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The Discourse of ADHD: Perspectives on Attention Deficit Hyperactivity Disorder
This book explores the discourse of attention deficit hyperactivity disorder (ADHD), one of the most debated mental health categories attributed to children and adults across the globe. The authors trace the origins, development and representation of ADHD to demonstrate how the category is produced through competing explanatory theories and processes of scientific, professional and lay discourse. Starting with the idea that medical categories are as much a product of cultural meaning, social processes and models of medicine as they are of scientific fact, this book utilises a range of perspectives from within critical discursive psychology to approach this topic. The authors discuss historical construction, media representation, parents’ accounts of family life, and the personal experience of children and adults to demonstrate how the construction of social identity and cultural stereotypes are embedded in the meaning of ADHD. They explore the origins of ADHD and how biological and psychosocial explanations of the mental health category have been produced, circulated, debated and resisted within a culture of ‘Othering’, and the discourse of blame.
318 pages, Hardcover
Published April 4, 2018
17 people want to read
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May 5, 2020
I'm shocked, that this is 1 of 2 books that i was kindof looking for.
1. It touches on Neoliberal takes, feminist takes, mainstream media misunderstandings and couches it all within what is at stake for the person with ADHD.
2. Unlike any of the other books I've found it actually uses a wide range of references that aren't just clinical in nature, nor self-help oriented, but both philosophical references and helps simplify the concepts and points the reader where to find out more information.
3. Probably the most even-handed clear conclusions in an ADHD based publication I've ever read because it's both clear and makes contextual sense where the difference in opinions come from, it's almost a medical anthropological view of the diagnosis from various points of view:
...Education is an important aspect of putting theory into practice. Kenny (2016) has, for example, reviewed studies of general practitioners’ and teachers’ knowledge and understandings of ADHD across the globe and found that 50% said that they did not know as much as they would like. Moldavsky and Sayal (2013) also found misconceptions, amongst children, adolescents, parents, healthcare professionals and the general public that were likely to reinforce stigma. In any society where people feel the need to hide their problems because of negative and stigmatising labels, clearly something needs to change (Singh et al. 2012; Davies and Horton-Salway 2016)...
...Cromby et al. (2013: 11) also observe that ‘people might end up receiving services, not because they themselves are distressed, but because their behavior and experiences are distressing to those around them’ (see also Cohen and Morley 2009). This certainly applies to dis-empowered social categories, for example, young people report that they are neither involved in making decisions about the management of their ADHD nor educated about the labels applied to them, less still consulted about the definition of their identities (Kenny 2016: 126). Cohen and Morley (2009: 165) described how ‘the child is acted upon by the relatively powerful adults around them, who in effect create the discourse of problems associated with the child’. Kenny therefore recommends ‘self-advocacy’, informed by children’s own experiences, to be promoted through schools, Educational Psychologists and members of health professions.
Along similar lines, Schrevel et al. (2016: 63) has suggested forms of strength-based coaching that are preferred by adults with ADHD because these methods allow them to identify their own problems, goals and solutions. Coaching and some post-structuralist forms of narrative therapy (Gergen and Ness 2016) are not based on the superiority of expert knowledge but instead they aim to engage with clients’ understandings and how they might construct the meaning of their experience in more empowering ways.
In the context of mental healthcare, the education of health professionals is an important issue for the future. Todd (2006) has described an application of post-structuralist theory and narrative practices to effect change in the way that health professionals think about the health categories they work with and the models that guide their practice. In workshops, they are challenged to consider how these categories have come to be afforded the status of truths in healthcare institutions. Todd has had some success with this and at the time of writing suggested that there was professional goodwill to engage with ideas that redirect the focus away from individualizing practices.
Colley (2010) has previously observed that unidirectional rather than bi-directional or circular and systemic explanations have been common in research on ADHD and that these may have contributed to polarised claim and counter-claim in biological versus psychosocial explanations of ADHD. In this way, psychosocial explanations are inclined to translate, at least in the media and public imagination, as parental blame and stereotypes of children with spoiled identities. Colley argues that it is not helpful to position parents in this way, because they are much more uniquely challenged by children with ADHD and require ‘extraordinary parenting skills’. This observation is endorsed by the parents, in Chapter 4 of this volume, who have indicated that, ‘normal parenting does not apply’.
We will conclude by acknowledging the people who have contributed their stories of experience for the research we have described and we thank them for helping us understand what ADHD means for them. Providing enabling forms of support throughout their difficult transitions of life requires greater public appreciation of the challenges people face and this can only happen if they are allowed to voice their experiences of distress without fear of being blamed or stigmatized.
A coordinated multi-agency approach that is properly funded and responsive to the task of promoting enabling forms of person-centered support is a goal (Epstein 2000; Epstein et al. 2010), although we are aware that this is not always easy to implement in practice. To this end, however, we agree with Cromby et al. (2013) and O’Dell and Brownlow (2015) that the personal experience of service users should be treated as a valuable and legitimate resource of knowledge. This has the potential to inform self-advocacy, peer support and also to inform the understanding and practice of health professionals, educators and policy-makers. We suggest that personal accounts of ADHD by children, parents and adults with ADHD can tell us more about the cultural meaning of ADHD as a mental health category and the impact of this discourse upon its subjects. From our perspective, accounts of experience should be heard as culturally situated, discursive, and inherently dilemmatic, arising as they do from a culture of ‘Othering’, gendered discourse, stigma and blame.
1. It touches on Neoliberal takes, feminist takes, mainstream media misunderstandings and couches it all within what is at stake for the person with ADHD.
2. Unlike any of the other books I've found it actually uses a wide range of references that aren't just clinical in nature, nor self-help oriented, but both philosophical references and helps simplify the concepts and points the reader where to find out more information.
3. Probably the most even-handed clear conclusions in an ADHD based publication I've ever read because it's both clear and makes contextual sense where the difference in opinions come from, it's almost a medical anthropological view of the diagnosis from various points of view:
...Education is an important aspect of putting theory into practice. Kenny (2016) has, for example, reviewed studies of general practitioners’ and teachers’ knowledge and understandings of ADHD across the globe and found that 50% said that they did not know as much as they would like. Moldavsky and Sayal (2013) also found misconceptions, amongst children, adolescents, parents, healthcare professionals and the general public that were likely to reinforce stigma. In any society where people feel the need to hide their problems because of negative and stigmatising labels, clearly something needs to change (Singh et al. 2012; Davies and Horton-Salway 2016)...
...Cromby et al. (2013: 11) also observe that ‘people might end up receiving services, not because they themselves are distressed, but because their behavior and experiences are distressing to those around them’ (see also Cohen and Morley 2009). This certainly applies to dis-empowered social categories, for example, young people report that they are neither involved in making decisions about the management of their ADHD nor educated about the labels applied to them, less still consulted about the definition of their identities (Kenny 2016: 126). Cohen and Morley (2009: 165) described how ‘the child is acted upon by the relatively powerful adults around them, who in effect create the discourse of problems associated with the child’. Kenny therefore recommends ‘self-advocacy’, informed by children’s own experiences, to be promoted through schools, Educational Psychologists and members of health professions.
Along similar lines, Schrevel et al. (2016: 63) has suggested forms of strength-based coaching that are preferred by adults with ADHD because these methods allow them to identify their own problems, goals and solutions. Coaching and some post-structuralist forms of narrative therapy (Gergen and Ness 2016) are not based on the superiority of expert knowledge but instead they aim to engage with clients’ understandings and how they might construct the meaning of their experience in more empowering ways.
In the context of mental healthcare, the education of health professionals is an important issue for the future. Todd (2006) has described an application of post-structuralist theory and narrative practices to effect change in the way that health professionals think about the health categories they work with and the models that guide their practice. In workshops, they are challenged to consider how these categories have come to be afforded the status of truths in healthcare institutions. Todd has had some success with this and at the time of writing suggested that there was professional goodwill to engage with ideas that redirect the focus away from individualizing practices.
Colley (2010) has previously observed that unidirectional rather than bi-directional or circular and systemic explanations have been common in research on ADHD and that these may have contributed to polarised claim and counter-claim in biological versus psychosocial explanations of ADHD. In this way, psychosocial explanations are inclined to translate, at least in the media and public imagination, as parental blame and stereotypes of children with spoiled identities. Colley argues that it is not helpful to position parents in this way, because they are much more uniquely challenged by children with ADHD and require ‘extraordinary parenting skills’. This observation is endorsed by the parents, in Chapter 4 of this volume, who have indicated that, ‘normal parenting does not apply’.
We will conclude by acknowledging the people who have contributed their stories of experience for the research we have described and we thank them for helping us understand what ADHD means for them. Providing enabling forms of support throughout their difficult transitions of life requires greater public appreciation of the challenges people face and this can only happen if they are allowed to voice their experiences of distress without fear of being blamed or stigmatized.
A coordinated multi-agency approach that is properly funded and responsive to the task of promoting enabling forms of person-centered support is a goal (Epstein 2000; Epstein et al. 2010), although we are aware that this is not always easy to implement in practice. To this end, however, we agree with Cromby et al. (2013) and O’Dell and Brownlow (2015) that the personal experience of service users should be treated as a valuable and legitimate resource of knowledge. This has the potential to inform self-advocacy, peer support and also to inform the understanding and practice of health professionals, educators and policy-makers. We suggest that personal accounts of ADHD by children, parents and adults with ADHD can tell us more about the cultural meaning of ADHD as a mental health category and the impact of this discourse upon its subjects. From our perspective, accounts of experience should be heard as culturally situated, discursive, and inherently dilemmatic, arising as they do from a culture of ‘Othering’, gendered discourse, stigma and blame.
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