Interpreting the inner world of ADHD children: psychoanalytic perspectives

Björn Salomonsson

doi:10.1080/17482631.2017.1298269

Abstract

ABSTRACTADHD is increasingly seen as associated with cerebral dysfunction and caused by it. This development is concomitant with an emphasis on medication, behavioural treatments, and parent training programmes. In contrast, psychoanalytic therapy has receded into the background and is often viewed as inefficient or even noxious. This paper argues that such views are based on a misunderstanding of the scope of psychotherapy. Though much more systematic research is needed to establish its efficacy, it can inform on the ADHD child’s emotional experiences. It can shed light on the connections between his/her inner world and symptoms, such as attention deficits, hyperactivity, and impulsivity. On the other hand, it cannot establish causality in the individual or general case. If we recall that the diagnosis is based on a list of symptoms, not of etiology, we realize that this limitation applies to any scientific perspective on ADHD. Psychoanalytic treatment is one of several approaches to understanding ADHD and helping the child cope with it. This is achieved by the psychoanalytic method, a hermeneutic approach with which the analyst interprets the child’s behaviours and communications as they emerge in the session. The implications of such an approach are discussed.

Highlights

If we adhere to the call of papers for this issue of the journal, to apply a critical yet informed perspective to the ADHD concept, it would be easy to link it with the critique against the overuse of the diagnosis and stimulants (Batstra & Frances, 2012; Frances & Batstra, 2013)
If we recall that the diagnosis is based on a list of symptoms, not of etiology, we realize that this limitation applies to any scientific perspective on ADHD
Findings from the “psychoanalytic laboratory”, that is, experiences gathered during individual treatments, can help us understand how the ADHD child experiences having these symptoms and how they connect with his affective world— and nothing more

Summary

Introduction

If we adhere to the call of papers for this issue of the journal, to apply a critical yet informed perspective to the ADHD concept, it would be easy to link it with the critique against the overuse of the diagnosis and stimulants (Batstra & Frances, 2012; Frances & Batstra, 2013). Frances points out that Freud, who founded psychoanalysis, the most influential school in the latter tradition, often linked his psychological theories with the insights of the neuroscientific knowledge of his era In his speculations on the death instinct and human aggression, he hoped that biology, “truly a land of unlimited possibilities”, might one day “give us the most surprising information and we cannot guess what answers it will return in a few dozen years to the questions we have put to it” (Freud, 1920). It is hoped that when various sciences, including neuroscience, are combined, a more comprehensive picture of ADHD will emerge This adheres to Zabarenko’s (2011) suggestion of fielding a team of psychoanalysis, neuroscience, and cognitive psychology. It will suffice to state that the symptoms of DAMP and ADHD are rather similar, the main difference being that DAMP includes dysfunctions in motor control and perception

Objectives

Conclusion