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      1. Problems in Diagnosis

John LeMay:   Problems in diagnosis with ADD/ADHD: There’s so many, I almost hesitate to start. Just looking at this list… I’m going to skip whether it’s organic or functional for the moment. So far, I’ve heard that Attention Deficit Disorders are a cerebrocortical issue, solely, and that you can find it specifically within the brain. I have also heard that ADHD/ADD is a thyroid issue, and that with proper nutrition and the proper thyroid medications, the symptoms all clear up. I have heard that it is a vestibular disorder. This has to do with the inner ear and the way that the cochlea works. I’ve heard that it’s an ocular disorder, and that it is the way the visual system works – it is the way that the eyes work. I’ve heard that it’s a respiratory issue – it’s a matter of blood oxygenation. I’ve heard that it’s a pituitary issue and adrenal issue – imbalances in neurotransmitters. We’ve all been sold that one, right? Environmental toxicities, nutritional deficits, heavy metal poisonings, and on and on and on and on…

Why is it that we were all coming up with all of these different things? We’re looking at a process. The brain goes through a process. It’s not one simple set of behaviors, and it’s not going to be localized to just one area in the brain. We were hoping for it to be localized because, gosh, that would make it really simple for all of our models. The truth of the matter is that it is not localized.

Dr. Green:   Each of these things may be, or could be (and I don’t discard them out of hand), producing something. Unfortunately, they’re presented as the answer for this problem. That brings up the question: Is it a problem?

Before we start fixing it, we have to find out what it is we’re fixing. When we asked the question that way, we began to discover that it’s not always a problem. It’s a problem of cultural expectations. That doesn’t mean these organic problems don’t exist, but it means functional problems can exist as well. These would state that there’s something organically incorrect in the body. What does that say? That says that there is a “disconnect” between a cultural expectation and an individual’s ability to learn. Is it capability or is it something else?

Question (Pat Entwistle):   Is ADHD the umbrella term of which ADD is the subcategory? Or are they two separate functions?

Dr. Green:   Who are you talking to? What’s their background, and who is right? Lucky for you, I’m right, so you don’t have to look anymore. Hyperkinesis is an independent, individual diagnosis. It was lumped with ADHD. It was Virginia Douglas’ work. It was brilliant work. It was an associative piece of work, an associative research we will call, “inferential”. It’s not conclusive. In fact, hyperkinesis exists as a separate process. The fact that they do come together is even more interesting. They don’t exist together as a unit.

Question (Pat Entwistle):   Why are people so tunnel visioned, determined that they have to find one answer? Are they just trying to find an easy fix? Most things in life are complicated. Most things are not simple one-stop fixes. So, I would think that, rather than fighting each other, they would be working in concert to try to see how these things interweave with one another.

Dr. Green:   Which “they” are you referring to – the health professionals or the people who have the problem?

(Pat Entwistle):   All the above, but mostly, the health professionals, in terms of the ones trying to find the answers.

Dr. Green:   If we ignore the unfortunate obvious issue of why health professionals don’t collaborate, that’s probably the dominant one. Fortunately, few people are as humble and secure as John and I are, but…

John LeMay:   He leans on me a lot.

Dr. Green:   That is the dominant issue. You bring up another point, which we will get to later. So I will reference it, and then we will get out of the way, and we will come back to it. The other good point is this: As you folks have been hearing about ADHD for the last 20 years, honestly and truly, with a show of hands, how many of you have thought, “Do I have that?” I’m serious. Is that like everyone in the room? Okay. Think what that means. Right away that says maybe it’s not a problem. If we all have it, maybe there is something else going on.

That’s why I asked you if you were talking about the health professionals or the people who have it. People are attaching themselves to the diagnosis, not because they’re neurotic and they need something, but because it’s answering questions about “why, when I was so well intended as I walked into the classroom – and I really meant to listen – by the time the teacher was a minute in the class, my brain was out to lunch? Why, when I could have gone home and studied, instead, I stared at the wall? It would have been easier to study, but I did not. Why?” And these questions go on and on.

You brought exactly the big point we are trying to make here. Think about how important it is if everyone says, “Yeah, is that me?” It doesn’t mean you’ve all got ADD, but it means something extremely valuable.