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A nine-year-old, wonderful little boy graduated from therapy with me this week. When he was five he was labeled as ADHD and placed on stimulant medication. Since then several different drugs have been tried. His school work has not improved, and his misbehaviors have become progressively worse. He has only been my patient for the last three months, but in this short time and with the Caregivers' Skills Program (CSP), he is no longer considered an ADHD child. This was accomplished without drugs. At the final session his father said to me:
I've got my kid back. His spirit is back. He's spontaneous again. He laughs, tells jokes, and plays normally again. During the years he was on all those damn drugs, he lost his humanity. Now he's well behaved, polite, doing well in school, and he's a kid again. I get so angry at the bad advice we were given over the last several years. I feel so sad when I see all those kids at my son's school who take these drugs. They have circles under their eyes, and they seem to have lost their God-given spirit.
I had been searching for the right words to begin this book, and then this father said them for me eloquently. Drugs are a quick and easy fix, but they are unhealthy and they rob us of our humanity.
I've been teaching psychopharmacology for nearly twenty years, and I've learned a very important lesson: the human body is a miracle. It is very delicately balanced, and drugs, taken over a long period of time, disrupt this normal balance. Very often the changes induced by thisdisruption are irreversible. I've learned that no drugs should be used unless they are absolutely necessary.
Psychotropic (also known as psychiatric) drugs are very powerful. They are also extremely unhealthy. I am not opposed to the occasional use of these drugs but only for the shortest time periods possible. If a person experiences a tragic loss such as the death of a loved one and becomes profoundly depressed, six months on an antidepressant can help ease the pain. If a person becomes severely anxious about a problem such as the loss of a job, then a short regimen on a tranquilizer may have some benefit. But the long-term use of these drugs to solve our life problems is dangerous business. This is especially important when psychiatric drugs are used in the developing bodies of children. I discuss these health risks in detail in Chapter Two: "The True Facts Parents Are Not Being Told."
Pills mask our problems. When the pills are stopped, the problems are still there, and so is our inability to tackle and cope with the problems. Pills teach us nothing. Pills can rob us of the motivation to solve our problems and our desire to mobilize our personal resources to conquer them. Our humanity—our spirit—is molded when we tackle problems and stresses and overcome them. If we stop doing that, we stop growing. We stop developing spiritually. We stop learning. We stop evolving. We give up our souls.
In the last two years at almost every talk I've given, someone in the audience has said something like this: "I'm a doctor, and I discovered, thanks to a psychologist friend of mine, that I'm ADD. I started taking Adderall [or any other stimulant], and I have a new lease on life. I feel better, and I can think better." My typical response is that probably he could have gotten the same results by using almost any other type of psychiatric drug. An antidepressant may have worked as well, or a tranquilizer, or even whiskey. We are increasingly relying on drugs to help us make it through our difficult days, and when we take drugs to cope, this is called addiction. This person's problem isn't ADD. It's ADD-I-C-T.
Drugs are rapidly becoming replacements for self-discipline in our society. But we have choices about how to handle our behavioral and emotional problems, which, in our stressed-out society, can be enumerable. If, for example, a man has a long-term problem with depression because he is not happy with his career, he can choose to take antidepressants for years to mask his problem. Or he can choose to see a therapist who may help him develop methods for stress management, perhaps for retraining for a more desirable career and for developing self-discipline techniques to control the thinking patterns that underlie his depression. If a woman has anxiety attacks because her life is filled with unrelenting stresses, she can choose to take tranquilizers for the rest of her life. Or she can change her lifestyle, develop better problem-solving skills, and learn effective cognitive (thinking) coping skills.
My point is that anything drugs can do can also be done in more lasting and healthy ways by learning a variety of psychological techniques for dealing effectively with almost any human problem. But these techniques require dedication, self-discipline, and hard work. Unlike the quick fix and the short-lived gains of pills, however, these changes can be permanent.
The doctor I mentioned earlier who thinks he's ADD and is taking Adderall has choices, too. I sometimes illustrate that by describing my own case. I begin by saying something like this: "Doctor, how do you think I would feel if I had a brain tumor and you just told me you are a neurosurgeon? What kind of confidence would I have in you? Do you think I would decide to use your services? I don't want someone operating on my head who is ADD and needs drugs to focus. I want someone who has self-discipline and who is sensible enough to limit his patient and surgery schedule to a level where he doesn't need pills to help focus and cope."
Then I add: "I'm the proverbial absent-minded professor. My mind is constantly focused on the world of ideas. And this often results in forgetting things, in losing my keys, or in misplacing my glasses. I can take a pill to help. An amphetamine would, indeed, help me calm down and focus better on all these things. Or I can practice being a bit more diligent and making certain I put my keys and glasses in specific locations to help me always know where they are. I can jot down memos to help jar my memory. One solution requires me to exert self-discipline; the other camouflages my emotions. One is a lasting solution, provided I continue to work at it; the other stops as soon as the pills stop. One maintains my human integrity; the other robs me of it. One helps keep me healthy; the other damages my health. You have the same choice."
During the 1990s I observed the pharmaceutical companies waging a successful campaign to market and sell all sorts of psychiatric drugs. Increasingly, they have been able to convince the public that everything is a disease and that the magical solution lies in simply taking a pill. How easy they make it for us! If we are depressed, we have a disease called depression. But don't worry, there is a pill for depression. If we are nervous, we have a disease called anxiety. But don't worry, there is a pill for anxiety. If we have a child who is not behaving well in school and not doing his work properly, he has a disease called attention deficit disorder. But don't worry, we have a pill for ADD, too.
Does it matter whether or not drugs are obtained from the streets or from the doctor's office? Not really. Prescription drugs, just like street drugs, allay nervousness, lift our spirits, and help us cope and make it through stress-filled days. During the 1990s we merely switched pushers. We shifted from the Colombian and Mexican cartels to the pharmaceutical cartels. The law now stalks one and protects the other.
Pharmaceutical companies have been discovering that psychotropic drugs yield enormous profits, often billions of dollars from one drug alone. Some companies have become reliant on these drugs as their largest source of revenue. When they shifted from targeting adults and started targeting the developing bodies of children, my concern changed to fury. They know stimulant drugs are risky. Every textbook I've used for teaching psychopharmacology clearly states what the side effects of these drugs are and that these are the most psychologically addicting drugs known. Surely pharmaceutical executives know this, and yet they have aggressively—and successfully—campaigned to legitimatize these drugs and get as many of our youth hooked on them as possible. And we are now discovering that we can't stop the drugs. When the drugs are stopped, any gains that were made evaporate. Increasingly, we have to keep kids on these drugs into the teenage and adult years. Is this not profitable for the pharmaceutical companies?
What amazes me most is that my fellow psychologists are supporting the drug companies' campaign. Things have changed vastly in the world of psychology since I trained in psychology in the sixties and seventies. Drugs weren't the basis for treatment then. Excitement and electricity permeated the air because of the excellent research that was being conducted to develop psychological techniques that produced amazing results, especially in child therapy. Lovaas developed techniques that produced miraculous results with autistic children. Paterson and Becker developed excellent parenting programs that produced real results. Bandura developed methods to reduce childhood fears and aggressive behaviors.
When I was training at the University of Mississippi Medical Center in the 1970s, the intern program there was ranked number one in the country for outstanding behavioral research. Behavioral research couldn't be conducted in the major metropolitan areas like New York, Chicago, or Los Angeles because of the entrenched power of the Freudians and Rogerians; neither tradition was research-oriented. But I recently visited with the only remaining professor in my old department; the others are now at universities in larger cities. He said to me frankly that the department is now biologically oriented. I was stunned. I said nothing, but my mind was racing. "What the hell do you mean, biologically oriented? Why aren't you factually oriented? How can a once-great department that produced great works now blindly accept the junk that is being produced? How much grant money is being given to the department and to the hospital to become 'biologically oriented' and to forget its once-great commitment to excellent behavioral treatments?" If being biologically oriented meant that modern research was based on fact and good procedures, then the claim to be biologically oriented would be profound. But such is not the case. I'm sad to say that what is being produced as research today is garbage, and our children are victims because of it.
Psychology seems to have given up on itself. Instead of developing effective cognitive and behavioral methods, psychologists have developed poorly designed behavioral treatments that have been repeatedly demonstrated not to work. The literature is replete with studies indicating that behavioral treatments for attentional disorders don't work, and yet psychologists keep researching and recommending the same old ineffective methods. In order to make any improvements, drugs are now almost always necessary. In fact, the same results are obtained without any psychologically based treatments. Drugs have become the bastion for treating children who misbehave in school and do poor school work. The change in paradigm has shifted from psychological to biological. Why? What has been happening? Why has psychology stopped believing in itself? Why are psychologists no longer carefully examining the poor research and lame methods that are being promulgated as treatments?
I don't know what's happened to the profession of psychology, but I do know this: what I present in the pages of this book works. I believe in psychology. I want my profession to reemerge with zest and aliveness and develop behavioral and cognitive methods that work without poisoning the bodies of children. I receive thousands of letters from parents reporting overwhelming successes without drugs. The CSP is based on accurate and precise behavioral principles.
Lately when I've attended professional conferences, I've been hearing statements supporting the use of stimulant drugs. Here's an example: "The best thing we can do for these children is help them with their self-esteem. By failing in school and constantly getting in trouble with teachers, their self-worth is constantly chipped away. The fastest way to help them is with the proper regimen of medications."
I say that's rubbish! The best way to help children is to teach them the skills and behaviors they need to succeed. Empty improvement with drugs only creates an illusion of meaningful change. What good does it do these children if every time attempts are made to stop the drugs, the improvements disappear? The drugs have not helped them master themselves. Children's humanity lies in controlling their own minds and behaviors. They have to learn self-discipline. School work is hard. The best thing we can do for these children is to help them make real and lasting changes. They can learn to control their behaviors. They can learn to study. They can learn deep concentration. They can learn to memorize. What a horrible thing it is to tell a child he has a disease when not one shred of evidence shows that to be true. Once told, however, a child will most likely believe he is mentally impaired for the rest of his life. When we convince children that they are sick and handicapped and will need pills for the rest of their lives, we rob them of their real sources of self-esteem. We rob them of their ability to learn and conquer. We take away from them the opportunities to dig deep within themselves to discover their personal resources and abilities. We steal from them the meaningfulness of their lives. No, my friends, pills do not give children back their self-esteem. They rob them of it!
I challenge my fellow psychologists to join in the quest. I've clinically tested and researched the program presented in this book. Help me to help children. Research even further the techniques presented here. Improve them. Make them better. Let's get back to believing in psychology and start, once again, producing exciting psychological methods that really work. Let's stop relying on chemicals to do the work for us.
I believe in the contents of this book with a light and uplifted heart. I still believe in psychology. What you learn here works and is healthy for your child. God bless.
David B. Stein, Ph.D.
Professor of Psychology
Longwood College, Farmville, Virginia
|Introduction: Is This Book for You?||xxi|
|Part 1||Preparation for the Caregivers' Skills Program|
|1.||Questions to Ask the Docto||3|
|2.||The True Facts Parents Are Not Being Told||19|
|3.||The Real Causes of IA-HM (ADD-ADHD)||35|
|4.||Why the CSP Works||49|
|Part 2||The Caregivers' Skills Program|
|5.||CSP Step One: Targeting Behaviors||59|
|6.||CSP Step Two: Improving Desired Behaviors by Reinforcement||75|
|7.||CSP Step Three: Understanding the Difference Between Punishment and Discipline||83|
|8.||CSP Step Four: Using a New Time Out||97|
|9.||CSP Step Five: Eliminating Lying and Aggression by Removing Reinforcement||111|
|10.||CSP Step Six: Using the Daily Report Card Program||115|
|Part 3||Beyond the Caregivers' Skills Program|
|11.||Teaching Important Values||133|
|12.||Preventing the Creation of an IA-HM (ADD-ADHD) Child||153|
|Resources for Parents||163|
Posted March 7, 2008
If your child is displaying 'symptoms' of ADHD/ADD, and you're thinking about or being encouraged to use drugs like Ritalin 'Class II narcotic', this is an absolute must read. It may very well change your childs life for the better for their entire life.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted July 8, 2004
Posted July 11, 2009
No text was provided for this review.