aba

Starting to read "ADHD 2.0" (#Hallowell and #Ratey 2021). At first it seemed perfect, a real breath of fresh air after "Taking Charge of Adult ADHD" (2nd edition, #Barkley 2022). Both authors of "ADHD 2.0" are ADHDers themselves. There was great emphasis on the positive potential of #ADHD — especially welcome after Barkley's relentless pathologizing. They even write:

"A person with ADHD has the power of a Ferrari engine but with bicycle-strength brakes. It's the mismatch of engine power to braking capability that causes the problems."

I was immediately reminded of my own mismatch analogy for #kaleidotropic autism: trying to fly an F-16 with a control system designed for a Cessna — with #AuDHD as an almost inevitable consequence. Not quite the same thing — "control" is much more general than "braking" — but much closer than anything I've ever seen before from any source other than myself. I was thinking: this book is going to be fantastic.

Then I skimmed ahead, into a part of the book I hadn't yet read continuously — and found FAVORABLE references to Applied Behavior Analysis (#ABA). I'm assuming that for most adult autistics, THAT practice needs no introduction.

😱 🤯 🤢 🤮

And, unfortunately, advocacy of #ABA isn't the only example of drill-sergeant thinking that I found. The emphasis on discipline isn't anywhere near as extreme as in Barkley, but it's definitely there. Given the appreciable overlap between ADHD and literal juvenile delinquency, I can understand the temptation to go that route, but it's a very dangerous path to traverse — and it definitely isn't for me. Probably not for anyone with #AuDHD as opposed to standalone #ADHD.

Of course, I admit — and even emphasize — that this is just a first impression from skimming material I haven't yet read continuously. I definitely hope that my final impression is different.

@autistics

@autistics I'm still reading Russell ⁨#Barkley⁩'s "Taking Charge of Adult ADHD" (2nd ed., 2022) — or rather, trying to. It's getting difficult for me to handle more than a page or two at a time. The problem isn't boredom (my #kaleidotropy makes me essentially immune to that) nor complexity of the material (Barkley is quite a good expositor). It's exasperation and outright anger, to the point of having fantasies of throwing the book across the room. The combination of arrogant, condescending neuronormativity with conspicuously sloppy conceptual reasoning makes this book more infuriating than ANYTHING I've yet read about autism, from ANY perspective. That includes Simon Baron-Cohen, and even one paper I read by a group of #ABA torture therapy apologists. I hope this book is not typical of #ADHD literature in general. If it is, studying ADHD is going to be a hell of a chore.

I've now finished Chapter 2 of "ADHD 2.0" (#Hallowell and #Ratey 2021). I've had some hard things to say about this book so far: its #extranormativity, its tone of pontificating certainty, its overconfident reliance on dubious #fMRI findings, the appalling glimpse of support for #ABA in a skimmed later chapter. But in the second half of Chapter 2, I've found something really interesting and potentially helpful, something that rings true from my experience, quite apart from any #fMRI findings.

The authors point out a way that #anxiety and #depression can arise purely from the #attentional-focus problems definitive of #ADHD, and NOT from the cognitive errors to which #CBT attributes such problems. The idea is that the obsessiveness of #ADHD, when focused on anything negative, creates a self-sustaining, self-amplifying vortex of negativity. Their description makes it sound almost like a bad trip on #psychedelics. The solution is NOT to try to debunk the negative thoughts that make up the vortex, #CBT-style; indeed, that approach might make things worse by reinforcing the focus on the negative thoughts. Instead, try to refocus on — indeed, obsess about! — something positive instead.

Indeed, #anxiety and (especially) #depression were my own psychiatric diagnoses (not counting bipolar disorder, which later psychiatrists rejected decisively as a misdiagnosis). #CBT was worse than useless. Instead, I got help from antidepressant drugs — and I don't think it was an accident that the best one for me turned out to be Wellbutrin (bupropion), which doubles as a third-line #ADHD drug. And the subjective experience of depression, and of recovery from it, matched Hallowell and Ratey's attentional account, rather than the error-correcting story #CBT tells. I suspect that if there were such a thing as "attentional psychotherapy", I might have benefited from getting that instead of #CBT.

@autistics