I am really “psyched” about it (pardon the pun). I have great pictures, video, and text that is relevant useful and helpful.This site integrates all the work that I do.
Previously I had several sites which had different elements of what I was looking to accomplish.
Then there was Clarity4Mind another blog focused specifically on Attention Deficit Hyperactivity Disorder, ADHD, ADD, or ADHD ADD as it is sometimes called.
Then there is my main site as a psychologist-coach
Yes it got to be a bit much. Now it is all integrated and on the way to a much better level of organization. Doing the Cogmed Working Memory TrainingTM myself has helped me with this.
Clarity4Health integrates everything I am doing with an online magazine look and feel.
I am very pleased with the results.
Also, as I have noted elsewhere when you register there you get access to the Largest Mental Health Portal on the internet. You have to check it out. A national company developed this over 6 years and now I can get you access free.
Please check out my new multi-media site: Clarity4Health
Sincerely,
Charles Shinaver, Ph.D.
Psychologist-coach
Founder Clarity4Health.
I was staring paralyzed in fear at an old woman. She had long gray stringy hair in an unwieldy bun on the top of her head with strands of hair flowing in the wind. In the background was a dark gray sky. She was shouting and pointing at me. She had a large black patch over one eye suggesting that she was blind in one eye. (My mom is actually legally blind in one eye, but is not a screaming old woman – more on her in later posts, my mom not the screaming old woman.) She was screaming one thing to me:
“You have it! You have it! You have it!”
I was a little perplexed, but I knew exactly what she meant. I woke up and it was clear without a doubt what she meant.
I had Attention Deficit Hyperactivity Disorder.
How could this be? I was never diagnosed with this. Yet on one level I knew the one-eye blinded old lady in my dream was right, at least partly.
I had taken a computerized test for ADHD and I scored well above average in my ability to pay attention on that task. So on that level there wasn’t an issue. I had never been identified by teachers as having difficulty with staying on task. I had attended and graduated from Notre Dame, Harvard and DePaul Universities. I graduated on time and I had one or two degrees from these schools. This gives me 4 degrees including a doctorate which means I finished a dissertation. Finishing a dissertation takes ‘sustained focus.’ So, on many levels I do not really have Attention Deficit Hyperactivity Disorder.
Yet, I have struggled with staying organized, remembering and getting daily details right and following through.
On this level she was right. Maybe I did not have the full blown version of ADHD but I had some symptoms that did get in my way. We psychologists tend to call this “Not Otherwise Specified”. There is actually a diagnosis called “Attention-Deficit/Hyperactivity Disorder Not Otherwise Specified”. It is for cases just like this where some of the criteria are met, but not all. So, I’ll call it NOS. I may be ADHD NOS. She may be right about that.
For me there is a combination of a few specific ADHD symptoms and then my own excuses and misdirected behavior which have historically gotten in my own way, slowed me down, limited my effectiveness and efficiency.
When I looked through the symptom list for ADHD I found the following symptoms did pose significant challenges for me:
1. Often fails to give close attention to details…
I used to tell the story of my primary professor for my research assistant job at DePaul had this huge “Detail Hammer” and he would pummel me with it whenever I missed a detail. Unfortunately that was more often than I would prefer.
2. Often has difficulty organizing tasks and activities…
I am using Zen to Done as my strategy to attack this one habit at a time. This battle started about 6 months ago and I am making significant strides.
3. Often does not follow through….
I too often switch to new programs without finishing the first one. Or from one topic to another in a conversation in what I consider to be creative, but which loses some listeners.
4. Often forgetful in daily activities…
Just ask my wife about the “Honey Do” list, upon which I have made significant progress after I ‘finished’ Cogmed.
So I am willing to accept the critique from my “Inner One-Eyed Wise Old Lady” that “I have it.” I have ADHD NOS. Okay, now we have that established. Let’s consider two programs I ‘completed’ recently and that I advocate because of their effectiveness.
“Completing P990X and Cogmed”:
In light of my ADHD NOS, let’s consider how I have completed P90X and Cogmed.
With P90X the first time I took out days of exercises if they didn’t fit logistically or were too rigorous. One was removed for risk of injury, another was due the needed time commitment, and others were due to the rigor of the program itself. So, it could be argued that both my first two rounds of P90X were not truly ‘completed’. However, just this summer I did truly ‘complete the program’ for the first time and the results were great. I was able to go from 1 to 10 or 11 pull ups with no assist. I could do around 19 with the assist of a large rubber band. So, I can say unabashedly I completed P90X.
With Cogmed, I ‘finished’ my first version of the Cogmed program which requires you to finish 25 sessions in 35-40ish days. I finished 22 sessions in 52 days. So, I did not technically finish it in that I did not do 25 sessions and I did not finish them in 40ish days, but my ‘real life’ behavior improved markedly. (Yes, this thought is both part excuse and part reality-based.)
I will ‘redo’ the program in the time frame suggested by Cogmed and with the proper number of sessions. However, I reviewing my completion of the Cogmed program in more detail is useful for me and I think it might help you.
There are two issues here. One is that I truly did start to see progress in myself as a result of doing this program in that I was not forgetting items on my “Honey Do” list. Honestly, ask my wife.
Also, I was getting details right, the vast majority of them. There were very few I was missing. I was not forgetting much either.
Yet my two biggest challenges are still getting and staying organized and finishing.
So, because I had ‘kind of finished’ and I had seen tangible progress on my ‘real world goals’ or what we call in psychology ‘generalization’ I stopped at 22 sessions instead of 25.
Let me introduce a few concepts here to guide my evaluation of my own progress. I invite you to use them to evaluate your progress toward a goal as well.
Total Responsibility
This concept is really ‘radical’ responsibility. The word radical has to get with getting at ‘root causes’. Total responsibility suggests that the root cause for not finishing is me. No way around that. I had the goal. I didn’t get it done. If I did not finish it is totally my responsibility – no fault finding, no blaming, it is ‘on me’. Total responsibility for your business, for your health, for the health of your relationships is critical. If I am not where I want to be it is totally my responsibility, even in relationships, to get there. So, when I look for reasons I have to look inside. Not in a self-blaming way, but in a let’s sit back in our reclining chair and investigate the facts and consider what is going on, both the good and the bad as objectively as possible and then take total responsibility for where I am and how to go somewhere new.
Confront the Brutal Facts, Use Disciplined Thinking and Disciplined Action, And Have Unwavering Faith that you will accomplish the Goal – It might just not be in the time frame you expected.
These concepts were used in the book Good to Great by Jim Collins. The concepts are simple. You have to look with hard-nosed honesty and discipline at the “brutal facts” of progress toward a goal. Companies that go from Good to Great use disciplined thinking and then take disciplined action. Disciplined thinking considers and incorporates the unpleasant reality of the ‘brutal facts’ in progress towards a goal.
Collins uses the example of what he calls the “Stockdale Paradox” to capture how to integrate a combination of these strategies. Stockdale was an officer who was a prisoner of war in Viet Nam. When asked who died first in the camp he said “That’s easy, the optimists.” Essentially they thought they would get out of the camp in a few months. They didn’t. Stockdale confronted the brutal facts of his situation and developed a way to communicate with taps on the walls and ceilings to other prisoners of war to help them in various ways with support and strategy. He also had unwavering faith that he would get out – eventually. So, his judicious use of disciplined thinking and action with unwavering faith resulted in him surviving a Viet Nam prison camp when others died.
So, let’s confront the “brutal facts” of my ‘completion’ of the Cogmed program with disciplined thinking and action and with unwavering faith that I will get this done, even if it is not on my preferred timeline.
Put simply, I did not finish it.
22 sessions is not 25. Getting them done in 52 days is not the same as getting it done in 40ish days.
So, disciplined thinking would lead me to conclude that I have not garnered the full benefit from the program. I will do it again. However, disciplined thinking also requires me to better understand what happened, the facts of why I did not finish it and what progress I did make. Considering that factual progress is also a part or ‘the part’ that many people leave out. They are more than happy to be very hard on themselves even denigrating, but they struggle to admit to themselves that yes they did make progress too.
Self-Monitoring:
Also, possibly the most under-rated and most effective tool for making progress is self-monitoring/and or tracking. Yet, that self-monitoring must incorporate the ‘brutal facts’ not sugar-coated facts or ‘fudged facts’. So in that vein let me explore why I didn’t completely finish and my ‘valid reasons’ which are real, but obviously I have to guard against making ‘excuses’ when I talk to myself. Usually I just let go of the goal too easily.
So what happened that affected my ability to ‘git-r’done’? A lot happened… More on that in my next post…… You will have to return to find out…
This question was recently posed to me by a good friend. Her son is very close to the cutoff for the birthdays to begin kindergarten. He is a smart boy, as are his parents, who are both physicians. If he were to go to school next year he would basically be the youngest child in his class. My short answer was essentially: “What’s the hurry?”
Now, yes, that may come off as flippant. But really, what’s the hurry? So, your son, who is definitely a smart ‘little guy’ will definitely be the ‘littlest guy’ in terms of age and quite possibly the ‘littlest guy’ in physical stature. “So, what?” says mom, who, I might remind you, did not grow up as a little boy. Well there’s a short answer to this one too: “Size matters.” I know you have heard that in a different context before, but I am not talking about that (this friend, if she is reading this now, is laughing out loud especially since her husband, the urologist, has been telling her this for years!).
Anyway, life growing up as a boy is all about size, physical skill, the ability to run, to play tag, to knock each other around and to be ‘tough’. I think you have heard of the ‘Napoleon complex’. Need I say more?
No, not all of life is about size. And, yes, certainly school is about learning, reading, math, writing, sitting still, waiting in line, and all of those lessons you are supposed to learn in kindergarten. I know, I know, a lot of mom’s are getting really juiced up about the thrill their son will experience the first time in kindergarten when junior gets to wait in line, wait his turn, sit still, finish his work, write neatly, etc., but most boys… not so much. Really, really, adult life has lots of that action-packed-fun-seeking stuff. He will get to kindergarten in good time.
For boys it is very much about the pecking order and both physical size and physical attributes like strength, speed, agility, all those things, really matter. Whether you like it or not, it is real. I don’t know if you noticed, but most kindergarten boys are not having contests about who can write the neatest, spell the best, or read the biggest books. Not unless there is some mother or father working very hard to drill this into the kid. Sitting still, being quiet in little chairs in little circles or rows, or pods, no, not on the top of their list.
The games we played were: “king of the hill”, “kick the can”, football, basketball, tag, races, etc. etc. Some of the games even had names that are not politically correct today, so we’ll skip those. The point is this. Just because your son might win all those intellectual contests even if everyone is a year older than he is, if he loses at all the games that establish pecking order: trouble is coming. Don’t believe me? Ask some guys who lost all those contests and see what they say. See if they remember getting beat up by a girl at recess. I’m betting they might.
If you think well, by that logic, he will probably struggle at all those games after a year’s more growth. Well, there you go you have something to work on for a year at home instead of sitting at a desk all year. Besides, where is the research that says the youngest, smallest kid in the class does the best?
As a matter of fact most research says the opposite: the oldest kids do the best. There was a great article in the New York Times on June 3, 2007 by Elizabeth Weil called “When Should a Kid Start Kindergarten?” Google this article and it will answer all your questions – especially those parents who do school as a ‘competitive sport’ as noted in this article. This is a well-written and very recent article on this topic and you will see that there is overwhelming and substantial research that supports letting your son wait a year.
This article refers to what they call an ‘age effect’ in the research. Essentially this is a negative effect of a child being younger than most kids in his grade. The focus here is on academics. Now, in our example here I am assuming that my friend’s son will be fine academically, but this research suggests that that there are some risks here too. And, the ‘age effect’ apparently last for several years. When I had this conversation with my friend I had not read this particular article, but I was familiar with some of the research. I am not basing my opinion on this article, but it truly is good food for thought.
I was basing my opinion on the fact that I am a psychologist, I was a boy, I have three smart boys, and many more boys are referred for treatment to all psychololgists than girls. For all variety of things including social develoment, emotional development, ADHD, learning disorders, etc. Most childhood disorders are dominated by boys. So, that extra year can help in all those social and emotional areas.
Yes, I did work on much of the academic activities I assume my friend focuses upon with her son, but I know how the pecking order works. I was just as focused on preparing my sons for the pecking order as I was on academic skills.
One other thought, and this, by the way, appeared to be the clincher for my friend, ask yourself: “What are my son’s true gifts?” No, not is he ‘gifted’, based upon IQ and achievement tests, and this boy is likely ‘gifted’ in terms of the normative population defined in this way. Just with his parents’ education and social economic status he is likely to land in that neighborhood. No, in what ways is your son truly gifted, distinct, special, in a way that you can tell already even before kindergarten? Now, is there a way you can work on his true gifts in the next year? Can you, yourself help him with that? Can you get someone else to help? That, and preparing for ‘pecking order stuff’, is how I would spend the next year. Good handwriting, chapter books, sitting still and being quiet, yeah, all great things, just not this year.
August 2007: The first week of school: Behavioral Norms balanced by an Empathic Connection.
There is a concept in behavioral psychology called norms. Norms are behavior patterns. They are what people actually do. The first week of school is the time to set behavior norms. This is different than ‘expectations’. Expectations are more about talking. They are what we want to see from someone. We can tell someone what we expect, but that is different from “establishing norms”. Let me give you an example. Establishing norms is actually making sure that behavior patterns occur.
We transitioned babysitters at the end of the summer and it had become clear that the sitter during the school year had been lax about many things. We focused upon two. The first one gives the clearest example of establishing a norm because it was so behavioral in nature. The behavior norm had become the boys left the garage door open consistently. This was a problem for several reasons. First, there were concerns about safety. Even though we live in a very safe neighborhood it is a bad idea to get in the habit of leaving the garage door open. Secondly, we just didn’t like the way it looked – junky. Third, there is a tendency by our kids to then expand leaving junk out onto the garage.
How to change this behavioral norm? The first week of the summer I disengaged the garage door openers. So, the kids would have to physically lift the garage doors themselves. Then we moved all their stuff to the garage which had a service door. So, they could go in and out the garage door without having to open the big doors. After the second week of disengaging the garage doors we no longer had that problem. This was a clean solution because physically it was difficult for the kids to open the door manually at all, so their behavior had to change. So, with more complicated behaviors or where there is not a clear physical barrier how do you do this without behaving like a drill sergeant? Well, again it depends upon the norms you want to set within your family as to how you do this. As a matter of fact my son’s, when I click into this mode often spontaneously starting saying: “yes, sir”. They then salute me sometimes. It is their playful way of letting me know that they know I am in ‘git-r-done’ mode. I will return to that later.
Let me give another example of shoes not in the boy’s locker or ‘cubby’. My wife has very high standards regarding cleanliness and order. So we don’t wear shoes in the house. We bought a house that has a mudroom with lockers for the boy’s stuff and my stuff. The boys have a tendency to leave their shoes and backpacks out all over the mud room, a pattern that started last school year. So we began this behavior modification two weeks ago. The first two weeks I warned them and made them come back and put their shoes away. I reminded them that for each shoe it would be $2 off their allowance. (The notion of allowance in our house is that if you do the things expected of a child your age you get allowance of one dollar per year of age. Among the expectations is doing your schoolwork, keeping your room picked up and keeping your cubby and the mudroom picked up, etc.) So we have a trial period in which the boys get only warnings and reminders of the consequence.
Starting time: Then the day we start issuing the consequences is announced and they are given swiftly and preferably without emotion. When the shoes are found not where they are supposed to be the boy is called back to immediately address it and the money lost is recorded. From that day on the consequence is clear: you lose the money and you must interrupt whatever you are doing now to address it.
So it is with a new school year. Decided on your norms, have a brief ‘trial period’. Implement the change. The goal is to deliver consequences without emotion, firmly, clearly without negotiation. This is easier said than done, but if you discipline yourself to do this your kids will begin to be more disciplined themselves.
So, we start with a new sitter this week and focused on the norms with me home the first day to oversee and implement. Day two I have to be at work and my wife happens to be off early and she can oversee the process. As any mom knows, that moment when they hit the door can be the beginning of chaos or order depending upon how it is handled. Day three and the rest of the week I will get home to take some peaks at how it is going and intervene as necessary. After 1-2 2weeks the boys should have a good understanding of the norms and be following them and so should the sitter. This is how you establish norms.
Don’t worry this isn’t the end of the story. I will give you an update. By the way, housebreaking the puppy in the midst of the new school year and new sitter is our biggest challenge.
Balanced by an Empathic Connection:
So that is the establishing behavioral norms, which, by the way, is very much about your norms as much as the kids. Now, how do you maintain ‘empathic connection’? What do I mean by ‘empathic connection’? Or, another way to put it, how do I keep my perspective?
Let me give you two very direct and concrete answers: HeartMath and ‘special time’.
First, what is HeartMath? It is an approach of connecting with your own heart and center of feeling through slowing the breathing and focusing upon feelings of appreciation, gratitude, etc. It actually involves going in your mind and heart to the feeling of gratitude, actually getting to that feeling state. It is not hard once you practice it. I have several references to it on my website, the technology for measuring whether you are there and books and tools to get you there and sustain that. Let me give an example again, I always find specifics very helpful. This morning we had an incident in which the boys followed the ‘new norms’ for the school year very well for about 85-90% of the time. The youngest was up, dressed on his own and got his breakfast started and only needed helping pouring a full gallon jug of milk. The oldest was up much earlier today and was on the ball, not in slow-motion. He was moving along fine. The middle guy was going along well too. We were ready in the mudroom ready to go much earlier than yesterday which was pushing it to the limits of punctuality.
I had taken the dog out to go to the bathroom and he went number one, but not number 2. I had him out there 10 minutes. I had to go in and shower and change myself. I go in. Dog gets passed to second son after he has dressed. He is to take dog out for at least 10 minutes stay in one place and wait for dog to go. He does not do his job well. He goes to the front where there are many distractions. Dog does not go. He puts dog in cage and as we go to leave out door dog goes in cage. Dad is not happy.
So, I am firm about this. We are not going back now. Dog must learn not to go in cage. Son must learn to give sufficient time for dog to go. Through my frustrated monologue I decide the new plan is we will move bedtime up 10 minutes and wakeup time up 10 minutes until we have enough time for dog to go to the bathroom. Son number 3 says: “Can we stop talking about this?” My answer: “Yes.”
So, I discipline myself and stop talking about it. I shift to a neutral place; slow breathing and think about the things the boys have done in the last 24 hours for which I have gratitude. I share some of this with each one of them. I go to work and connect to the EmWave PC and proceed to do more HeartMath. The moment the night before when I was reading to my son from his “Complete Guide to Fishing” book and we were talking about the history of fishing and how it is about nature, understanding nature and imitating nature that allows one to fish well. You may not think about this, but when you fish you imitate the animals in the environment of the fish to get them to bite. He has always been a great outdoors person, first bugs, deer, salamanders, and now fish. That was a moment I felt love, connection and awe for him. Then I shifted to the moment when son number 2 said: “we had to do these math problems and the teacher, well she is real young, didn’t know how to teacher division with remainders, but I did them anyway. I finished the whole sheet when they were on number 17.” Then he told me about football and the highlights there. Then I shifted to the moment when my oldest made this wry comment in the front seat and he turned and grinned with a great big smile and we enjoyed the moment as I got it and he didn’t get it for being a smart Alec. These moments give me perspective and allow me to truly connect with the boys, but hold firm as it is time to establish new norms.
Special time:
This is a concept borrowed from Russell Barkley and his book Taking Charge of ADHD. It is an idea kind of like “time in” instead of time out. The idea is that you set aside 15 minutes or so and truly focus on your child, not the dishes, the phone, the laundry, etc. The concept is that he chooses an activity and you essentially narrate out loud what he is doing. This gives him the feeling that you are ‘in there with him’. You let him make the rules and choose the game. It is his time. Kids really love this. It is like their batteries are charged up by this. These empathic moments are the foundation upon which you continue to build as a child gets older. Over time my sons continue to turn to me and talk to me about important things on their mind because I often try to do some version of special time – an activity on their terms in which I narrate or empathize and shut off my own mind chatter. This empathic link to my sons balances when I am in ‘drill sergeant’ mode which I must do sometimes especially with these boys who are loud and rowdy at times. Those are two critical tools or skills I use. They work. Try them yourself. Now ‘git-r-done’ and set some ‘new behavioral norms’.
This is a moment from our Egypt trip in front of the pyramids. With so much divorce in the midst of what appears to be the next great depression the best marriage counseling is time together when you turn toward each other with love. Love relationships are fragile and need to be nurtured. As a matter of fact close relationships are a tremendous buffer against anxiety. They can provide you with stress relief. Mental health, spiritual health and stress relief are all closely tied to a good marriage. So to save your marriage spend time with your spouse. Dr. Charles Shinaver
Today I saw my son grow up in a leap, in a quickening of my heart.
Tears welled up in my eyes.
It was at the Crowning of Mary ceremony at Our Lady of Mount Carmel.
Sometimes it is just a moment when you know.
You know that everything has changed.
You know that your boy is now a man.
It is about physical maturity, but it is more about dignity.
Years of little decisions as well as portent ones had come to a point where I was watching my oldest son with a group of his peers. Boys to men, there they stood joking and teasing each other. I stood in the Narthex watching from the distance overcome with gratitude. The gratitude was for these young men who had embraced my son as one of their own even though he had joined them 6 years into their 9 years at Our Lady of Mount Carmel. He had come in as fifth grader in the confusion of the second 6 weeks no less. Most of them had been there since Kindergarten.
These were now young men, 8th graders in suites, it was the first time he wore a suite. He was talking and laughing with a group of his friends, there was a free exchange of smiles, friendly comments and warmth. Those young men had no idea the impact that they had had on my son’s life and on mine. Many of them didn’t even know who I was. That didn’t matter. What mattered was the camaraderie he had with them. This is the kind of thing a father hopes for his son. The reality is that friends have much more impact on the mental health of all of our children than we would prefer. Peers connect or reject our kids whether we like it or not. We tend to miss these moments of grace, the grace of kindness, of warmth.
This may seem like a normal moment for many kids but it was a moment pregnant with meaning for me, the end of a transformation and the beginning of new phase of life filled with promise, opportunity and challenge. You see my son, for a while, a long while, in another city, at another time which seems miles and years ago, was the boy left out.
He was the one with a name slightly different, with a shade of skin slightly darker than the rest, the one who had a bit more difficulty keeping his focus, containing his impulses. Yet, it wasn’t his behavior that kept him out it was his ever so slight differences. Truly these were and are subtle differences, yet he was on the outside, alone, or with only a friend or two. Thank God for those two.
This was not him any longer. Those free exchanges that seemed so effortless were of value that is hard to underestimate, yet so gentle and subtle that most go unnoticed, but not by me.
A mom unknown to me until that moment volunteered a comment. She said: “They really have a great class don’t they. That 8thgrade class really is a great group of kids.”
I could not agree more. It hadn’t completely registered until this day. There he was with guys considered ‘jocks’ and ‘nerds’. All of them were his friends. They were just kids, just young men finishing 8th grade at the May Crowning of Mary. There was joy and acceptance.
With such little effort young people can either embrace or alienate each other with profound consequences. Indeed in some cultures the highest form of punishment is to ostracize a person. People can actually die from such treatment. This is why isolation is considered such an extreme punishment in a prison. Isolation from a peer group, for a teen is mortifying.
I remember the first weekend when we moved to a small town a little over a decade ago. There actually had been a Klu Klux Klan rally in a nearby town. I had no idea at the time, but that was the most overt sign of a community which was socially closed. It was much more subtle than a KKK rally, but it was closed nonetheless. It was a community in which my wife, a physician and of Persian descent fit in with her colleagues, but my son with his uniqueness was not accepted by the children of that community save those two friends and I in my Mr. Mom role with my four degrees culminating in a PhD was like a duck out of water too.
My son with all his gifts knew he was locked out of the “jock” culture as he had a ‘scissor walk’ as a young boy which required orthotic inserts for a couple years and as a result his speed and agility were limited. He finally landed on soccer as a goal keeper and became quite good, but the social currency in small Midwestern towns like this one was athletic ability and ‘sports talk’. He knew he lacked these things. He was the boy left out.
We had survived this semi-isolation for 8 years of his young life almost too many years, almost to a point where the trajectory could have been inalterable. Now it had all changed.
Like my son, stay-at-home-dads were not aplenty in this middle-sized Midwestern city feeling bigger than its britches because there were no cities of any size around. So the “Mr. Mom” social experiment of mine was short-lived, but my own social isolation was not. As a matter of fact psychologists within a decade of my age were scarce. I had looked under every rock and around every bush I could find in search of my own sense of community. Besides it is difficult enough to find a ‘normal’ psychologist as it is. Here there were none within 15 years of my age, let alone a ‘normal’ person who happened to be a psychologist.
The Notre Dame club of the area was filled with very nice men in their 70s. I was in my 30s. My basketball team was filled with men in their 20s, unmarried, hitting the bars and the clubs. I was married with had 3 young boys at this point. I went to the small group bible study at my church, God loves them, but they were all women in their 60s (yes, at times I did call them the ‘menopausal bible study’, I hope I am forgiven for that) and the deacon, a warm man was in his late 50s. So my social expansion didn’t fare much better than my son’s.
So, when my wife who is a radiologist went to the ‘big city’ to look at some radiology equipment and she was recruited on the spot to come to the ‘big city’ she hesitated. She knew her salary would get cut in half, her vacation days would dwindle comparatively and she would have to begin from ground ‘0’ with no partnership. This meant 3 years until she would be a partner and even then she would not see the salary she used to have possibly ever.
This was a very difficult decision for her.
It was a no-brainer for me.
She hesitated to tell me that she was being recruited because she knew what my reaction would be. I had been ready to get out of that bunkered in town for about 4 years.
She told me and we moved.
Weirdly a tornado hit our old ‘small town’ only weeks after we moved. Sometimes coincidences are too blatant with serendipity to ignore the possibility of supernatural forces.
Yet, my wife struggled for that first year and a half. Just because of the move.
I had to take heat for much of that time.
Meanwhile my son gradually began to blossom. Today was a culmination of that. My parents repeatedly remarked how dramatically my son had changed. He was socially comfortable, humorous, well-mannered, sardonic with a heart that was uplifted, not downtrodden.
In our quest to find his talents and interests he had discovered music and became a part of the choir by playing guitar. Since he was 2 or 3 we had known his talent for technology, but he discovered making videos and editing mini-movies in the last two years. The other students and teachers had noticed his prodigious talents in these areas and freely lavished him with praise for this. They coined him the “technology-genius”.
He just continues to blossom.
This is something many parents fail to understand. They seem to think that the development of their children into young men and women is only about sports, good grades and achievement, achievement, achievement. Indeed, the focus upon such ‘super kids’ often leads to burnout and kids quitting sports or activities in which they truly do have talent.
These parents truly have forgotten their own coming of age.
Those other things matter, sure I remember those awards I got. But they are not as critical as you might think. Missing those awards are not ‘life threatening’.
Social death is as close to life threatening for a teen as you can get. It doesn’t require a psychologist, or coach, or psychologist-coach to understand that many of those horrific teen attacks on schools were perpetrated by young men who had experienced ‘social death’. If you just go back to Columbine you see the seeds of discontent and rage from such social alienation.
Yes, it is those small seemingly insignificant little things that young people do to either connect or to reject.
So, today there was my son talking and laughing with his group of friends, with a free exchange of smiles, friendly comments and warmth. Those little gestures of kindness and warmth, those young men had no idea of the impact that they had had on our life.
It is these small gestures to include not exclude, to connect not reject, to build up instead of destroy that changes lives.
They require what seems to be such small effort but transform lives.
I have tremendous gratitude toward these young men of Our Lady of Mount Carmel.
When I was at Notre Dame one thing that made me well up with pride was that Notre Dame Men really did strive to be gentlemen and scholars. I still do.
It strikes me that the same is true of these young men of Our Lady of Mount Carmel.
Thank you Our Lady of Mount Carmel for embracing our son and our family.
Sincerely,
Charles Shinaver, PhD.
a proud father…
a psychologist..
a coach…
a reflective but imperfect parent…
A few of my recent activities:
www.charlesshinaver.com
www.fitfamilies.tv
www.ourfitfamily.ning.com
www.beachbodycoach.com/drshinaver
www.brncommunity.com
Please contact me with questions you would like me to address in my blog, tweets, podcasts, video responses on www.fitfamilies.tv, a discussion group on www.ourfitfamily.com or an email.
Please let me know how you would like me to respond by ranking your top two methods:
For example, rank your top two methods for response of those below:
1. a tweet
2. a blog post
3. a podcast
4. a video response on my companion site: www.fitfamilies.tv.
6. a discussion with members of our community at: www.ourfitfamily.ning.com
7. an email response to you
This will help me to develop my distribution methods accordingly.
I have two good friends with whom we have laid down an “accountability challenge”. These guys are in my networking group the Business Roundtable Network (www.brncommunity.com).
We have challenged each other to be accountable for blogging consistently to provide you value.
(The challenge between us is part of what makes this ‘social media’. The other part is you, your comments, views, you sharing our blogs with your friends. So I am asking for your help. Please comment and share this with your friends. Otherwise I will have to resort to having my buddies comment on my blog and vice versa. I think you are much more interesting. Don’t tell them I said that.)
So there it is.
It is a public commitment.
(Yes, that is a tactic to motivate myself. I hate to not do what I say I will do publicly. So, now I am publicly committed to blogging. You are stuck with me.)
I will blog at least once a week, but I intend to far surpass that.
So check this blog often (more than once a week – I have to lay down the challenge for my buddies) for goodies of value.
WEDNESDAYS: ADHD DAY!
School’s out so what better time than now to think about next school year? Do you want to endure the same struggles as last year with your ADHD child or with your ADHD self? Maybe you are in denial and you don’t want to admit your child has ADHD? Maybe you know he or she has a ‘problem’ but you don’t want to medicate it away? Read on.
I have dedicated Wednesdays to ADHD (Attention Deficit Hyperactivity Disorder) in my blog.
I have decided that every Wednesday I will discuss Attention Deficit Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD) as people commonly call it.
My story of diagnosing and treating Attention Deficit Hyperactivity Disorder is long and circuitous. It began when I received my doctorate in child clinical psychology from DePaul University in 1996. Now, in 2009, I have learned a few things about Attention Deficit Hyperactivity Disorder. I will share it with you one piece at a time over the next few Wednesdays.
This will lead up to the kickoff of a program in which I will offer the treatment of ADHD without medications.
IMPORTANT!
I have a wait list for people who want ADHD treatment without medication. This list includes adults and children. Yes this approach works with preschoolers to adults in the 50s and even older. Email me at charles.shinaver@gmail.com.
YES! You read that right. One more time, I will do ADHD treatment without medication. No, it will not be behavior modification. ‘B-mod’ as it is commonly called among psychologists does help to manage ADHD, but it is debatable whether it addresses the “core symptoms” of inattention and hyperactivity, more on that in a later post.
So before we get too deep into this if you want you or your child on my wait list send me an email to charles.shinaver@gmail.com subject line “ADHD treatment without medication wait list”. I will be happy to put you on there.
When does the program kickoff?
When I fill my wait list I will start the program – preferably early this summer.
Now this treatment could be a compliment to medication, but my goal would generally be to go off of medications.
Why?
“THE SIDE EFFECTS SHUFFLE”:
You know the story, you get your kid diagnosed with ADHD and you get a medication. Then you get a side effect. You don’t like the side effect. You get a new ADHD drug. You get new side effects. You change your ADHD drugs again and get a new side effect again and on and on. In other words you begin “the side effects shuffle”.
Side effects for ADHD meds can vary from sleeplessness, weight loss, irritability, etc.
You pick your med and you get your side effect. Then you begin the shuffle.
Adderall side effects:
So, let’s take Adderall for example, anxiety, tremors, insomnia, dizziness, headaches, dry mouth, diarrhea, or constipation, impotence or change in sex drive. (See www.adhdnews.com/adhd-drug-side-effects.htm).
Yes, fun stuff. It reminds me of those ads for Viagra. Among the list are some pretty unpleasant things, like 4 ‘straight’ hours of well, you know …. Who would want to endure 4 hours of that? Yes, like you are going to call your physician if that is one of your side effects!
Well, the side effects shuffle for ADHD gets to be quite a nuisance too. It makes you want to avoid calling your doctor.
Ritalin side effects:
You don’t like the side effects for Adderall then let’s try the old favorite Ritalin. The main culprits are the same nervousness and insomnia. But there are many other possibilities:
“Other reactions include hypersensitivity (including skin rash, urticaria, fever, arthralgia, exfoliative dermatitis, erythema multiforme with histopathological findings of necrotizing vasculitis, and thrombocytopenic purpura); anorexia; nausea; dizziness; palpitations; headache; dyskinesia; drowsiness; blood pressure and pulse changes, both up and down; tachycardia; angina; cardiac arrhythmia; abdominal pain; weight loss during prolonged therapy.
Allergic reactions: skin rash, hives, drug fever joint pains possible. Headache, dizziness rapid and forceful heart palpitation-infrequent.” www.adhdnews.com/adhd-drug-side-effects.htm
Now you are getting the idea. Med, side effect, shuffle, rinse and repeat.
It is a time-consuming and expensive process. I won’t cite research here, but many of you know from experience what I mean.
By the way, the white elephant in the room: no new skills are learned along the way.
Isn’t that one of those things that makes you go: “Hmmmmmm?” No new skills, only new ADHD medications and new side effects… What is that about? Personal growth? Your child reaching his potential? Hmmm?
Strattera side effects:
“Upset stomach, decreased appetite, nausea or vomiting, dizziness, tiredness, decrease in appetite, some weight loss, and mood swings were the most common side effects.
In rare cases, Strattera can cause allergic reactions, such as swelling or hives, which can be serious. Your child should stop taking Strattera. Call your doctor or healthcare professional if your child develops any of these symptoms.” (www.adhdnews.com/adhd-drug-side-effects.htm)
So now we have a name for it, the “the side effects shuffle”.
If you are interested in moving beyond the “side effects shuffle” email me to join my wait list for a non-medication treatment of ADHD at charles.shinaver@gmail.com.
Obviously some kids do not experience these side effects, but their parents would probably not be reading this blog!
Next Wednesday we will have more on ADHD: EEG biofeedback treatment of ADHD.
I will discuss what worked when I took my 3 year foray into EEG biofeedback treatment of Attention Deficit Hyperactivity Disorder (ADHD) and what didn’t. A couple other concepts I will introduce: executive functions and the role of inhibition in ADHD.
Charles Shinaver, PhD.
PS: Tomorrow I have to do something with one of our Cairo, Egypt pictures from my trip with my wife to Cairo, Egypt and Alexandra, Egypt given that President Barrack Obama will be speaking from Cairo. Egypt. So, tomorrow’s focus will be relationships with a picture from Cairo, Egypt.
BLOG # 2 in one week since the ADHD BLOG last Wednesday.
Goal this week: 3 blog posts.
I had to get a blog in before ADHD Wednesdays tomorrow so here it is.
Relationships that work and marriages that succeed have a pivotal insight in common and it is not what you expect. And no, it is not that they both learned “I statements”.
This is a primary INSIGHT about effective relationships and loving marriages:
Some marital conflicts are NOT resolvable.
Yes you read that correctly,
NOT resolvable.
This is a concept from a book called 7 Principles for making Marriage work by John Gottman.
Amazingly this psychologist found that when they made 15 minute video tapes of couples who were asked to discuss contentious topics that he could with 91% accuracy whether the couple would divorce or not. So this guy has some insight about marriages.
So, what does his research say about what works in marriage?
Let’s do it like a geometry proof:
Marriages and relationships have conflict.
Some of those conflicts are not resolvable.
Then what to do?
Focus on what you appreciate about your spouse.
Gratitude. Yes that is it.
I know. I know. It sounds like a cop out. But try this and you will learn two things:
1. It is not easy to focus on gratitude toward your spouse when you have an irresolvable problem.
2. It works.
This is especially confusing when many people have notion that you MUST always be assertive and GET your needs met. Assertiveness is good and necessary. Getting your needs met is good too.
But some conflicts will not bend to your assertiveness.
For guys, what if she will NEVER like football?
For gals, what if he will NEVER be great at gift giving?
Well, if you are not married you can ask yourself this question:
What are my “deal breakers”?
Clarity about that is crucial.
If it is not a “deal breaker” then you ask yourself is it actually resolvable?
If the answer is an honest “no” then ask yourself can you live with it?
If yes then it is time to focus on what you appreciate about your partner.
When couples come to me for marital or pre-marital counseling I often ask a question which for me is a “deal breaker” meaning if they can’t answer yes to this then I can’t work with them.
This is the question:
Can you think of three things you appreciate about your spouse? Two? One?
If we get a big goose egg on this question it is a “deal breaker” for me. I can’t work with them.
Because here is the deal, think about this logically.
If at least some relationship conflicts are not resolvable, then your hope or dream, wish or desire to change your partner is a ‘failed project’.
If you cannot accept that the ‘project of changing him’ is what is failed and not him or her that has ‘failed’ then you are in trouble.
Often people want to go to counseling or marital therapy to vent and have an ‘objective professional’ make it clear to the spouse the error of his or her ways.
I always start with the premise that if you both don’t have some responsibility in the problems then you both will lack motivation to solve the problems. Are there exceptions, yes a few, but not many. The few are extreme and obvious and most rational people would agree upon those.
I am talking about the rest of the problems.
So, next time you go thinking “If only he would….” Or “If only she would….”
Maybe it is you who needs to ask:
“What do I really appreciate about her?”
“What do I really appreciate about him?”
If you have no answer to these questions then maybe it is you who needs to change.
How bad can ADHD (Attention Deficit Hyperactivity Disorder) really be?
How many kids have it?
First the core symptoms of ADHD are inattention and hyperactivity.
General prevalence rates put ADHD at 5% of children mostly boys.
People have heard things like those with ADHD have more risk for drug abuse, more car accidents, more job loss and career change, etc. etc.
What is the long term story or likely story of someone with ADHD?
What are typical trajectories of their lives?
Some parents’ minds get overwhelmed when they begin to do research on ADHD online. There seems to be an overwhelming number of problems associated with ADHD. Is my child at greater risk for all that?
A deeper look will ease some of those fears but also engage you in realistically assessing what you need to do now.
When considering ADHD statistics the complicating factor is what we psychologists call co-morbidity.
Co-morbidity is when another problem co-occurs with ADHD. So what else is going on with your child other than ADHD?
Co-morbidity is the critical factor when attempting to understand what ADHD in children means for adult ADD. In other words, what will be the life trajectory of a person with ADHD?
A few years ago I did a thorough review of research and I concluded with an important insight:
When ADHD occurs alone then the primary problem you get is significantly lower academic achievement than you would expect for that person’s IQ level.
On a research level or a statistical level most of the other problems fade out when you remove those people who have co-morbid problems along with ADHD compared with those who have only ADHD.
This does not mean on an individual level that they never co-occur. It just means that they are not close to as likely as when you have a co-morbid problem.
The research trends continue to bear this out. A useful study by Joseph Biederman MD and Stephen Faraone PhD can be read at this link: http://adjix.com/fe5q. They studied 150 boys diagnosed with ADHD and compared them with controls (120 boys without ADHD).
What is useful about this study (Harvard Mahoney Neuroscience Institute Letter: On the Brain, Winter, 1996 Vol. 5, number 1) is that it breaks down how prevalent some of those co-morbidities are within the population of boys diagnosed with ADHD. Take a look at their graph and try to figure it out http://adjix.com/fe5q. Here are a few highlights:
1. 49% had ADHD alone.
2. Anxiety, Depression and Conduct disorder are common problems that are co-morbid with ADHD
3. Co-morbid disorders predicted later disorders consistent with that original co-morbidity.
Their study involved a follow up after 4 years. What they found was that if a child had anxiety then 4 years later he was likely to still have anxiety and possibly more anxiety. If he had conduct disorder he was more likely to have antisocial personality disorder (a progression beyond conduct disorder). If he had depression he was more likely to have mania when he was 4 years older.
So, the concept is that having ADHD alone leads to risk for academic underachievement but does not necessarily predispose a child to adding along the path of life anxiety, depression and conduct disorder. However, if he had one or more of these issues originally then they are more likely to continue and worsen.
Biederman and Faraone had some other interesting conclusions as well. I will quote them directly here: “The MGH study was the first double-blind study to clearly show not only that ADHD is familial, but also that the way the illness clusters in families is most consistent with the effects of a single gene of modest effect. We were able to dismiss other explanations such as socio-cultural factors.” (Biederman and Faraone, 1996) http://adjix.com/fe5q
This is pretty potent here. As has been often concluded that ADHD is primarily hereditary this study is more conclusively stating this.
Additionally, this study found the following:
“…ADHD and major depression are variable expressions of shared underlying risk factors and that ADHD with conduct disorder might be a distinct familial subtype of the disorder. However, anxiety and learning disorders were not tied to ADHD familially; instead, when those disorders co-occur with ADHD in families, they appear to be transmitted independently.” (Biederman and Faraone, 1996) http://adjix.com/fe5q
These findings are also very significant in that they suggest different things about intervention and prevention. In families in which depression is common with ADHD children in those families are more at risk for that combination, but conduct disorder with ADHD is a subtype. This is an important distinction that it suggests that just because a child has ADHD does not mean he is at greater risk for breaking the law and violating the rights of others, but if he has a family that tends to do so he is at more risk for that.
In contrast anxiety and learning problems were found to be transmitted independently. So, anxiety might develop out of stress related to academic struggle, social interaction, etc. Learning problems may stem from brain problems etc.
What does this mean for intervention and prevention?
1. Diagnosis of ADHD or ADD earlier and intervening earlier reduces lagging in academic achievement.
2. Co-morbidity determines whether only ADHD or another disorder(s) needs to be addressed.
3. As anyone in mental health who works with this population will tell you, families with ADHD and conduct disorder are very difficult to treat. (Keep in mind that conduct disorder symptoms include bullying other people, cruelty to others (people and/or animals, fighting, stealing, destroying property, deceit and theft.) As you would expect when this runs in a family it is hard to treat.
4. Families will tend to have patterns of depression to accompany ADHD when a child tends to have it.
So, if the family has those signs and the child doesn’t have it yet, you might prevent it with intervention.
5. Anxiety and learning problems may or may not be in the family history when they occur in a child.
6. Each subgroup is fairly distinct although there is some overlap. In other words a child with conduct disorder and ADHD will be quite distinct from a child with ADHD alone or with ADHD and anxiety.
So, in short, a more refined review of the ADHD statistics is in order when attempting to understand the risks for your child.
Keep in mind I am presently investigating a treatment approach for ADHD that does not involve medication. I will update you on that as I engage in it.
Finally, I do short videos on www.fitfamily.tv to teach you about mental health topics. Look for one on ADHD soon.
This video is an example of what parents grapple with when deciding what to do with their ADHD-diagnosed child. Watch and get the facts on medicating a child.
I am a psychologist-coach & father with a son who HAD ADHD and I have chosen to use COGMED with him and use COGMED in my practice. It is important that you know that I have committed to this alternative way to improve working memory and thereby improve attention. More importantly, I think you should know more of my story to get how I got to where I am today. When you know what I know you will understand why COGMED is a potent alternative way to improve working memory and attention.
Here is the first chapter of the story:
I am Dr. Charles Shinaver.
I am married and I have three sons who are 14, 11 and 8 years old.
When my oldest son was 5 or 6 I knew he had Attention Deficit Hyperactivity Disorder – ADHD that was around 2000. Yes, the disposition is distinctly different.
He was diagnosed with ADHD when he was 8 (2003). These dates will matter at a later point on my blog when I begin to consider the largest multimodal treatment intervention research of ADHD to date and it’s reported results over time. (That will not be today, but it is coming.)
We held out on using medication for ADHD because we didn’t like the reported side effects and my son was not falling behind academically or socially. However, by the time he was 8 it was time to do something.
He is now 14 and he no longer has ADHD or I would say he is no longer diagnosable.
Yes, he no longer has ADHD. No he didn’t grow out of it. Yes some people do, kind of. I will come back to that later in the story.
So to be clear, I am a clinical child psychologist with a doctorate and masters in child clinical psychology from DePaul University and a masters degree in counseling and consulting psychology from Harvard. I am also the father of three sons, the oldest is now 14.
Back to my son, yes, HE HAD ADHD. He doesn’t now. How is that?
I used EEG BIOFEEDBACK to help him to overcome it. That is, Electro-Encephalograph Biofeedback. Or to put it another way, his work with EEG biofeedback enabled him to shift his brain functioning or improve his brain activity so that that he no longer exhibited symptoms to a degree that he was diagnosable.
That is how I helped my son overcome ADHD. So you probably think I am going to tell you about EEG Biofeedback. That is not really my focus. My focus is broader on alternative treatments of ADHD. More specifically there needs to be a focus on the alternatives to address the core areas of deficit in Attention Deficit Hyperactivity Disorder. Those core symptoms are inattention and hyperactivity or impulsivity.
As you may well know it is not a simple thing to address these problems.
I know both as a parent and a clinical child psychologist.
So, the nagging problems begin. I know you are likely to have experienced some of these nagging problems. I articulate them here so you know you are not alone.
I have been there before, both professionally and personally.
NAGGING PROBLEM #1: THERAPY DOESN’T HELP THE ‘CORE SYMPTOMS’ OF Attention Deficit Hyperactivity Disorder or ADHD, or ADD.
As a clinical psychologist I watched countless kids be medicated for ADHD. I saw them struggle with the side effects of these powerful drugs.
I am a clinical child psychologist, after all.
But here is the tough part.
I also knew that doing therapy with them or counseling them would not help these kids with their impulsivity or inattention.
How did I know? I tried it.
Yes, as a licensed psychologist. I did both individual and family therapy with kids with ADHD and ADD. When we would work on issues in therapy it would allow the kids to vent of feel a sense of connection and compassion. This could help the kids with depression or anxiety and sometimes with other problems.
There was only one problem whatever we worked on did not carry through in terms of behavior change. Their inattention and impulsivity kept them from being able to use strategies we worked on in therapy. It simply didn’t stick.
So, I knew that to address the ‘core symptoms’ of ADHD therapy simply did not work. You could address other problems. You could improve parental consistency, strategy and how the family system worked, but the core problems did not improve.
Drugs appeared to ‘work’. But there were some other nagging problems…
NAGGING PROBLEM #2: MEDICATIONS OFTEN HAVE SIDE EFFECTS: “the side effects shuffle”.
The first set of problems I observed up close and personally was what I call the “side effects shuffle” as he tried one medication after another.
He would try one medication and he would have to deal with a loss of appetite and weight loss. Then my son tried another medication and we dealt with his irritability and sleeplessness, and so on and so on. I didn’t like the impact the meds had on my son. He didn’t either.
However there was nagging problem #3 on my mind, if we took him off the medications.
NAGGING PROBLEM #3: WILL MY SON FALL BEHIND ACADEMICALLY AND SOCIALLY IF I DON’T MEDICATE?
Up until that point, like you I was confronted with a dilemma. The research trials of medications did show that meds were effective in rapidly MANAGING the ‘core symptoms of ADHD’ impulsivity or inversely a lack of inhibition, and inattention.
The problem was did they really address the root cause of the symptoms or just the symptoms themselves?
I use the term managing the symptoms because they just came right back as soon as the meds wore off. So, I couldn’t really call it ‘addressing’ the symptoms or stopping them. It was just managing them with chemistry.
But that begs the question, were we really helping my son?
This was a rather vexing problem.
So, I had my son taking medicine from age 8 to about 10, but this was an unholy alliance for me.
The question that plagued me was this: if you remove the meds you remove the improved attention and reduced impulsivity. The skills we work on while he is the meds do not materialize when he is off the meds. So this contrasted to medicating people with anxiety or depression. In those situations you can medicate work on skills and they are still there when the person is off the meds. With ADHD it didn’t really work that way. Why? They weren’t paying attention to when do use the new skills. Or they couldn’t stop their impulses long enough to try that new strategy we worked on developing. So, this is a very distinct situation from medicating depression or anxiety, at least in my experience.
So, he took meds BUT he did not develop any new skills. He did not learn a way to better manage his impulses. He did not learn to better pay attention. His brain did not make any progress or develop more ‘activity’ where it was heretofore lacking.
He simply had what I will call a ‘bullet train’ in a bottle temporary in charge of his brain (more on that in Nagging problem #4).
Besides I was teaching him that if he took a pill he could get a bullet train in his brain and he could ride it during tests, while he was working on papers, when cramming for exams in college, while running his technology company, when did it stop, ever? Wasn’t this kind of like pro athletes who take steroids? Well, obviously the analogy doesn’t completely hold up, but you get my point.
NAGGING PROBLEM #4: “THE BULLET TRAIN IS IN THE BOTTLE WILL NEVER BE A PART OF ME”
As a matter of fact I found these medications and their effects so puzzling I tried one of my son’s meds one day just to see how it would affect me.
Yes, I know something I probably shouldn’t do or reveal, but it is worth you getting my perspective because I don’t have ADHD and I wanted to see how it affected me. Besides as I have dug deep into the literature it turns out I am far from alone in doing this.
Once I took that med I was like a heat seeking-missile with laser like focus. I cranked at getting work done that day, well, uh, and night too, well into the night as a matter of fact. I often stay up late, but this was a totally different deal. I was cranking the whole time non-stop. I felt like I was on a bullet train, but there was one problem, I couldn’t get off. I was on a “bullet train from a bottle” and I was not the conductor, I couldn’t get off the train. I couldn’t stop the train. I couldn’t really even slow it down. I know, I know, with a physician properly managing the meds and me it might be the case that the train would not quite be so fast or possibly out of control, but the experience was palpable. From judging kid’s reactions over the last decade or so I can definitely see the similarities.
Also if someone attempted to get in front of the bullet train, well, let’s just say that getting run over by a bullet train is not a pretty sight.
Yes, the word wrath might apply. I was a pit bull with a femur in my mouth and I was not about to let go. This feeling of being intensely focused, but not in control was very, very uncomfortable for me. I definitely developed some empathy.
It was that day that I realized I had to find different solution for my son and our family now. No more waiting and carrying these dilemmas it was time for action.
However, many people would like the effect of riding a ‘bullet train’ through life, even if the ‘bullet train was in the bottle’ and not part of me. Me? Not so much.
Before I was “concerned” about the impact these meds had on kids.
Now I was massively motivated to find an alternative.
I know I am not the only one. I had seen many other parents who saw the “side effects shuffle” and they didn’t like it either. Boy could I understand how some of those kids might get a ‘little irritable’ after taking these meds.
After my bullet train experience I felt like I had a grasp on both the ‘benefits’ and the ‘risks’ of these meds. Not to mention the years of clinical experience and my concerns about the research, or lack thereof which will we will get to in a minute.
Yes, you can focus and yes you can get a lot done, but that was not ‘me’ or how ‘I’ ‘normally’ focus. Yes, I can have periods of time with intense focus, 2 hours 5 hours as a maximum when I am really on a roll, but this was like 12 hours straight, but that in itself was somewhat ‘cool’.
Yeah, the kind of ‘cool’ that scares you.
Again, I was simply not the conductor of the bullet train. It had a ‘mind’ of its own. It was at that point that the father in me moved into action. The father in me saw a boy who was 10 years old (in my mind soon to be 14 – given that I am always thinking 4 years ahead) and was right around the corner from some serious temptation as he would be hitting high school. Kids would be gearing up to get into the ‘best schools’. Boy would there be an appeal for ‘a bullet train in a bottle’ as kids compete to be the best and the brightest.
I kept coming back to this question:
Did the ‘bullet train in a bottle’ solve this problem or was it the beginning of a whole new set of problems?
NAGGING PROBLEM #5: THERE WAS NO RESEARCH TO ANSWER THE MOST CRITICAL QUESTION:
WHAT IS THE IMPACT OF MEDICATING AN ADHD CHILD FOR A DECADE, FROM AGE 7 TO 17 – AT MINIMUM?
This gaping hole in the research went against the grain of all my training.
We didn’t know the answer to this question and we were medicating kids like crazy. I was medicating my own son, or allowing him to be medicated.
As a psychologist I am trained in two primary areas: clinical work and research.
In clinical work I have the goal of getting to the ‘root cause’ of things AND facilitating behavior change.
With research I have been trained to systematically review the method of knowing from which a person bases his or her claims. It can be a pretty annoying place to live especially in your early days post training, but you get used to it and the role of logic and empirical research assumes both its power and limits over time. In this case research has a critical role, but we had no answer to the critical question.
On both counts medicating kids as a ‘solution’ to Attention Deficit Hyperactivity Disorder fell way short.
At best it is a short-term band-aid.
I would never get that ‘bullet train in a bottle’ to be a part of me, neither will my son, neither will your son, or daughter. It was like adding NO2 to a car. All of a sudden I was ‘juiced up’ and moving at a speed and with focus I simply could not summon without my ‘bullet train in a bottle’. Now, NO2 in a car looks pretty exciting with Vin Diesel in the Fast and the Furious, but for me on an everyday basis, driving the car pool, picking up the kids after football practice, not so much. It looks more like a serious wreck waiting to happen.
Medication doesn’t get to any root causes. Like understanding why does his brain work this way? Medication does not facilitate any new behavior or skills, or at least not once the meds wear off. So, on a clinical level this is not a sustainable intervention or at least whether you can call it ‘effective’ is questionable. (I will discuss this in detail in a later blog.)
Yet, and here is the dilemma, on one level medicating kids with ADHD or ADD works. On one level, or make that two levels: fast and easy. It is fast and seemingly it is easy to do. Little work is involved for the kids or parents. Just take the pill.
The kid after taking that medication sits still and pays better attention. Yet, without understanding how his brain is different from other kids and how to help him to develop his brain in a way to make him more effective the power is in the pill. That seems like a recipe for a risky precedent. It is disempowering.
Again, realize that I am not “anti-medication”. My son was medicated at the time. I was vexed because he was 10 and this was not a long term solution I found acceptable. This was on a logic level and a level of training as a researcher and clinician. It applied to all the kids who dealt with this issue. I had the blessing of working with kids who were 17. I saw in real life where this whole convoy was going and I was concerned.
On the research logic level there was another huge problem.
Even though shorter term studies of 1 or maybe sometimes 3 years seemed to show reduced symptoms of ADHD while on medication.
There was a research question screaming to be answered.
It was a simple research question that I had not seen sufficiently answered:
What is the effect of medicating a kid for a decade, really, a decade?
Why? We are medicating kids beginning around age 7 until at least age 17, more likely age 25 (assuming they are going to college and you want them to make it through)?
This question bothered me. No one was asking that question in 2005. Or at least I could not find evidence of it. No one had answered that question in 2005, again not that I could find.
My son was 10 in 2005 when I sought out EEG biofeedback. I had not seen any longitudinal studies for a decade or more that followed stimulant medicated ADHD kids that had addressed this issue.
Remember, I am not ‘just a child psychologist’, I am the father of an oldest son who HAD ADHD. So, I am always thinking about 4 or 5 years ahead. In my mind he was going to high school tomorrow and that ‘bullet train in a bottle’ seemed way to tempting. (I will blog on that later too.)
So, my son is 10 in 2005.
I am thinking when he is 15 if he is taking this medication what will be the risk to abuse it?
What will be the risk for him to sell it?
Will other kids sell it?
Besides do I really want to teach him that the way to improve his life is through a pill?
Not to say that pills don’t have their place. Remember, again, I had had my son medicated as I dealt with NAGGING PROBLEM #3 because I didn’t want him to fall behind socially and academically. It wasn’t that I was totally against drugs or I would have not have medicated him.
The issue was this: Is medication a solution for a DECADE OR MORE?
Does anyone know the effect of giving MY SON a stimulant for a DECADE?
RESEARCH SAYS: WE DUNNO! WE HAVE NO IDEA!
Will he have learned any new skills? Obviously, the answer is no.
My response was simple: I have to find something else, I thought.
So, I returned to one of my primary skills: research.
I researched until I found EEG biofeedback.
I will continue with the story on my next blog post.
Watch this to video clip to learn more about how college kids get medicated these days; its shocking!
2 Why I sought natural ADHD treatment, my concern about ADHD treatment Drugs and where medicine for ADHD was leading people in 2005….
As I mused in my last blog post:
“So, my son is 10 in 2005. I am thinking when he is 15 if he is taking this medicine for ADHD what will be the risk to abuse it? What will be the risk for him to sell ADHD treatment drugs? Will other kids sell it?”
As you may recall, I am not anti-medication. My son took medicine for ADHD from age 8 to 10 or so. I also explained how with other problems like anxiety or depression that medication can help to stabilize a person while they learn skills that can then help them to better manage without the medication. Yet, that isn’t the case with ADHD treatment drugs because once the medicine for ADHD has worn off their ability to inhibit responses and summon the skills that were being developed evaporates too.
No stopping, no thinking, no summoning, no behavior changes.
The way this was viewed in 2005 was that ADHD treatment drugs aren’t a short-term step; the medicine for ADHD or ADD have become a long-term “solution” from at least age 7 to 17.
So, what are the risks?
In 2005, I saw risks, so I turned to research to help me find the answers.
In 2005, I could not find many research or news articles.
However, I had this: foresight.
(On Strength Finders 2.0 my strengths are maximizer, learner, strategic, futuristic and ideation).
At the time I had these data points:
I had seen the “side effects shuffle” of ADHD treatment drugs as we shuffled weight loss, loss of appetite, sleeplessness, irritability, with different medications which never fully solved the struggle.
I had experienced the “bullet train in a bottle” and here, in my view, is what was risky about it, treating my son with medicine for ADHD. There were many positive qualities about the impact of taking a medicine for ADHD. I was focused like a ‘bullet train’, for hours’. Those are two ‘addictive’ qualities. Yet, I could not get off that bullet train. That ‘ride’ itself was enticing and very much potentially addictive. The hours of focus that I ‘normally’ couldn’t muster given by that ‘bullet train in a bottle’ were also very tempting for that ‘inner achiever’ in me.
My son didn’t like the ‘feeling’ of being on the ADHD treatment drugs.
This was not a true long-term solution in that no new skills were developed.
I had seen other kids and their parents’ report that their child ‘seemed to lose his personality while on the medicine for ADHD or ADD.
I had enough. I acted upon my foresight in 2005. I sought EEG biofeedback training as a natural ADHD treatment and used it to help my son get off medication. What happened since I decided to take action in 2005?
See my coming blog posts…..
Meanwhile, if you are ready to take action now on what I consider the most user-friendly natural ADHD treatment with the best research I have found to date is a treatment through Cogmed. This treatment for ADD ADHD is carried out at home with weekly coaching calls. Its’ effectiveness rate is 80% which is extremely high for any behavioral intervention.
Call Dr. Shinaver at 317-641-7794. Or email him at Charles.shinaver@gmail.com. I will do a free 20 minute consult to help you determine if this program is a good fit for you.
I offer Cogmed a treatment for working memory which improves attention. I am accepting new clients for this program. It is not bound by geography so you can be out of state or even in another country to do this.
Come back here every day while the plot of the treatment for ADD ADHD thickens every day.
Wow, have things changed in the world of medication for ADHD! According to Webmd.com a study published in Pediatrics reported that calls from 1998 to 2005 for abuse of ADHD meds among 13 to 19 year olds rose by 76%.1 They note that this is rate of increase that is “faster than calls for victims for substance abuse generally and teen substance abuse.” 1 This is cause to pause and reflect.
I am stunned that the increase of the rate of say, Concerta abuse and other ADHD drug abuse has surpassed alcohol and pot, and substance abuse generally in the rate of increase, among teens from 13 to 19 at least among calls to poison control centers. It is really amazing and sad to consider thatADHD drug abuse is now rivaling pot and alcohol abuse among teens. In later posts I will discuss the reality that the increased use ADHD medications across the world is one of the major contributing factors. Yet, this is more than sad. It creates a much more complicated reality when you consider using ADHD medications to treat your child. I do not have the sense that parents are aware of these facts.
Today I am writing about how urgent and important it is that parents to consider what some have called “natural remedies for ADHD.” More broadly I would describe these as alternative treatments of ADD and ADHD.
Attention Deficit Hyperactivity Disorder (ADHD) commonly called ‘attention deficit’ is typically treated with medications. This form of treatment is on the rise, but it creates a whole slew of other problems, problems that don’t exist with non-medication ADHD alternative treatment.
The issue, in my mind, is how do you utilize ADHD treatment medications in the short term while finding better long term solutions?
Today we will consider one of the slew or problems created by using medication for ADHD: the abuse of ADHD meds by students who don’t have a diagnosis of ADHD.
One way to answer the question of how to use ADHD medication effectively is to thoughtfully consider the age of the student. ADD or ADHD medications may be more effectively used in the short term especially with younger kids, but you get into all kinds of thorny issues in adolescence if you continue to treat teens with ADHD medicines. Many of these problems might be successfully avoided if you prepare and thoroughly investigate other ADHD treatment options earlier while possibly using ADHD treatment drugs as a short-term or stop gap measure.
In high school and college your children if treated with ADHD medicines will have a controlled substance in their possession or at least accessible to them that their friends and/or classmates will want to abuse. It puts your child in a precarious position to say the least.
There is a market in which high school and college kids are buying and selling prescription stimulants illegally. That’s right, those ADHD treatment Drugs are going to kids without prescriptions and that is dangerous. What if they get the ADHD medicine from your son? You really don’t want that to be on your plate if you can avoid it.
So as your son or daughter turns 10 or 11 years old and you are using an ADHD medicine to treat his ADHD or ADD you need to consider that in 3 or 4 years he will be in school with many other kids that will be abusing that same drug that you give him every day. In essence he will have a product and a market…. So it would be wise to consider and actually try other options when you child is this age.
If you continue to use medication to treat ADHD once your child is a teen, he will be tempted to sell it or give it to other kids who use it to study, write a papers, etc. Yet, this is illegal for him and the kids who abuse these drugs without a prescription. Your role might be considered as contributing to this crime. Besides, it is dangerous.
So, as a short-term solution for children from ages 7 through 10 or 11 medications may fit your child. However I believe you should also consider other options during this time to find other things that work. When your child hits his or her teenage years, as you know, everything changes.
For teenagers the temptation to sell these ADHD drugs to other teens should make you pause and consider this issue. At minimal you have to seriously contemplate the security of your distribution of ADHD medication to your own child. This is not something most parents of 7, 8, 9, 10 or 11 year olds consider.
For example, like nurses at residential facilities, you have to check your teens’ mouth and have him lift his tongue with his mouth open to make sure the medication has been swallowed, or be as sure as you can be. The problem with this is that many teens will ‘cheek’ meds. So they will hide the ADHD meds either in their cheek or under their tongue. Yes, this really happens. I have worked in residential facilities where this happened. The meds really have to be placed under lock and key. I realize that this all sounds intense and possibly overblown, but given that there is a market for these drugs you need to consider it seriously. So, now you see that this is one of the more serious reasons other treatments for ADHD should be considered and tried before your son or daughter is a teen.
Realize that I am talking about those teens who abuse it for performance reasons today. So, the irony here is that if you have a teen that is very competitive and wants to get into the best schools he or she will have friends like that. Those kids are very tempted to use ADHD medications to give them an edge on tests, papers and standardized tests. So, the irony is that if you have a “good kid” he still will be tempted by this issue as will his friends.
What other options are there? I will consider this more thoroughly in later posts.
However, if you remain unconvinced consider this.
The core of my own concern with my son in 2005 was where would the medicating of him end, in college, in adulthood? When, ever? What is the effect of medicating kids from 7 to 17, 7 to 22? Do we know? (We still don’t know, by the way.)
Other concerns included: what will he think about himself if he feels the need to pop a pill to pay attention? Since the ability to attend wears off with the meds is this really a solution for increasing attention at all? How effective will this really be? I was skeptical and the data supports my concerns as you will see in coming posts.
My other concern in 2005 was that other kids will start abusing these drugs and do I want to put my son in the situation in which other kids want to get this drug from him? No.
It was not because I don’t trust my son. It is because one primary dysfunction of kids with ADHD is that they act impulsively – without thinking. I used to explain it this way. Take a kid with ADHD who loves chocolate chip cookies and put a jar of chocolate cookies in front of him. Then tell him you will leave the room. If he can manage to not eat any cookies while you are gone you will give him the whole jar. You leave the room. He takes a cookie. He doesn’t get the jar. He can’t stop and think.
Stopping and thinking, or a lack thereof, is at the core of the problem of ADHD. By giving them access to a drug which now has a thriving market you place a tremendous temptation in the hands of those who are significantly limited in their ability to resist such temptation, think very big cookie jar, but in a very small pill bottle that is very easy to conceal.
Not going there. I’ve seen other kids end up there. I saw it coming. Don’t even want to get near the entrance. On this one what the studies say as far as how many admit to selling or giving away the drug doesn’t even matter to me as a father. I am simply not going to put my son in that place, end of story.
Stanislav Svetlov, et al (2007) use a particularly apt term: “Steroids for SATs” in their article “Performance enhancing, non-prescription use of Ritalin: A comparison with amphetamines and cocaine.” Candidly Svetlov et al (2007) note that the “Psychotropic effects and pharmacological pathways evoked by MPH (methylphenidate – RitalinTM) are similar, but not identical to those produced by amphetamines and cocaine.” 2
That is the appeal: “performance enhancing”.
A comparison with amphetamines and cocaine just sounds disturbing.
Arguably, it is this ‘similarity’ of effect of cocaine to ADHD drugs which creates the appeal of ADHD meds: the focus, the energy and depending upon the circumstances, the high.
Additionally ADHD medicines can be addictive (we will consider that in more detail when we consider side effects). The way that a person ingests ADHD medicines and the dosages matter in terms of creating higher risk for addictiveness and other negative side effects. When the ADHD meds are prescribed by a physician he or she provides oversight on these issues. Not so with kids abusing these drugs.
Another difference between Ritalin or Adderall or most ADHD medicines in contrast to illegal drugs is that there is the common assumption that since this isn’t cocaine and it is prescribed by doctors, that it cannot be a problem. It must be much safer since doctors prescribe ADHD medications for kids all the time, or so the thinking goes. Well that thinking is not correct. As a matter of fact it is because there are risks of adverse side effects and addiction that these prescriptions drugs are monitored by physicians.
One wonders about the relationship of the professional approval of ADHD drugs to what is clearly a trend of increasing ADHD drug abuse on campuses.
Many researchers like Stanislav et al have found that (2007) 1: “MPH and similar medications have been widely used on College campuses and by students preparing for exams. Nicknamed ’steroids for SATs,’ MPH and related medications are purchased without prescription and their use may even be encouraged by parents and tutors…. Use by those without any medical or psychiatric diagnosis is increasing.”
This is the key point for parents: ADHD/ADD medications are “widely used on College campuses” by people without a prescription, without a diagnosis and that abuse is very much on the rise. There are a series of studies that have found this trend of ADHD medication abuse.
Then as a parent you are presented with the fact that on college campuses the abuse of ADHD medications is very much on the rise. Yet your son or daughter who will be away at college will likely be out from under your daily supervision at college. What to do then? Well, preferably you sought out other options before your child with ADHD goes off to college. This issue takes on new importance with adult ADD and adult ADHD, especially if those adults are your college students taking ADHD meds just out of your supervision for the first time.
Parents: The Unwitting Distributers of Controlled Substances?
How are those on college campuses getting Ritalin without a prescription?
Two ways:
Those kids who are diagnosed and prescribed the ADHD drugs are selling it.
People are stealing prescriptions and selling them.
Either way, is this a situation you want to be contemplating in high school as you prepare your child to go to college?
As I noted earlier I found what I consider to be a better long term strategy to address the problem of inattention: Cogmed. Note that I did not say a solution to the problem of ADHD or ADD. ADHD also includes hyperactivity and Cogmed has had impact on this area, but it is not as well established and consistent as its impact on attention. So, Cogmed does not make this claim. Nor does Cogmed make the claim that it ‘cures’ ADD. Such claims are easy to assault. Cogmed makes the claim, supported by placebo controlled, double blind studies that have found 80% of its users have improved significantly in working memory and working memory is related to attention. So attention is improved as well. Get the logic? The key here is that Cogmed is an alternative which may be included with ADHD medicine or not, but it is a viable, reasonable and comparatively financially appealing alternative.
Cogmed is not a drug. It is not a controlled substance. Cogmed’s results compel you to complete their program to improve how your working memory functions. Doing the Cogmed program requires work and effort. It affects brain functioning. As such, people who use this program also make the connection that effort and work affect their ability to pay attention instead of simply popping a pill. However, this work and effort involve doing this very specific set of activities that they discovered through thorough research. This is very noteworthy. It is not simply work and effort on anything that will address this issue. Again, Cogmed is careful not to claim to replace medication for ADHD or to be a cure for ADHD. However, it is an alternative and you may or may not have a child taking ADHD medications as well doing Cogmed at the same time. It is an alternative you should seriously consider.
The kids who abuse ADHD medicines for performance enhancement is just one group of ADHD medication abusers. There is another group of kids that abuse these drugs.
To learn more about them see my next blog post……
1 (Aug. 24, 2009) Warner, Jennifer “ADHD Drug Abuse Rising Among Teens” Study Shows Increase in Calls to Poison Control Centers Related to ADHD Drugs. http://www.webmd.com/add-adhd/news/20090824/adhd-drug-abuse-rising-among-teens
2Performance enhancing, non-prescription use of Ritalin: A comparison with amphetamines and cocaine. Svetlov, Stanislav I.; Kobeissy, Firas H.; Gold, Mark S. Journal of Addictive Diseases. Vol 26(4),2007, 1-6.
Self Improvement Tips: Getting Worse in a Burst Before You Stay Better
Self help motivation is elusive.
How do you maintain positive thinking when you backslide and overcome a momentary lapse and get back on track to continue on your personal development program?
Understand the Extinction Burst
Extinction bursts are one of those pesky little things that confuse people in the process of self improvement. Let’s say you make progress on a workout routine for a while. Then have a bump, you miss a workout and have a burst of bad behavior – you eat McDonald’s or somewhere with food filled with fat, sugar and empty calories. Is this a burst of bad behavior or backsliding and the evaporation of a trend toward personal growth? All is not necessarily lost.
Perspective
First you must better understand to get perspective. Realize that this is self-help I am discussing. If I am coaching you or counseling you this can be a part of this process, but with self-help you are on your own to discover this.
Let me give you an example.
I have committed myself to changing my behavior. Zarvos Coaching based in Carmel, Indiana or Indianapolis, Indiana (where I am based too) uses a levels view of commitment that I really like – 5 levels of commitment.
Jim Zarvos articulates 5 levels of commitment. I will not use all of Jim Zarvos’ distinctions but I will borrow the last two. The highest level of commitment is “I will do whatever it takes” to get it done. The 4th level of commitment is “I will do anything, but…” The ‘but’ could include any inconvenient or overtaxing aspect of change, like it takes too long or it requires a lot of work, or it means I have to change my work schedule, etc. Essentially it is whatever excuse you might have to keep you from making the change. You get the idea.
So, we first have to establish that you are at what Zarvos would call a level 5 commitment. I like that idea. It captures your intention. You will do whatever it takes to change. It captures my intention.
So, let’s assume that I am at a level 5 commitment and I am. I am at a level 5 commitment with many things, but let me focus on three: doing my “3 most important things” each day in my business, doing my P90X work out (I am a Beachbody Coach – www.beachbodycoach.com/drshinaver) and doing Cogmed. Now these three sets of tasks are quite difficult to get done in one day. Mostly due to time limits. So I must have a level 5 commitment to each.
So, without making this post about my level of commitment to each of these areas let’s stick with the assumption that I will do ‘whatever it takes’ to get it done in all of these three areas of my personal development program.
Ok, so here I am trucking along making progress in all of these areas of self improvement. In fact, I have had progress in all three areas for several weeks and even months then one day recently – yesterday (by the way it was 4 days before going on vacation) I have massive backsliding.
I don’t get my ‘three most important things done’. (I get one done.)
I don’t work-out. (I did do 25 pull ups.)
I only partially get Cogmed done (half).
How do I interpret that? First of all, I don’t interpret it in a way that creates an attack on my self confidence or my commitment to my self-improvement. No need to do that. It will sap my motivation for self development. Self-help motivation is hard to come by, no need to poke any holes and drain the fuel.
This interpretation affects whether my view of myself is that I am making progress and that this is a ‘slight regression’ and/or a burst of bad behavior or am I lost and now off track?
Here was my direct experience:
So yesterday, I made the questionable call to put ‘getting up to date on email’ on my list of my ‘3 most important things’.
I found this totally disorganizing. The crazy thing was as I got up to date, printed, filed, acted on email and responded to peoples’ emails. They had the gall to respond back. It was as if we were in this stop and go dialogue, much of the day. Boy that is disorganizing, but it did feel more ‘live’ and ‘dynamic’. But I can also see why some people have that overwhelmed look on their faces, they seem a little sweaty and agitated, their eyes have a glazy quality to them. They have been trying to stay up to date on email! Not a good choice for a ‘most important thing’. This could be the new definition of insanity.
Then there was the fact that my ‘honey do’ list and my ‘get ready to go on vacation’ lists dominated my time. My wife had been pretty good about not piling on with the ‘honey do’ list for quite a while. I do not recall that I have ever started on the ‘get ready for vacation’ list with 4 days before vacation. So this is progress for me. My wife works several weeks to at least a week in advance.
I didn’t realize that by starting with being up to date on email as one of my ‘3 most important things’ it was disorganizing because it is alive it is near impossible to get ‘done’. People keep responding. So, being ‘up to date’ ‘done with that task’ has to be further refined.
I also didn’t expect the ‘honey do’ list to grow within the day (it hadn’t for some time), but it is 4 days before vacation and my wife tends to send more my way then as she has more to do too.
I also had more on my biz ‘before I leave on vacation list’.
One level I didn’t realize that being better organized involves working on this preparation to go on vacation 4 days before we leave!! Yes that seems like a long time to me – it used to be I would do all this 1 day before we left. So, there is definitely progress.
However the other two things on my list didn’t get done.
Then there was the unexpected change for the week: our two boys got the opportunity to practice at the Colts facility. This took up probably an extra hour and a half. So, my normal workout time in the evening disappeared.
Also I found it incredibly difficult to focus when I was doing Cogmed. I didn’t finish it for that day. The ‘email disorder’ I had developed of responding to responses and responding to responses threw me and the ‘honey do’ list and the ‘prepare for vacation’ lists (forgot to mention the ‘gather junk/facts for financial planner list’ I had worked on the day before post meeting and had lingering undone pieces of business.) Needless to say, I was in a whirlwind.
So, when I get on a ‘get the little things done rampage’ the big things – the most important things’ don’t get done. Yes, I must admit I added some caffeine with a Coke in there and the combination was disruptive. So I clearly learned that ‘getting up to date on email’ clearly, should not be among my three most important things to do in one day. I will have to refine the goal there.
Now, I do think this was in part an ‘extinction burst’. During that day I actually got to a point when I just took a longer break than usual – like an hour. I was rebelling against myself, (I am my own boss there is no one else to blame), and my own ‘email disorder’. In the larger picture of my ongoing increasing order and much more consistent focus and follow through on my ‘most important things’ this is progress. It was a blip. Several factors came together in a ‘perfect storm’ of sorts. By the way, considering such variables as these is important in being fair to evaluating yourself. Yet, my measuring stick is “do what it takes.” That stays as is. On that level I simply didn’t get it done. No sugar coating it. You get it done or you don’t. If you don’t learn from it, understand why, allow that to help you to ‘get it done’ next time.
Today I am, getting it done. I am doing one of my ‘three most important things’ right now.
Also, I am getting ready for vacation much earlier. I am following up our financial planning meeting with getting my ‘house’ in order in such a way to keep it in order. So, all in all I am on track.
I had a little ‘extinction burst’ mixed with preparation for vacation, follow up from a planning meeting snafu, a super-charged ‘honey-do’ list and I was under misguided notion that being up to date on email should be on my list of ‘most important things.’
I am well on my way to greater order, being in better shape and having a more robust working memory I just had an ‘extinction burst’ yesterday. Back to the road of personal growth and keeping my ‘self help motivation’ up and working just fine!
PARTY! PARTY!! With Adderal or other ADHD medications???!!
Yes, young adults are using ADHD drugs for performance enhancement. I established in my last post that there is a black market for ADHD drugs at high schools and colleges for kids who want to abuse ADHD drugs for performance reasons. There is much more to the story which establishes why this is such a serious concern. Kids are now using ADHD drugs to party. This is a whole new level of abuse because it establishes a market that has the potential go grow very rapidly. It creates a reinforcement context which more deeply ingrains this abuse into the culture of young adults.
Where do the college kids get the ADHD medications? The college kids get ADHD medications from “friends, acquaintances, or even parents” according to the 2008 study by DuPont, Coleman, Bucher and Wilford.
There is overwhelming data that supports the trend that ADHD drug abuse is happening more and more often. The effects are more alarming as you will see in later posts.
In 2008, a relatively large survey sample of 1400 subjects was the basis for the conclusion that “one in five adults misuses cognitive enhancing drugs”1 (Ohio Department of Alcohol and Drug Addiction Services). It is amazing to consider the prospect that one if five adults have misused an ADHD drug. This was a poll in which 1 in 5 “college students and shift workers admitted to using Ritalin, Provigil or beta blockers to stimulate focus, concentration or memory”. These people were using these medications as “off label” essentially to improve performance. The explanation for the increase was that this group is using these drugs for performance enhancement essentially.
Another large-scale survey was published in 2008 investigated the “non-medical use of Ritalin”2 or methylphenidate (MPH). The authors of this study state that the “nonmedical use of MPH has increased particularly among college students,” they found this: “Of 2,087 respondents, 110 (5.3%) used MPH nonmedically at least once. Most obtained MPH free from a friend, acquaintance, or family member. Misuse of Ritalin® occurred four times more frequently than Concerta®.”2
ADHD drug abuse (and addiction) has not been restricted to enhancing the performance of these college students. They have been using such medications as Ritalin and Concerta “nonmedically for recreational reasons as well as to improve academic performance.”2 The recreational abuse of Ritalin creates a reinforcement system of a totally different magnitude and sets the stage for massive abuse. This puts Concerta abuse and Ritalin abuse along with the abuse of other ADHD drugs on par with the abuse of alcohol and marijuana. What I take this to mean is that there is a culture of young adults who abuse ADHD drugs. There was no culture of young adults abusing ADHD drugs when I was that age. It simply didn’t exist. As such the reinforcement for ADHD drug abuse is at a dangerous level. This is particularly the case as we consider the risks of these drugs in later posts.
Both of these initial studies are surveys, but they do have good sample sizes. However, a much larger study with a sample size of 24,409 was published in 2007. This study was investigating gender differences in the prevalence and characteristics of methamphetamine (meth) misuse and prescription stimulants among adults aged 16-25. “About 1 in 10 youths reported any misuse of stimulants in their lifetime.”3 Basically one of the findings is that boys or young men are more at risk for abusing ADHD medications.3
This puts the range of Concerta abuse, Ritalin abuse and other stimulant abuse in a range between 5% and 20%. Wu, et al (2007) were the first researchers I found to unabashedly give this warning: “Parents should be informed about the risk of prescription stimulant misuse.”5
Part of my purpose is to warn parents that ADHD medications are being abused and that high school kids and college students are abusing and partying with these prescription drugs. This means at school there is a black market for your child to sell his ADHD medications. Since I have not engaged with this part of the health care system which prescribes medications for ADHD, I do not know to what extent parents are warned that prescription medications for ADHD are one of the drugs of choice by high school and college students. I wonder.
At least you now know and you can spread the word.
1Survey: One in five adults misue cognitive enhancing drugs, e-Update 2008 Ohio Department of Alcohol and Drug Addiction Services.
2Performance enhancing, non-prescription use of Ritalin: A comparison with amphetamines and cocaine. Svetlov, Stanislav I.; Kobeissy, Firas H.; Gold, Mark S. Journal of Addictive Diseases. Vol 26(4),2007, 1-6.
2 Characteristics and motives of college students who engage in nonmedical use of methylphenidate. DuPont, Robert L.; Coleman, John J.; Bucher, Richard H.; Wilford, Bonnie B. The American Journal on Addictions. Vol 17(3), May 2008, 167-171.
3 Misuse of methamphetamine and prescription stimulants among youths and young adults in the community. Wu, Li-Tzy; Pilowsky, Daniel J.; Schlenger, William E.; Galvin, Deborah M. Drug and Alcohol Dependence. Vol 89(2-3), Jul 2007, 195-205.
Some consequences of the temptations of ADHD medications that DO NOT come on the warning label…
Prescription stimulant abuse is on the rise among high school and college students. A subgroup of prescription drug abuse is the abuse of ADHD medications. Abuse of ADHD drugs is becoming commonplace for high school and college students, but the consequences for high school students can be severe, arguably more severe than the other two most commonly abused drugs: alcohol and marijuana.
All this might seem foreign and bizarre for parents who grew up 20 years ago when the abuse of ADHD drugs was essentially nonexistent. Nor was prescription drug abuse an issue when most of today’s parents grew up.
To capture a sense of the scale of prescription drug abuse consider the results of a 2008 study:
Past-year prevalence rates among twelfth grade students documented that prescription drugs were among the most abused illicit substances: 9%- 10% reported Vicodin abuse, 4%-5% reported OxyContin abuse, 8%-9% reported amphetamine abuse, 6%-8% reported sedative abuse, and 5%-7% reported Ritalin abuse in each of the past several years (Johnston et al. 2007). Thus, prescription drug abuse has reemerged recently as a major and costly public health threat (Birnbaum et al. 2006).1
Now that prescription drug abuse is being labeled as a “public health threat”, my fears from 2005 before all these surveys and studies were published appear to have been confirmed. My view then was that I did not want to have my son in high school on meds that other kids might want. I did not want to present him with that temptation.
This study clearly articulates the confusion parents are likely feeling which I felt in 2005: “prescription drug abuse presents unusual difficulties for clinicians for two reasons: first, the medical system is the origin of the substances in many cases; and second, the boundary between therapeutic use, misuse, and addiction can be quite vague.”1
This unclear boundary between use and abuse of the ADHD medications was exactly what had me confused and annoyed in 2005. Those “nagging questions” in a previous blog are now vexing. To me, it seems that relative silence seems to surround these issues in the public. Unhappily, the research data shows these concerns about ADHD drug abuse is on a scale that is increasingly hard to over estimate.
What exactly is the risk?
During 2004 there were almost 8,000 visits to the emergency room from methylphenidate (Ritalin or Concerta) and methylphetamine (Adderal) over dose. Disturbingly, the rate of 12 to 17 year olds sent to the ER for the abuse of Adderal, Ritalin, Concerta and other ADHD medications was higher than that of those 18 and older. This is the case even though those from age 18 to 25 had a higher rate of nonmedical use of Adderal, Ritalin or Concerta.1 This was according to the Substance Abuse and Mental Health Services Administration (SAMHSA) latest Drug Abuse Warning Network (DAWN) Report in 2006.
Another disturbing fact was that more than one drug was commonly abused in addition to the ADHD medications. This polydrug use may increase the health risks. In short, these are powerful drugs and that is why their distribution is controlled.
Parents who are not informed of this risk becoming unsuspecting distributors of controlled substances or their children become (unknowingly, perhaps?) prescription drug dealers with their doctors as their ignorant suppliers and parents as unwitting accomplices. What are the consequences for this and how common is this occurrence?
Read my next blog post for information on this….
1ADHD Medication Misuse by Those Aged 12 to 17 Results in Higher Number of Visits to Emergency Department. (Sep 22, 2006) US Department of Health and Human Services Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane Rm 12-105 Parklawn Building
Rockville, Maryland, 20857, US
Could your ADHD child be dealing drugs…? What role role could you be playing?
So, that son of yours with ADHD, that young man with difficulty modulating his impulses, is given a controlled substance, such as Concerta or Ritalin. The ADHD medication has a high value in a black market of 5 to 10 % of his peers 1,2,3,4,5. Your son is at risk for committing a felony for illegally distributing a controlled substance. By selling that very substance that was intended to help him manage his impulses, he has the chance of being in trouble with the law. Regardless of whether he sells or gives it, whether it is for recreation or performance, he is in serious danger of making a long-term mistake with substantial consequences. This is the kind of thing parents need to consider when medicating middle school, high school and college students for ADHD.
If you need a more sobering view of this white elephant in the room scenario, a Texas law firm captures it well on their website as they describe what is occurring on America’s campuses (http://www.thibodeauxlaw.com/PracticeAreas/Prescription-Drug-Charges.asp):
“Prescription drug addiction and criminal charges for illegal possession and prescription fraud are increasing on college campuses and in communities across America. As prescription drugs such as Adderall and Xanax are used in treating symptoms and ADHD, anxiety disorders and depression, they are also increasingly abused as “speed” and “uppers” by young adults.
At the Law Offices of Lane D. Thibodeaux, Attorney Thibodeaux is Texas Board Certified in criminal defense to protect college students and young adults from felony charges for illegal possession or distribution of prescription drugs. Attorney Lane D. Thibodeaux has more than twenty years of legal experience applying defense strategies that focus on dismissing charges, or reducing felony charges.
If you are a college student charged with illegal possession or distribution of a prescription drug, or if you are the parent of a college-age student charged with a misdemeanor or felony crime, we can help.” http://www.thibodeauxlaw.com/PracticeAreas/Prescription-Drug-Charges.asp
Yes, I found this information disturbing, too. The fact that there is confusion about use and abuse of ADHD medications and that prescription drugs are being supplied to a population least suited to effectively manage the impulse to sell or abuse these ADHD drugs is a serious concern. As far as I can see, not much has been discussed about this obvious problem. It is something for you to consider when your child is 10 or 11, before the massive onslaught of peer pressure arises to influence his decision-making. In other words when your child is 10 or 11 is the time to seek out alternative treatments for ADHD. This gives you time to find something that works for you. Waiting until he is a teen puts much more pressure on you and him because the abuse of ADHD drugs is so common he will be presented with this dilemma sooner than you would prefer.
Aside from the prevalence of ADHD drug abuse on campuses, how does it rank in availability compared to the other drugs abused on campuses?
Read my next blog for that……
1Survey: One in five adults misue cognitive enhancing drugs, e-Update 2008 Ohio Department of Alcohol and Drug Addiction Services.
2Performance enhancing, non-prescription use of Ritalin: A comparison with amphetamines and cocaine. Svetlov, Stanislav I.; Kobeissy, Firas H.; Gold, Mark S. Journal of Addictive Diseases. Vol 26(4),2007, 1-6.
3 Characteristics and motives of college students who engage in nonmedical use of methylphenidate. DuPont, Robert L.; Coleman, John J.; Bucher, Richard H.; Wilford, Bonnie B. The American Journal on Addictions. Vol 17(3), May 2008, 167-171.
4 Misuse of methamphetamine and prescription stimulants among youths and young adults in the community. Wu, Li-Tzy; Pilowsky, Daniel J.; Schlenger, William E.; Galvin, Deborah M. Drug and Alcohol Dependence. Vol 89(2-3), Jul 2007, 195-205.
5 ADHD Medication Misuse by Those Aged 12 to 17 Results in Higher Number of Visits to Emergency Department. (Sep 22, 2006) US Department of Health and Human Services Substance Abuse and Mental Health Services Administration
5600 Fishers Lane Rm 12-105 Parklawn Building
Rockville, Maryland, 20857
US
6 Website of Lane Thibodeaux. http://www.thibodeauxlaw.com/PracticeAreas/Prescription-Drug-Charges.asp:
CNNHealth.com posted an article about a Link between ADHD and Internet Addiction.
Read the story at this link: cnn.com/2009/HEALTH/10/05/depression.adhd.internet.addiction
This summer I watched a special on television about how Asian children tend to be the highest users of the Internet. The story was intriguing and I had not realized that there was such a high use of the Internet differentiated by countries, particularly in the East. I can tell you this. Halo has intruded upon our family in the past year, how about yours? I have three sons.
Halo is an online war game. It like those described in the CNN article. Games like Halo are potentially the most addictive. Part of what is addictive about these games is that you get real time feedback and they are stimulating, very stimulating. Back several years ago I did a series of television interviews for Fox TV in Evansville, Indiana about the impact of violent television and violent video games. It was a fun interview. I had my kids watch the Power Rangers. Almost immediately when we turned off the show the kids started kicking and hitting each other. The kids who were 7 or younger were especially vulnerable to this.
The research at the time stated that kids 8 to 11 were a little less vulnerable to immediate acting out of what they had seen and those older than 11 even less so. This tended to be true with both violent TV and video games. One way to understand this in my view is the idea that as children get older they have a greater ability to inhibit their responses and playing such games are not as problematic. Yet, ADHD kids have a more limited ability to inhibit their responses.
The CNN article even suggests that such games or ‘role playing’ games are therapeutic. I would argue yes, and no.
Consider this. Occasionally I will go down in the basement and play these games with the kids. First of all, I am terrible so I am a laughing stalk. I provide comic relief. What begins to strike you as you play these games is that this game, Halo is brutal, savagely brutal. The game is simply about killing, over and over again. This in itself is disturbing, very disturbing, but, yes, I hate to admit, the game is captivating. You are running around, hiding, looking around corners, trying to stay alive and trying to get the bad guys. Before you know it you are at war too. And, yes, I hate to admit it, especially because I am so bad it, it is captivating. The other thing is that the kids tend to get more and more irritated with each other. It is as if the violence of the game seems to feed increased irritability. Kids who are depressed obviously might derive some pleasure out of ‘killing’ the enemy. Kids with ADHD surely love the total lack of inhibition in these games. And, obviously those less socially skilled can crawl into these games and roles and engage from an arm’s length away. The overkill of violence is disturbing and definitely makes you wonder.
So, anyway, the story gets a little more perplexing. Last summer my oldest son, who had been diagnosed with ADHD previously as discussed on this blog, but due to my intervening with him is no longer medicated and is essentially asymptomatic. So, last summer he decides that he is essentially “beyond most online games”. He is 14. He is a techno-file. His classmates dubbed him the ‘technology-genius’ and, yes, all proud pappa stuff aside, is unusually talented with technology and he foreswore online games.
How did this kick in? When I asked he simply said that they were a “waste of his time”. His explanation is a little limited. After reading this CNN Health.com article I am really wondering what happened.
Now, back to my two other sons. I am not thrilled at the hold these games have on my 11 year old and the more limited interest of my 8 year old. Now you may or may not be aware of this but the kids get online and play with other kids. They meet kids online, kids they have never met before. It is truly a social event. You have to admit, it is a pretty cool phenomena for all these kids to be sitting in their own homes online playing a game together when they can see the same things on the screen and talk to each other via head sets. It is very cool, no way around that. The downside: the violence and the fact that some of them use profanity online. My kids turn off the speakers when I am down there. They have a good deal of control over who is playing the game with them. They shut out the kids with the bad mouths.
My kids have a balanced life. They get excellent grades. The two younger kids are both playing football and they play soccer. One will play basketball and the other might too. They have good social lives. We do various family games. Keep in mind that addictions, as do most mental health diagnoses, involve functional impairment, meaning that the behavior intrudes upon the rest of their lives or their ability to function.
Technology is here to stay. The Internet and online games will be around too. They are just too captivating to leave. But you need to get down there and play those games with your kids or at least watch them a few times. It will be worth your time.
Yet, most perplexing is that my oldest found them passé. Why? I am still unclear. I will ask him again tomorrow.
Current college student talking about friends’ struggles and temptations with ADHD medication.
7 Yes Times Have Changed: The Top Three Drugs Abused and Available on College Campuses Today: Beer, Pot….and Adderal?
People used to ask me the difference between a psychologist and a psychiatrist. I used to joke: “I don’t deal drugs.” I was half-joking, only half-joking. Now, it doesn’t seem so funny.
As a clinical psychologist, I often used to get a line from parents that essentially things now were the same as when they were kids. Growing up is growing up, no matter what generation you’re talking about. On one level that is true. On another level, young people are being more pressured to perform at a high level, and are therefore more stressed than I think our generation ever was.
Sure on one level there was “sex, drugs and rock ‘n roll’ then and in today’s generation, there is still “sex, drugs and rock ‘n roll”.
Yet, there are distinct differences. We won’t even consider the economy as one difference. On the simplest level the stakes have risen and mistakes are broadcasted to the world. Many of those teenage transgressions of our youth stayed teenage transgressions. There was no one with a cell phone camera or video circulating what happened at the party when it got a little over the top and sending it to millions online. There weren’t social networking sites circulating pornographic images of all ages, seemingly suggesting that it is all okay and normal. Similarly, there was no underground market of ADHD medications being abused and dealt in high schools and on college campuses across the nation. There are large discrepancies between ‘then’ and ‘now’.
When it came to drugs it seemed clearer. Back then, drugs were drugs and the kids who did drugs were easy to identify, or so it seemed. Sure there were kids who overlapped and did drugs when you didn’t completely expect it. Yet, whether you like it or not, the phenomena of Blink noted by Malcolm Gladwell in his book by that name occurred then and occurs now. People do make split second judgments about people. Often we are wrong. Yet, the terrain was different.
When it came to drugs, those judgments made in the blink of an eye seemed easy, now, not so much.
If you were underage you knew drinking was illegal. People took risks. Often they knew whether they were high risks, sometimes they didn’t. Deaths related to college hazing and drinking rituals come readily to mind.
Often the people who smoked pot were easy to identify, as well as the users of many other drugs. Often they knew the risks. That was part of the reason those drugs were illegal. They entered at their own risk, so to speak.
Prescription drugs present an altogether different scenario. The Miami Hurrican student newspaper captures this well at this link: http://www.themiamihurricane.com/2008/09/17/college-students-use-abuse-adhd-drug-adderall/#.1
College students are feeling pressure and to ‘deal with the workload’1 are abusing Adderall and other ADHD drugs:
“I think that sometimes these are the most overstressed people that need the extra concentration the most to deal with the workload,” said Robert, an unprescribed 21-year-old University of Miami Business Law major from Delaware, who spoke to The Miami Hurricane under the condition of anonymity.1
One of the most interesting comments to that article was a student named Patrick who stated the following:
“I’m 24 am I’m addicted to Adderall. Although never diagnosed as ADD/ADAD I’ve been prescribed to Adderall for 10 years. I was never addicted to the drug until I began college. Ever since then, I have become an Adderall fanatic. I used to give away the pills I didn’t use, but now I can’t spare to loose a pill. It’s pathetic. I used to be ashamed of being ADD, but now I’m ashamed of being addicted to an ADD medication.”1
Prescription drugs are legal for the intended user. Doctors prescribe them to the intended user. So it seems reasonable that people would assume that they are less dangerous than illegal drugs. Yet, it is illegal to take a prescription drug without a prescription. The professional who wrote the prescription presumably provides oversight of your use of the drug, reducing side effects or medication interaction. It should be obviously illegal to sell these drugs without the proper credentials. Yet, the seemingly professional medical approval and mental health professional approval of the use of these drugs appears to give tacit approval for their use and blurs the boundaries between therapeutic use and abuse. It seems acceptable to abuse the use of prescribed ADHD medications by trafficking them to non-prescribed individuals. The risks are not properly considered when these drugs are abused in this way.
That the abuse of prescription drugs such as ADHD medications is this rampant and their availability ranks just after alcohol and pot bothers me as a parent. It makes me utter a heavy sigh. As a professional, it is beginning to irk me. It is especially irksome because WE, professionals, are substantially contributing to this problem. From either position, I am disgruntled.
Yes, in 2006 the results of a qualitative survey of university students found that after alcohol and marijuana, the prescription stimulants Adderall and Ritalin are perceived to be the most easily available drugs misused on campus. ADHD medication abuse is a part of this generation’s “sex, drugs, and rock ‘n roll”. I don’t remember that EVER being a part of my youth.
“Methylphenidate is among the top 10 most frequently reported controlled pharmaceuticals stolen from licensed handlers. There is a significant diversion of methylphenidate. A 1994 national survey indicated that more high school seniors in the US abuse methylphenidate than are prescribed it legally.”2 In other words people steal methylphenidate and sell it.
The study’s authors said that the results show a widespread availability of prescription drugs on college campuses. Now I am moving beyond the sigh and I am starting to get vexed.
So are things different for kids today? Yes, when we were in high school and college, Adderall and Ritalin were not among the top 4 drugs abused by kids. That is different….
You can really start to get worked up about this if you start asking questions:
1. Do we even have research on how these drugs will affect kids in the long term? (I will discuss this in later blog posts, but basically the answer is no.)
2. By the way, are you aware that most of these drugs used with kids did not go through an FDA approval process for the use on kids? Typically, once a drug is approved for use with an adult through an FDA approval process, a physician, through his own individual judgment can start prescribing the drug “off label” for kids for purposes for which it wasn’t originally intended. Yeah, that one is kind of mind-blowing.
3. What is the role of the financial incentive for the prescription use and even the illegal abuse for dealing these prescription drugs? Everyone is making some money here, but the health dangers are more negative than the financial ‘gain’ may be.
4. If there weren’t many people making money off of these transactions, would all of this be happening?
Additionally, as noted in my previous blog posts, anywhere from 5% to 20% of the kids on college campuses have abused an ADHD medication, like Ritalin, Adderall, and Concerta. Keep in mind these are not the kids diagnosed with ADHD. Therefore, this is the percentage range of college students that are ADHD drug abusers.
So, parents need to be aware of the white elephant in the room, which I will discuss in my next blog post….
Yes, this is different than when I was in school, what do you think?
Give me a comment and feel free to ask me questions on this topic.
Dr. Charles Shinaver
1 Galinana, Ramon “College Students Use, Abuse ADHD Drug Adderall” Sept 17, 2008, The Miami Hurricane. http://www.themiamihurricane.com/2008/09/17/college-students-use-abuse-adhd-drug-adderall/#
2 Recent Advances in Understanding the Abuse Potential of Methylphenidate (Ritalin) Rush, Ph.D., CR, Stoops, WW, Kelly, TH, Ph.D., Glaser, MD., Ph.D, P. A.E. Hays, L. R. MD, MBA, Department of Behavioral Science, Dept. of Psychiatry and Department of Psychology University of Kentucky. (Supported by grants from the National Institute on Drug Abuse (DA 10325 and DA 12665)
Ashley, a college student that I have seen through Cogmed Training reports on her experiences with Cogmed.
I am a college student who recently finished the Cogmed training program. I’ve got to be honest; when I began the program, I was doubtful of its said effects. However, since finishing the training, I have noticed several positive changes, mainly with my academics. Like I said, I was skeptical, even doubtful at times, of it working for me. I thought, “How could a computer game help me to get to meetings and class on time?” or “Is this really going to help my anxiety?”
The training was a process. My coach played a vital role in reminding me on a weekly basis of why I was doing the training and how to train right to get the best effects from it. Honestly, the actual training wasn’t fun. It was a real challenge to me. Planning in the hour to train five days a week was difficult to do with a busy schedule. I tend to have anxiety anyway. But, as it turns out, my general anxiety was something that Cogmed ended up improving after completing my Cogmed training.
I am a senior in college, looking to attend Graduate School in the fall. I am at a in the midst of a very important time in my academic career. I am a full-time student. My classes are upper level seminars and all include major presentations and term papers. I am preparing to take the GRE for grad school adimissions; I am researching schools for the fall. I have a job, and I am a college athlete. My plate, so to speak, is full and I almost always feel overwhelmed by my daily schedule and upcoming commitments or deadlines. So you can imagine how I felt when Cogmed was added to my plate. I thought that if I had to make time for another thing, this had better be worth it!
In the beginning of my training, I was able to rush through the activites just to finish and check Cogmed off of my list of to-do’s for the day. I quickly learned that this was not the right approach. My coach helped me to see the importance in doing Cogmed with a certain focus every training day. I had to block out all of my other obligations and deadlines, and concentrate on Cogmed only. Teaching myself to focus on the task at hand and to pace myself instead of rushing through activites just to finish and move on to the next thing has really helped me academically.
I have been able to transfer the skills I gained through my Cogmed training to my daily life. One of my goals from the beginning of my training was to study more effectively and efficiently. I struggled with getting side-tracked with other tasks while doing one thing, and because of that, I never seemed to get any one thing finished. After finishing with Cogmed, I have noticed that I am more systematic in getting things done. It’s like I can ‘attack’ tasks and complete them efficiently without feeling overwhelmed or like I need to rush through them.
Another goal that I set in the beginning of my training was to be more punctual to class, meetings, work, etc. I remember it being embarassing to set that goal, as I had always considered myself to be very puctual, but when it came down to it, this had become a real weakness of mine. Before Cogmed, it was like I was always rushing from one class to a meeting and then to practice; going, going, going… Cogmed helped to teach me a rhythm. I had to find a way to get through the training; to not drag it out and to not rush through it. Since my training has been finished, I can find a rhythm for the day, based on what I have to get done, and I roll with it.
I am writing these things to illustrate to you just how effective Cogmed really has been for me. I hope that this gets you thinking about how Cogmed might be able to help you or someone you know. Maybe it’s a co-worker who is always whirling around with no focus. Maybe it’s a child of yours who can’t make it through his chores without continous support and reminders of what he/she is supposed to be doing. Maybe you can identify with my previous struggles and want to see similar effects. I’m not sure where Cogmed fits into your life, but it wouldn’t hurt to ask about it and learn more about it!
As evidence of my commitment to transparency and my own growth progress which I hope can benefit you I am going to tell you about my frustrations today for the purpose of transparency to help you and to help me. When I am publicly transparent it motivates me to improve. I also hope that both that vulnerability invites you into my world and you are able to learn something while you are here. So, here are some reflections on my frustrations for today.
A ‘nested loop’ is a term that I use to describe when I start with one problem and in the process of attempting to address it another problem arises. So, I then have a problem inside of a problem. Then I find that I have to spend an inordinate time on the problem inside the problem to the preclusion of solving the original problem. This makes me hugely frustrated with myself.
Do you ever have that problem?
Consider this. I am on Day 3 of focusing on “organize” and “Review” using the Zen to Done approach for getting organized (get it here: http://ad.vu/vgd9).
By the way, I really like this approach.
I have worked on the first 5 habits for about 6 months and made significant progress. I am at a challenging impasse where I am focused on the “organize” and “Review” habits for the next 30 days. (Focusing upon changing one or two habits for 30 days is a very good idea. This is how you solidify a behavioral habit change.) I will make steady incremental progress here and part of how I will make sure of that is that I will be transparent about it on my blog and in my ‘tweets’.
Let me set the stage. I was out of town last week. I have two weekly appointments that didn’t show this morning. Then I had a scheduled phone call and that person didn’t call. So, that has thrown me off. I checked my automated email reminders and they are all still set. I checked my phone and it is working too. So it wasn’t me. I will let that go. I will email each one and get back on track for next week. Yet, that process has thrown me off, more than I would prefer.
When one of my phone calls did not happen I began reviewing the email campaign he had sent to me to understand his strategies. I figured he had gotten me to bite I should study how exactly he did that. I started taking notes on that. However, it is not on my 3 most important things to do, but as I began reading his emails I realized it should be in my top 3. His strategies which are marketing strategies would be very helpful for me as I ‘review’ my own marketing plan. Yet, reviewing my marketing plan was not on my top 3 most important things, but as I said I realized it should be. So I put it on there.
So, back to my three most important things for today, that just became 4. The concept of focusing upon one’s three most important things at the beginning of the day is also from the Zen to Done approach for getting organized (get it here: http://ad.vu/vgd9).
Here are my three most important things for today which became 4:
1. Brand Integration document.
2. Organize files and folders – especially those that relate to Cogmed & my marketing plan.
3. Prepare for Fitfamilies.tv video-taping for next week.
4. Review my marketing plan and my metrics to see my progress.
I put quite a bit of time in #2 so we can check that off for the day. However….
Problem #1: I realized that as I was organizing my files that I really needed to review my marketing strategy and progress on that. As a matter of fact it was probably the most important thing to do today, but it was not on my list of most important things to do. I know this is getting redundant, but that is what happens when I get thrown off. I get redundant.
Problem #2: So, I stopped to save a document, a document that was notes on his email marketing campaign that had succeeded in getting me to contact him. Yet, it was not on my list of 3 most important things. Yeah, we covered that. Then I realized that in my process of ‘organizing’ I had changed the folder name. My brain had not yet caught up to my change. I couldn’t remember where it went.
That is when it happened, or continued to happen. I got frustrated. I became indecisive. Then I realized I was off the track. I was now thinking about the need to review my marketing plan, but I had not finished my brand integration document review and revision.
That was the moment when indecision meet disorganization and a ‘nested loop’ began to cycle. I began to ‘cycle’ or loop. This is when historically I would get frustrated with myself, take a break, etc.
I am not completely sure whether I always got out of ‘nested loops’ before. However, I am convinced that I now have the skills to do so. One of those skills is the transparency of blogging about it. By letting you in on my little ‘nested loop’ it motivated me to make SURE I do something about it.
What did I do?
I wrote about it which helped me to clarify what I needed to do.
Solution #1: I will ‘review’ where my most recent marketing strategies have gotten me to tomorrow with my interns. I had felt pressure to keep working on blog posts, but it is exactly this pressure to ‘do’, ‘do’, ‘do’ that gets me disorganized. I was feeling pressure to get organized so my interns can help me get more blog posts up, but I am actually up to date on them.
So, I will instead, ‘review’, ‘review’, ‘review’ with them. This is making me realize that reviewing is devalued by me. It is not ‘doing’ or so I thought. I am realizing that ‘reviewing’ is critical to keeping on track. It is what will keep me moving in the right direction within the forest instead of just hacking away without a sense of the bigger picture or the pathway I should be on. So, now it is clearer to me what gets in the way of me of having ‘review’ as a routine habit for me. This is useful and I can catch myself when I devalue reviewing in the future. This will keep me on track.
Solution #2: I will go back to the brand integration project and work on it now.
Solution #3: Because I am ahead of schedule on fitfamilies.tv I don’t have to work on it too much. I will review it tomorrow and fine tune what I want to do.
Whew! I am out of the nested loop and back to work and I even got a blog post out of it!
By the way, I really did like my opening, I hope you did too:
“Uncovering the seeds of Ineffectiveness: Where indecision meets disorganization, a ‘nested loop’ begins to cycle…
