Psychoanalytic Energy Psychotherapy [PEP] - Phil Mollon Ph.D. DCEP
 
 
 
 New Book:The Disintegrating Self: Psychotherapy of Adult ADHD, Autistic Spectrum, and other disorders. Phil Mollon [Karnac] click  For the first chapter, click here
 
 
This page is not concerned with energy psychology. I have posted the guidelines below because there are many individuals and families for whom Attention Deficit Hyperactive is a problem. It can cause immense distress, yet is often not well understood. Often the lack of understanding adds to the stress and despair.
 
The following notes reflect my personal impressions and are not necessarily shared by any colleagues and should not be regarded as a substitute for  professional medical advice.
 
 
Here is a series of powerpoint slides for a talk I gave on ADHD as a hidden core in various mental health presentations: click
 
 
Some guidelines regarding ADHD
 
Attention deficit hyperactivity disorder [ADHD] involves problems with attention, the pursuit of goals, and the regulation of emotion. It is thought to reflect primarily a subtle variation from normal brain function.
 
The diagnosis of ADHD is not precise (this is true also of most psychiatric diagnoses) – but a common constellation of problems are often found together, and in recent years this has been termed ADHD. Some clinicians consider this is quite common, whilst others are doubtful of its existence in adults. Often it seems not to be recognised in childhood, where a child is viewed just as ‘naughty’ (although in some instances an overdiagnosis of ADHD may occur). It seems reasonable to suppose that a child with ADHD will grow up to be an adult with ADHD. A person who has struggled throughout life with ADHD problems, and the impact of these on their family and social relationships, may very likely also attract a diagnosis of ‘personality disorder.
 
Why does ADHD occur?
ADHD is thought to involve a deficit in the functioning of the frontal lobes of the brain – areas that are to do with planning, attention and concentration, abstract reasoning, inhibition of impulse, and regulation of emotion. This can give rise to the follow set of difficulties:
  • Impulsivity
  • Lack of normal social inhibition (when emotions are aroused).
  • Difficulties with concentrating and attending
  • Low tolerance of frustration
  • Proneness to rage and tantrums
  • States of being overwhelmed with emotion – no ‘emotional brakes’ – resulting in escalating storms of rage and other emotions.
  • Self harm, when rage is discharged on the self.
  • Aggression against others, particularly within the family.
  • Difficulties in forward planning, establishing goals, and pursuing these.
  • Social difficulties – resentment of the demands made by others.
  • States of feeling overwhelmed by the demands of daily life.
  • Difficulties staying on track – wandering off and being easily distracted.
  • Very low tolerance of boredom – some people with ADHD describe boredom as ‘terrifying’.
  • Childlike neediness – appearing immature and experiencing difficulty grappling with the demands of adult life.
  • Egocentricity, due to a difficulty in decentring from one’s own need, emotion, and perspective.
  • Lack of clear identity and self-concept.
  • Low self-esteem.
  • Restlessness, dissatisfaction, and dysphoric mood.
  • Mood swings – with extremes of mood and emotion.
  • Violent feelings of hatred.
 
There are some positive features of ADHD – and no doubt it has been selected by evolution for having value for the survival of the group:
  • Creativity (in both arts and science).
  • Enjoyment of activities involving constant change and challenge.
  • Activities where risk-taking is an advantage
  • Artistic innovation
  • The capacity to be ‘different’.
  • In earlier evolutionary times, such people may have been hunters or fighters.
  • People with ADHD can be highly intelligent.
 
It is thought that many high-achieving people have ADHD.
 
ADHD can run in families.
 
Ways of adapting to ADHD.
  • Understanding the problem can be important.
  • Realising that it is no-one’s fault – this can be a relief to both the person with ADHD and their family.
  • A person with ADHD may appear angry – and may assume that they must be angry about something, perhaps blaming family and other circumstances. The truth is more likely that the person is angry because he or she has an ADHD temperament and therefore finds life inherently frustrating, irritating, sometimes enraging, and often overwhelming – the demands of society being experienced as impossible, and perhaps even an offensive imposition. Understanding this – and accepting the nature of the basic ADHD temperament – can be important.
  • A person with ADHD can learn methods of affect-regulation, to reduce agitation, anger, and anxiety. Simple and natural de-stressing methods, such as EFT, can be helpful.
  • Simple exercises from the field of educational kinesiology can be helpful in generating greater coherence and balance in mind and brain – for example, ‘Cooks’ Hookups’.
  • Simple adjuncts to memory and planning, such as writing goals and lists, can be helpful.
  • Avoidance of foods and additives that appear to trigger ADHD symptoms can often have a marked effect – these are often highly individual, but the additive ‘Aspartame’ is particularly notorious.
  • Those close to a person with ADHD may need to learn to reduce expressions of emotion. Expression of anger towards a person with ADHD may evoke strong and overwhelming anger and anxiety in response – creating situations that can easily escalate. Communications are best kept simple, and emotionally ‘low key’.
  • Interpersonal communications that are too complex, confusing, or contradictory, may cause the person with ADHD to feel overwhelmed with anger and anxiety.
  • It must be understood that a person with ADHD will not be able to control his or her emotions once they have escalated beyond a certain critical point – resulting in potentially hazardous situations. Therefore it is important for that person, and those close to him or her, to find ways of noticing the warning signs and shifting to an alternative strategy. For example, a person with ADHD may learn that walking away from an escalating situation, before it reaches the critical threshold, may be a feasible option. Others around the ADHD person may find that backing off, speaking quietly and with less emotion, leads to a calming.
  • People with ADHD are easily overwhelmed with the tasks of life – resulting in anxiety, anger, and even panic. Therefore, help with organising, planning, and thinking through these tasks can be enormously important.
  • Tasks need to be broken down into manageable chunks.
  • A person with ADHD will often be extremely grateful for understanding of their difficulties – particularly since much of their life may have been characterised by negative social interactions, spiralling mutual aggression, and an ever-plunging self-esteem.
  • Society needs people with ADHD – life would lose much colour without them.
 
 
Dr. Phil Mollon PhD. 23.1.08. This outline reflects the views of Phil Mollon, psychotherapist, and may not necessarily be shared by all other clinicians.