On his web page, Russell A. Barkley, Ph.D., is described as an internationally recognized authority on attention deficit hyperactivity disorder (ADHD) in children and adults. Dr. Barkley has specialized in ADHD for more than 30 years and is currently a Clinical Professor of Psychiatry at the Medical University of South Carolina.
In 1997 when Barkley first presented a variation on Strang and Rourke’s 1983 Executive Functions model to explain ADHD, Barkely chose to incorporate into his model the existing body of literature of brain function, and to emphasize the similarity between symptoms of pseudopsychopathy (right frontal lobe damage – remember our story about Phineas Gage in Part 1?) and ADHD.
The right-frontal-lobe brain damaged individual has been shown to experience increases in motor activity, talkativeness, and a lack of tact and restraint; symptoms commonly associated with ADHD. Animals with frontal lobe damage cannot adapt to new situations or environments, while humans with such lesions similarly experience extreme difficulties in situations requiring problem solving and unique solutions.
Because he only focuses on similarity of symptoms and because he assumes ADHD to be synonymous with this type of brain damage, Barkley concluded, rather amateurishly and incorrectly, that persons with ADHD are also less capable of creative thought, and stated this hypothesis concerning ADHD and creativity explicitly in several of his writings.
Boy, is that such an obvious gaffe, and yet he still promotes the idea!
As an aside, the Executive Functions model Barkley chose to modify (Strang and Rourke’s 1983 Executive Functions model) was being applied to problems in the relatively new field of NLVD (non-verbal learning disorder) which attempts to identify the neurocognitive, psychosocial and adaptive characteristics of children with learning disabilities, whatever the cause. Strang and Rourke never mentioned anything related to “AD/HD” from what I have read.
So, back to Barkley: About a year after presenting his model for the expressly stated purpose of “explaining ADHD”, Barkley announces the discovery of the polymorphic DRD4 receptor gene and describes his version of the executive functions – presenting both in the September, 1998 edition of Scientific American magazine:
Russell Barkley states that the Executive Functions can be grouped as a set of 4 mental activities:
1) Working memory: Holding information in mind while working on a task, even after the original stimulus is gone. Said to be crucial to timeliness and goal-directed behavior. Also provides the means for hindsight, forethought, preparation and the ability to imitate the novel behavior of others.
2) Internalizing self-directed speech. Said to allow one to reflect to oneself, to follow rules and instructions, to use self-questioning as a form of problem solving and to construct “meta-rules”, the basis for understanding rules about rules – all quickly without tipping one’s hand to others. The idea is to make this self-talk private, preventing others from knowing one’s thoughts.
3) Controlling emotions, motivation and state of arousal. Said to help individuals achieve goals by delaying or altering potentially distracting emotional reactions to a particular event and to generate private emotions and motivations. Those who rein in their immediate passions can behave in more socially accepted ways.
4) Reconstitution. Said to encompass two separate processes: breaking down observed behaviors and combining the parts into new actions not previously learned from experience. Said to give humans a great degree of fluency, flexibility and creativity and allows them to propel themselves toward a goal without having to learn all the steps by rote. Also said to permit children, as they mature, to direct their behavior across increasingly longer intervals by combining behaviors into ever longer chains to attain a goal.
Barkley states the essence of his ADHD model thusly:
“In the early years [In all children], the executive functions are performed externally: children might talk out loud to themselves while remembering a task or puzzling out a problem. As children mature, they internalize, or make private, such executive functions, which prevents others from knowing their thoughts. Children with ADHD, in contrast, seem to lack the restraint to inhibit the public performance of these executive functions.”
…and he states it again:
All 4 Executive functions become internalized during typical neural development in childhood. As normal children grow and develop, they develop the capacity to behave covertly, to mask some of their behaviors or feelings from others. Either through faulty genetics or embryonic development, ADHD children have not attained these covert abilities and therefore display too much public behavior and speech.
The first three things I noticed is 1) the obvious value judgment: “too much public behavior and speech”. How much is too much and who gets to decide and why? 2) the high value that is placed on covert thought and emotion as if the mere expressing of one’s living thoughts and feelings were a criminal offense; and 3) how the focus of this model is obviously on reinforcing the concept of social conformity – the mistaken view that the most important thing is to be approved of by one’s peers and to avoid their punishments.
The same overt justifications can be found in his description of Ritalin’s “benefits”. Here it is in his own words:
“…they tend to be liked better by other children and to experience less punishment for their actions, which improves their self-image.”
In my opinion, it’s a very unhappy camper who can abuse a position of trust as a psychiatrist by first, attempting to demolish an individual’s self-esteem – teaching them that they were born ‘defective’ and that what they must do is to take pills to be ‘acceptable’. Then, to improve the self-esteem he devastates, he reassures them that all they must do is whatever it takes to get people to like them and to not want to punish them.
Perhaps he just feels a bit guilty concerning the rumors of being paid by Novartis (maker of Ritalin), never mind the devastating effects of psycho-stimulants on so many innocent, bright, creative and loving kids.