ADD students tend to be very good - especially given the high level of intelligence in those I have in my studio - at picking up on their flaws and almost less certain of how they did this or that element well. Self perception, and SUSTAINED self perception (by which I mean sustained for literally anything over two or three seconds) is the tough part. But on the plus side, if I stumble across a practice method or an approach to a technical difficulty which can help someone with ADD, I know that trick is worth its weight in gold and will be applicable to the widest spectrum of students. Getting an ADD student in one year to go from stumbling through Bruch concerto's third movement to the point where he could play Paganini Perpetuum Mobile (for velocity and spiccato reliability), Bach G minor fugue (for polyphonic stability, for mastery of READING chords and associating what is read with which fingers go to which strings) and Prokofiev Concerto No. 2 (first + second movements for hand frame positions, for getting away from finger-by-finger searching around for notes)...well, that is an immense victory. And that victory's methodology will definitely be recycled.

But, to answer Emily's original question (and to the chagrin of the mother of the student in question, I'm afraid), I haven't seen medication have any consistent effect. Sometimes the student is hyper-focused and immediately absorbs all that's said and presented. Sometimes the same thing is said and tried ten times before it registers. And these instances do not correlate invariably - or even close thereto - with his use of his prescribed medication. It can be lack of sleep, as his hours are almost as mangled as mine, or the stresses of senior year, or ADD itself, or dietary factors that feed into that day being a golden day while this day is a miserable and soul-wrenching trudge. For what it's worth, I've tried asking him to note what he eats for breakfast on days when he's totally with it vs. days when he's zonked. And/or of noting the number of hours AND the specific times (6 hrs. of sleep from 11 to 5 am? from 3 am to 9 am?) he sleeps. And/or noting any other consistent elements that coincide with stretches of concentration vs. vacuousness.

Unfortunately, he forgot to do it. I didn't insist. After all, this was an attempt to use a disease that interferes with observation in observing itself. It was a hand drawing itself (thank you, Mr. Escher), and such things don't really work in real life. More's the pity.

March 7, 2007 at 08:03 PM · I had a student (viola, so that should explain a lot) who suffered from serious ADD/ADHD problems. He had a very difficult time focusing on his lesson material and frequently forgot music at his home. It was very frustrating. He was very talented. Apparently, he took medication, as his mother informed me at school he was very focused, but it would wear off by the time of his lesson.

I used to teach in the school system down here, and I'm not usually a proponent of medicating a child, but in this case I would catch myself thinking "Gee, I wish his lesson were in the morning"!! He is majoring in music now, but is having some problems with his current teacher (I ran into her at a gig).

I guess my point is that some children really need it, and a doctor is the best judge of that.

March 7, 2007 at 09:53 PM · In both the medical and the psychological arenas, one aspect of diagnosis and treatment in the real world has to take into account the unique features of the individual, their problem, and the context of treatment.

There is no such thing as a "standard person." Each of us is a combination of things that are predictable and categorizable, and also unique and individual.

Where medication might be the last thing you'd want to recommend in one instance, with another person having the same problem the best thing you could possibly recommend is medication.

For any approach to be effective (whether it's nutrition or medication or yoga or counseling) it has to take into consideration the standard recommended treatment as well as the unique features of the problem and the person and even their understanding of the problem.

Otherwise, it's like saying, "There's only one way to play Bach."


March 7, 2007 at 10:39 PM · Sandy, as a counselor, have you ever encounted people who gave you the impression of not wanting to improve, even though they are there and going through the motions? I think that's an interesting phenomenon. Maybe encountered more frequently than not even?

March 7, 2007 at 10:29 PM · >The condition and all its other variations does not even have a reliable test. Its usually some kind of questionaire administered by anyone that includes quesitons like `Is your child childish? (sic) Another typical `indicator` is something like `does not pay attention in class.` Aside from the obvious problem that a lot of taechers are completely boring ot young children , as is school environment, what is being increasingly taught to teachers is that the child -is paying attention- A great dela of attention. Its just simply to what the child is interested in and is often an indicator of more than a fair share of intelligence. Too often we judge children behaviour inrelation to ours instea dof asking where they are going or why.

Thanks for saying this, Buri. I appreciate it, as my husband and I are currently entangled with my son's teacher/school over his little boy boisterous behavior, which we are calling "being a 7 yr old boy" and which ppl around us would rather we called ADHD and brought out the drugs.

But this has nothing to do with the musical mind - he sings well, but doesn't play a musical instrument, so this doesn't answer the original post's question, does it?

Then again, a lot of these replies don't. But some of them are sure fun to read.

March 8, 2007 at 01:47 PM · Jim:

I encounter people all of the time who give the impression that they are motivated to succeed but who actually are not and who actually sabotage their own best efforts. I've co-authored two books on the subject and have done research, counseling, and training with this problem ("underachievement") for over 30 years. So the answer to your question is, "yes."

And as to the question of whether there really is such a thing as ADD, I think the answer is also, "yes." The problem (as has been so eloquently pointed out by Buri and others) is that two symptoms do not a diagnosis make. The problem of ADD really does exist, but there are many, many other kinds of problems and situations that have some similar characteristics as ADD. With all of the attention paid to it, my observation is that it is overdiagnosed in today's world.

ADD really does have physiological and historical characteristics, but it takes an expert on ADD (which I am not) to make the careful diagnosis in each individual case.

The key is what is called "differential diagnosis," or making the best educated guess (i.e., working hypothesis) of what the cause of the "overactivity" is. And the same "symptom" can have different causes and therefore different diagnoses and therefore different treatment approaches. That is the basis of the concept of differential diagnosis.

It is that working hypothesis (which is all a "diagnosis" actually is) that determines what to do about it. If the "treatment" doesn't work in any individual case, you have to re-think the diagnosis.


March 8, 2007 at 10:05 PM · I would like to add! a couple of observations to this discussion.I entertain myself in the mornings (whilst my violin students are all at school) by teaching general music in an elementary school.The school tends to have a higher intake of newly arrived immigrants as it is small wich gives it a more large family type atmosphere.Some of these children that arrive come from war torn countries and are disturbed.A good proportion of the class dont speak Italian very well (but neither do I so we get along just fine).Each class has at least two or three ADDS children.Along side this the local non ADDS local children all have incredibily short attention spans,don't listen carefully and have problems remembering from one week to the next what went on in the previous lesson.I've also noticed that they find it difficult to work in groups,organise methods of completing tasks,follow team rules and play together.They also have very little fantasy.Giving a title to a musical composition they have just done is beyond most of them.Television and computer has made play a solitary event where satisfaction is instant and short lived.To overcome these problems I work on three different themes each lesson for short periods of time.Every week I repeat a good part of what was done the previous week introducing only one new element at a time.I teach the kindergarten singing games to learn participation and co-operation and the older ones learn to play recorder in a group which is good for co-ordination.However its amazing how many chidren these days dont know their right from their left.I do however think that the benefits of learning music are many and are a great advantage to all chidren but are essential for those with asny kind of problem.

March 8, 2007 at 10:34 PM · that is great, whatever they have is almost not that important because the music is their therapy.

March 8, 2007 at 10:35 PM · Greetings,

interesting you mention TV. There is a greta dela of research curreently underway in Japan about the effetcs watching TV has on young children. Japanese TV for younger people is mostly animation and it is quite distinct form western style.It does not flow all the time but rather Frequently changes so that kids see one often violent image after another in rapid succession.There is , in my opinion, a very storng argument that this is preventing the young mind from sytematically building up organized models of the world though self initiated play and exploration.

Interestingly, there has bene a very significant increas ein the numbe rof hours childrne sit in form of the goggle bo even before the age of one. Youngparents apparently seize upon the idea that this is the way to help kids acquire English which remeains the bete noir of Japanese culture. I am assuming the programs in question are in english but I would not be surprised to find this minor point ignored. Better than leaivng them in a coin locker while playign pachinko I suppose...



March 8, 2007 at 11:25 PM · In kids programs, ratings (revenue) correlate with how much movement is on the screen, I have read.

March 8, 2007 at 11:58 PM · Greetings,

that`s interesting. I guess it explains why `The Paint Drying Show,` never mad e it into the top ten.



March 9, 2007 at 12:37 AM · It was good. I'm sorry they took it off.

March 9, 2007 at 07:04 AM · Unfortunatley Buri those Japanese cartoons are everywhere and it seems you can watch them non stop these days on satellite tv.

March 9, 2007 at 07:46 AM · The more I read about ADD, the more I’m confused about it. Can someone explain where the line can be drawn between ADDers and non-ADD absent-minded or disorganized individuals? In other words, if both type of people are basically leading a productive life (e.g. finishing demanding educational programs and keeping jobs that require paying attention to details), what would distinguish true ADDers from non-ADD absent-minded people? Or is it a matter of spectrum and no clear line can be drawn here? Or does my question make sense to anyone?

March 9, 2007 at 01:55 PM · yixi, here is a link,,,, although the source may be suspect, the content may be helpful. with medical science, as you can probably relate given your background in health care as you have shared, it is more often than not medical art instead, that is, a few diagnosticians are simply outstanding (may be the right mixture of talent, experience, etc). this is particularly true with psychiatry and those who know what to look for, it is so obvious, and vice versa.

however, to those who do not know what to look for but are in a position to look and help, help:)

March 9, 2007 at 01:47 PM · Dear Yixi:

Let me try to answer your question this way. Let's take a characteristic such as "distractability." The degree of distractability can be caused by a thousand things.

It is also randomly distributed in the population. In other words, some people have some of it, a few have only a little bit, and a few have lots of it. As you get to the extremes (none vs. 100%) there are less and less people.

Most people are in the middle. And for most, distractability is not a serious problem; most of us learn ways to cope with it in the real world.

However, if it reaches a point of intensity at which it starts to interfere with our functioning in areas that we consider important (school, violin lessons, driving, etc.), we begin looking for underlying reasons so that we can figure out what to do about it.

ADD is one such reason for distractability, but there are others (overactive thyroid, anxiety, excitement, diet, sleep patterns, love, hate, drugs, presidential elections, etc.).

Therefore, the "symptom" of distractability is not an automatic diagnosis of ADD. And that is why if there is any question about it, you can't just add up a laundry list of characteristics and decide that someone has ADD.

You need a careful, specific diagnosis by someone competent in the field. This would probably include a detailed medical and educational history, various kinds of tests, and a lengthy discussion.

Since there is not yet an identifiable germ, virus, or physiological cause, the diagnosis is made as a best educated guess, an hypothesis. And then there are various treatment options.

Hope that explains what is indeed a confusing area.


March 9, 2007 at 02:36 PM · well said, sandy.

let me ask you something if i may.

if we look (actually imagine, to some extent) the kids at year 2000 vs year 1900, anywhere in the developed cultures, it is probably true that the 2000 kids are receiving education earlier (with the exception of violin i guess, hahahah), in a more structured way, under more intense scrutiny and observation, and under the supervision of people with more standardized training. in your opinion, do you think the surge of add is more of a dx made since the dx is coined, that it is easier to elicit the symptoms inside the pressure cooker or, simply a disorder unqiue to the modern society where instead of laying on the haystack, feeling the gentle breeze carassing the senses, the little jack and jane are getting very serious very early, absorbing like a sponge anything and everything from an ever peculiar society, with our expectation that they are going places and if confronted with any deviation, we go,,,OMG...ADD!?


March 9, 2007 at 02:46 PM · Yes, I believe that ADD has always been around, but it was called different things (laziness, overactivity, oversexiness, whatever). When we recognize it, we begin to see signs of it everywhere, and it becomes overdiagnosed (sometimes to the point of being viewed as an epidemic).


March 9, 2007 at 03:10 PM · This is just anecdotal and I don't have time to look it up seriously, but I've read and heard that being outdoors and spending time in the natural world helps people with ADD. Some folks say that the ADD mind is good for hunting (and maybe gathering): that short bursts of attention and hyperfocus actually (somehow) help with tracking and following prey. I've also heard that the ADD mind can be a positive attribute for soldiers in the military in a similar way. I don't think these are anything more than hypotheses, not proven by scientific evidence, but intriguing nonetheless.

I sometimes wonder about the effects of modern electric light and modern adherence to clock time on the prevalence of ADD in our society. One semi-joke that Hallowell (an ADD clinician who has written a number of popular books--Yixi, I'd recommend reading his work for a readable introduction to the subject) likes to make about ADDers is that for them there are only two kinds of time: now, and not now. I laughed at that when I read it because it rang true to me. I have special trouble keeping track of time when my only cue is a clock, but I do better when I can see the sun or other natural cues. And it "feels" better too when I structure my life around natural cues rather than clock time: rather than get up at 6:30 a.m., eat lunch at 12 noon, practice at 10:30 p.m. every day etc. it's much better to get up when the sun comes up, practice my instrument when I'm energetic and focused, eat when I'm hungry.

Music "feels" like a natural cue to me in some similar ways. It's a way to make an emotionally satisfying transition from one hour to the next and one season to the next and give time a flavor. Probably because it is external and sensory and touches deep emotional chords. It's not all in the head the way clock and calendar time is, but also in the body.

How all this relates to the musical mind I don't really know, but I will speculate that music could help ADDers bring order and structure to their lives in a deep way, a way that attempts at adherence to schedules and calendars and clock time cannot.

March 9, 2007 at 03:55 PM · i probably need to get checked for add as suggested because as i was reading yet another fine write-up from karen on structure and nature, my mind keeps wondering off to that geico bushman commercial. i don't get it.

March 9, 2007 at 04:41 PM · Karen, I really appreciate your comments. I have been teaching a boy with ADD. He is very smart, but it has taken a lot of patience to teach him violin. He loves violin and music so much, it has been worth it for both of us (and his Mother, Bless Her Heart). He is one of my favorites.

March 9, 2007 at 08:52 PM · Greetings,

>only two kinds of time: now, and not now. I laughed at that when I read it because it rang true to me. I have special trouble keeping track of time when my only cue is a clock, but I do better when I can see the sun or other natural cues. And it "feels" better too when I structure my life around natural cues rather than clock time: rather than get up at 6:30 a.m., eat lunch at 12 noon, practice at 10:30 p.m. every day etc. it's much better to get up when the sun comes up, practice my instrument when I'm energetic and focused, eat when I'm hungry.

But that is how people -should- be.

You are just about perfect....


March 10, 2007 at 12:44 AM · Karen, thanks for your writing and the recommendation of Hallowell’s books. I read an interview article about him and he strikes me as being a very nice guy and has a lot of compassion and love for people. What intrigues me the most is what you mentioned in your earlier message that high-functioning ADD adults succeed in life “both because of and in spite of their different brain wiring.” Are there well established evidence indicates that ADDers have different brain wiring or is it somewhat a theoretical conjecture?

Sandy, thank you for detailed explanation and it is helpful. Ontological issue (whether there is such as thing as ADD) aside, what still puzzles me the most is a seemingly lack of criteria (theoretically) that will demarcate true and pseudo diagnosis of ADD. As you nicely explained, none of the ADD symptoms (such as distractability) is necessarily (let alone sufficiently) caused by ADD. One question pops up right away is: when other causes (anxiety, diet, love, etc) are present in an individual, how can we be justified to add ADD on top of other causes, especially there appears to be no tangible tests for ADD? When it comes to practice, of course we need someone competent in the field to appropriately APPLY the knowledge with skills and mature judgment. But at the theoretical level, I’m not sure the question what separates functional ADDers from functional non-ADDers has been clearly explained so far.

The puzzle comes from my initial impression of ADD as a disorder, which implies normal functions of life are adversely/seriously affected because of it. If this is still the case, then ‘functional ADDer’ becomes a funny concept – not a misnomer per se, but certainly makes one feel a bit slippery. Although it’s an entirely different issue as to why label someone ADD who leads a successful life in the first place, I find it interesting that ADD guru such as Hallowell makes ADD look very attractive in some ways and makes me to wonder if it’s wrong to even consider ADD a disorder as opposed to rather disirable personality traits :^)

al ku, thanks for the link – interesting.

March 10, 2007 at 02:05 AM · Yixi, very good, I think. I wonder if ADD would exist if there was nothing to treat it with. Where are those people in the past? I really think these kinds of things were viewed as personal challenges, personal or parenting. We have to define personal growth and choose what value to attach to it. Is it a needless struggle? I think there are very fundamental philosophical questions here.

March 10, 2007 at 02:22 AM · Wow, I'm really glad to see this discussion on here. This can be a very sensitive topic, so I'd like to say first Kudos to everyone for keeping this discussion relevant and informative!

I am ADHD, inattentive type, so I have experience in dealing with this disorder.

In my opinion diet and nutrition definately can have significant effects on the symptoms of ADHD, negative or positive, although I'm not sure I'd go as far to say diet and nutrition alone can cause ADHD. There is very strong evidence that ADHD is hereditary, although I do believe environment can play a role in the way ADHD is expressed in an individual.

In regard to the question of wether or not medication is necessary, this is like asking, will a certain set of strings make my violin sound bright or dark?

What we would we all say to this question? It depends on the violin of course, so the same answer applies here, it depends on the individual. The exact diagnoses, the severity of the symptoms, and wether or not that individual already has successful coping strategies in place are just a few of the factors involved.

It needs to be understood, however, that medication when used is only meant to be part of a comprehensive treatment plan, and, in fact there is evidence that medication is not completely effective without other therapies such as ADHD coaching, biofeedback, etc.

In response to how this relates to the musical mind and the violin, there is thought to be a link between ADHD and creativity. I think this might have something to do with the novelty involved with many creative pursuits.

In the ADHD brain the frontal lobes turn off instead of on when asked to sustain attention. However, if an activity is novel, or engaging enough, the ADHD brain can be "tricked" into sustaining attention, at least for some brief period of time.

As for teaching a student with ADHD, this can be very hard! One reason is that there are different types of ADHD & many different symptoms that can be expressed and might affect the way a student learns. The hardest ADHD type to teach, I think, is the Hyperactive type, for obvious reasons!

In general, though, with both ADHD and nonADHD students I try to tailor my teaching strategy to their specific personality and way of learning. The difference, I think, is that with ADHD kids you have to work harder, sometimes, to figure them out. You really can't be afraid to think outside the box with these kids. And, I think it's important to not be too rigid in your teaching style. One example I can think of is a student I have who does not respond at all to a lesson that is structured in any way, she gets bored immediately. It's not a matter of maturity so much as she's really gifted and she does not want to learn things the slow way! And, it took me a few weeks to really understand this about her, but as soon as I realized that she was acting out because she was mentally frustrated, I immediately changed my strategy with her, and the results have been kind of amazing.

Just some thoughts . . .

Oh, and, in response to the last post, ADHD Has existed long before it was recognized as a disorder and treatments were developed for it. I can imagine how hard it might be to conceive of this disorder if you personally have no experience with it, however, the fact remains ADHD is a documented biologic abnormality of the brain, or, neurobiologic disorder.

It is true that there are very positive traits and qualities atrributed to ADHD, but that does not negate the fact that ADHD can have very negative effects when undiagnosed and untreated. Because of the potential ADHD has to wreak hovoc in a person's life it's thought of as a disorder. I think it's important to note, though, that most of us ADHDers would not trade in our "disordered" brains for "normal" ones in a minute!

March 10, 2007 at 06:51 AM · You finish by calling it a disorder, followed up by saying you desire to have the disorder.

You can't say ADHD existed before it was recognized as a disorder. ADHD is the name of the recogition. You can say though that brains operate now as they did long ago. That brings us to square one again.

My question was when and why was it recognized as a disorder. If there are a group of people with a distinct set of unique physiological goings on in thier brains, when does that become a disorder and a drug? When they're close to discovering an anti-jaywalking drug, will the circuits active during jaywalking become a disorder? Obviously not everybody has them, because not everybody jaywalks. Is anything lost if we prevent jaywalking by treating the brain directly? Is anything really gained then? Was jaywalking even a problem? You seem to say you prefer jaywalking. Should we throw out the old solutions to jaywalkng? Did they have any value other than the mundane end; the end of jaywalking? Not to take a bad analogy too far. Is it an enlightenment drug or a enlightenment-inhibiting drug? I believe that's the real question of the original post, now that I think about it.

March 10, 2007 at 06:26 AM · Jim, hahaha, you know this is just semantics, but entertaining nonetheless!

Look, why don't you take a ride on the highway with me Unmedicated and then Medicated and you can be the judge of how enlightening or enlightenment inhibiting my medicine can be!

To seriously answer your question though, the point at which particular symptoms cause dangerous problems is when treatment needs to be sought to deal with them, in my opinion. Until I was diagnosed ADHD and began treatment I did not drive. Despite my reasonable amount of intelligience, for some reason I was not able to operate a motor vehicle as well as it seemed other people could, or at least not in a safe manner. Would you like to know my record for running out of gas in a one week period? The truth is ADHD might not be such a problem if the world we lived in were tailored to the ADHD mind, but of course it can't be.

March 10, 2007 at 07:06 AM · That's good. I like what you wrote. And of course if someone would otherwise belong in a padded room, it's a different matter entirely. I only ran out of gas once, but it was at a really inopportune time :) It's not just semantics though, as you know.

March 10, 2007 at 07:22 AM · Jim, yes I do! But, How did you Know that I Know that is what I'm wondering!

Allright, the labels we use Are important, but maybe what we're talking about is more a matter of perception anyway.

If I were in fact prone to random bouts of uncontrollable jaywalking I would surely want to take medicine to fix that. A non-random jaywalking person might not understand what it's like to have this "problem", but they would still understand it's a problem(to them) as they would definately not want me to randomly jaywalk in front of their car!

It was 3 times by the way, all in one week, but that was quite a few years ago! It was actually kind of cathartic, the last time, I cried so hard I started laughing!

March 10, 2007 at 09:13 AM · You would take medicine. Somebody else would join the Church of the 11th Commandment. I also know you didn't have much money for gas, and I think your gas gauge was broken too. Most people just take that in stride. Would you have run out of gas if the consequences were great enough? No. Would you have run out of gas at 2:00 am in the bad part of town? No. You had no good reason to not run out of gas, therefore you did. I agree - you really had no good reason not to. I don't see any problem. Now, crying so hard you start laughing, maybe that needs to be medicated. That's not a pretty picture.

March 10, 2007 at 09:02 AM · Jim, you are so funny, you crack me up!

Actually, this argument has been made to me before:

Would you have run out of gas the second time if the consequences were great enough?

And, there is a little validity to it, but not as much as you'd think. It has to do with novelty/excitement and the way it affects or stimulates the ADHD brain.

You are wrong about one thing though, I really did have good reasons not to run out of gas, one of which being the extreme embarrassment of having to call someone to bale me out for the 3rd time in one week. And, now that you mention it, I did always tend to run out of gas late at night, I'm not sure why!

The interesting thing is, I don't take medicine always, and I still haven't run out of gas in years. I would say it's due to coping strategies I've developed in the last few years. This is why I was saying medicine if used should be part of a comprehensive treatment plan.

What I really want to know is what is this Church of the 11th Commandment?! And, what Is the 11th commandment?!

March 10, 2007 at 10:45 AM · "And, there is a little validity to it,"

No, there's a lot of validity to it, as in it's 100% true.

I am beginning to recognize what you're describing, though. The answer is yes, they should be medicated, not for their benefit, but for the benefit of the rest of the world. I see now that what I said before about the role of character in addressing this assumed a whole lot. What you're describing is too much like the criminal mind for that really.

March 10, 2007 at 10:40 AM · Jim, no, I think you've misunderstood me somehow. Sorry, must be my fault, but I'm sure nobody I know would describe me as having a criminal mind, so you see there must be some kind of misunderstanding.

March 10, 2007 at 11:27 AM · I'm not accusing you of taking my wallet.

I'm saying it's similar to the criminal mind in that character is not part of the picture - for whatever reason. For example, you don't avoid running out of gas simply because that's the right thing to do or the best thing to do.

March 10, 2007 at 11:06 AM · Ah, yes, it was my mistake, I see now what you're saying! Well, that's totally true, it has nothing to do with character at all. Or, that is to say, character can not have a profound effect on the symptoms. The symptom's can't be simply willed away, although this is the number one myth about ADHD. Some people have this completely misinformed idea that the symptoms are due to some character flaw and that the label ADHD is simply an excuse for this character flaw.

Sorry for the mistake, lol, I think I skipped a few words when I read your last post, I do that sometimes! Well it is rather late . . . :)

March 10, 2007 at 12:16 PM · Well like I said, because of exactly that I'm stumped for a solution. There's nothing left except biological. So take all the medication all the time. Sounds like the best bet :)

March 10, 2007 at 12:36 PM · lol, well, now, I wouldn't go that far! Medicine is not always the answer, after all there was a study out, recently I think, that linked the use of methylphenidate with genetic mutations of chromosomes in children? So. . . .

Obviously it was a very small sample though, and since I live near Houston, I can tell you, it's Extremely Polluted down there!!! I think maybe the pollution could be causing the chromosomal changes!

March 10, 2007 at 12:48 PM · You want it both ways. You want it all! I can't blame you. Nurse, show this patient out of my office.

March 10, 2007 at 02:25 PM · This raises an interesting question about what repertoire the ADD violinist should have. Might I suggest the following:

- Medication for Thais

- Till Eulenspiegel's ADD pranks

- Introduction and Rondo Hypercapricioso

- On Wings of Ritalin

- The Five Seasons

- Ascending on a Lark

- The Half-Minute Waltz

- Queludium and Allegro

:) Sandy

March 10, 2007 at 12:30 PM · I think Jim is right, at least some ADHD symptoms were, and still are, viewed as personal or parenting challenges.

I think that may be too kind of a way to describe it, though, because in my experience ADHD symptoms are often viewed not just as "challenges" but as character defects to be dealt with using negative consequence mechanisms that are largely ineffective and have serious personal and human costs associated with them: You didn't practice your violin this week? Well, if you don't practice again next week, I'm going to embarrass you in front of your friends and family. And if you still don't practice, I'm going to terminate your lessons. That'll make you practice!

At the beginning of _Delivered from Distraction_, Hallowell poses a hypothetical: could a person with ADHD be "persuaded" to pay attention by a loaded gun pointed at his head? The answer was yes, for a limited time. But Hallowell claimed that at some point the ADHDer's mind would still wander, that after a while he would stop paying attention to whatever it was the shooter wanted. The shooter would still have to periodically remind the ADHDer that the gun was there in order for it to have the desired effect.

This extreme hypothetical may sound ridiculous to some people; it doesn't to me. I think the story goes to the question, though, that someone posed above: "if the consequences were severe enough, would you still have run out of gas?" I won't speak for Erin, because I think there's a lot of individual variation. But, if someone can forget, even temporarily, about the consequences of a loaded gun pointed to his head, he can forget about the consequences of running out of gas, or certainly of something as relatively benign as not practicing the violin. But does this make him a bad person? And maybe more to the point, what does it say about "character building" (or "challenge meeting") strategies for dealing with ADHDers that rely on negative consequences?

Some folks admire and maybe even try to live by the bromide "that which doesn't kill me makes me stronger." I guess that old saw would be technically true for everybody and for all relationships, except that that which does kill you . . . well, kills you. Kills musical talent, kills self-esteem, kills happiness, kills relationships.

I think that's why many ADHDers embrace the diagnosis. It gives them a way to leave that particularly futile worldview behind.

March 10, 2007 at 01:27 PM · Hahahaha, Sander, that's hilarious!

Yes, Karen, I totally agree, I would definately forget about the loaded gun! And, I personally know a lot of people who would think that's ridiculous, but it's true.

Very insightful post, especially in regard to the futile world view you mentioned.

I think many ADHDers experience some healing after being diagnosed simply because it causes a shift in the way they are allowed to perceive themselves and their problems. I think a lot of ADHDers internalize the pain associated with these problems before being diagnosed, and simply having a name for the problems can be, like I said, very healing.

March 10, 2007 at 02:21 PM · Erin: Thanks for the compliment. Couldn't resist.

But to be serious, children do not think in "categories" the way adults do. Children do not say to themselves, "I have a problem in this particular area, but in these other areas I'm good at it." No, they generalize. If they are no good in one little area, it means that they are no good - period. What children say is, "If I have this one little problem, it must mean that I must be stupid or totally defective and unworthy in some way."

Then they carry these attitudes into adulthood. This is what accounts for a lot of the self-esteem and confidence problems in adults with these problems, especially if the problem has not been diagnosed properly (or at all) and the person cannot put it in its proper context. ADD, after all, is NOT a problem of intelligence, talent, creativity, motivation, potential success, mental health, or overall worth as a human being.

Cordially, Sandy

March 10, 2007 at 02:11 PM · An interesting discussion. Just as I can't imagine what it is like to be a Maori warrier of the 16th C, I suspect those at one end of the distractibility scale can't imagine what the other end of the scale is like. The whole world probably looks different.

I notice the compensation failures more than the distractibility. Stress, illness, lack of sleep shifts me from being able to relatively easily redirect back to the task at hand, or to head off the glitches into a state where I will simply have no idea what I was just doing. None. One compensation I have is to carry a clue with me. A nut file will tell me I was working on something with a nut, after I put down the phone! But under high levels of stress and too much multitasking, I find those clues scattered randomly about, with no memory of having put them down. My inner experience can become analogous to driving down a highly rutted dirt road, intense chattering and blurring. Most disorienting.

On the other hand, I am sort of glad that I didn't get drugged as a kid. I moved so often nobody figured out a pattern and I ended up reasonably well compensated, extremely tough, and able to focus exceptionally well under the appropriate conditions.

An interesting thing I noticed early on was that under real stress I become very calm and extremely focused. The most striking example I can think of is my experience along the Gulf of Suez, Egypt, while the Isralis occupied the Sinai. I used to do fieldwork in the area. It was full of minefields, teenagers with automatic weapons, guards, unexploded thingies. I loved it. Some of our visitors would be hypernervous, scared, started by being held at gunpoint. But I found a great peace in that environment. Odd. Perhaps I normally have too much of the excitement/stress/fight-flight chemicals in my blood, and when the real need for those arises I'm all set and ready to go.

Watching my son get diagnosed was quite interesting. Lots of computer tests, interviews, interviews with teachers. Very thorough. Then very minimal intervention. Made a tremendous difference. Still a few effects, but the results in socialization, grades, ease of interaction in general, and his mental state are remarkable. All with extremely small drips of two mild drugs. He's still got a little of this and that, so we're working on diet. The goal is to get him off everything over the summer, see if he can meld in with his new set of skills. The reassuring thing with this doctor is the regular use of objective tests for distractibility. These show the rapid improvement and monitor the current state well. The initial improvement was excellent, and we've been gradually tweeking things in.

However. We're working with a recognized and very sharp specialist who does not hurry and is very thorough. I have seen others not as good in this trade. This nice fellow carefully screened out everything else before accepting that ADHD type things were going on. That's the way to do it. I've heard real horror stories from other parents!

Now is this a disease or not? I see that as pretty much semantics. So much depends on context. The things that trouble me in this world allow me to be a very good stalker and probably would allow me to work as a hunter quite effectively, with a high chance of survivability in tough circumstances. My attention instantly goes to the slightest rustle or distant snap of a twig. I see and recognize the barest flash of feathers and can spot fur through a complex network of branches. Works fine for 12,000 BC, but becomes overwhelming in NYC!!!

Interesting discussion.

March 10, 2007 at 02:47 PM · sandy, i hope you will find the time for a follow up book with the above title on the thread:)

the only qualm i have is that daunting The Five Seasons. i am looking for The Two Seasons -- The Cold And The Not Cold.

March 10, 2007 at 04:44 PM · Al, I forgot the "Russian" series:

- Rushin' Sailors Dance

- Rushin' Easter Overture

- And, of course, the everpopular "Pictures of an Exhibitionist."

- And what about, "The Mis-Handeled Sonatas."

:) Sandy

March 10, 2007 at 08:47 PM · Karen, the gun hypothetical I just can't believe. Why? Because you would be reading consequences daily in the newspaper. "So-and-so drove their car into four lanes of oncoming traffic yesterday for no apparent reason..." You don't see it. Maybe Hallowell takes the right idea too far.

That would be getting into the significance realm of psychosis. Even a psychotic can "straighen up" which is an interesting thing to behold. In my early 20s I had a friend who worked one day a week at a donut shop. I went to see her there and there was a guy sitting in the corner who was obviously psychotic. He was crying and talking to himself. She said he was there every week. I told him to shut the hell up :) It had a minimal effect besides getting his attention. The tension stayed high and I went behind the counter to get a donut or something. He saw that and took it to mean I had some authority there, like perhaps I owned the place and would call the police to get him. He immediately began acting normal. A week or two later I went back and he was there and he obviously remembered me; you could see him straighten up a little, and he stayed quiet.

There is or was a theory, Sandy will know about it, that at least some of the mental disorders aren't what they seem; that the real disorder actually is taking the decision to display symptoms; as opposed to the usual view that it's something there's no control over. The reason I told the guy to shut up was I knew about this from a psychiatry school friend. Before then I would have just assumed he had no control over what he was doing and left him alone. Interesting stuff.

March 10, 2007 at 11:20 PM · Jim, I understand why some of our discussion would be considered as just semantics or something worse. The time when someone has decided to opt out this world, all of a sudden, all the logic, commonsense and normative thinking (i.e, the "ought to" stuff) that stop apply to him. This is a very common philosophical path taken by people, now, in the past and in different parts of the world. Like you, I am troubled by this approach/attitude and find it problematic both in the thinking itself and the consequences it could bring to the individual himself and people around. Let’s just look at the logic of the thinking behind:

“I'm just so different that you simply can’t imagine what’s like to be an ADDer simply because you are not an ADDer.” Well, but you don’t know if I am not an ADDer, do you? If I am an ADDer, then I know what's like to be one but may still disagree with your interpretation about the problems entirely. If I’m not an ADDer, you don’t know what it is like to be a non-ADDer either because you can’t experience it. You see, this argument leads us no where in mutual undersatnding. Yet, we do understand each other despite the difference.

The assumptionthat ADDers are so unique that they are not easily adaptable to this world as the others could is also troublesome to me. How do we know what everyone else is going through in their life?

If we are looking for problems in our life, we will find them. Professionals and big money grabbers like this too:^) The more interesting thing for me is to look for happiness and ways to achieve it.

“We are hard wired and these problems can't be simply willed away.” This sort of thinking preempts the possibility of the power of one’s will. IMHO, a quick way to unhappyiness. It’s one thing not knowing the complexity of the notion of free will, but it’s another thing to deny the existance this most powerful creativeness we have. To accept we are so hardwired that not only we can’t control our action, but also we can not even foresee the immediate consequence of our action is quite extreme. It is a stragegy frequently used in courts as a defence, but it provides exculpation only but it never justifies our conduct. There are good reasons for this important distinction. For one thing, it is in a way giving up the notion of free agency and human action is viewed as a bunch of events that just happened to us. How deflated can one get? How uncreative? Is it true that we just can’t transcend the physical constrains nature imposes on us? Is it not premature to think this way, given that stuff like free will, consciousness, or intention are explored but not at all understood by modern science?

“The diagnosis explains the problems that I have.” We are story tellers and we always look for the best storys to tell about ourselves and about why we do or don’t do certain things. The diagnosis provides a good tool for this task – it describes the causal chain of events. But as I said before it such theory/diagnosis only provides exculpation while we as free or moral agents are also looking for justification – some thing that requires the support of reasons (rational justifications; normative thinking, creativity, socialization in this world, etc.), in order to live a happy life. Reasons as I described is outside the scope of descriptive science but without which we can’t be connected with this world thus we cannot be happy. While I understand the obvious therapeutic benefits of embarrassing a label that explains symptoms very well, I can’t resist to point out that the thinking is deeply flawed.

We won't be happy if we can't be a full moral agent, who looks for justification, not exculpation, for his own action.

March 10, 2007 at 11:43 PM · Allright, I will describe to you what it's like to have ADHD, or at least I'll try, and you can tell me if you can imagine this happening to you, because maybe I'm wrong, maybe you can imagine it.

You walk into a room full of people and an old friend walks up and says to you,

"Yixi! How are you?! I haven't seen you in forever! Hey you know who I saw last Week, it was . mumblemumblemumble . . .(the person is still talking your mind is just not paying attention because someone just passed by wearing a really bright shirt, or something equally as random!)

So, you immediately realize the person has stopped talking and is waiting for an answer, so you fake it and pretend you know who they were talking about, or you can just smile and nod, which is probably my favorite strategy!

Now, Imagine that happens at least 50 times a day to you while talking to people, this is not counting all the other times your brain randomly switches focus,

Imagine trying to take notes in a class when this type of thing happens every few minutes! Imagine trying to have any real conversation with anyone. Imagine taking a violin lesson with that happening, or trying to play in a rehearsal. . . .

The point is, it's not controllable by will power. If anything ADHDers have more willpower than most people because we have to work extra hard sometimes to accomplish what others would consider to be the simplest things, i.e. holding a conversation or cooking a meal or reading a page of a book or Every other activity in life that takes more than a minute of sustained focus.

Not to say nonADHDers don't ever space out, but do they space out consistently, several times every day, regardless of other factors, over years of time since they were small children?


March 11, 2007 at 12:07 AM · "We won't be happy if we can't be a full moral agent, who looks for justification, not exculpation, for his own action."

By the way, I'd just like you to know, I am one of the happiest people I know. I really, really am! I'm not like crazy happy all the time, I'm just very content with my life, and I love being me, what can I say?!

Life is good!

So, by your definition then ADHD is in fact the cause of my ADHD symptoms?

March 11, 2007 at 12:35 AM · Erin,

No one is denying that people can have health problems that are so serious that it must be controlled by medication.

No one is saying symptoms can simply be willed out.

No one is saying that you shouldn’t keep taking whatever is helping you to have a normal life.

My discussion was on something quite different:

a)it does not take an ADDer to understand the problem. I understand you, and you believe this too, otherwise we won’t have this conversation.

b)it’s deeply problematic to think that we are hardwired.

c)Being ADDers are part of us, in this world, being loved, understood, cared for by this world.

d)ADDers are and should be moral agents just like the rest of us, and are responsible for understanding, foreseeing and finding ways of avoiding harmful consequences of one’s action. Your taking the medicine is one example of this responsible deed. Good for you!

March 11, 2007 at 12:39 AM · Erin I like a lot what Yixi said about opting out. You are able make sure you're dressed before you go out in the morning. What would happen if you sat down every evening for a couple hours to read a book? Really I think B.F. Skinner said almost all we need to know, 50 years ago. Maybe the problem is what we consider a reward and choose to persue?

March 11, 2007 at 12:39 AM · Allright, I understand now Yixi what you are saying, and I agree,

Jim, I can get myself dressed in the morning, but it has been known to take me hours!

And, I couldn't agree more about B.F.Skinner, behavior modification therapy has been a huge part of my personal treatment for ADHD, and I think the medicine would not be nearly as effective without it.

Oh, and, actually, I mentioned trouble reading simply because almost all ADHDers suffer from this symptom. But, for some strange reason I don't, go figure! I actually hyperfocus when reading so that I very often read books in one sitting (I'm not exaggerating!)

But, I don't indulge myself often in books, just magazines, because, who has time to give a whole day to reading? I'd much rather be practicing!

March 11, 2007 at 05:24 AM · Yixi, that was a very interesting post you wrote, and I did completely misintrepret it, which, is actually kind of ironic and funny considering what you said!

I'm so used to people (ADHDers and nonADHDers) approaching this topic with a closeminded viewpoint that, you'll have to forgive me, but I'm not used to actual real discourse on the subject!

I should clarify something for you though. I do not think that my problems that are related to ADHD are that unique at all. The way I see it, ADHD has the potential to have both positive and negative effects in my life, and as long as I stay informed about the mechanisms involved I essentially believe I have the ability to minimize the negative effects and to enhance the positive effects.

So, I am aware that I can control my ADHD, but only in a roundabout way, through the way I structure my life.

I do think the symptoms are essentially hardwired though, there's no doubt about that, it's brain chemistry. I can't control the symptoms, but I can choose to structure my life in a way that diminishes the possible negative effects of the symptoms.

And! I guess it could be argued that that means I Can control the symptoms, even if only by proxy. So, now we're back to the question of the role of semantics!

March 11, 2007 at 12:15 PM · Jim, I think the reason people don't drive into 4 lanes of oncoming traffic is that, well, they see the oncoming traffic. Not because they refer to some mental construct about the negative consequences of hypothetically driving into oncoming traffic.

I was reading another thread on, where I think Buri quoted Johnson as saying that nothing focuses the mind like the prospect of being hung. I hate to disagree with Johnson, but I don't think that's broadly true. There are a wide variety of mental responses to stress, only one of which is calmness and focus. And in my experience that's relatively rare. At least as often, people freak out, they panic, they can't sleep and become basket cases, they engage in all kinds of really unhelpful behaviors. Time magazine had an interesting article after 9/11 about how to increase your chances of survival after a catastrophe. If I recall correctly, their point was that only around 10% of people would really keep their heads in a crisis like 9/11. But the percentage of people who do the right thing in a crisis can be increased with practice, so they recommended that businesses, schools, homes, cities, all have plans for crises and practice them. If there had been a coherent plan for getting out of the towers, more people would have survived. Not that anyone actually does this (who's practiced a response to a flu pandemic? Anyone?)--our society still seems to prefer to rely on pious moralizing before and after the fact, despite its demonstrated ineffectiveness.

Yixi, I think we mostly agree except for the idea that having some things hard-wired is so problematic. I think the idea that nothing is hard-wired is equally problematic. It seems to me that it all gets back to the serenity prayer: needing acceptance to live with what can't be changed, courage to change what you can, and wisdom to know the difference. Learning more about ADHD helps us all better understand the difference.

March 13, 2007 at 08:20 PM · As a violinist with ADHD, I have actually found that my ADHD goes away whenever I start practicing or playing (unless I'm in the pit of a musical, where the lights are distracting). I think it has something to do with my appreciation for music, because my ADHD is very obnoxious in almost all other settings. I think if I like what I am playing, my ADHD does not fire off so much, but when I do etudes...its absolutely impossible.

March 14, 2007 at 03:25 AM · I kept meaning to jump into this discusison, but I never got around to it. Thanks for the input, everyone!

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