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In issue 3 of The Mother magazine (pp. 38-9), Maya Hayward offered us a passionate, heart-felt critique of the highly dubious notion of ‘Attention Deficit Disorder’ (ADD). I strongly agree with her, for example, that a child with ADD is displaying ‘emotions aimed at drawing attention to the fact that they haven’t received the attention they needed’. There is undoubtedly a crucial place for polemical critique in this most emotive of fields, and I applaud Maya’s impassioned offering. Yet alas, in our (still) overly intellectually-dominated world, passion and polemic will usually not be sufficient to persuade, or even challenge effectively, those wielding the positional power to impose a narrowly mechanistic, alienating and, above all, unscientific psychiatric world-view on to our children. In this article, therefore, I set out a rational-analytical argument which, I believe, comprehensively undermines the psychiatric profession’s pathologisation and medicalisation of what I will term children’s ‘challenging behaviour’. I hope that the arguments set out below will empower parents to resist the crude ‘chemical-cosh’ approach to our children’s disturbing behaviour – an approach which not only completely misses the underlying generative processes which drive challenging behaviour, but may well be inflicting quite inestimable life-long damage on a generation of psychoactively medicated children.

I begin with a systematic critique of the orthodox psychiatric approach to ‘disturbed behaviour’, an approach in which such behaviour is spuriously conceived of, and then responded to, as a medical problem, rather than as an understandable, and even healthy, child response to the crazy culture in which children routinely find themselves – whether it be the familial culture in which they have to survive, or the wider societal culture to which they are exposed. I return to these critical familial and cultural questions later. I ask the reader to ‘hang in’ with what might seem like a rather abstract, philosophical section – for these are quite crucial arguments for anyone to master who needs an informed and sophisticated perspective from which to stand up to the psychiatric profession.

According to the Jungian James Hillman, in Western diagnostic psychiatry, ‘what a person has, his diagnosis, has become more important than who a person is’. And as I.E. Harvey has written, conventional psychiatric systems ‘rely on an implicit but powerful prescriptive, normative, metaphysical foundation that is never examined’.

Hillman also highlights the disempowering, infantilising dynamic intrinsic to the professional medical-model relationship, where ‘All health is on one side, sickness on the other’.

These and related perspectives have been systematically picked up and developed by Professor of Social Psychology Ian Parker and his colleagues. In 1995, they collectively authored a path-breaking book entitled Deconstructing Psychopathology, which mounts a devastating challenge to the scientific pretensions of conventional psychiatric practices. For Parker et al., language and professional discourses ‘always entail relations of power’ (p. 41), ‘offer[ing] positions of power to certain categories of people and disempower[ing] others’ (p. 10). The professional use of language is seen as critical, for ‘language does not only organize reason but it also structures what we imagine to lie outside reason’ (p. 14). All this in turn has momentous implications for the way in which the very identities of psychiatric ‘patients’ (in our case, children) are constituted in professional discourses.

The way in which (allegedly ‘scientific’) psychiatric knowledge gains its privileged cultural status, far from being the result of rational scientific progress, is understood as a fundamentally ideological, socially constructed process, indissolubly infused with issues of power. For ‘knowledge, theoretical and scientific, does not describe a pre-existing reality but constructs realities’ (p. 131, added emphasis). Within this framework, Parker et al. pose the ‘deconstructive’ question, ‘how did our ideas of psychological distress become current and what are their implicit assumptions and implications?’ (p. 47).

Their Chapter 3 focuses on symptomatology, describing the ways in which the official psychiatric diagnostic systems of DSM and ICD are used to categorise individuals as ‘abnormal’. The authors show how the conventional oppositions between so-called ‘normality’ and ‘abnormality’, and health and illness, are ideological and socially constructed rather than being the objective scientific categories that traditional psychiatry claims them to be. The philosophical demolition job that Parker et al. do on the notions of ‘normality’, ‘abnormality’ and ‘psychopathology’ is breathtaking. They write, ‘The very idea of "normality" is founded upon the idea of "abnormality", of that which lies outside the definition of the norm’ (p. 104). Yet it makes far more sense to see ‘abnormality’ not as some objective statistical generalisation falling outside of a normal distribution, but rather as a fear-induced, socially constructed category whose unacknowledged function is to reduce anxiety in the face of others’ difference. Thus, as Parker et al. so poignantly write, ‘for those who diagnose others as pathological, a position of normality is secured’ (p. 61). The medicalisation and pathologising of challenging behaviour, of course, conveniently locates it outside of the ‘comfort-zone’ of what is familiar, predictable and ‘normal’ - in turn distancing mental health professionals from direct engagement with the challenging, often disturbing subjective experience of their child ‘patients’.

Notions of the normal and the pathological, then, far from being scientifically or statistically determined, are concepts of value deeply embedded within political, economic and technological imperatives. As the psychologist David Smail has written (in his book Taking Care, Dent, 1987, p. 55): ‘Who does not know for him- or herself the savage tyranny of the "norm"? Being different, standing out, feeling differently from others, experiencing oneself as conspicuous in some way... are at the very core of much of what gets called "psychiatric disorder", and indeed of the everyday terrors of us all’.

Parker et al’s Chapter 4 then looks at cultural representations of psychopathology, focusing in particular on the ways in which language structures common cultural conceptions of ‘illness’ and ‘abnormality’. ‘Madness’, for example, is seen as a cultural representation; and the typically taken-for-granted distinction between professional and lay knowledge is fundamentally questioned.

In Chapter 6 Parker et al. devastatingly expose the tautological circularity of traditional psychiatry's approach to, and labelling of, ‘psychosis’ (which, following Lucian Buck, we might term ‘Pervasive Labelling Disorder’). In a brilliant critique, the authors show how a ‘disorder’ is at the outset assumed to exist (e.g. ‘abnormal’ hyperactive behaviour), and then ‘psychiatric research... actively constructs a version of both normal and abnormal [behaviour], which is then applied to individuals who end up being classified as normal or abnormal.... Research draws on existing clinical categories and... its results are fed back into the diagnostic systems.... Psychiatric language, embedded in research and clinical practices, constitutes the very "pathological phenomena" it seeks to explain’ (pp. 92-3, original italics; added bold text); and ‘a vicious circle is created where diagnosis and research encourage one another leaving their assumptions unquestioned, while maintaining the same practices’ (p. 97). Thus, Parker et al. show quite convincingly that ‘the opposition between "normal" and "psychotic" cannot be sustained any longer’ (p. 110).

Crucially for currently purposes, their compelling argument about the self-fulfilling circularity of diagnostic procedures is equally applicable to so-called "ADHD" and the like. In short, some kind of perverse alchemy seems to occur whereby the ordinary (albeit often distressing) everyday difficulties of living and existence are surreptitiously transformed into a mechanistic professionalised lexicon of quasi-medical terminology that legitimises a professional ideology that, in turn, self-fulfillingly becomes the guarantee of its own existence. As the great philosopher William James dramatically put it, ‘medical materialism finishes up St Paul by calling his vision... a discharging lesion of the occipital cortex... It snuffs out St Theresa as a hysteric; St Francis of Assisi as a hereditary degenerate…’.

The real everyday practices of traditional psychiatry are shot through with, and informed by, these fundamentally ideological conceptualisations. In particular, if 'How we reflect upon and define ourselves is determined and constrained by the structures of knowing available to us’ (p. 88), then ‘psychiatric patients, through the course of repeated assessments, come increasingly to define their experiences in accordance with a professional definition of psychiatric illness’ (p. 89). In short, ‘clinical discourses impact upon individual autobiography thereby influencing both the types of subjectivity and identity that are brought into being’ (p. 73). Professional elites are seen as constructing people’s realities through their often mystifying language, and ‘the ubiquity of particular types of discourse makes it impossible for their subjects to "think" or even imagine an "elsewhere" ’ (p. 75). Further, patients are exposed to the objectifying diagnostic clinical gaze of the psychiatrist ‘which supposedly records symptoms and compares them with diagnostic criteria’ (p. 66).

In sum, then, rather than discovering a supposed objectively existing identity of the diagnosed, the psychiatrist actually constitutes the identity of his/her ‘patients’ through tautological, ideological linguistic practices which are in turn indissolubly implicated in the power-infused discourse of traditional psychiatric practices. Again, ‘Discourses always entail relations of power’ (p. 41), and ‘we are caught in a historical process that positions psychiatrists... and other mental health professionals in relations of power over "users" of services, and the best we can do is to identify the fault lines in that power, to open up new spaces of resistance for those working in and against the clinical apparatus’ (p. 16) – something which I try to do in the remainder of this article.

It follows quite naturally from these arguments that, as already mentioned, the conventional distinction between professional and lay knowledge is highly problematic: thus, ‘it is impossible to separate different realms of knowledge since all are thoroughly embedded in cultural practices of one kind or another’ (p. 57), and ‘professional knowledge too is deeply embedded in wider cultural stories’ (p. 63). Clearly, the implications of these arguments for clinical practices can hardly be overemphasised. And if Parker et al.'s analysis is anything like right, then a wholesale paradigm shift in the theory and practices of ‘mental health treatment’ is surely indicated – and, some would say, long overdue.

Parker et al. mischievously write that the proponents of conventional psychiatry could perhaps suffering from the condition of ‘Professional Thought Disorder’ (following Dave Lowson) – or Buck’s ‘Pervasive Labelling Disorder’; and in similar vein, I maintain that what lies at the emotional root of the defensive clinical practices of psychiatry is a ‘pathological’ fear of intimacy, and an unconscious caught-up-ness in the worldview of a mechanistic and soulless modernity (a crucial issue to which I return below).

Parker et al. offer, then, a quite devastating critique of the dehumanisation of existing mechanistic clinical-psychiatric practices, and the prospect of a less alienating and more empowering approach to emotional distress and ‘the necessary pain of living’ (as Scott Peck has called it). And once the central message of Deconstructing Psychopathology has been culturally assimilated and integrated, ‘mental health’ practices will surely never be the same again - and that will be cause for no little rejoicing and celebration in many quarters… not least those children and their families who are routinely exposed to the clinical practices that Parker and his colleagues so convincingly take apart.

According to Eugene Schwartz in his important book The Millennial Child (Anthroposophic Press, Spring Valley, New York, 1999), childhood constitutes an ‘endangered species’. Signs are all around us of adult-driven intellectual agendas and a hyper-active, materialistic culture impinging ever more relentlessly on the lives of children at ever younger ages. One-quarter of British children aged under 4 now apparently have a television set in their room (Daily Mail, 30 June 2000). Martin Large, proprietor of the holistic British publishers Hawthorn Press, is currently putting the finishing touches to a follow-up book to his seminal book Who’s Bringing Them Up?, which looked at television and the pervasive, insidious harm it does to children. In his new book (to be published next April), Martin will conclude, having reviewed the considerable available research, that children should ideally not start watching television, or begin using computers, until at least the age of 7. My own hunch is that if this advice were followed faithfully by today’s families, not only would conditions like ‘ADHD’ virtually disappear overnight, but the overall quality of family life would improve immeasurably.

Even relatively conventional neuroscientists, like Professor Susan Greenfield of Oxford University, are beginning to suggest that an increasingly ubiquitous ‘Information Technology’ may entail profound long-term risks, including ‘the potential loss of imagination, the inability to maintain a long attention span, the tendency to confuse fact with knowledge, and a homogenisation of an entire generation of minds. These risks could even actually change the physical workings of the brain’ (The Independent [Monday Review], 19 June 2000, emphasis added).

Rudolf Steiner was pointing out comparable dangers nearly a century ago. In a lecture given in Torquay in 1924, he said, ‘[B]efore the change of teeth, the child is [quite literally] wholly "sense-organ"... If something takes place in the child’s environment..., the whole child will have an internalized picture of [it]... The results of [such an] implanted tendency in the early years will then remain through the rest of the life... [E]verything that you do yourself passes over into the children and makes its way into them.’ On this view, the environments to which we expose our young children have a quite fundamental influence on their whole being - physically, emotionally, spiritually. And it therefore behoves us to take great care in how we create those environments - a task which is becoming increasingly important as modern culture’s assaults upon young children become ever-more strident, universal and unavoidable.

Against the cultural backdrop just described, it is little wonder that mental health problems are at record levels amongst children (Nursery World, 6 April 2000, pp. 8-9); that the anxiety-driven hot-housing atmosphere of mainstream educational settings is now demonstrably leading to severe psychological and emotional problems (e.g. The Independent, 6 July 2000, p. 5; Nursery World, 22 June 2000, pp. 4-5); and that, as child psychotherapist Peter Wilson estimates, about one-quarter of British children in their mid to teenage years are displaying symptoms of extreme stress, depression or anxiety (quoted in Natural Parent, 1, 1997, p. 22). In the tender pre-school sphere we are now witnessing the grotesque phenomenon of early years ‘experts’ routinely talking of a ‘curriculum’ for the under-threes! Language is, of course, profoundly revealing: my Concise Oxford Dictionary defines the term ‘curriculum’ as ‘a course of study’; and in the casual use of this term by early years professionals and politicians, we see the tell-tale signs of the ideologically driven dismemberment of childhood referred to by Eugene Schwartz and other holistic early years authorities. Conventional education is increasingly coming to resemble the force-feeding of growth hormones to cattle to artificially speed up (for commercial reasons, of course) what should be a naturally unfolding and respected developmental process.

It is within this cultural context that we should try to understand the rapid increase in young children’s ‘challenging behaviour’ which has grown apace in recent years. Yet the societal response to this phenomenon throughout the Western world has been wholly inadequate. The Breggins describe in frightening detail the way in which drug treatment for children is burgeoning in the United States – to take several particularly stark examples, Ritalin prescription to the under-fives (i.e. 2-4 year olds) has recently increased three-fold (Nursery World, 27 April 2000); and probably at least 5-6 million of the USA’s 50 million school-age children are currently taking stimulant drugs (Breggin, 2001). In Australia, according to Lynne Oldfield, the number of children on prescribed amphetamines for ADD rose from just 3,000 in 1991 to 16,000 in 1993.

Here in Britain, similar disquieting trends are evident. Between 1993 and 1998, for example, the number of child Ritalin prescriptions rose by no less than thirty-six times (Observer newspaper, 27 February 2000); and recent data showed a 20-fold increase in Ritalin prescription in Scotland between 1994 and 1999 (Nursery World, 12/10/00). Yet rather than so-called ‘Attention Deficit’ and ‘Hyperactivity’ ‘disorders’ being valid medical-diagnostic categories, these symptoms are far better understood as children’s understandable and, paradoxically, even healthy response to the routine violence that modern technocratic culture is doing to our children’s healthy development – and not least the unbalanced over-intellectual ‘left-brain’ distortions of its early educational practices. Until we possess the wisdom and insight to recognise, learn from, and then respond appropriately to this malaise at a cultural level (not least via protecting young children from the soul-assaults of modern ‘dead’ technology and inappropriate educational practices), children’s so-called ‘behavioural difficulties’ will inevitably continue to escalate – Ritalin or no Ritalin.

In his important recent book Ritalin Nation, Richard DeGrandpre agrees that ADD is the direct result of the over-stimulation of a speeded-up culture (cf. James Gleick’s deeply disquieting book Faster). There is, moreover, strong corroborative evidence for this ‘cultural-level’ explanation from Steiner Waldorf educational philosophy. The latter places the forces of imitation at the very centre of children’s early learning and development (see Lynne Oldfield’s Free to Learn), and it is hardly surprising that children sometimes imitatively ‘act out’ or imitate in their feverish behaviour the frenetic hyperactivity of the culture and society in which they find themselves – especially when there is a dovetailing and mutual reinforcement of these influences with the difficult biographical-environmental circumstances which many children also experience. It seems extraordinary that in all the mountainous ‘scientific’ (sic) literature on this broad issue, such an obvious explanation has, to my knowledge, never even been suggested.

Consider the multiple levels of ‘madness’, then, with which our poor children have to cope – with children imitating the crazy world we adults have created; and then those same adults, being quite incapable of accurately interpreting the message our children’s behaviour is desperately trying to communicate to us, responding with a crude chemical cosh that not only may do incalculable long-term damage to the children so treated, but which approach also conveniently enables its apologists to evade taking any responsibility whatsoever for the madness which their soulless ‘modernist’ worldview has created in the first place. No wonder so many children are displaying ‘disturbed’ behaviour, when subjected to such mad-making treatment – where, for example, a society prohibits the use of cocaine, and at the same time sanctions the placing of many of its school children on doses of a virtually identical substance. It is the children who are, indeed, the sane ones, whatever their behaviour might be...

Rather than drugging to the eyeballs the children who, through their behaviour, dare to challenge our adult world, we should be asking the question: If these children were able verbally to articulate to modern technocratic culture precisely what they are feeling and why they are feeling it, rather than acting it out through their behaviour, what do we think they might be saying to that culture? Only when we begin to address this kind of question at a cultural level will we be able to begin the urgent task of fundamentally re-assessing the crazy world which we adults have collectively created, and move towards a healthier re-foundation of that culture.

There is also an important point to be made about causality. Medical professionals who prescribe mind-altering drugs to treat behaviour difficulties are effectively assuming that such behaviour is mechanistically caused by a ‘malfunction’ of the brain, and that by artificially correcting the malfunction, the behaviour will then be ‘normalised’. In contrast, a so-called ‘bio-psycho-social’ perspective sees the direction of causality being the other way around – with any observed brain disturbances being the consequence of the disturbed behaviour (or at most, an associated concomitant of it), rather than its cause. On this latter view, then, to tinker with the symptomatic chemical imbalance in the brain, which is merely the material end-result of a highly complex sequence and combination of factors, may, in the short run, provide some relief from the symptoms, but will do little or nothing to address the underlying cause(s) and the factors which may be precipitating the child’s behavioural difficulties. I return to these crucial questions below.

It should be clear from the foregoing that a truly human response to children’s challenging behaviour is to seek meaning in it – to listen deeply and respectfully to its manifest symptomatology in order to get as close as we can to understanding that behaviour, and then fashioning appropriate healing responses to it. It was Carl Jung who poignantly wrote: ‘We should not try to "get rid" of a neurosis, but rather to experience what it means, what it has to teach us, what its purpose is. We should even learn to be thankful for it, otherwise we... miss the opportunity of getting to know ourselves as we really are... We do not cure it - it cures us’ (added emphasis). Such a view – with which I completely concur - is a million miles away from the pathologising approach which medicalises and then "chemical-coshes" children unfortunate enough to come under the objectifying clinical gaze of modern psychiatry.

I maintain, then, that what are commonly diagnosed and medicalised as children’s ‘mental health’ problems are often, or even always:

• a manifestation of children’s struggle towards meaning-making;
• a meaningful process, typically operating at many levels, rather than some kind of ‘abnormal malfunction’ of the (physical) brain.

I am also tempted to argue that there may always be some kind of spiritual, trans-biographical (but by no means random) dimension to any and every unusual/exceptional subjective experience, and that to ignore this (which medical-model diagnostic psychiatry routinely does) is to miss perhaps the most important aspect of those experiences, and - far worse - to do an untold violence to those people whose experiences are subjected to psycho-chemical treatment and objectifying regimes of professional ‘truth’. This in turn suggests that a facilitator-therapist-educator must be able to acknowledge and work empoweringly with material from all these levels - which will require flexibility and freedom from conceptual orthodoxy.

Perhaps it is not the symptoms that accompany these childhood experiences per se which are the problem, but rather, our ego-fixated attempt to resist and avoid pain, discomfort or suffering, which in turn disrupt and complicate what could and possibly would otherwise be a transformative or healing process. And on this view, conventional psychiatric ‘treatment’ will tend to be routinely harmful rather than healing and healthily restorative.

The second and concluding part of this article will look at the side-effects of child medications, some practical guidelines for parents to adopt, key quotations from critical professionals in the field, and resources and further reading sections, and will appear in issue 5 of The Mother magazine.

Regular Mother magazine contributor Richard House is an NHS counsellor, a Steiner Waldorf early years teacher and an academic writer/editor living in Norwich, UK. His new bookTherapy Beyond Modernity is published in November (by Karnac Books, £19.99). Address for correspondence: richardahouse@hotmail.com

I referred to education in passing in part I of this article. There seems little doubt that modern technocratic educational practices have a great deal to do with the rapid growth of children’s challenging and disturbed behaviour. As the famous critic of mass schooling John Holt has said in commenting on the diagnosis of ‘hyperactivity’, ‘We consider it a disease because it makes it difficult to run our schools as we do, like maximum security prisons, to the comfort and convenience of the teachers and administration who work in them’ (quoted in Beggin’s Toxic Psychiatry, p. 387). Similarly, Professor of Psychology Steve Baldwin says that ‘There is a very strong social and economic need for parents, teachers, educational psychologists and the medical profession to label and prescribe, mainly because of the need for social control’ (quoted in Nursery World, 12/10/00, p. 11, added emphasis). Little wonder, then, that in the American DSM-IV psychiatric classification manual, the official criteria for diagnosing ADHD are ‘behaviors that interfere with an orderly, quiet, controlled classroom’! (Breggin, 2001). One could hardly wish for a more telling example of the spurious scientificity of these allegedly ‘scientific’ diagnostic systems – and of their socially-culturally constructed nature. Indeed, there are now, even, quite absurd ‘official’ medical-psychiatric diagnoses in the DSM-IV of so-called ‘disruptive behavior disorder’ and ‘oppositional defiant disorder’!…

All this provides a very strong rationale for, and vindication of, the educational approach to be found in the worldwide Steiner Waldorf schools movement. As Hilary Wice points out (quoting Richard DeGrandpre), ‘Much better would be a regime that slowed children down and offered them time, attention and active engagement with the world as opposed to constant electronic input’ – a very good, albeit inadvertent, description of what Waldorf education does, in fact, offer, with the way in which the calming, behaviour-modifying possibilities of rhythm and repetition are explicitly and consciously made intrinsic to the early learning environment (see Lynne Oldfield’s Free to Learn). There is also an increasing sense in the Waldorf movement that early learning environments will in future, and as a matter of course, need to encompass a crucial healing element in their pedagogies – which reminds one of the extraordinarily prescient quotation from Rudolf Steiner, when he said: ‘Once in olden times, there lived in the souls of the initiates powerfully the thought that by nature every person is ill. And education was seen as a healing process which brought to the child, as it matured, health for becoming a whole human being’ (11^th March 1924, added emphasis).

School size is also almost certainly a factor in all this – for smaller schools allow teachers to really get to know the children much better and, thereby, be more responsive to their developing needs; and conflict can more easily be ‘worked through’ rather than suppressed. The Breggins quote research that shows that when schools are indeed smaller, the diagnosis of behavioural ‘disorders’ all but disappears; and they quote New York Times reporter Susan Chira, thus: ‘Students in schools limited to about 400 students have fewer behavior problems, better attendance and graduation rates, and sometimes higher grades…’. Of course, it is no coincidence that Steiner Waldorf schools have these close teacher-child relationships built into the very structure of the Class Teacher system from age 6 to 15, and that Waldorf schools also tend to be of a size such that a community rather than a ‘factory’-like, mass-schooling atmosphere prevails.

I believe that the whole issue of literacy is also of especial relevance in the increasing incidence of children’s challenging behaviour. Early this century the holistic educationalist Rudolf Steiner made the extraordinary statement that ‘When… a child is obliged to learn to read and write, it is torture for the soul that wants to develop and unfold in accordance with its own nature’ (in Volume I of his Karmic Relationships). Now if one reads the best-selling book by Leonard Schlien, The Alphabet and the Goddess (1998), this statement is not nearly as far-fetched as it may at first sound – and indeed, Steiner may be yet again demonstrating the profound insight into human development that the modern technocratic mentality has long since completely lost sight of.

Through painstaking historical research, Schlien discovered that throughout human history, whenever literacy has been introduced into any and every society, it has led to mayhem within the whole society – typically involving wars, torture and widespread outbursts of generalised violent behaviour. He also maintains that literacy encourages ‘masculine’ linear, reductionist and abstract modes of thought (little surprise that modern, male-dominated politicised education is introducing literacy at ever-younger ages). And in this context too, if Steiner is indeed correct in his startling perceptions about literacy, we would indeed expect precisely the kind of upsurge in children’s ‘protesting’ behaviour which we have been witnessing in recent times – coinciding almost exactly with the foisting of over-formal intellectual education on to younger and younger children. Seen in this light, the very gentle and artistic introduction into literacy that the Steiner Waldorf educational system insists upon makes complete sense. It is also all the more ironic that reading concentration is a standard test used by doctors to diagnose ADHD! This truly is madness heaped upon madness, which quite beggars belief…

With the recent upsurge in formally taught literacy at younger and younger ages in our schools, then, perhaps it is the ‘tortured’ souls of prematurely awakened children that are crying out to us through their disturbed behaviour that we are getting it all wrong... Certainly, the technocratic modernising agenda of current politicised education has completely lost the feel for the subtleties and complexities of child development and child-appropriate learning experiences; and in this context it is the Steiner Waldorf movement and the ‘holistic’/humanistic education movement which are the only educational approaches currently offering an educational experience which remotely responds to these concerns in an informed and appropriate way.

It should be clear from the foregoing that a truly human response to children’s challenging behaviour is to seek meaning in it – to listen deeply and respectfully to its manifest symptomatology in order to get as close as we can to understanding that behaviour, and then fashioning appropriate healing responses to it. It was Carl Jung who poignantly wrote: ‘We should not try to "get rid" of a neurosis, but rather to experience what it means, what it has to teach us, what its purpose is. We should even learn to be thankful for it, otherwise we... miss the opportunity of getting to know ourselves as we really are... We do not cure it - it cures us’ (added emphasis). Such a view – with which I completely concur - is a million miles away from the pathologising approach which medicalises and then "chemical-coshes" children unfortunate enough to come under the objectifying clinical gaze of modern psychiatry.

I maintain, then, that what are commonly diagnosed and medicalised as children’s ‘mental health’ problems are often, or even always:

• a manifestation of children’s struggle towards meaning-making;
• a meaningful process, typically operating at many levels, rather than some kind of ‘abnormal malfunction’ of the (physical) brain.

I am also tempted to argue that there may always be some kind of spiritual, trans-biographical (but by no means random) dimension to any and every unusual/exceptional subjective experience, and that to ignore this (which medical-model diagnostic psychiatry routinely does) is to miss perhaps the most important aspect of those experiences, and - far worse - to do an untold violence to those people whose experiences are subjected to psycho-chemical treatment and objectifying regimes of professional ‘truth’. This in turn suggests that a facilitator-therapist-educator must be able to acknowledge and work empoweringly with material from all these levels - which will require flexibility and freedom from conceptual orthodoxy.

Perhaps it is not the symptoms that accompany these childhood experiences per se which are the problem, but rather, our ego-fixated attempt to resist and avoid pain, discomfort or suffering, which in turn disrupt and complicate what could and possibly would otherwise be a transformative or healing process. And on this view, conventional psychiatric ‘treatment’ will, again, tend to be routinely harmful rather than healing and healthily restorative.

First, some factual information. Ritalin in a class II category controlled substance, like barbiturates and morphine, with a high potential for addiction and abuse. DeGrandpre points out that Ritalin’s qualities are ‘pharmacologically almost indistinguishable from cocaine’. Far from have a calming-down effect on children, the drug actually creates a chemically induced backdrop of stimulation which temporarily satisfies their craving for stimulation, in turn freeing them from the relentless pursuit of sensation-seeking stimulation via their own behaviour. Thus, the drug is a purely mechanistic, quick-fix response to manifest symptoms, and does absolutely nothing to address the underlying generating processes of the behaviour.

According to radical psychiatrist Peter Breggin, in animal experiments, stimulant drugs: (1) suppress spontaneous and social behaviours, rendering them more submissive and manageable; and (2) enforce so-called ‘perseveration’ and obsessive-compulsive over-focusing… and, he maintains, the effects on children are identical. In line with this, some studies have found that most children become sad and unhappy, lethargic, and disinterested in others (i.e. anti-social) while taking stimulant drugs.

Stimulants also cause gross brain dysfunction. Thus, routine doses of Ritalin lead to a 23-30 per cent drop in blood flow to the brain in volunteers; and all stimulants disrupt at least three neurotransmitter systems. They also inhibit growth – including growth of the brain; they are highly addictive; and they commonly cause tics and other abnormal movements, which can become irreversible (Breggin, 2001). More chillingly still, ‘There is strong evidence that stimulant-induced chemical changes in the brain can become irreversible’; and ‘stimulants suppress a children’s behaviour in a global fashion that has nothing to do with any diagnosis or disorder’ (ibid.). Stimulants can also actually worsen the symptoms they are trying to reduce; they can induce reduced self-insight, memory impairment, exhaustion, irritability, anxiety, bizarre behaviour, and even suicidal feelings (the Breggins); they can precipitate psychoses (Breggin); and they have even been implicated in cancer (DeGrandpre). Moreover, harmful effects are almost certainly far more common than the professional literature suggests, for ‘doctors almost never report or publish negative side-effects’ (the Breggins, 1994).

Breggin points out how, when children develop adverse drug reactions to Ritalin, these reactions are often mistaken by the medical professional as a worsening of the ‘disorder’ they are spuriously assumed to have! – so precipitating further prescribing of a wider range of equally inappropriate drugs (the ‘When you’re stuck in a hole – just keep digging…’ mentality). Madness heaped upon madness once again.

There is also no evidence whatsoever that stimulants have any positive long-term influences. They do not improve academic performance or learning, and they do not impact favourably on anti-social behaviour.

It should be clear by now that in considering side-effects, we should consider psychological and emotional as well as purely physical ones – important though the latter certainly are. It is highly telling, of course, that none of the ADHD diagnostic criteria relate to how the child actually feels. Peter Breggin notes that, when taking stimulant drugs, ‘the child literally becomes neurologically unable to express feelings of boredom, frustration, distress, or discomfort’ (2001, original emphasis). Moreover, the pervasive use of Ritalin and similar stimulants means that children so treated will tend to become dependent upon an artificially introduced, drug-induced and extrinsic source of behaviour control, rather than learning naturally (and sometimes painfully, as we all had to) to develop their own ‘muscle’ of intrinsic motivational resources and self-control. That children are thus being deprived of the opportunity to develop natural self-efficacy and control will likely have long-term, even life-long consequences, the mal-effects of which can scarcely be dreamt of.

First, according to the Breggins (1994), children should never be told that they are suffering from ‘crossed wires’, a ‘biochemical imbalance’, ‘hyperactivity’ or ‘ADHD’. And if children have already been labelled, they should be told that it was a mistake and that there is nothing wrong with their brains.

It is also important that parents are emotionally open to the possibility that it might be their own behaviour or relationship with their child(ren), or some difficult (possibly unconscious) dynamics within the ‘family system’, to which the child is reacting in the only way it knows how, given its current level of development and capacity to articulate. Let me say immediately and categorically that this is not about blaming – for blaming is a waste of energy and entirely misses the point. Rather, a far more empowering perspective for everyone concerned is to think of the situation in terms of how children and parents come together (or, at some level, choose one another?) in order to learn from one another. I profoundly believe that our children have at least as much to teach us – if only we can be sufficiently open and undefended and humble to learn it – than we have to teach them; and if we could lightly but genuinely take this belief and accompanying attitude into our relationships with our own children, my strong hunch is that ‘syndromes’ like ADHD would largely disappear very quickly, and would rapidly become minor footnotes in medical history, where they belong…. In this sense, then, perhaps a central purpose of our children’s ‘challenging behaviour’ is to give we adults and parents a possibility for growth and consciousness evolution – if only we can possess the wisdom to grasp the gift of the opportunity for growth that our children are bringing us.

The ‘hyperactive’ or ‘attention deficit’ child is suffering profoundly, and is crying out to us for something – trying to communicate through their behaviour; and it is adults’ task to have the patience, wisdom and insight to find out what that is, and then respond to it appropriately such that the child (and we ourselves) can heal. And it might just be our own growth and development that they are crying out for… One useful approach might be to ask oneself, ‘If my child were able to articulate clearly in words what s/he is thinking/feeling/needing/wanting, what might s/he be saying to me right now?’. One can frequently be amazed at the insights that can flow from asking oneself such an apparently simple question – for the very act of being sufficiently open and undefended to ask it somehow creates the space for all manner of insights to make themselves manifest.

It is also highly relevant, perhaps, that the rise in these so-called ‘disorders’ has roughly coincided with the cultural demise of the father in many (now single-parent) families, and the cultural crisis in ‘manhood’ more generally. According to the Breggins, ‘Most so-called ADHD children aren’t getting enough attention from their fathers, who are separated from the family, too preoccupied with other things, or otherwise impaired in their ability to parent… The "cure" for these kids is more rational and loving attention from their dads’. This ‘missing-father’ view is also consistent with the fact that young boys are far more frequently diagnosed than girls – suggesting, again, that the presence of the father is crucial for helping boys towards mature self-containment and self-control. Of course, this is far more easily said than achieved in many family situations; but if it were widely known and accepted within modern culture that this is a crucial factor in children’s challenging behaviour, perhaps there might be a much-needed shift in parental attitudes to the often neglected importance of the father in family life. It might also lead government to take whatever measures are available to it to increase the woefully low number of men who teach in pre-school and primary/first-school settings.

It is also important that parents can feel empowered when dealing with the attempt by professional ‘experts’ to pathologise and medicalise their children’s challenging behaviours. The Breggins usefully remind us that parents can always seek a second opinion from a more psychotherapeutically or family-orientated therapist; and that schools who might be urging medication will often back down when parents find a professional therapist who is prepared to work with their child without drugs. They continue: ‘Rarely should a consultation be sought from an ordinary psychiatrist or pediatrician, or from any mental health professional considered an expert in ADHD or other childhood "disorders", since people who specialize in them are usually biased toward diagnosis and medication’ (p. 197); and ‘Wherever possible, parents and caregivers should politely refuse to have their children subjected to psychiatrically oriented tests; they should try to keep any and all diagnoses out of the official school record’ (ibid.).

You should also feel free to ask any medical professional questions like, ‘How many children do you treat with Ritalin?’; ‘How often do you refer children for possible Ritalin treatment’; and ‘In your view, is ADHD a medical condition – and if "yes", then how and why is it so?’. And of course you can be armed with relevant critical literature (like this article and some of the references cited in it – e.g. Peter Breggin’s excellent books Toxic Psychiatry and Talking Back to Ritalin) to demonstrate to medical professionals that you are all too aware of the strong arguments that can be ranged against the routine psychiatric medicalisation of children’s challenging behaviour.

Above all , if you can acquaint yourself fully with, and are able to articulate, the arguments set out earlier in this article, it will be impossible for any medical professional to prevail in any discussion or dispute with you on this issue, for there is simply no adequate response from within the narrow mechanistic world-view of biological psychiatry to the arguments I presented earlier.

We should also not be afraid to take up an overtly political stance in relation to the pharmaceutical companies in all this. As Richard DeGrandpre and the Breggins relentlessly point out, there are massive (i.e. multinational-capitalist) vested material interests in propagating these highly profitable child medications. It is as if the forces of materialism have fashioned these abhorrent products in their own image – mechanistic, reductionistic, soullessly barren and lacking any sense or understanding of human life and development. And it should come as little surprise that both research and support networks are often funded directly by drug companies… As the Breggins themselves write, ‘Psychiatric research reflects politics and the profit motive much more than it does science… The livelihood [of biomedical researchers and scientists] depends upon justifying their research in terms of public policy. They are backed by large national organizations and supported by powerful interest groups. They have massive federal and private funding to support their promotional activities.’

As the ‘Resources’ section (below) illustrates, there is a growing number of ‘user movements’ who are taking on the struggle against these pernicious forces of materialism and modernity. In Texas, parents were, in late 2000, taking action against Novatis Pharmaceuticals (Ritalin’s manufacturers) for (allegedly) failing to give warnings about the effects of the drug on children’s cardiovascular and nervous systems. Overload is a Scottish-based charity which has pursued action against various NHS trusts in connection with the side-effects of psychotropic medication on children. And a new pressure group, Santa, is pressing for legislation to tighten up on Ritalin’s availability.

Our children need to be protected from the assaults of modernity in all its diverse and pernicious forms and manifestations, and you will be performing a service of inestimable value for a generation of children if you refuse to sanction the medicalisation of what is commonly at root a cultural and a societal problem, and which children then express for the culture in which they find themselves. As Jung so poignantly said, ‘We do not cure [neurosis] - it cures us’; and it is the ‘neuroses’ of our children to which we should be listening carefully if we are to cure ourselves of the insane culture which we have collectively created. There are also many positive actions you can take in your own lives – one crucial one being the introduction of strong (technology-free) rhythms in the home life, to act as an antidote to the chaotic and anti-life nature of modern technocratic culture. One can glean all kinds of useful tips from reading Lynne Oldfield’s book Free to Learn, and also Ready to Learn by the Martyn Rawson and Michael Rose – indeed, the Steiner Waldorf early childhood professional typically works directly with parents (not least through friendly home visits) to encourage and enhance a healthy home life for the children who attend their Kindergarten.

Methodologically rigorous research… indicates that ADD and hyperactivity as ‘syndromes’ simply do not exist. We have invented a disease, given it medical sanction, and now must disown it. The major question is how we go about destroying the monster we have created.

Diane McGuinness, academic psychologist

Any biography of Einstein, Freud, or Picasso will demonstrate enough childhood ‘pathology’ to warrant diagnosis and drugging with the inevitable suppression of his unique contribution to life… Parents ought to be thankful for every bit of spunk and spirit their children possess. It demands energy, attention, and involvement on our part as parents, but it will result in bright, creative, spirited, and secure young adults.

The Breggins, psychiatrists and writers

Whatever the case, no good comes from applying the fraudulent diagnosis ADHD… In the short term, Ritalin suppresses creative spontaneous and autonomous activity in children, making them more docile and obedient. In the long run, we are giving our children a very bad lesson that drugs are the answer to emotional problems… The drugs themselves are causing severe disorders in millions of children in the United States… The massive drugging of children in North America… indicates a willingness to subdue children as a substitute for identifying and meeting their genuine needs for improved family and school life… You’re going to face a national tragedy [in Britain] like we are facing here [in the USA].

Dr Peter Breggin, psychiatrist; author, Talking Back to Ritalin and Toxic Psychiatry

There is no empirical evidence to support psychotropic drug treatment in very young children and… there are valid concerns that such treatment could have deleterious effects on the developing brain… The validity and reliability of the diagnoses of attention deficit/hyperactive disorder, mood disorders and schizophrenia in very young children have not been demonstrated.

Dr Joseph Coyle, Harvard Medical School

There is a whole category of ‘sit down and shut up’ drugs that are being given to children in place of what they really need – security, love and discipline.

An American Psychologist (quoted by Lynne Oldfield)

Most mental health professionals teach and use approaches that don’t mention the word love… Nothing matters as much as the loving attitude of the caregivers, and nothing can compensate for the lack of it… Children respond so quickly to improvements in the way adults relate to them that most children can be helped without being seen by a professional person… They should never be given the idea that they are diseased or defective or are the primary cause of their conflicts with their schools and families… They need empowerment, not humiliating diagnoses and mind-disabling drugs. Most of all, they thrive when adults show concern for and give attention to their basic needs as children.

The Breggins (original emphases)

Children whose capacities to learn have become suspended… by ongoing levels of difficulty may be trying to communicate very difficult and painful experiences which may in turn feel unpleasant to those who experience that behaviour. Such children may require safety, a containing relationship and time, in order to be even within processable proximity to their feelings… Educational therapy can provide an appropriate response for this… challenging group of children.

Heather Geddes, Educational Therapist, London (added emphasis)

It’s the whole story of acceleration – too many things in a child’s life are speeding up.

Dr Joel Ryce-Menuhin, child psychotherapist and writer

There is not enough time left over for the children and too many new people are introduced too frequently.

Dr Walter Barker, Director, Early Childhood Development Centre, Bristol (1997)

Dramatic rises in the prescription of psychotropic drugs to children are much more about adults being intolerant of normal levels of activity in young children and having unrealistic expectations of what is normal behaviour.

Jennie Lindon, child psychologist

Most of the stresses of pre-school children stem from our desire to push them into school too early… and then into situations which are no longer playgroups but crammers for primary school… Children of this generation are growing up with an overwhelming sense of time pressure…

Lynne McTaggart, Editor and writer

Unless we’re prepared to get back to planning… an appropriate curriculum for early years education, we’ll have increasing behavioural problems and when it all ends in tears, they’ll say it’s the child’s fault instead of asking: ‘Is there something wrong with the approach?’

Dr Marian Whitehead, early years specialist and writer

We will need to observe and note… the increasing attacks upon the nerve-sense system of the child before his seventh birthday, for in this phase of development is the greatest opportunity to delay humanity’s progress.

Lynne Oldfield, Steiner Waldorf Kindergarten trainer and writer

The Left argues that the best way to change serotonin levels [in the brain] would be to reduce economic inequality. Using drugs is seen as an unnatural, side effect filled substitute for social change. Pills… would never be preferable to striving for a more equitable society in which everyone feels good "naturally". [Little surprise, then, that Ritalin prescriptions are rising especially strongly in more deprived areas – RH]

Oliver James, Clinical Psychologist and writer

Biopsychiatry has no place in a world in which children need attention, love, improved parenting, better schooling, and more equal opportunity. It has no place in a society in which adults take responsibility as parents, teachers, or child advocates.

The giving to children of mind-altering drugs will, in the future, ‘come to seem like we now view putting them up chimneys’.

Jean Robb, educational therapist

At an important level, what we are seeing played out in this child medication controversy is just one symptom of the pervasive "paradigm war" (as Mark Woodhouse calls it in his book of the same name – Frog Ltd., Berkeley, 1996), between modernity and its reductionistic technocratic worldview, on the one hand, and postmodernity or New Paradigm thinking that combines ancient perennial wisdoms with the latest cutting-edge holistic thinking in science and philosophy, on the other. There is absolutely no professional agreement on the validity or very existence of ‘syndromes’ such as ADHD. Thus, as Anthony Browne writes, ‘The two opposing support groups on Ritalin… trade insults, casting aspersions on each others’ motives and intelligence’ (Observer, 9/4/00). It will be unambiguously clear from the foregoing which ‘camp’ I align myself with – and I believe that the weight of rational argument, when examined as dispassionately as one is able to, comes down overwhelmingly on the side of New Paradigm thinking and practice, and against the naively simplistic technocratic worldview which those favouring the drugging of our children support.

I maintain that a radical shift in world-view, from the naive technocratic scientism of conventional psychiatry and towards a postmodern, more spiritually informed 'New Paradigm' perspective opens up creative, liberating and potentially healing avenues for thinking about and understanding the widest spectrum of human subjective experience – including the phenomena delimited by alienating and mystifying terms like ‘Attention Deficit Hyperactivity Disorder’ and the like. Thankfully, there exists a steadily mounting and formidable literature which is quite fundamentally challenging to the foundational metaphysical assumptions of psychiatric diagnosis and all that goes with it.

Within a truly postmodern approach to healing and transformation, it might well be that the most effective healers are precisely those who do not (need to) take preconceived beliefs and a defensive clinical-diagnostic ‘gaze’ into their work with ‘patients’, but rather, are able to enter into their professional healing relationships in a relatively undefended way that privileges the healing power of intimacy and the immediacy of the real I--Thou encounter, as opposed to the objectifying practices that the diagnostic procedures of conventional psychiatry typically entail

The by-now obvious ‘treatment’ implication of this article is that, rather than these childhood ‘conditions’ being routinely (psycho)pathologised, with brain-altering, psychotropic medication routinely being prescribed for those undergoing such experiences, it is far more fitting that concerted attempts be made to understand with the child, in appropriately and sensitively containing environments if necessary, just what their experience might be indicating, presaging or portending - in cultural perspective as well as in purely individual biographical terms. Alas, the chances of alternative, supportive-facilitative modalities gaining ground over crude reductionist pharmacological treatment is at present somewhat limited, given the massively entrenched vested material interests in the modernist status quo, manifested by the burgeoning global pharmaceutical industry and its close relationship with the professional institution of Psychiatry. As Newnes and Holmes (1999: 274) have bluntly asserted, ‘capitalism rather than altruism seems to be the dominant force in the shaping of modern psychiatry’.

Yet parents can play their part towards creating a viable alternative to the medical-psychiatric norm; and I hope this article has armed them with at least some arguments and information that will enable and empower them to do this with authority and conviction.

Asylum: The Magazine for Democratic Psychiatry, editor Prof. Alec Jenner, Tel. 0114-286-2546, e-mail F.A.Jenner@Sheffield.ac.uk; subscriptions, Stella Thomas, Lane Head Farm Cottage, Heptonstall, Hebden Bridge, West Yorks HX7 7PB; e-mail RStellaThomas@aol.com

Peter Breggin’s website: www.breggin.com

Campaign Against Psychiatric Oppression: 28a Edgar House, Kingsmeade Estate, Homerton Road, London E9

Children First! – Center for the Study of Psychiatry (Peter Breggin): 4628 Chestnut Street, Bethesda, MD 20814, USA

Early Childhood Therapy Course: Ongoing, weekend workshops in London based on Steiner-inspired anthroposophical medicine and pedagogy. Details from: ECTC, Silver Ridge, Card Hill, Forest Row, East Sussex RH18 5BA

Hyperactive Children’s Support Group: www.adders.org

International Waldorf Kindergarten Association: D-70188 Stuttgart, Heubergstrasse 18, Germany; e-mail Inter.Waldorf@t-online.de

MIND: Granta House, 15-19 Broadway, Stratford, London E15 4BQ; tel. 0208-519-2122

Overload Network: 58, Flat 1, North Fort Street, Leith, Edinburgh E87 HMP

Psychology Politics Resistance: c/o Prof. Ian Parker, Dept of Psychology and Speech Pathology, Manchester Metropolitan University, Hathersage Road, Manchester N13 0JA, e-mail I.A.Parker@mmu.ac.uk

Stimulants Are Not The Answer (SANTA): www.santa.inuk.com

Young Minds Parents’ Information Service: 0800 018 2138 or 020 7530 4933

Further Reading

1. Pam, ‘A critique of the scientific status of biological psychiatry’, Acta Psychiatrica Scandinavica, 82 (Supplement 362), 1990, pp. 1-35

Regular Mother magazine contributor Richard House, Ph.D. is an NHS counsellor, a Steiner Waldorf early years teacher and an academic writer/editor living in Norwich, UK. His latest books, Therapy Beyond Modernity and Ethically Challenged Professions: Enabling Innovation and Diversity in Psychotherapy and Counselling (co-editor, Yvonne Bates), were published, respectively, by Karnac Books, London, in 2003 (£19.99), and by PCCS Books, Ross-on-Wye, 2003 (£17). Address for correspondence: richardahouse@hotmail.com