Driven to Distraction (Revised)

by Edward M. Hallowell

  22. Learn about mood management. Anticipation is a great way to help anyone deal with the highs and lows that come along. This is especially true in ADD. If you know in advance that when you say “Good morning, honey!” the response you get might be “Get off my back, will you!” then it is easier to deal with that response without getting a divorce. And if the other member of the couple has learned something about his or her moods, the response to “Good morning, honey!” might be “I’m in one of my ADD funks,” or something like that, instead of an attack on the other person.

  23. Let the one who is the better organizer take on the job of organization. There’s no point in flogging yourself with a job you can’t do. If you can’t do the checkbook, don’t do the checkbook. If you can’t do the kids’ clothes shopping, then don’t do the kids’ clothes shopping. That’s one of the advantages of being in a couple. You have another person to help out. However, the job the other person does instead of you must then be adequately appreciated, noticed, and reciprocated.

  24. Make time for each other. If the only way you can do this is by scheduling it, then schedule it. This is imperative. Many people with ADD slip away like quicksilver; now you have them, now you don’t. Clear communication, the expression of affection, the taking up of problems, playing together and having fun—all these ingredients of a good relationship cannot occur unless you spend time together.

  25. Don’t use ADD as an excuse. Each member of the couple has to take responsibility for his or her actions. On the other hand, while one mustn’t use ADD as an excuse, knowledge of the syndrome can add immeasurably to the understanding one brings to the relationship.

  In 2010, my wife, Sue, who is a couples therapist, and I published a book on marriage called Married to Distraction. It was not exclusively about ADD, but about how our age of interruptions and distractions has impacted all intimate relationships. The book also has the virtue of including the viewpoint both of a woman (my wife) and a woman married to a man who has ADD (me).

  5

  The Big Struggle

  ADD AND THE FAMILY

  Consider the following scene, which is representative of many families in which one person has ADD:

  “Mom, I told you I would have my homework done by Sunday night, and I will have it done by Sunday night. Now will you please just get off my back?” Tommy Eldredge kicks the trash basket next to his mother’s desk as he storms out of the living room and into the kitchen.

  His mother rises from her chair in pursuit. “No, I won’t just get off your back. Why should I? What have you done to deserve my trust? It’s spring term of your tenth-grade year, you’re in the middle of high school, and you’re flunking two courses. All you do is make promises and you never come through. I’m fed up with it. If you want to ruin your life—”

  “Mom, calm down already. I’m not ruining my life. I’ve just had some bad grades, that’s all.”

  “Some bad grades? Some? You’ve had nothing but bad grades. And it’s not the grades I’m concerned about. It’s the effort that goes into them. Or lack of effort, I should say. You just don’t care. As long as you can get out of the house, you don’t care what happens tomorrow. Which is why you are not leaving the house this weekend. Not even for a second. Not even for a half a second,” she says, and snaps her fingers next to the back of his head.

  Tommy turns on his mother. “You’re just a bitch, you know that? You’re just a fucking bitch.”

  At that point Tommy’s mother loses her temper completely, slaps him across his face, and falls forward trying to follow the slap with a punch at his arm. When she hits the floor, she starts crying. Tommy tries to help her up, but she pushes him away as Tommy’s dad walks into the kitchen. “Get out of the house,” he barks at Tommy and rushes over to help his sobbing wife.

  “I didn’t mean to hurt her,” Tommy says.

  “Just get out,” his dad says. “Don’t come back.”

  “Fine,” Tommy says, and leaves through the kitchen door, letting the screen slam shut behind him.

  The next day, Saturday, the family has reconvened. The other kids go elsewhere while Mom and Dad sit down to talk with Tommy, who was brought home by the police after being picked up in the bus station at 3 A.M.

  They all stare at each other, years of recriminations focused in this one moment. “We need to make a plan,” Dad begins.

  “First I want an apology,” Mom interrupts.

  “I’m sorry,” Tommy says. “I didn’t mean for you to fall down. I didn’t mean to call you what I called you.”

  “Then why did you say it?” she asks.

  “I don’t know. I was mad. It just came out.”

  “But that’s the whole problem, Tommy,” his mother goes on. “You don’t mean to do the things you do do, and you don’t do the things you say you mean to do.”

  Let me stop the scene here. What Mrs. Eldredge has just said gives a pretty good short description of ADD: You don’t mean to do the things you do do, and you don’t do the things you mean to do. If she could stop herself at this point in the conversation, and say to Tommy, “Aha! I can tell by what I just said that what you have is not a case of incurable obstinacy but attention deficit disorder instead!” then the outcome might be favorable. But what usually happens is that these arguments build and ramify into conflagrations, burning down many a family in the process.

  What often develops in families where one child has ADD (or one adult for that matter) is what we call the Big Struggle. The child with ADD chronically fails to meet obligations, do chores, stay up with schoolwork, keep to family schedules—get out of bed on time, arrive home on time, show up for meals on time, be ready to leave the house on time—keep his or her room tidied up, participate in family life cooperatively, and in general “get with the program” at home. This leads to chronic limit-setting by parents, with increasingly stringent penalties and increasingly tight limitations on the child. This, in turn, makes the child more defiant, less cooperative, and more alienated, which leads parents to feel more exasperated with what increasingly appears to be an attitude problem, under voluntary control, rather than the neurological problem of ADD.

  As parents become more and more fed up with the child’s behavior, they become less and less sympathetic to whatever excuses or explanations the child may offer, less and less willing to believe in promises to do better, and more and more apt to apply stricter and stricter consequences in a usually futile effort to control the child’s behavior. Gradually, the child’s role in the family solidifies around being the “problem child,” and he or she becomes the designated scapegoat for all the family’s conflicts and problems. An old saying about scapegoating is that the process requires a mob and a volunteer. In the case of the Big Struggle the family forms the mob, and the ADD behavior volunteers the child. Virtually anything that goes wrong in the family gets blamed on the ADD child. Over time the child is draped with a kind of blanket of derision and scorn that smothers his development of confidence and self-esteem.

  The Big Struggle may last for years. It may resemble a war, with seasonal campaigns along various fronts—the homework front or the attitude front or the chores front or the cooperation-and-responsibility front, or all of these at once—attacks and counterattacks, the use of spies and special weapons, temporary negotiated settlements, momentary surrenders, occasional desertions, betrayals, treaties, and victories and defeats for both sides at various times. Unfortunately, as in most civil wars, the whole nation, or in this case the whole family, suffers.

  The Big Struggle usually develops innocently enough, as one side tries to persuade the other side to do something. The first bad report card comes home, say in the fifth grade, and parents try to set up a better study program. Or Dad tries to persuade his son to get out of bed on time so he can drive him to school without being late for work himself. Or Mom gets upset at her daughter’s refusal to read books. Whatever the issue, once the struggle begins, it is hard to prevent it from becoming the Big Stru
ggle.

  In the Big Struggle, parents feel they are doing their duty, that they are doing all they can to straighten their child out, that if they didn’t join in the Big Struggle the child would simply goof off interminably. And the child feels he is fighting for his independence, that he is resisting becoming an automaton. Or worse, the child doesn’t really know what is going on. He is simply reacting. Punch, counterpunch, you attack, I counterattack. The reason for the war is long forgotten as the battles go on and on, taking on a life of their own. After a while neither side quite remembers what is being fought for as resentments build, grudges encrust, and the family slugs it out one season into the next.

  The problem is that the Big Struggle rarely achieves any constructive end. There may be short-term gains, such as getting homework done, but usually at so high a cost that it hardly seems worth it. Until a diagnosis of ADD is made and all parties can understand what is really going on, there will be little real progress.

  Unfortunately, the hallmark symptoms of ADD—distractibility, impulsivity, and high activity—are so commonly associated with childhood in general that the possibility of an underlying neurological cause is often not considered. A child like Tommy is dealt with as just a rebellious adolescent, and each side ups the ante as the misunderstanding gathers force and the Big Struggle rounds into full swing.

  “So what should I do?” Tommy asks. “Commit suicide?”

  “You should try to get your act together,” his mother answers. “You should take advantage of all the help we’ve tried to give you. You should show up for your tutor. You should make the effort to bring home your assignment book so we can help you check it over. You should consider telling the truth when we ask you if you have any tests on Friday. You should take that chip off your shoulder and get over thinking the whole world is against you or just doesn’t understand you. You should show us a little respect. You should—”

  “Wait a minute,” Dad interrupts. “Tommy, you’re not even listening to your mother, are you?”

  Tommy has been staring at his red and purple Nikes. “I’m listening, Dad. I could recite it all back if you want. I’ve heard it all before.”

  “Then why don’t you do something about it?” Dad asks through clenched teeth.

  Tommy looks at his father as if he’s about to tell him to piss off, then stops himself and utters the words that form the last line of defense for so many children and adolescents with ADD: “I don’t know.”

  “What do you mean, you don’t know?” his father bellows. “I can accept anything but that. That’s just your way of tuning us out. You don’t know. Well, why don’t you know? Can’t you think about it and come up with some explanation as to why you’re such a screw-up? Are you just stupid? I don’t think you’re stupid, although I’m beginning to wonder. You just won’t wise up, will you?”

  Tommy’s mother pushes her fingers through her hair. “I wish I could give up on you,” she says. “I wish I could just let you fall and not give it a second thought.”

  “So do I,” Tommy says glumly.

  Mom and Dad look at each other and Tommy gnaws on his fingernails as the Big Struggle reaches another impasse. This family has been here many times before. Tommy is now sixteen and in the tenth grade. His school career started out well, with his teachers assessing him as a very smart and creative child, but the last several years have been downhill. Now Tommy is just barely getting by academically. His parents feel that they are taking school more seriously than Tommy is. There are so many fights in the household about Tommy that his younger brother has begun to resent him, and his older sister, a high-school senior, is trying to play peacemaker between Tommy and his parents.

  The past few years read like chronicles from the war room:

  March: Tommy promises to get extra help from French teacher on a regular basis. Parents believe him when he says he’s doing this.

  June: French teacher sends note home wondering why Tommy never came in for extra help, given that he was going to fail the course. Tommy and his father get so angry at each other that Tommy runs away from home.

  October: At a parent conference the school questions Tommy’s parents as to whether everything is OK at home. Tommy seems so erratic the school wonders if he is using drugs or if he is upset about something they don’t know about. Tommy’s parents reassure the school their marriage is fine and things at home are OK. They go home and have a big fight over what is wrong with Tommy.

  January: Tommy, who has told his parents all fall that he was working on his science project on his own at school, admits, a week before it is due, that he has done nothing on the project. Dad says he can put up with anything but not lying. He says Tommy can damn well face the consequences. Mom says the consequences will be flunking science and it’s not worth it. Dad says, what should I do, do it for him? Mom says, yes, and give him some punishment. In a week’s time Tommy and Dad put together a prizewinning project, based on an idea about a computer program Tommy had but never got around to working up. They actually have a lot of fun doing the project. Dad forgets about the punishment, and the whole family glows for a while over winning the prize.

  March: The day the family is to leave on vacation, Tommy announces he doesn’t want to go. When pressed, he says he feels cramped when he’s with the family. Dad explodes and gives Tommy a lecture about how much he has to be grateful for. Tommy listens passively and goes on the vacation. While away Tommy is apprehended by a hotel security man for jumping from a second-floor balcony into the pool. Tommy’s explanation is that he was bored. Mom and Dad ground him for twenty-four hours and have an argument with each other.

  June: Tommy promises to mow the lawn before going out to the movies with his friends on Friday. He forgets to do it. The next day he promises he’ll do it after the football game. Once again he forgets. On Sunday his father tells him he cannot leave the house until the lawn is mowed. Tommy takes this as a challenge and sneaks off on his own, getting his sister to cover for him by saying he is upstairs studying. However, his father catches him as he is coming home. Enraged, he starts screaming at Tommy and then slams him against the kitchen counter. A saucepan falls from a rack, clanking on the brushed-stone floor. His father makes a fist and pulls back his arm as if to punch, but then catches himself. He bites his knuckle and kicks a cupboard door. He draws a deep breath and lets it out slowly as Tommy looks on in fear. A moment passes before his father says, “I can’t tell you how disappointed I am in you, son.”

  Tommy winces, thinking it must be serious this time since he’s never heard his father call him “son” before. “I just wanted to go over to Peter’s house before I did the lawn. I knew you wouldn’t let me.” His father turns and walks away. “Dad, I’m sorry. I’ll do the lawn now. Really, I’m sorry.” His father just keeps on walking.

  Finally, the Eldredges decide to seek professional help. They visit with Tommy’s tutor, who suggests they get a diagnostic evaluation from a child psychiatrist. “I think more may be going on here than meets the eye,” he tells Tommy’s parents.

  Tommy meets with a psychiatrist who interviews him alone, then his parents alone, then the three of them together. After that, Tommy is referred to a psychologist for some testing, then back to the psychiatrist for the full report.

  The evaluation yields the diagnosis of ADD. As the psychiatrist explains what this means, Tommy’s mother looks on intently. “Attention deficit disorder, or ADD, is a common condition,” the psychiatrist begins, “and one that we have good treatments for. However, until it is diagnosed and seen for what it is, it can lead to very big misunderstandings. I think that has been happening in this family. A lot of Tommy’s behavior can be explained in terms of ADD. The main symptoms of the condition are easy distractibility, impulsivity, and restlessness, all of which Tommy has.”

  As the psychiatrist goes on with his explanation, Tommy’s mother breaks down in tears. “You mean it’s not his fault? I’ve been after him all these years for something he can�
�t help? I feel so guilty. This is terrible.”

  Often in families when ADD is diagnosed relatively late, in high school, say, rather than in elementary school, parents feel guilty and angry. They feel guilty that they didn’t pick it up sooner, and angry that no one else told them about it. Keeping matters in perspective, it is quite understandable for the diagnosis to be missed, as knowledge about ADD is still spotty in schools and among many professionals. Once the diagnosis is made, many parents need help in getting past their own troubled feelings, just as the child needs help with his or her feelings. The diagnosis can require a whole rethinking of the family roles.

  “So you’re not the family bozo anymore,” Tommy’s fourteen-year-old brother pipes up at a family-therapy session designed to educate the entire family about Tommy’s ADD.

  “Alex, don’t talk that way,” Mom says.

  “Well, it’s true,” Alex says. “He’s been a bozo, but now we’re supposed to say he’s got a disease. It just sounds like a big excuse to me.”

  Alex’s reaction is typical of siblings when ADD has been diagnosed. Siblings feel resentment at the amount of attention the person with ADD is getting, and they feel anger, believing that their own hard work will go unappreciated.

  “You know, I work hard to get my stuff done,” Alex goes on. “What if I just said, ‘Ooops, can’t do it this week, I have ADD.’ Could I get special treatment then?”

  “But you don’t have ADD,” Dad says.

  “How do you know? I’ll bet I could have it if I let myself. And I’ll bet Tommy wouldn’t have it if he tried not to.”

  “What do you mean?” Mom asks.

  “Well,” Alex says, “according to the doctor, with ADD you have trouble paying attention and staying focused. Who doesn’t have that? I can promise you whenever I’m in Mr. Hayworth’s classroom I have lots of trouble paying attention and staying focused. And I don’t see how if Tommy lies about having his homework done it’s anything but a lie. Does ADD make you lie? It’s a license to kill, this ADD thing. He’ll be able to get away with anything now.”