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Foreword by Rick Green:
At the core of stigma is ignorance, not just about what ADHD is, but also what it means. As I learned more and started to realize how much of my life had been driven or sabotaged by this hidden disorder, a fundamental question arose.
Do I have ADHD, or I am ADHD? I discussed this with Dr. Anthony Rostain in an interview I was fortunate to have with him. A few snippets of that interview have appeared in some of our videos, but I wanted you to hear it all.
If you missed it, PART 1 of the interview can be found here.
PART 2 of the interview is below, or listen to the audio version here –>
Keep in mind that the following is a transcript of our conversation. It’s a dialog but with most of my questions removed, and there will be more to come.
Having ADHD vs. Being ADHD
I remember one time a patient, a very thoughtful man, he was working as a physician’s assistant and he was a really talented guy but he never could get into medical school because his grades weren’t good enough because he had ADS, never diagnosed.
He finally figured it out after his son was diagnosed and came to see me. We went through it very carefully and we discussed all the reasons why he might have it.
At one point he came back and he said to me – now I don’t understand whether what you’re telling me is that I have ADHD or I am ADHD.
In that statement was a very important conflict he was experiencing.
On the one hand, is it a set of symptoms, and that I just need to focus better?
Or, have I developed who I am as a result of having my brain be working this way? If that’s the case how do I live with myself?
If you say to somebody, well you have ADHD it’s like you have poor vision, just wear your glasses. Or, you have diabetes take your insulin. That’s easy for people to buy. Okay? Yeah okay, I’ll just take the medication and I’ll go to cognitive therapy, or take some organizational skills classes, or communication classes with my spouse.
But it’s more than that you see, because if what ADHD really is, is about how you construct the world, and how you experience your life, then it isn’t that easy. Right? Because then are you trading off some things you like? Like being spontaneous or thinking outside the box?
This is what we got into, this conversation, and I get it in into it all the time. What does it mean to you now that I’ve told you this. And that’s the step that’s missing a lot. It’s not just what is going on with you, but now you tell me, what does it mean to you? And that dialogue is I think important for people to have with their clinicians, because then the doctor can hear – oh it means that you are feeling inferior because every time you take that pill it’s a reminder that you’re not as good without it. Okay, well then, let’s talk about that.
You see, it’s not about – hey you have ADHD and everything is fine. It’s, you have ADHD, now you have another way to explain what’s going on with you, but you have a new set of challenges then. Right? How do I fit the old view of myself with this new view of myself?
I’ve been quite open about my ADHD, but not everyone has that freedom. Dr. Rostain not only sees patients, and does research, he also trains other doctors, and he trains the doctors to consider what the diagnosis might mean in practical terms.
ADHD Stigma, Workplace Issues, Classroom Accommodations
The other important piece of stigma we need to look at, and not underestimate is the way the rules of the game are set up in this society.
In school you have to reach, and prove to people that you have a certain level of impairment before you get help. And this is a very bad set up as far as I’m concerned, because it kind of creates this idea that if I’m this much, I get the help. But if I’m this much ADD I don’t. And then we spend all our time figuring out well should we try to push you to make it look like you’re really worse off than you are? Or how do you get help if you’re just struggling, but you haven’t met that “magic” number on an exam or something that entitles you to extra time? That to me is really bad. And the same occurs in workplaces, I think because especially now with the job market being what it is, and everybody being more and more concerned about keeping their jobs, most employers don’t give workplace accommodations for ADHD. And they’re not really bound to.
So there’s a battle going on between the, I would call it, the disabilities movement that says listen, you know, we need to make reasonable accommodations. Now how much of a major accommodation is it to give somebody a little extra time to turn in an assignment, or to you know, maybe give them a slightly reduced workload, just till they get good at it?
‘Being Smart’ Doesn’t Help People With ADHD
This comes up a lot where I work in a Medical Center, where I have residents, and medical students who come to see me. They’re failing because they can’t work as fast as everybody around them. They’re very bright, you know, and they’re extremely competent and caring clinicians-to- be. Young doctors in training. And yet, the workload is so great, that just having that, even medicated they still aren’t quite getting enough done.
And if they’re in the wrong setting, you know, they’re told – you know what’s wrong with you?
So I think the stigma is reinforced by what I think of as a set of expectations that, we’re sort of saying – everybody should be able to be the same. And the truth is, no we’re not the same. How do we tailor the environments? How do we make the environment more likely to get people to succeed?
We’ll talk about success in Part 3 of this interview, coming up soon!
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