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THE
EVIL PRACTICE OF NARCOTHERAPY
FOR ATTENTION DEFICIT
by Dr. David Keirsey
Something is wrong
with the idea of attention deficit. Not just a little wrong,
but terribly wrong, and, as it turns out at the turn of the
century, tragically wrong. Tragic because it gives the appearance
of legitimacy to the practice of prescribing stimulant narcotics
for children who are said to be short on attention.
During the 1950s
the practice of experimental narcotherapy for so-called “hyperactivity”
came into vogue. The drugs of choice were amphetamines such
as Benzadrine and Dexedrine, and in the late 1950s, methylphenidate
(Ritalin), and pemoline (Cylert). At first only the extremely
active boys got zapped with stimulants, maybe one or two per
school. But since only a few psychologists complained about
this questionable practice, and since the “special education”
movement was growing rapidly, more and more teachers demanded
that somebody else should be held responsible to put a stop
to disruptive behavior in the classroom.
During the 1960s
and afterwards only the corrective counselors trained and
experienced in the methods of Dreikurs, Erickson, and Glasser
knew how to control disruptive behavior in the classroom.
Not knowing this, parents turned to those local medics who
claimed they could control disruptive behavior with drugs.
These medics, knowing that activity level could be dampened
with drugs that act on the brain, started experimenting with
brain-disabling drugs. They’re still experimenting,
but they have multiplied exponentially because the practice
is so easy and so lucrative. Now there are millions of kids
being drugged, whereas there were only thousands in the 1950s.
Tragically, a kid
doesn’t have to be disruptive to get his brain disabled.
All that need be done is for someone—teacher, principal,
nurse, counselor—to tell the parent that her boy doesn’t
have enough attention to succeed in school. In the face of
such news parents may go a local medic who will “verify”
that her son may afflicted with “attention deficit.”
Now, what makes
the teacher think the child doesn’t have enough attention?
Notice that this isn’t a disruptive child, so the teacher’s
not busy with him trying to stop him from getting out of his
seat so often and wandering around, or from making noises
and motions that bother the teacher and the other kids. This
kid stays in his seat and doesn’t bother anybody. What
he doesn’t do that bothers the teacher is his assignments,
or if he does them, he’s sloppy and slow about it. She
knows what he doesn’t do, but not what he does do. Indeed,
nobody knows what he does because, unlike the disruptive child,
he doesn’t call attention to himself.
Now any skilled
corrective counselor can chat with the kid and find out what
such a child does with his time. I did this for around twenty
years and then trained my staff and my students to do this
for another ten or so years. I also handled all cases of chronic
disruption referred to me when I was in practice such that
the disruption stopped and productive behavior started and
continued. I also trained my staff and my students to do likewise.
Spare me the nonsense that nothing can be done about either
sloppy school work or disruptive classroom behavior. Any counselor
practiced in the methods of Dreikurs, Erickson or Glasser
can do a lot about both, and even the so-called “cognitive-behavioral”
counselors of late can handle these rather simple cases. And
make no mistake about it, these are simple cases compared
to the other kinds of things kids can do at home and school
that even these well practiced counselors are hard put to
deal with. My advice to medics, since they have only brain-disabling
drugs to offer, is to tend to their own business and refer
these cases to those corrective counselors who know what to
do.
A
Disparity of Agendas
The point is that the child who is sloppy or slow in pursuing
the teacher’s aims is not short on attention, as is
claimed, but is long on attending to his own aims. What we
have here is a disparity of agendas. It is silly to suppose
that the reason a kid pays little on no attention to someone
else’s agenda is because he doesn’t have enough
attention to pay. Attention isn’t something that one
“has.” Rather it is something that one “pays.”
Unless we’re sleeping, we cannot not pay attention to
something, whether the something is present or absent. Everybody
is paying attention to something all of the time. Now in the
case of the disruptive kid it should be obvious that he’s
paying a lot of attention to his own agenda. It’s a
mistake to say he hasn’t enough attention to succeed
in school. It’s just that his attention is focused on
things of no interest to the teacher.
Indeed, it is likely
that both “Attention Deficit” and “Attention
Deficit Hyperactive” children are long on attention,
belying the attention deficit part of this phony “disorder,”
and leaving only hyperactivity. If there’s no attention
deficit in either hyperactive or non-hyperactive children,
then there’s no attention deficit disorder.
The question arises,
is the not very active child who ignores the teacher’s
agenda distractable like the very active child, who also ignores
the teacher’s agenda? But the question is unanswerable
because nobody checks up on what such a child is paying attention
to. I think it rather unlikely that kids who do sloppy or
slow schoolwork are distractible. In any case they’re
hardly distracted from their lessons because they aren’t
attracted to them in the first place. And nobody knows what’s
going on in their heads because nobody bothers to find out.
No, these kids are just doing their own thing and don’t
care to do those definitely unfun things their teacher wants
them to do.
A
Disparity of Interests
Now why do some kids pursue their own agendas rather than
the teacher’s? One answer I find more useful than others
is that what the teacher requires the kids to do is not fun
to do, which is to say it doesn’t interest them. Most
of the kids, even though schoolwork isn’t much fun,
want to please the teacher, so they do as they are told, if
only halfheartedly and with some annoyance. But some of them
are not only disinterested in schoolwork, they are also disinterested
in the teacher.
It’s a matter
of temperament. Though none of the kids can figure out what
good it does them to do their schoolwork, those endowed with
a certain temperament resist doing that sort of work because
it bores them. This has been true as long as this sort of
kid has been sent to school and told to obey the teacher.
These are what Plato called the “Artisans,” what
Aristotle called the “Hedonics,” what Galen called
the “Sanguines,” and what Myers called the “Sensory
Perceptives.” As far as these kids are concerned there’s
no point of doing things that aren’t fun or of no immediate
use. They’re what I call “concrete utilitarians,”
this because they’re concrete in speech and utilitarian
in pursuing their interests. And I figure that they’re
about 40% of the school population, at least in elementary
schools (about half of them drop out of school when they get
to the ninth grade).
Since there are
so many of them attending elementary schools, how come only
about 5% are turned over to the tender mercies of medics?
One reason is that lots of parents aren’t taken in by
the educators and the medics and simply decline the invitation
to have their kid drugged.
But what about
the rest? Here the teacher makes a whopping difference. Most
teachers are smart enough to figure out how to get their pupils
interested in pleasing them so they’ll go along with
doing their assignments. They don’t have a problem with
wandering attention because they know how to engage the intentions
of their pupils. Too bad, but those kids whose temperament
is unsuited to school routines, the Artisans, are not at all
easy to train to take on these routine demands of school life.
So some of the teachers are hard put to deal with such kids.
Before World War
II these kids were not a problem. If they didn’t do
their assignments they were not promoted. By the way, two
of my classmates were two years older than me, while three
of them were three years older than me, all five superb athletes
when they got to high school. But after WWII schooling became
a very serious matter and those children that displayed little
interest in school work were regarded with grave concern.
Holding them back would no longer do.
The
Myth of Attention Deficit
To understand how the myth of attention deficit came about,
it’s instructive to look carefully at its source. I
refer to the Diagnostic and Statistical Manual of Mental Disorders.
The idea cropped up in its third edition and was finalized
in the fourth edition. Let’s have a look at what the
“criteria” for making the “diagnosis”
of “attention deficit disorder” in the fourth
edition.
First, it must
be said that this particular “disorder” is rather
peculiar. The contention is that the symptoms of the disorder
cause the disorder. This is said very pointedly in the section
on “Attention Deficit Hyperactivity Disorder,”
so we must conclude that the writers meant to say it. As far
as I can tell this is the only “disorder” among
hundreds in which the “impairment” is “caused”
by the “symptoms” of the “impairment.”
This is peculiar, to say the least, in an ostensibly “scientific”
document.
Notice that inattention
is a negative concept, that is, something not done. The claim
is that those with impaired attention fail to attend to things
like directives, speakers, accuracy, equipment, daily activities,
exerting mental effort, and organizing tasks. But what is
not done cannot be observed and can only be inferred. If,
for example, a directive is not carried out, then it can only
be inferred that the directee failed to carry out the director’s
command. But it can also be inferred that the directee did
not intend to obey it and so did not fail. The same holds
for the rest of the list of so-called “causes”
of impaired attention. Just because a kid seems not to listen
to a speaker can either be because he does listen but gives
the impression of not doing so, or because he really doesn’t
listen because he doesn’t care to, or yet because he
has his mind on something else and is therefore oblivious
to what the speaker says. Take the last item on the list,
failure to “organize tasks.” Now, what if the
seemingly inattentive kid has no interest in an assigned task,
which, by the way, is usually the case? Why would he bother
to “organize” it? As far as the kid is concerned
let it lie unattended and get on to more interesting pursuits.
The
Big Switch
Having only assumed that disruptive kids were also impaired
in attention, that is, “can’t pay attention”
to anything for long, the writers of DSM IV appended another
assumption, that impaired attention may be independent of
disruptiveness. Some kids, they claimed, could be deficient
in attention without being disruptive. Since it was quite
apparent that stimulant narcotics could decrease the amount
of disruption, perhaps it could also increase the amount of
attention. Voila! The market for stimulants suddenly expanded
from a mere one case per school of five hundred to twenty
five cases per school of five hundred, that is, a jump from
.2% to 5% of the school population. By the 1990s over million
kids were on stimulants (mostly Ritalin), while in the 1960s
there were only thousands.
Megabucks had entered the scene for makers, dispensers, and
prescribers of stimulants, with parental, educational, and
governmental approval to boot!
Now, making zombies
out of disruptive kids was already an evil practice. But to
add several million victims just because they did sloppy school
work was a great big switch. Alas! Just as money had fueled
the expansion of illegal cocaine traffic, so too had it fueled
the expansion of legal methylphenidate traffic. The irony
of this enormous expansion is that both drugs are narcotics
which are indistinguishable in their effects on the person
who takes them. Addicts can’t tell the difference!
As a kind of poetic
justice, many youths who in the 1990s were required to but
didn’t want to take Ritalin, began selling the drugs
prescribed to them to other youths who did want to take Ritalin.
From being victims of pill pushers they themselves become
pill pushers, at the same time saving themselves from the
(concealed) consequences of long term use of Ritalin—1)
brain atrophy, 2) loss of motor control, 3) stunted growth,
and 4) low self-esteem.
Think of this problem as a matter of orders that are not obeyed.
The teacher orders kids that don’t do their work, don’t
stay put, or don’t keep quiet, to get to work, stay
put, and keep quiet. The so-called “attention deficit”
kid obeys the order to stay put and keep quiet, but disobeys
the order to get to work. The so-called “hyperactive”
kid disobeys all three orders, so he gets more attention from
the teacher than all the other kids. The point is that both
“inattentives” and “hyperactives”
are disobedient, and that will not do. Disobedience in school
must not be tolerated. Since punitive measures fail to increase
obedience, and the medics claim they know what’s wrong,
give them over to the medics. This is the “final solution.”
Who’s
to Blame?
Some behavioral scientists—anthropologists, biologists,
philologists, psychologists, sociologists—are inclined
to blame the medics for this blatant drug abuse, even calling
them “pill pushers.” But this is unfair, because
medics are no more to blame than the educators and parents
who bring their children to the medics for a quick fix. After
all, medics, like educators and parents, are not even close
to being corrective counselors, and, as laymen, are not students
of behavior of any kind, and certainly not students of misbehavior.
Nor are they students of the methods that have been developed
to correct misbehavior since the 1950s. They don’t know
that disobedience at school is easily corrected by corrective
counselors who know what they’re doing.
Medics, of course,
study anatomy, physiology, pharmacology, and surgery, which
is to say, medical practice. And once in practice they are
hard put to keep up with the steady advances in medical practice.
They can hardly be expected to take the long hard journey
to become corrective counselors after taking the long hard
journey to become medical practicioners. For that matter,
only some clinical psychologists and some marriage, family,
and child counselors actually become proficient in the methods
of corrective intervention, such as practiced by Dreikurs,
Erickson, and Glasser. The other methods are largely useless
in dealing with chronic disobedience.
Let’s face
it, nobody’s to blame for the final solution. And the
evil practice won’t end, not at least in the foreseeable
future. One reason it won’t end soon is that drugging
disobedient kids is but a small part of the practice of drugging
anybody that is said to be “afflicted” with a
“mental disorder”—all get drugged. Witness,
for instance, the fantastic increase in the use of Prozac
for the so-called “mental disorders.” The other
reason is that all but the disobedient kids profit from the
evil practice. The makers, dispensers, and prescribers get
lots of money, while the parents and teachers get relieved
of responsibility. Maybe by the middle of the 21st century
the final solution will be recognized for what it is, a very
evil practice, and so will end. In the meantime parents and
educators are wise to steer clear of the medics, whose “cure
is worse than the disease” even though the medics who
engage in the evil practice have sworn to “do no harm.”
ABOUT
THE AUTHOR
A clinical psychologist for nearly half a century, Dr. Keirsey
began dealing with youthful mischief in 1950 as a counselor
at a reform school for delinquent boys. He then worked as
a corrective counselor in public schools for 18 years, during
which time he collected a large repertoire of corrective counseling
methods. He followed this practice with 11 years as a professor
of the behavioral sciences (California State University Fullerton)
training graduate students in the technology of corrective
counseling at home and school. Since 1982 he has been writing
books and articles on varieties of temperament, varieties
of interpersonal disorders, and varieties of intelligent behavior.
Two million copies of his 1978 book Please Understand Me (revised
in 1998) are in print. [See www.keirsey.com]
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Bibliography
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• Breggin P 1997—Brain Disabling Treatments in
Psychiatry, Springer
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• Coles G 1987—The Learning Mystique: A Critical
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• Keirsey D 1991—Abuse it—Lose it: Logical
Consequences for Teaching Self-Control to Mischievous Children,
Prometheus Nemesis
• Keirsey D 1991—Drugged Obedience in the School,
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• Keirsey D 1998—The Great A.D.D. Hoax, Prometheus
Nemesis
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MD
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Children, Government Printing Office, Washington DC, December
29, 1970
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