Why Ask Why?

Chapter 42 of the book Self-Help Stuff That Works

by Adam Khan

A QUESTION THAT NATURALLY comes to mind when something goes wrong is "Why?" But it's a question fraught with danger. Research has repeatedly shown that the human brain is designed to answer a question with whatever knowledge it has (no matter how little) and come up with a plausible answer (however wrong). Self-blame or victimhood is a frequent side effect.

For example, you can ask why you're overweight and, without any problem at all, your mind will come up with answers. But all it can give you are theories. What's the "real" answer? Is it because you weren't loved as a child? Is it a genetic weakness in your family? Is it an evolutionary holdover precaution against famine? Is your mouth simply bored?

The problem with a why question is that you get too many answers you can do nothing about. You can't change your childhood or a genetic weakness.

There is only one good thing about asking why: It can be entertaining. It's intriguing. It's like a mystery and mysteries capture our attention like nothing else. But if what you want is to handle the situation well or solve the problem and get on with the business of living, ask how not why. It's more efficient.

Since your mind will try to answer any question you put to it, the kind of question you ask makes a big difference. So ask what you really want to know: "How could I get slimmer?" Or "How can I avoid this problem in the future?" Or "How can I solve this problem now?" Or "How can I make things a little better?" Let your mind go wild on one of those questions. The answers will be more productive.

With how, you go straight for a useful answer. You avoid getting sidetracked into what can become an endless search for "understanding." With how your answers lead to actions. And it is actions that solve problems and produce real change.

Instead of asking why you have a problem, ask how you can get what you want.

A simple change in perspective can make you feel better and can also make you more effective at dealing with the situation. Here's one way to change your perspective.
Adventure

What if maximizing your full potential was bad for you?
Be All You Can Be

 


This is a simple technique for reducing a little of the stress you feel day to day. Its biggest advantage is you can use it while you work.
Rx to Relax

Why are some people interested in life and others bored?
Find out here.
Interest is Life

Self-esteem should be intimately tied to integrity.
If it isn't, the self-esteem is a farce.
How to Like Yourself More

Why do people in general (and you in particular) not feel happier than our grandparents felt when they had far fewer possessions and conveniences than we now have?
We've Been Duped

next: Science of Happiness

APA Reference
Staff, H. (2008, October 12). Why Ask Why?, HealthyPlace. Retrieved on 2024, December 23 from https://www.healthyplace.com/self-help/self-help-stuff-that-works/why-ask-why

Last Updated: March 31, 2016

What Was Abraham Lincoln's Religion?

ABRAHAM LINCOLN DIDN'T talk much about religion, even with his best friends, and he didn't belong to any church. But he once confided to a friend that his religious code was the same as an old man he knew in Indiana, who said, "When I do good, I feel good, and when I do bad, I feel bad, and that's my religion."

Do you lack self-esteem? You can feel better about yourself, and it's easier than you probably think. But there's a little-known fact you need to be aware of:
Your Inner Guide to Self-Esteem

Do you have parents or well-meaning friends that try to persuade you to do one thing or another for a career, but your heart tells you your path lies in another direction?
Sometimes You Shouldn't Listen

Does it feel that you have had a bad upbringing? Does this seem like a barrier to the fulfillment of your dreams, your career, your mission or calling? Do you think your circumstances hold you back? Read this:
A Slave to His Destiny

Here's a conversational chapter on optimism from a future book:
Conversation on Optimism

If worry is a problem for you, or even if you would like to simply worry less even though you don't worry that much, you might like to read this:
The Ocelot Blues

 

 


next: Why Failing to Lose Weight Is a Good Thing

APA Reference
Staff, H. (2008, October 12). What Was Abraham Lincoln's Religion?, HealthyPlace. Retrieved on 2024, December 23 from https://www.healthyplace.com/self-help/self-help-stuff-that-works/what-was-abraham-lincolns-religion

Last Updated: March 31, 2016

Constitutional Right

Chapter 41 of the book Self-Help Stuff That Works

by Adam Khan:

ABOVE ALL," wrote the Danish philosopher Søren Kierkegaard, "do not lose your desire to walk. Every day I walk myself into a state of well-being and walk away from every illness. I have walked myself into my best thoughts...."

Friedrich Nietzsche, the German philosopher, went so far as to say "All truly great thoughts are conceived while walking."

A walk taken regularly for the sake of one's well-being is called a constitutional. Kierkegaard and Nietzsche were in good company. Gandhi, Darwin, Emerson, and many creative (and long-lived) people throughout history took constitutionals often. You can too. Here's how to have a good one:

  1. Walk at a pace that's easy and pleasant. Don't make your constitutionals do double duty as an exercise program. A constitutional is closer to meditation, but it's not a "discipline." It's more like a vacation, and that's exactly the attitude to have.
  2. Bring a little pocket-sized notebook and a pen, but don't try to get ideas. Of course, you'll sometimes think of things you want to remember. Taking notes is a way to free your mind - once your idea is down on paper, you're free to forget about it for the moment.
  3. Walk for longer than fifteen minutes. A half hour to an hour is good. You need to do it long enough to let your mind relax. This is a temporary vacation from our compulsion to do, and it needs to be long enough to have an effect.

ON A WALK, you get a fresh perspective; you can find solutions to problems; you look at things more clearly. You become calmer, saner and healthier. It's easier to think because, 1) you have the time to think, 2) there's nothing else you need to attend to, and 3) your brain is getting more oxygen.

This way of taking a walk is aptly named: It's good for your constitution - your overall well-being, body and mind. You have a right to some quiet time to yourself, so exercise your right. A haven of peace and sanity awaits you...only a few steps away.


 


Clear your head and relax by going for a long walk.

A simple change in perspective can make you feel better and can also make you more effective at dealing with the situation. Here's one way to change your perspective.
Adventure

What if maximizing your full potential was bad for you?
Be All You Can Be

This is a simple technique for reducing a little of the stress you feel day to day. Its biggest advantage is you can use it while you work.
Rx to Relax

Why are some people interested in life and others bored?
Find out here.
Interest is Life

Self-esteem should be intimately tied to integrity.
If it isn't, the self-esteem is a farce.
How to Like Yourself More

Why do people in general (and you in particular) not feel happier than our grandparents felt when they had far fewer possessions and conveniences than we now have?
We've Been Duped

next: Why Ask Why?

APA Reference
Staff, H. (2008, October 11). Constitutional Right, HealthyPlace. Retrieved on 2024, December 23 from https://www.healthyplace.com/self-help/self-help-stuff-that-works/constitutional-right

Last Updated: March 31, 2016

About Tammie Bryam Fowles

Dr. Tammie Fowles

Tammie Byram Fowles, PhD, LISW-CP

Tammie Fowles is a psychotherapist, author, consultant, and trainer currently residing in Columbia, South Carolina where she has a private practice. She has a Masters Degree in Social Work and a Ph.D. in Counseling Psychology. She is the author of "BirthQuake: The Journey to Wholeness," and "Finding the Forest: Working with Trauma Survivors."

Tammie provides psychotherapy, wellness counseling, and workshops to both individuals and groups, and continuing education seminars and retreats to social workers and other mental health professionals. She has appeared on both national radio and public television. You can reach her 803-873-1495 or at tammie@sageplace.com

During her two decades as a therapist, she has come to view therapy as a powerful process of self-discovery and healing where numerous lessons can be learned, strengths developed, and deepest truths honored. Having witnessed again and again the innate pull toward change and growth that exists within each of us, she views herself as an optimist who honors her clients' stories, offers deep respect and genuine caring in a pleasant, safe and nurturing environment that promotes creativity, resilience, self expression, and personal growth.

Dr. Fowles' approach is strength-based and she works collaboratively with clients, synthesizing various treatment techniques in order to best meet each person's unique and specific goals and needs. She is committed to meeting her clients warmly where they are and offering active, empathic, and pragmatic support and guidance.


 


next: SagePlace Vision...

APA Reference
Staff, H. (2008, October 11). About Tammie Bryam Fowles, HealthyPlace. Retrieved on 2024, December 23 from https://www.healthyplace.com/alternative-mental-health/sageplace/about-tammie-bryam-fowles

Last Updated: November 22, 2016

How to Earn More Money

Chapter 62 of Adam Khan's book Self-Help Stuff That Works

WHETHER YOU OWN YOUR OWN company or work for someone else, you can earn more than you now earn. The first question to ask yourself is "Am I providing a product or service that is both wanted and needed?"When the answer is yes, you can earn more money by increasing either the quality or the quantity of your service.

The hardest part of increasing your service is thinking up ways to do it. Sure, if you work faster and put in more hours, you will increase your service. And if you take more care and pay more attention to your work, you will certainly increase the quality. Those are obvious. But there will come a time when these things cannot be increased any more: There are only twenty-four hours in a day, there are physical limits to how fast you can move, and you can give no more attention to your work once you are giving it all your attention.

But it is possible to think of other ways to increase your service. It will only take some thinking. Sit down ten different times in the next month and each time think up three different ways you could increase your service. Allow your imagination to go wild. At the end of the month, pick the best one and do it.

Another thing you can do to increase your earnings is to read books and listen to tapes related to your line of work, your health, or your ability to deal with people. Learn more about these three topics and it will help you earn more.

The first subject to study is the specific area or industry you work in. Every field has a history. How did it start? Who were the principle originators? And that's just the beginning. The libraries and bookstores are full of books and tapes and videotapes on every conceivable subject. Study not only background, but also information that will make you better at your job. Take night classes. Listen to tapes in your car. Educate yourself. As you learn, you become more of an expert. Generally speaking, the more of an expert you are in your field, the more useful you are. And the more useful you are, the more money you can make.

Learning ways to increase your level of health will help you in two ways: First, your level of energy is closely tied to your level of health, and you can do more work with a high energy level. Second, when you have better health, you tend to have better relationships with people. Have you ever noticed how difficult it is to be nice to people when you feel like hell? Our health affects our moods, and our moods affect our relationships with others. And people who get along well with others, according to the research, make more money than those who don't. Their relationships are better with their bosses and with their assistants. They get more cooperation and consideration. In the long run, this adds up to more money.


 


Which brings us to the third area to study: people. As far as I can tell, there is no final attainment in this area. I've been actively improving my ability to deal with people for about twenty-two years now (and I was pretty good when I started), and I'm nowhere near as good as I could be. In other words, I can profitably continue to improve my ability to deal with people for the rest of my life, and I'll bet the same is true for you.

Learn about your line of work, read up on how to maintain good health, and constantly practice the fine art of dealing with people. These are lifetime studies. And do the hard work of thinking up ways to increase the quantity and quality of the service you provide. Do these things and you will earn more money.

Increase your service, and continue to learn about your work, good health, and people.

Here's something to learn about dealing with people. Would you like more self-confidence? It's important. Find out how to increase yours:
Self-Confidence

If you want to earn more money while at the same time not increasing your stress, or if you want even less stress than you have now, read this:
Stress Control

next: The Trouble With Troublemakers

APA Reference
Staff, H. (2008, October 11). How to Earn More Money, HealthyPlace. Retrieved on 2024, December 23 from https://www.healthyplace.com/self-help/self-help-stuff-that-works/how-to-earn-more-money

Last Updated: March 31, 2016

Work is Good Therapy

Chapter 82 of the book Self-Help Stuff That Works

by Adam Khan

THERAPY CAN BE EXPENSIVE. Work is cheap - they even pay you for it! When your work is challenging enough to fully compel your attention, but not so challenging it outstrips your ability, you enter The Enjoyment Zone, where your attention is focussed on what you're doing, where you're experiencing the pleasure of being engrossed and engaged in what you're doing, where the petty worries and frustrations that normally plague your mind have no foothold. And whether or not you work in The Enjoyment Zone is up to you, not the job. You can make your job into an enjoyable pursuit. If you want to read more about that, read Mihaly Csikszentmihalyi's excellent book, Flow: The Psychology of Optimal Experience.

When you can work in that enjoyable state of concentration, you're giving yourself an excellent form of therapy. Work can be therapeutic! It can heal and restore your mind. It can rid you of depression, negative moods, and feelings of helplessness. And it can give you confidence and self-esteem.

One of the things that contributes to negative, unpleasant emotions is rumination: dwelling on thoughts you can do nothing about, running negative and self- defeating thoughts through your head over and over, convincing yourself ever more thoroughly of the validity of your misery. Once these kinds of thoughts get going, they're hard to stop. You feel bad, you think about your situation in a negative way because you feel bad, and then the negative way you're thinking just makes you feel worse. The thoughts aren't doing you any good. The best thing you can do is stop thinking about it, but you can't seem to do that. You're like a train on a track, and there's nowhere to go but down.

Engaging work takes your mind off that track. Like distracting a crying baby with a rattle, your mind gets sent in a new direction.

And while you're working, you're causing an effect. Even moving your fingers on a keyboard causes an effect. Helplessness is a core symptom of depression, contributing to it and often causing it. Productive work proves you are not helpless, so simply doing your work can lessen or even eliminate a bout of depression.

 


Also, when you work in The Enjoyment Zone, your skills improve. One inevitable consequence of challenging work is an increase in competence and expertise. This gives you confidence and self-esteem - not based merely on the encouraging words of a therapist, but based on real evidence.

Work cannot accomplish everything therapy can, but it can do a great deal of therapeutic good - far more good than leisure (most leisure produces nothing: it doesn't increase skills, competence or self-esteem, and it doesn't engage your mind enough to stop ruminations). Work has, however, been an effective therapy for generations of people. And it can work as well for you.

Get to work - keep it challenging, but not stressful.

Have you been discouraged from pursuing your goal by a parent, a teacher, a well-meaning expert? Check this out:
Sometimes You Shouldn't Listen

Are you pursuing a purpose and sometimes get discouraged when you hit a setback or when it seems difficult? Here is a way to get back your spirit:
Optimism

Dale Carnegie, who wrote the famous book How to Win Friends and Influence People, left a chapter out of his book. Find out what he meant to say but didn't about people you cannot win over:
The Bad Apples

An extremely important thing to keep in mind is that judging people will harm you. Learn here how to prevent yourself from making this all-too-human mistake:
Here Comes the Judge

The art of controlling the meanings you're making is an important skill to master. It will literally determine the quality of your life. Read more about it in:
Master the Art of Making Meaning

Here's a profound and life-changing way to gain the respect and the trust of others:
As Good As Gold

What if you already knew you ought to change and in what way? And what if that insight has made no difference so far? Here's how to make your insights make a difference:
From Hope to Change

next: Work Principles

APA Reference
Staff, H. (2008, October 11). Work is Good Therapy, HealthyPlace. Retrieved on 2024, December 23 from https://www.healthyplace.com/self-help/self-help-stuff-that-works/work-is-good-therapy

Last Updated: March 31, 2016

Why Pessimism Shuts Down Our Immune System

PESSIMISM PRODUCES DEPRESSION. And when a person is depressed, certain brain hormones become depleted, creating a chain of biochemical events that end up slowing down the activity of the immune system. For example, two key players in our immune systems are T cells and NK cells.

T CELLS recognize invaders (like viruses) and make more copies of themselves to kill off the invaders. Pessimists' T cells don't multiply as quickly as optimists', allowing invaders to get the upper hand.

NK CELLS circulate in the blood and kill whatever they come across that they identify as foreign (like cancer cells). Pessimists' NK cells can identify foreign entities, but they don't destroy them as well as the optimists' NK cells.

Learn more about how to reduce your pessimism

Here's a conversational chapter on optimism from a future book:
Conversation on Optimism

If worry is a problem for you, or even if you would like to simply worry less even though you don't worry that much, you might like to read this:
The Ocelot Blues

Learn how to prevent yourself from falling into the common traps we are all prone to because of the structure of the human brain:
Thoughtical Illusions

 


next: Earth

APA Reference
Staff, H. (2008, October 11). Why Pessimism Shuts Down Our Immune System, HealthyPlace. Retrieved on 2024, December 23 from https://www.healthyplace.com/self-help/self-help-stuff-that-works/why-pessimism-shuts-down-our-immune-system

Last Updated: March 31, 2016

What is a Wookah?

(Celebrating a Child with "Voice")

M., when you were two and a half, we bought two identical goldfish which we placed in a small plastic fishbowl that sat in the middle of the kitchen table. One fish you named Mommy and the other, Daddy. Of course, as soon as they began to swim around, it was impossible to know which was which. One day (a few months later) we came home from the grocery store only to find one fish floating belly up at the top of the tank.

"Soooo...," I said, dipping my hand into the tank to scoop up the dead fish, "Who's left?"

"Mommy," you said with certainty.

"What?" I said. I looked at the fish again to see if it had any any identifying marks. "How do you know it's not Daddy?"

"I know," you said. "It's Mommy."

It was around this time that I first noticed you were a Wookah. What is a Wookah? You have asked me many times, but my answers have always been incomplete.

First let me tell you what a Wookah is not, just so there is no confusion. A Wookah is not a Wookie, which we all remember to be a large, but friendly beast from the Star War movies. While sometimes you make the same noise as a Wookie, particularly when doing your homework, you are nothing at all like a Wookie.

What then is a Wookah? First of all, a Wookah is a child whose knowledge of the world belies their age. Take this example:

When you were one and a half years old you were walking down a street in Northhampton. We were visiting your sister, C., at college. It was nighttime. You looked across the street at a storefront sign, and you said "ice cream." "What?" I said, shocked. I looked for a picture of an ice cream cone on the store front. I looked for a person carrying an ice-cream cone on the street. Something that might have given you a clue. I could find neither. Only the pink and blue fluorescent letters spelling "ice cream."

Typical of Wookah behavior, the sign on the store next door said "Dry Cleaning," but you didn't read that.

Or how about this example:

One day, we were discussing the concept of heaven, and you said:

"Heaven is the attic of the world."


 




"Heaven is the attic of the world." Hmmm. Let's think about that. It's above the world, and old things are stored there, things that evoke memory. One can imagine boxes, rafters and dust--hardly the romantic image of movies. Good metaphor. How old were you when you made this observation? Not quite three. Obviously a Wookah.

Wookahs tend toward skepticism. Some, of course, will see this as a fault. Wookahs are bored by Mr. Rogers, Barbie and Ken dolls, and trite discussions of family values. Ms. Y., your first grade teacher, once took me aside to tell me what you had said when the class, on a field trip, happened upon preparations for a Christmas festival. "They care more about decorating than they do about people's needs," you told her. As you can see, a Wookah will scramble up Kohlberg's Moral Development Scale as if it were a jungle gym.

Outspokenness and self confidence are certainly some of a Wookah's most notable traits. All of my previous examples suggest this, so I need not offer more proof. Suffice it to say, one always know where a Wookah stands.

Finally, the sine qua non of a Wookah is that they have an irreverent relationship with their father. Mr. J., your second grade teacher, asked me a few weeks ago whether I remembered what you used to call me. "The idiot," he said, laughing. You still call me that. Wookahs push the hair on the top of their father's head around and casually say: "Hmm, the bald spot looks a little bigger today than it looked yesterday." And of course, fathers of Wookahs say, when they kiss their Wookah good night: "I hate you, pup." And Wookahs reply: "I hate you, Dad." For Wookahs know all about subtext and irony.

But what happens to Wookahs when they get older, when they become teenagers? Nothing! Nothing changes! They're still Wookahs. Why would they change? If they rebelled they'd start watching Mr. Rogers. And how does one bless a Wookah? This stumps me since blessing a Wookah is much like waxing a car that's still sitting on the showroom floor. There's simply a limit to how much something or someone can shine. But I can say this: every day I ask myself, how'd I ever get so lucky as to have a genuine Wookah. For most fathers can only hope to be as fortunate as that.

About the author: Dr. Grossman is a clinical psychologist and author of the Voicelessness and Emotional Survival web site.

next: Voicelessness: The Depressed Teenager

APA Reference
Staff, H. (2008, October 11). What is a Wookah?, HealthyPlace. Retrieved on 2024, December 23 from https://www.healthyplace.com/self-help/essays-on-psychology-and-life/what-is-a-wookah

Last Updated: March 29, 2016

History and Evolution of ADD

Read about the history of ADD, attention deficit disorder. When were ADD symptoms first recognized and how was the Read about the history of ADD, attention deficit disorder. When were ADD symptoms first recognized and how was the disorder named?

Where the story began is impossible to say. Certainly, the symptoms of ADD (attention deficit disorder) have been with us as long as history has been recorded. However, the modern story of ADD, the story of bringing those symptoms out of the realm of morality and punishment and into the realm of science and treatment, began somewhere around the turn of the century.

In 1904 one of the world's most prestigious medical journals, the British journal Lancet published a little doggerel verse that might be the first published account of ADD in the medical literature.

The Story of Fidgety Philip

"Let me see if Philip can
Be a little gentleman;
Let me see if he is able
To sit still for once at the table."
Thus Papa bade Phil behave;
And Mama looked very grave.
But Fidgety Phil,
He won't sit still;
He wriggles,
And giggles,
And then, I declare,
Swings backwards and forwards,
And tilts up his chair,
Just like any rocking horse--
"Philip! I am getting cross!"
See the naughty, restless child
Growing still more rude and wild,
Till his chair falls over quite.
Philip screams with all his might,
Catches at the cloth, but then
That makes matters worse again.
Down upon the ground they fall,
Glasses, plates, knives, forks and all.
How Mama did fret and frown,
When she saw them tumbling down!
And Papa made such a face!
Philip is in sad disgrace . . .

Fidgety Phil has had many incarnations in popular culture, including Dennis the Menace and Calvin from "Calvin and Hobbes." Most everybody knows a little boy who bangs into things, climbs to the top of trees, scales the furniture, beats up on his siblings, talks back, and displays all the characteristics of being out of control, maybe a little bit of a bad seed, despite the generosity and best efforts of the parents. How can this be explained? And how is it that this person has existed throughout the centuries?

Noticing the Symptoms of ADD

The story might start with . . . George Frederic Still, M.D., who in 1902 described a group of twenty children who were defiant, excessively emotional, passionate, lawless, spiteful, and had little inhibitory volition. This group consisted of three boys for every girl, and their troubling behaviors all had appeared before the age of eight. What was most striking to Still was that this group of kids had been raised in benign environments, with "good-enough" parenting. Indeed, those children who had been subject to poor child-rearing were excluded from his analysis. He speculated, in light of the adequate rearing these children received, there might be a biological basis to the unbounded behavior, a genetically inherited proneness toward moral corruption. He gained confidence in his theory when he discovered that some members of these children's families had psychiatric difficulties such as depression, alcoholism, and conduct problems.

While it was certainly possible that the pathology was psychological only, and was passed down from generation to generation as a kind of family neurosis, Still proposed that genetics and biology should be considered at least as much as free will in assessing the cause of these children's problems. This was a new way of thinking.

Although it would be decades before there was conclusive evidence bearing Still out, his new way of thinking was pivotal. In the nineteenth century--and before--"bad" or uncontrollable behavior in children was seen as a moral failing. Either the parents or the children or both should be held responsible. The usual "treatment" for these children was physical punishment. Pediatric textbooks from that era are full of descriptions of how to beat a child and exhortations on the necessity of doing so. As clinicians began to speculate that neurology, rather than the devil, was governing behavior, a kinder, more effective approach to child-rearing emerged.




ADD: Psychological, Behavioral or Genetic?

The puzzling contradiction between upbringing and behavior in this population of children captured the imagination of turn-of-the-century psychologists. Still's observations supported the theory of William James, the father of American psychology. James saw the deficits in what he called inhibitory volition, moral control, and sustained attention as being causally related to each other through an underlying neurological defect. Cautiously, he speculated on the possibility of either a decreased threshold in the brain for inhibition of response to various stimuli, or a syndrome of disconnection within the cortex of the brain in which intellect was dissociated from "will," or social conduct.

The trail of Still and James was picked up in 1934, when Eugene Kahn and Louis H. Cohen published a piece called "Organic Driveness" in the New England Journal of Medicine. Kahn and Cohen asserted that there was a biological cause for the hyperactive, impulse-ridden, morally immature behavior of the people they were seeing who had been hit by the encephalitis epidemic of 1917-18. This epidemic left some victims chronically immobile (as those described by Oliver Sacks in his book Awakenings) and others chronically insomniac, with impaired attention, impaired regulation of activity, and poor impulse control. In other words, the characteristics plaguing this latter group were what we now take to be the diagnostic triad of ADD symptoms: distractibility, impulsivity, and restlessness. Kahn and Cohen were the first to provide an elegant description of the relationship between an organic disease and the symptoms of ADD.

At about the same time, Charles Bradley was developing another line of evidence linking ADD-like symptoms to biological roots. In 1937, Bradley reported success in using benzedrine, a stimulant, to treat behaviorally disordered children. This was a serendipitous discovery that was quite counterintuitive; why should a stimulant help hyperactive children become less stimulated? Like many important discoverers in medicine, Bradley couldn't explain his discovery; he could only report its veracity.

Soon this population of children would be labeled MBD--minimal brain dysfunction--and treated with Ritalin and Cylert, two other stimulants that were found to have a dramatic effect on the behavioral and social symptoms of the syndrome. By 1957 there was an attempt to match the symptoms of what was by then called the "hyperkinetic syndrome" with a specific anatomical structure in the brain. Maurice Laufer, in Psychosomatic Medicine, placed the location of dysfunction at the thalamus, a midbrain structure. Laufer saw hyperkinesis as proof that the work of the thalamus which was to filter stimuli, had gone awry. Although his hypothesis was never proved, it did promote the conception of the disorder as one defined by an overactivity of a part of the brain.

Throughout the sixties, clinical skill with the hyperkinetic population improved, and the clinician's powers of observation grew more attuned to the nuances of the children's behavior. It became more apparent to the clinician's eye that the syndrome somehow was due to genetically based malfunctioning of biological systems rather than to bad parenting or bad behavior. The definition of the syndrome has evolved through family studies and statistical analysis of epidemiological data that absolve parents and children of blame (although the pernicious and unfair tendency to blame parents and children persists to this day among the ill informed).

By the early seventies the definition of the syndrome included not just the behaviorally evident hyperactivity, but also the more subtle symptoms of distractibility and impulsivity. By then, we knew that ADD clustered in families and was not caused by bad parenting. We knew that the symptoms were often improved by the use of stimulant medication. We thought we knew, but couldn't prove, that ADD had a biological basis, and that it was genetically transmitted. However, this more accurate and encompassing view was not accompanied by any major new discoveries related to the biological causes of the syndrome.

Due to the lack of further biological evidence, some people argued that ADD was a mythical disorder, an excuse contrived to exonerate reprobate children and their parents. As is usually the case in psychiatry, the intensity of the debate was inversely proportional to the availability of factual information.

As in a good mystery, the journey from suspicion to proof, from speculation to empirical evidence, from Kahn and Cohen to Paul Wender and Alan Zametkin and Rachel Gittleman-Klein and the other current researchers, has been riddled with false leads, multiple possibilities, contradictory findings, and many gut reactions of all kinds.

A Chemical Imbalance in the Brain

One of the first attempts to unite the effects of the stimulants with what we know about the brain was made by C. Kornetsky, who in 1970 proposed the Catecholamine Hypothesis of Hyperactivity. Catecholamines are a class of compounds that includes the neurotransmitters norepinephrine and dopamine. Since the stimulants affect the norepinephrine and dopamine neurotransmitter systems by increasing the amount of these neurotransmitters, Kornetsky concluded that ADD possibly was caused by an underproduction or underutilization of these neurotransmitters. Although this hypothesis is still tenable, biochemical studies and clinical tests of neurotransmitter metabolites in urine over the past two decades have not been able to document the specific role of the catecholamines in ADD.

No single neurotransmitter system may be the sole regulator of ADD. Neurons can convert dopamine into norepinephrine. Many of the drugs that act on the catecholamines act on serotonin. Some of the drugs that act on serotonin can act on norepinephrine and dopamine. And we can't rule out the role of other neurotransmitters like GABA (gamma amino butyric acid), which have showed up in some biochemical studies. The most likely possibility is that the effect of dopamine and norepinephrine and serotonin is key and drugs that alter these neurotransmitters will have the most telling effect on the symptomatology of ADD.

So can we say that ADD is a chemical imbalance? Like most questions in psychiatry, the answer is yes and then again no. No, we have not found a good way to measure the specific imbalances in the neurotransmitter systems that may be responsible for the ADD. But yes, there is enough evidence that neurochemical systems are altered in people with ADD to state that the problem derives from the chemistry of the brain. Most likely, it is a dysregulation along the catecholamine-serotonin axis, a dance where one misstep by one partner creates a misstep by the other, which creates another misstep by the first. Before they know it, these dance partners are out of step not just with each other but with the music--and who is to say how it happened?

About the authors: Dr. Hallowell is a child and adult psychiatrist and founder of The Hallowell Center for Cognitive and Emotional Health in Sudbury, MA. Dr. Hallowell is considered to be one of the foremost experts on the topic of ADHD. He is the co-author, with Dr. John Ratey, of Driven to Distraction, and Answers to Distraction.



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APA Reference
Staff, H. (2008, October 10). History and Evolution of ADD, HealthyPlace. Retrieved on 2024, December 23 from https://www.healthyplace.com/adhd/articles/history-evolution-of-add

Last Updated: February 14, 2016

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"It seems that our travails are often a preparatory path, helping to make us better instruments through which we may serve, especially during times of crisis, which the world is now entering - a BirthQuake of worldwide proportion." Anonymous

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APA Reference
Staff, H. (2008, October 10). Welcome to SagePlace, HealthyPlace. Retrieved on 2024, December 23 from https://www.healthyplace.com/alternative-mental-health/sageplace/healing-wholeness-homepage

Last Updated: February 17, 2017