Читать книгу New hope for ADHD in children and adults - Helena Bester - Страница 9

Various disciplines can shed light on the questions a therapist might ask at an initial interview. Through experience and personal preference the therapist will refine or change those questions until they become accurate searchlights that light up the relevant dark corners.

On page 32 there is an example of questions that might be asked in an introductory interview. I encourage you to go through the list and try to answer the questions as they pertain to your child or yourself as a child (if you have the relevant information). Teachers, therapists and students can use the questions as guidelines to help them sift through the relevant background information more easily.

I have included high-frequency responses, that is, answers that I hear most often from parents. I have not (yet) been able to determine response patterns when it comes to certain questions, although those questions do relate to certain aspects of ADHD. For example, one often hears that sleep disorders or problems are common among those with ADHD. But of the thousands of children with ADHD with whom I have worked intensively over the past twenty-three years, those with sleeping problems are in the minority. I have indicated the places where, according to my own observations and experience, there is no clear pattern of responses.

Questions are a vehicle of immeasurable importance to the therapist. But even more important is the therapist’s ability to listen. Regardless of how effective the questions we ask are, there is always the possibility that we might be overlooking an important component. The other danger is that a specific set of questions may shed light on a particular issue from one angle only. This can lead to prejudice on the part of the therapist. It is like when you begin focusing on red cars on the road: It will eventually seem to you that there has been a sudden increase in the number of red cars. And the longer, figuratively speaking, you look at someone through a particular lens or set of questions, the clearer certain aspects of that person become while others fade into the background, which could influence the type of intervention you decide on. That is why my opening statement is usually: “Tell me, I’m listening.” This important open question can offer you, the therapist, a perspective that your limiting lens or questions cannot.

As the reader, I ask that you do as follows: In your own words, state the problem as it is in your experience with your child (or with you or a child in your classroom). Awareness is an important step in treatment, and also in the decision-making that could lead to a positive change.

Professor Rudoph E. Tanzi of the department of neurology at Harvard University’s medical school says in Super Brain (2012), a book he co-wrote with medical doctor and author Deepak Chopra, that in every task we perform we are either unaware or aware or self-aware (aware of our own role in the situation rather than “shy”). When we are unaware, we are driven by our emotions and lower brain functions. The brain is then in an unbalanced state of functioning. Our decision-making functions are impaired and our behaviour is controlled by fear and anger, among others.

When we act consciously or are in an aware state, we can express how we feel about something. The emotions are then put in perspective by the higher brain functions, including judgement. The brain is therefore in a more integrated state, with both the higher and lower brain functions playing a part. Emotional as well as cognitive brain functions are involved. We do not feel as overwhelmed by our emotions and as if we have no control over the situation. The ADHD sufferer often feels overwhelmed by an emotion he is caught up in, so much so that his powers of judgement and decision-making functions are crowded out.

When we are aware of our own involvement in a situation – in other words, when we are self-aware – we are able to think about it properly. Once we have that awareness, we can evaluate our own behaviour and make the right choices. In this way alone lies positive change. Emotions are not the opposite of a state of awareness, but are in fact an important searchlight to highlight what questions we should ask to bring about insight and growth.

I believe awareness to be essential not only for those with ADHD in managing their symptoms, but for every one of us as we grow as human beings. We will discuss this further in the chapter on neurotherapy. Neurotherapy generally improves self-awareness.

Back to the initial interview: You need to start at a specific point when describing the problem as you experience it, to the therapist. Some people’s thought process is more analytical whereas others think in a more systemic way. Some mothers arrive with a list of ten points, with pregnancy as point one. Others start with an incident that occurred the day before the interview and others sum up the problem in a single sentence.

It disturbs me greatly that many test conductors allocate only a ten-minute time slot for the first interview. Time is a factor, but I do not understand how one can get to the essence of the problem after just a few questions. You may perhaps leave a consultation clutching a prescription, but plagued with doubts, questions and fears.

Once the parent has responded to my initial statement – “tell me, I’m listening”, I ask questions about those aspects that may be relevant and which the parent has not yet addressed. It is primarily in response to the first question that I start to discern synchronicities and patterns hidden behind the general symptoms that I would not necessarily have noticed at first. A large percentage of children with ADHD, for example, had high fevers or fever convulsions at a very young age. Most are also emotionally very sensitive, though it often seems that they are not at all aware of other people’s needs. They are also often creative thinkers. In adults in particular, it is clear that people with ADHD do not like problems. They appear to need their environment to be under control because of the often chaotic state of their own thoughts.

The following questions are useful not only in setting up an intervention programme but also in other practical aspects of managing the condition. They may perhaps make you as a mother smile as you realise that there are many other moms walking the same path as yours. As already mentioned, I have also included general answers and comments and indicated where there is no clear pattern. Questions that are more appropriate in an initial interview with adult ADHD sufferers are covered later in this book.

Please bear in mind that the answers are based on my experience as a therapist and not on a research project.