449: ADHD Parenting Principles with Dr. Russell Barkley
Dr. Russell Barkley has been something of a firebrand in the ADHD community for over four decades. With twenty-five books — 43 separate editions — and his name behind numerous assessment scales and journal articles, he has established a career of education and advocacy in the field second to none. Today, Dr. Barkley joins us on the ADHD podcast.
He’s here, ostensibly, to tell us all about his new book — 12 Principles for Raising a Child with ADHD — but the conversation quickly turns toward advocacy, the tangible dangers of ADHD as a disorder, and the lives lost because too many dismiss it. We talk about the role of genetics and parenting and the role of each in ADHD. We hope you join us today; it’s an incredible honor for us to have Dr. Barkley on the show and are grateful to be able to share it with you all.
Bonus! His team was kind enough to offer us a 25% discount on the new book! Click here to get it now!
Links & Notes
Episode Transcript
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Pete Wright: Hello everybody. And welcome to Taking Control: The ADHD Podcast on TruStory FM. I'm Pete Wright and I'm here with Nikki Kinzer.
Nikki Kinzer: Hello, Pete Wright.
Pete Wright: Oh, Nikki. What a guest we have on the show today.
Nikki Kinzer: I know. I'm so excited and starstruck.
Pete Wright: Totally starstruck. This is one of those ... it goes in the category ... I feel like we need a whole category on the website of guests who make us feel starstruck and giddy.
Nikki Kinzer: Right.
Pete Wright: We do need a whole ... Today we have the most fantastic Dr. Russell Barkley on the show. He's written a book. And we're going to talk to him about the book. And so, so very much more. Before we do that, head over to TakeControlADHD.com to get to know us a little bit better. You can listen to the show right there on the website. Or subscribe to the mailing list and we'll send you an email each time a new episode is released. Connect with us on Twitter or Facebook at Take Control ADHD.
Pete Wright: And if this show has ever touched you or helped you make a change in your life for the better, if you've ever found that you understand your relationship with ADHD in a new way, we invite you to consider supporting the show directly through Patreon. Patreon is listener supported podcasting. With just a few dollars a month, you can help guarantee we continue to grow the show, add new features, invest more heavily in our community. Please, visit Patreon.com/TheADHDpodcast to learn more.
Pete Wright: Before we get started, we have some news? Do we have any news? Did you have anything to say? Do we have anything to report?
Nikki Kinzer: I don't think so. The only thing I want to just remind people is about the Study Hall. We still have that going on. We have that going on through November. If you're interested in joining us on Thursday afternoons, check that out on our website, under the Study Hall. I'm sure you'll have a link in the show notes for that.
Pete Wright: There will be a link in the show notes. I'll put it in there.
Nikki Kinzer: Yeah, that's it. That's all that's really going on right now.
Pete Wright: Well, then let me take a minute to introduce our dear guest, Dr. Russell Barkley. Dr. Barkley is a retired, I think semi-retired, Clinical Professor of Psychiatry at the Virginia Treatment Center for Children and Virginia Commonwealth University Medical Center in Richmond. But most importantly, he has published 25 books and rating scales and clinical manuals. Over 43 separate editions of his publications. He's created seven award-winning videos on ADHD and defiant children. He has worked with children and adolescence and families since the '70s. And he's actually the name behind many ... six assessment scales. And more than 280 scientific articles and book chapters on ADHD, executive functioning, and childhood defiance. Come on.
Pete Wright: We have been fans of Dr. Barkley's for a long, long time. And we deeply appreciate that he has granted us a bit of his time today. Dr. Russell Barkley, welcome to The ADHD Podcast.
Russell Barkley: It is my pleasure. Thanks for inviting me. I look forward to speaking with you about anything related to ADHD.
Pete Wright: Well, the table is set broadly here. You should have seen, when your folks emailed us. It was one of those, it was like in a cartoon. Where the cartoon character's eyes turn into jackpot.
Nikki Kinzer: Uh-huh (affirmative). It was.
Pete Wright: Like holy cow! What is he doing writing us?
Nikki Kinzer: Exactly. I'm like-
Russell Barkley: A slot machine.
Pete Wright: Yeah, a slot machine.
Nikki Kinzer: ... is this fake? Is somebody pulling a joke on me?
Russell Barkley: No. No. That's my publisher, Lucy. I mean, Lucy, she's so good.
Nikki Kinzer: Well, it is certainly a pleasure to have you here and spend some time with us. And I know our audience is so excited to hear from you, as well.
Russell Barkley: Thank you.
Nikki Kinzer: You have this new book, one of many, that you have written.
Russell Barkley: Yeah. Right.
Nikki Kinzer: And it's this new book called 12 Principles for Raising a Child with ADHD. Can you give us just a little bit of a summary of what it's about? What can people expect?
Russell Barkley: You know, I've just turned 70 this year. I can see the end of my career coming, much less the end of my life. A year ago, I sat back with some time on my hands and I thought, "If I had to distill 44 years of my clinical and research work and the thousands of families I've worked with. And I read thousands of research papers, 100 and some every month that hit the internet. And I track them weekly. Could you distill all of this to some basic messages?" It's kind of a pay it forward moment for me, where I'm looking at, what is the wisdom you would like to see carried forward from all of this information?
Russell Barkley: And that's when I sat down and created a presentation. And I gave it a couple times last year to standing ovations. And I thought, "This has really struck a chord." And so I wrote the book. And it was really just, here are 12 ideas that if you know nothing else about ADHD, you must know these things. Everybody. And I was lucky that my publisher agreed with the idea of getting this out there. So it's very complementary to my other parent book, Taking Charge of ADHD. But this really is the 12 best ideas to come out of the last 40 years.
Nikki Kinzer: How do you get to 12? Yeah.
Pete Wright: It's just crazy that you would even narrow it down. We've got 400 episodes, I wouldn't even know where to begin.
Russell Barkley: It was 20. But I had to pare it down. Because sometimes you can get almost too molecular in the print. And I was looking for grand ideas. Kind of like a Stephen Covey, seven habits thing. Which is a book I greatly enjoyed. Rather than getting into the too much of the texture of these ideas. I think there could be any number. But we settled on 12 that we thought were unique enough and separate enough to try to capture the landscape. And I think they do a pretty good job of it.
Russell Barkley: That's where it came in. And that led to the first principle, which is you have to really understand the nature of ADHD. It's not what the name says it is. It's not what the DSM or diagnostic manual says it is. It's not what most trade books say it is. It is not a disorder of attention. That is like referring to autism as hand flapping. And yes, they engage in stereotypic motor behavior. But that's not autism. That's just one of it's most superficial expressions.
Russell Barkley: And so the first principle that opens the book is ADHD is a disorder of self-regulation. And if we could change the name, that's what it would be. Self-regulation deficit disorder. But self-regulation comes from the brain's frontal, executive system. And there are seven mental abilities that come out of this frontal lobe, out of this brain's executive, that allow us to control our own behavior and eventually become independent and self-regulating, self-determined, future-directed creatures. And that's what ADHD is disrupting. That's why it's such a serious disorder. It is truly the most impairing disorder we treat on an outpatient basis. Other than perhaps autism. And some of us think it's even worse than that. Unless the autism itself is rather moderate to severe.
Russell Barkley: It's a very serious disorder. It will shorten your lifespan by at least 13 years. You're five times more likely to die from this disorder by the time you're 45. And it's a public health menace. Because it leads to all of the other public health problems that we worry about, smoking, drug abuse, obesity, diabetes, and on and on. Sleeping problems. And people don't get that.
Russell Barkley: To me, we need to rename the disorder, but we won't. Because of legal and regulatory and other things that would have to change along with it. Which they're not going to change. But people who live with people with ADHD or people who have ADHD really need to know. This is a serious disorder that cuts through a wide swath of our mental abilities that we depend on for self-regulation. And that's pretty serious.
Nikki Kinzer: And I find, and I think I'm getting this from you or picking it up from you, people just aren't taking it that seriously.
Russell Barkley: No, it's the Rodney Dangerfield of psychiatry, Nikki. I mean, it gets no respect at all. And the name is part of the problem. It's kind of, "Oh, you just have an attention disorder."
Nikki Kinzer: Right.
Russell Barkley: "Get some sleep, go to Starbucks. Take a little Omega three, six. And life will be grand." It's that kind of trivializing of that. If I told you this was executive function deficit disorder, you might stop for a moment and take that seriously. If I told you it's a self-regulation disorder. Well, self-regulation is what predicts human success and effectiveness. And you've just undercut a person's ability to lead a really successful, effective life if they don't get this treated. And that, to me, is really the crime here. Is the superficiality with which the public generally ... And even my psychiatric colleagues, particularly in the adult area, just don't take it as seriously as they need to. And that's a shame. Because it really is, it's pretty devastating.
Russell Barkley: I mean, let me just list the seven things that are at risk when you get this disorder. Number one, your self-awareness is going to be dramatically disabled. You're not going to be as good at monitoring of yourself, your own behavior, what you're doing. And as a result, you're going to wind up finding yourself in trouble and you're not even realizing you're heading that way. Because other people will be more accurate in assessing you than you are. And so you'll blame them. "Oh, it's my mom. It's my dad. It's my teacher. I wish my wife would get off my back. It's my boss." Because you don't see yourself as being as affected by these symptoms as the people around you do.
Russell Barkley: Number one is how do you deal with somebody who, themselves, doesn't fully realize the extent of their difficulties?That's why when we evaluate people with ADHD, we always corroborate what they're telling us through other sources. Just to be careful here, because they're not always the best reporters of the degree to which they may be having problems.
Russell Barkley: The second thing is inhibition. Which we know. They're very impulsive people. But it's not just in their hyperactivity or in their language. They're impulsive in their thinking. They don't contemplate ideas as long as other people do. They're impulsive in their emotions. So that their emotions come out too quickly, too raw, too unmitigated. And that will get you in trouble real quick with your employer. And then they're impulsive motivationally. They opt for the little rewards now, the fun stuff to do now, rather than turning away from that and pursuing the longer term goals with the bigger rewards.
Russell Barkley: And this leads them to procrastination, to distraction, to disruption of their workspace. Because there's this constant pull toward what would be more fun and interesting for me to do right now? The impulsivity really cuts across all areas of human responding.
Russell Barkley: And then people don't understand this, but it really disrupts visual imagery and hindsight and foresight and the ability to look back on your life and look ahead. And use that to advise you. It's what we call working memory, this visual imagery system.
Russell Barkley: But along with that, is the mind's voice. We all talk to ourselves in our mind during our day. And a large part of that is for self-control. And although they talk to themselves, it's not controlling their behavior at all. The mind's voice and the mind's imagery system are very deficient.
Russell Barkley: And the way to think of that is this is the mind's GPS. If you were in your car, you would plug in a destination in your GPS. And it would use images and speech to get you to where you're going. So it's exactly like Waze or Google Maps. And that's exactly what the brain is doing. It's uploading maps of your past and projecting those ahead. And it's putting in a destination. And you're talking to yourself as you head to that destination to keep yourself on track, on target, on task. So the brain's GPS is very deficient and highly variable and prone to being wiped out and crashing, if you will. That's a good way of thinking about working memory.
Russell Barkley: And then, of course, as I said, there's the emotional and the motivational problems, as well. When you put all seven of these together, this can be very devastating to a person, because it interferes with their ability to do what they want to do, to accomplish the things they set out to do, the goals they have, the plans they have, the projects. Not to mention, all the stuff everybody else wants them to do.
Russell Barkley: And so, we meet with people who are very demoralized, because they can't get to where they want to be. And they don't know why and they blame themselves. "Oh, I just don't have any willpower. My mother's right, I'm just a lay about ne'er-do-well, who's failing to launch." And it's not that at all. It's a neurobiological disorder of the executive system. And that's what I want people to know. So principle number one is, this is not an attention disorder. This is a self-regulation, executive functioning disorder. And it's serious.
Nikki Kinzer: I have a 15-year old daughter who just got diagnosed with ADHD in February. And I, obviously, know a lot about ADHD. I've researched it, I coach it, I've been doing a lot around it. So I know a lot about it. My husband doesn't know a lot about it. He knows probably more than a lot of people, because of me.
Russell Barkley: Right.
Nikki Kinzer: But the situation comes to, okay, we know now that she's been formally diagnosed. And when somebody is newly diagnosed and they're young like that or even younger, right? How much do you either share with them or talk to them about it? I guess what happens is I talk more about it with her than my husband does. And my husband is afraid that if we talk too much about it, she's going to get sometime stigma about it or feel bad about it. So I'm just curious about the new diagnosis. How do parents deal with that?
Russell Barkley: The younger they are, I don't want you brow-beating them. I don't want you sitting down and telling them what ADHD is. I mean, if they're five, six, seven, it's a little early. All they need to know is, is that they do have this learning and attention problem and we're going to make some adjustments for you and get you some extra help for that.
Russell Barkley: But there, I present it to the younger kids with what we call the individual differences model. We all differ. You wear glasses, I wear glasses. I'm bald, God knows you don't want to see me hang wallpaper. I have no spatial ability. My artwork is still at the stick figure level of rendering humans. We all have our weaknesses. And I wish more people would talk about those instead of just, "We can be everything we want to be." Which, of course, is absurd. We can't. The Air Force told me I'll never be a pilot, because I wouldn't know how to even get in the plane, much less how to fly the thing. And I'm color blind. There you go.
Nikki Kinzer: There you go.
Russell Barkley: I prefer to tell kids, "Look around you. Okay, all right, you see that person? You know that they're not very good at this. And I'm not very good at that. Dad has to wear glasses and he's colorblind and I can't do mechanical stuff. And I sometimes get lost when I'm out driving." Just bring up all of your own foibles and weaknesses and say, "We all have them. And here's yours." Okay? "Yours is you have trouble concentrating on things." And so, for them, I do kind of keep it at the attention deficit level. Because they're just ... They're not going to get into this self-regulation thing at that point.
Russell Barkley: The older they are, the more it's the professional's job to sit down and start explaining it to them. Because they will take it better from a professional than from you.
Nikki Kinzer: Yeah.
Russell Barkley: After all, you're just mom.
Nikki Kinzer: Right. Right.
Russell Barkley: You can be written off really easily, especially by a teenager. Because once they get past 12 years of age, your IQ has plummeted and you are the most ridiculous thing and they don't even want to be seen with you.
Nikki Kinzer: Right, right.
Russell Barkley: We got to deal with that. The professional is going to be more influential at explaining to them. And the way we tell professionals to do it is, ADHD is the diabetes of psychiatry. How would you explain diabetes to somebody? You wouldn't avoid explaining it. You would explain it in such a way that they would understand that it's biological, they would understand that there's no cure for it. It's something that you have to cope with. But that a normal life is possible. If we will take it seriously and manage it every day and go out of our way and do the things we need to do. And this is part of you now. This is part of who you are. You need to own this.
Russell Barkley: And if it helps, Adam Levine created a great video on YouTube. He made it for Shire, the pharmaceutical company. Because Adam is a raging adult with ADHD who's very successful. But he talks about the need to ... You got to buy this. You got to be the stakeholder. You've got to give up this thing of, "It's my mom's problem. It's my teacher. I don't have this problem. It's not me." This is you. Okay? At some point, you got to own your diabetes. You got to own your ADHD. Otherwise, we can't go anywhere. You're going to defeat every effort we make to try to help you. Because you don't believe it.
Russell Barkley: Step one, to me, is getting them to understand it and own it. We don't even talk about strategies, accommodations, medications, anything. Because that's a waste of time for somebody who has yet to even accept the diagnosis. To me, there's ... it's an age-related gradient. But the older they get, it's more it's the professional who should be doing it, because they carry more weight.
Russell Barkley: And then, in the meantime, any time your child says, "Mom, why do I," blank. Meaning, why am I in time out again today? Why didn't I get invited to that party? Why are those other kids picking on me or saying those things? Or why can't I do this at home? I can't seem to finish my homework. They are vulnerable. Those are teaching moments. I call them windows of opportunity. Listen for those. Because when they're there, that is your chance to get into that mind and educate. And that's where you bring out the little books from the ADD Warehouse about what ADHD is. Maybe some of the videos on YouTube. If they're a teenager, I think Chris Dendy's book with her son, A Bird's-Eye View of ADHD, is excellent for introducing teens to ADHD. But there's a lot out there to help.
Russell Barkley: So, keep it around. But for God's sake, don't just plop them in a chair and duct tape them in and brow-beat them.
Nikki Kinzer: Right.
Russell Barkley: As if you were interrogating them for espionage. Because that's just not going to wash. But I watch for vulnerability.
Nikki Kinzer: Yeah, that's a really good point.
Russell Barkley: And I teach to it.
Nikki Kinzer: And I love the comparison of the diabetes. Because it's so true. If you have diabetes, you have to monitor your blood sugar, you have to take the insulin, you have to do these things. And you do them daily.
Russell Barkley: It's about health. It's about wellness, it's about exercise and hygiene and nutrition. Well, so is ADHD. I mean, ADHD is about owning it. And sometimes I might have to take medication. And I do have to watch my diet, because there's a tendency to drift to junk food when you're that impulsive. And that leads to obesity and diabetes. I have to watch that. I have to exercise, because that really helps control my symptoms better and gives me more effort and self control than I would have if I didn't work out or exercise. So I have to do that, too.
Russell Barkley: Then I have to ask for these accommodations at school, because it's no different than somebody in a wheel chair saying, "Hey, let's put a ramp in front of this building, people. I want to come in there, too." And we get the idea with the ramp. Nobody says to somebody in a wheelchair, "Why should we do it for you when we don't do it for the other kids?" Pardon my whining, but I do call it the educator's whine. Because it tells me that you don't know what you're talking about.
Nikki Kinzer: Right.
Russell Barkley: You would never say that to a physically disabled person. And yet, teachers say this to ADHD families all the time. "Well, why should we make that exception for your child?" Because they're disabled, for God's sake. You know?
Nikki Kinzer: Well, parents will say it to their kids. I had an interview sith a ... because I work with college students, too. And I had an interview with a college student and their mom. And they were talking about how they didn't want to use medication as a crutch.
Russell Barkley: Right.
Nikki Kinzer: And I immediately kind of went into kind of how I felt about that, which is very similar to what you just said, and kind of went into it. And I don't know if I offended them or what, but I thought, "Well, there's no way that I can even work with this person if that's what they think. And they need to know what I believe. Because I'm not going to necessarily go along with that." And it is, it's such a misconception.
Russell Barkley: It sure is. It sure is. And isn't that a shame, that we look at ADHD medication as a straight jacket of the mind, covering up the real problem, which we know is their mother. If it wasn't for bad mothering and mom just wants to give you this, because she doesn't want to address her own failings.
Russell Barkley: This idea that every child's behavior problem is the result of bad parents and mother bashing. I mean, it's just absurd. Because this is the most neurogenetic disorder in psychiatry. The only thing that comes close is autism. And yet, people view it as a life choice or a parenting failure. And therefore, medication, God forbid, is reprehensible and inhumane and it's just masking the real sociological problem. And that is just utter nonsense. That's like telling a diabetic that insulin-
Nikki Kinzer: Is a crutch.
Russell Barkley: ... is a crutch.
Nikki Kinzer: Right.
Russell Barkley: [inaudible 00:22:44].
Nikki Kinzer: Yeah.
Russell Barkley: Yeah and if you wanted to, you could will your pancreas back into normal health. Well, that's not going to happen.
Nikki Kinzer: Not going to happen. That's right.
Russell Barkley: Yeah, yeah. So thank you for pointing that out.
Pete Wright: And you write about that very early in the book. And it is stunning to me, how many people we have here who are ... that we're still having this conversation. Because this was a conversation we were having about my peers when I was in the sixth grade. It's the same language is still being used. So it is stunning to me.
Pete Wright: But you've put yourself in a position through your writing and educating on the subject of not just helping others to understand what ADHD is and helping those of us living with ADHD understand ourselves a little bit better. But of engendering a sort of advocacy about ADHD in parents and educators and health care workers. I wonder if you could talk a little bit about what it is that you want this book and your sort of legacy to be around building advocates in support of ADHD?
Russell Barkley: Well, clearly, especially in the Taking Charge book, I talk about a parent's role or even the role of somebody adult with ADHD. That there are three roles. One is, you need to learn more about this than other people. That's part of the ownership to me. And that is, you need to become an expert. And I quote David Lindsey, "A truth is an assembled thing." Read widely, don't just take it from one source. But you need to know as much as you can about this. Because that will help you understand why you need to treat it the way we treat it.
Russell Barkley: The second thing is to become what I call the executive parent. That's the advocacy role. That's where when you go into meetings, don't be intimidated by doctors and school professionals and teachers and others. Because nobody knows this child and nobody knows you better than you do. Take charge of that meeting. These people work for you. And yet, they want you to think that you work for them and they are the experts and they frown upon you and are condescending to you. And don't take that. To me, if a professional does that, that clearly tells me that, first of all, they're condescending and arrogant. But also that they probably don't know what they're talking about.
Russell Barkley: Yes, you're absolutely right, I want people ... First of all, I want people to own it and stop denying it. I want them to understand that it's more serious than they think. And then I want them to advocate for the services that are available to them or even getting new services if necessary. Because nobody's going to advocate for you any better than you are.
Russell Barkley: You look at any movement where people have changed their perspective about whether it's LGBT, whether it's civil rights and injustice, even earlier, whether it has to do with other disabled people, like autism or intellectual disability or LD. Those people got pretty militant at the beginning in order to push back against what I thought was societal prejudice and stigmatizing of them and just a lack of seriousness about it.
Russell Barkley: But just as an aside, I think we partly created this in the field of psychiatry and psychology ourselves. Because we have had 150 years of teaching people that the environment is everything in determining how you're going to turn out. Whether it was Freud's ideas about parenting. Whether it was Watson and Skinner about the role of environmental consequences and contingencies of reinforcement. Whether it was Marx and his views on the environment as creating sort of a historical imperative for society. Kind of a utopian idea that we can engineer societies to make people more perfect.
Russell Barkley: Every one of these ideas across all of these thinkers held the environment up as the most important determining factor in human life, welfare, society, and so on. And yet, science has continued to reveal just how strong the role of genetics, biology, and chance are in human outcomes. And that the things we thought were so important turn out to be somewhat important, but not that important. And you can't engineer people the way we think you can.
Russell Barkley: This idea has led people to think that if a child has a problem, it's the environment. And the environment we blame is the parents. Schools take a hit on that, too. Bad schools, bad parents, diet, sugar. But notice, everyone blames the environment. And nobody accepts the neurological and genetic basis of certain human traits and predispositions. But they're there.
Pete Wright: You say throughout the book, in addition to here, ADHD is due to the fast pace of our culture, sugar, too much screen time simply. And you call it a myth, right? And we do get this question often. Yes, I know ADHD exists. And that it doesn't exist because of these things. I'm saying in heavy air quotes. But to what extent do these things potentially exacerbate symptoms or experience of ADHD? Because there are people out there who want to know and are making changes to diet and screen time and things. What does that look like?
Russell Barkley: Well, what it looks like, there's a small element of diet involved in young preschool children with regard to food coloring. There's a little tiny bit of evidence that might suggest that, that's an irritant. Only to preschoolers over time. So if you're going to take something out of the diet, that might be it. But it's not sugar, it's not additives, it's not Feingold stuff like salicylates and flavorings and the things he talked about 30, 40 years ago as causing ADHD. It's none of those things. You can get rid of that.
Russell Barkley: But, yeah, every time we do these large studies of hundreds or thousands of people, we do pick up a little bit of a signal around dyes. Around food colors. And mainly with kids under six. There's a little bit there, okay?
Russell Barkley: The second thing, there's a little bit of evidence that ADHD children are more likely to be iron deficient. And iron deficiency could lead to fatigue. And fatigue could show up as exacerbating your attention and your ability to concentrate. Yeah. I mean, if you're a little iron deficient, have your pediatrician check that out and take some iron supplements. But, by the way, that's a small minority of kids. We don't want to be giving iron to everybody with ADHD when it's really just the kids who are deficient where that might be good to do. Again, I don't want to throw the baby out with the bath and say there's nothing there. There's nothing there that's that important. It's not the main cause of ADHD.
Russell Barkley: What we have learned about screen time, whether it's smart technology, iPads, tablets, computers, gaming, whatever, is it's the other way around. Having ADHD causes you to gravitate to, become more addicted to, more dependent on screen technology. Because it's very engaging. And as I said, people with ADHD are looking for, what can engage me right now? What's exciting? What's stimulating? Yes. And so, 17% of these kids have a gaming addiction by 15 years of age. I mean, it's remarkable how susceptible they are to that technology. But that's the ADHD leading to the excess use and dependence on that.
Nikki Kinzer: Right. It's not the video games that are causing it. That's the important piece.
Russell Barkley: Right. No, that's not doing it at all.
Nikki Kinzer: Yeah, right.
Russell Barkley: And some of the early studies had suggested that it were, were correlational. And they got the chicken and the egg backwards.
Pete Wright: Right.
Russell Barkley: Because it was just a relationship. People with ADHD watch more screen time. Well, notice that, that's kind of like a roar shock test. Now you're going to project on your own interpretation. "Oh, well that means screen time is bad." No. It means people with ADHD search out these more engaging media. If screen time does anything, particularly social media contributes to depression. It doesn't contribute to ADHD. We have to be careful about that, too. We don't see anything there either.
Russell Barkley: All of the major players in ADHD are in the realm of biology. And there's a little bit of environment, but it's mainly toxins. Like alcohol during pregnancy or being exposed to certain pesticides or certain industrial chemicals that you might be exposed to. These, as well, could be having a detrimental effect on brain development. We know lead does, too, lead poisoning.
Russell Barkley: Where there's a role for the environment, it's a toxic sort of effect of these chemicals in the environment that might be doing it. But it's not parenting. And it's not the fact that you did or did not time out your child for misbehavior. It's not discipline. It really is ...
Russell Barkley: Genetics accounts for two-thirds of all cases. Accounts for 80% of the variation in human behavior when it comes to ADHD symptoms, is accounted for by differences at the genetic level. Which is why genetics is a very exciting area of research right now. And what are those genes doing? These are genes that build and operate the frontal lobe and the executive circuitry and the functional connectivity of the brain. That links the genes to the brain. And that explains why the brain is three years delayed, two to three years behind in its maturation. The connections aren't connecting up as quickly. When they do connect, they're quite variable. They're almost like a TV signal that comes in and out. And so, even when it's working, it's not working consistently very well.
Russell Barkley: It's the genes that are doing this to the brain. And it's the brain that's causing these behaviors to be manifest the way they are. And as a result, biological remedies are okay for biological disorders. Hence, the reliance on medication as part of a treatment package. He was very quick to point out. It's only one of many things we recommend, and not the only thing. But that's why.
Russell Barkley: What this leads me to, is the second principle in my book, I think, is so important. It's for parents to know this, that you didn't cause this. This is the gift you were given at birth. This is a unique genetic mosaic of everything in your family. All those traits out there have combined and conspired to create this unique individual. Some of which is their ADHD.
Russell Barkley: And because it's largely neurogenetic in origin, you are not going to engineer this out of this kid. You have got to stop thinking of yourself as an engineer, architect. You are instead, a shepherd to a disabled person. And boy, does that shift the metaphor and the framework. Because shepherds don't change sheep into cats. We don't do that. Shepherds care for the sheep. It's a very important role.
Russell Barkley: As one mother said, "Oh, you're just saying I should leave him a loaf of bread and go to Vegas and play the slots." I'm not saying that about your kid at all. You're a very important person. Just understand where you're important. You're important as a shepherd. You get to pick the pastures. You get to determine how nutritious and stimulating and educational they're going to be. You determine who the other sheep are going to be this sheep is hanging around with. Right? All of these things, the protection, the sheltering, the nurturing, the safety, the stimulation, the education.
Russell Barkley: Judy Harris summed it up in one sentence in her book in 1996, The Nurture Assumption. "You have more to do with how your children turn out by where you chose to buy your home or rent your house than you will ever have with what you do inside that house, short of child abuse." And it is shown time and time again. She was absolutely spot on when it comes to the research evidence.
Russell Barkley: This idea of molecular parenting, that if I play classical music to my uterus when I'm pregnant, I'm going to have an Einstein. And if I get the right educational toys. And if I just do these little engineering things throughout the day with my child, I can turn them into whatever they're going to be. And that is so far off the mark. Basically, you're wasting your time doing those kinds of things.
Russell Barkley: That doesn't mean that parenting doesn't matter. It doesn't matter to the degree that you think it does. The peer group matters more, the school matters more, the resources in your community matter more. And your child's biological make up matters more. Would you stop trying to change the child to the one you wanted? And would you please accept the one you've got?
Russell Barkley: And if you want to follow that thread, go on YouTube and Google, Welcome to Holland. And then go looking for the one on ADHD. Because there's one on there for autism, there's one on there for down syndrome. And it's about a mother who expected X during her pregnancy. She was going to go to Venice, right? And being pregnant was like learning Italian and doing it right and getting ready to go to Venice. And you had the map and you studied the language and you read up on the food and you were ready for Venice, baby. And you got on that plane and it landed in Amsterdam. You are so unprepared for this. And now you're running around trying to create Venice in Amsterdam.
Russell Barkley: Would you live in Amsterdam? That's where you are. And I'm sorry you didn't get the child you wanted. And that those dreams are crushed. And that you have to jettison whatever that was, parents day at Yale for instance, or something like that. And would you please just accept and love the kid you got? I mean, it's kind of like the Stephen Stills record, Love the One You're With. And stop longing for what I can't give you and you can't get. And yet, that's what parents are doing. I am going to make him into the person I want him to be. How about letting him be the person he is.
Pete Wright: And Amsterdam is amazing.
Nikki Kinzer: That's right.
Russell Barkley: And so it is. And by the way, just so you know, if you say this in Holland, they use Iceland. But my point is this. If you'll look at the shepherd's role and what can I do? Okay. Where do I live? What are my resources? How good is that school? How good are those teachers? What are the peers like in this neighborhood? Are they anti-social? Are they criminogenic?
Russell Barkley: Also, what about the other adults out there? My son's gifted in athletics, I'm going to do what Mrs. Phelps did with Michael. I'm going to take him to the Baltimore Athletic Club and hire the best swim coach on the planet. And what did Adam Levine's parents do? They bankrolled his music career. And Richard Branson, they bailed him out of jail for pirating the Beatles' music and sent him over to a private school in Vermont. Pick the pasture and get that right. And stop worrying about Baby Einstein toys and crib stuff and all this other things that really have a very-
Nikki Kinzer: Very little.
Russell Barkley: ... little influence on children's outcome.
Pete Wright: But you know what? They sort of feed off of one another. Because, putting myself back into that space of being a new parent, it's all I can control. And so, it's a dopamine hit for me to think about all of those things and to try to be woke about all of these ADHD dietary, all of these issues, because it's all I have.
Russell Barkley: It is. But I'm warning you, you're going to lose your children. That's the opening chapter of my Taking Charge book. I cannot tell you, I learned that 35 years ago. One mother taught me that lesson. I have never forgotten it. Boy, if you over-weight that kind of suffocating parenting over a child's behavior, you may win in the short run, they're going to hate you. You're going to lose your kid. You're going to lose your relationship with that kid. They're going to pull away from you. They're not going to want to spend leisure time with you. They're going to feel every hour of the day how they disappointed you. And that's why you have to keep doing these things and nattering and nagging and punishing and shaping and molding and all of this.
Russell Barkley: I just tell them, "What's more important to you? Okay? It should be your relationship with this child should take prominence over even the school system. And yet, you are taking their side against your child." There's a great Dennis the Menace cartoon where he's crying in his mother's arms at the door of their house. Because he ran away from school because he needed somebody on his side. That even brings tears to my eyes now. Because I see this all the time when I saw clinic patients. Was this idea that we're taking sides against our children. When in fact, our relationship with them should be paramount.
Russell Barkley: And that doesn't mean you don't parent. And you don't set standards and have household rules. Nobody's talking about that. But it means you give up the suffocating, helicoptering, every interaction matters kind of parenting. Would you just step back and be a little mindful of the child you've got? Let's get into the moment. Let's live with his abilities, his strengths, his aptitudes. Many of which are non-traditional. And can we play to those? I mean, to me, that's principle number three, you follow as being a shepherd.
Russell Barkley: Principle number three is, can you assess the uniqueness of your child and find out what those aptitudes are? No matter what they are. For my ADHD twin brother, it was rock music. It was music. And for other people, it's art. For my sister, it was the art of pottery, water colors, and things. For other people, it's stand up comedy. For some people it's acting. For others it might actually be working in EMT in the medical field. Becoming a videographer or a photographer. There's a woman with ADHD doing great stuff out of New Zealand, where she's flying drones with cameras and getting pictures of scenes you would never think of. And framing them as artwork and making a killing. She's on YouTube, by the way.
Russell Barkley: But my point is, look at all these non-traditional pursuits that people can succeed in. And we won't even give them a chance. No, it's got to be the educational route to success. Everybody's got to be a lawyer, a doctor, a white-collar professional. And that's the pathway. And if your kids aren't on that pathway, God help them. And I'm just saying, there are many paths. And it doesn't have to be traditional.
Pete Wright: I feel like we should talk briefly about what is going on, then, at home and in school. And as people are making this transition to online learning, both as parents and as kids. Because so much of what you're talking about, the overweight of some of these issues as parents of some of these behaviors, is exactly what I'm finding myself fighting every day not to over parent.
Russell Barkley: Oh, yeah.
Pete Wright: Because we're in each other's faces all day long, right? We sort of can't help it. It is an every day struggle to take a step back and say, "We're going to have some parenting space. You're going to be able to ... you have to be able to make some mistakes yourself." Well, now we're going back to school, we're still in the same space.
Russell Barkley: Yeah, we are. Yeah, we are. Well, I tell parents, first of all, these are historic times. This is unprecedented. It is the most quoted word of the day right now. Why you would expect normal during historic, chaotic, unprecedented times? It's like you're in the City of London. You're cowering down in a subway tunnel while the Nazis are bombing London. And you want to do distance learning with your teacher.
Pete Wright: Right.
Nikki Kinzer: Right.
Pete Wright: Right. Okay.
Russell Barkley: The bombs are falling, the city could be destroyed.
Nikki Kinzer: It's what it feels like.
Russell Barkley: All hell is breaking loose. You're anxious. Your kids are anxious. They're reading your feelings. They have their own. But no, we're going to do seven, eight hours of video distance learning with you. How about you just make a fort out of a blanket in the living room and snuggle a little bit once in a while? And then everybody should have a safe space in their home that they can go to and that they can retreat to for 15, 20 minutes of rest, R and R, throughout the day. And let's just create safe spaces. What I mean by that, of course, is not what the campus people mean. You need a place to recover, to recuperate, and to grieve.
Russell Barkley: These are historic times. We are all upset. And we all find our emotions all over the map. Would you give the kids a break? Okay, they might be a little bit behind. But everybody's going to fall behind. And kids are little sponges anyway. And when school gets back to normal, they're going to catch up. Please, don't make that the priority. You got to do some of it, space it out. Do something fun, then do a learning thing. Then do something fun. Then do learning. And back and forth like that. And then sometimes, just take a break and do backyard science or cooking science. Or something that's more hands-on and fun for kids to do. And just don't worry about school right now.
Russell Barkley: You see, this gets back to the, "I can determine who my son's going to be or my daughter." And because we can't do it the way we're doing it, "Oh, my God, they're going to turn out to be ... they're going to need psychoanalysis for the rest of their life, because they're not able to do," and that's just not true. That's not going to happen. Do what you can. That's all I ask parents to do. Do what you can. That's enough. And give everybody a break from this from periodically. I think we're over-weighting schooling in the middle of a pandemic, for God's sake.
Nikki Kinzer: Right. Right.
Russell Barkley: Right? The bombs are falling on London and you want to do homework. Great.
Nikki Kinzer: Well, and it's interesting, because I'll tell my kids and when this conversation comes up, if you really think about it, this is just the ... it is historical. But it's a very small part of your education.
Russell Barkley: Yes.
Nikki Kinzer: They're never going to stop learning. I mean, they're going to always learn.
Russell Barkley: No.
Nikki Kinzer: So even if they're not getting it in the way that they got it last year, they're still going to have it. And it just is going to look different. And like you said, they may fall behind, but they can catch up. I mean, you are still capable of learning.
Pete Wright: Well, and everybody's falling behind together.
Nikki Kinzer: Yeah.
Pete Wright: That's the point.
Russell Barkley: Yeah.
Pete Wright: You know? They're all behind. So don't worry about it.
Nikki Kinzer: Right.
Pete Wright: And they're all going to catch up.
Nikki Kinzer: And teachers are just pretending that they know what they're doing. But they know, I mean they're just as confused and living in chaos, too.
Russell Barkley: Well, here's what I told ... one of my grandsons, he's a very talented young man. A bit of a worrier. But I love him dearly. And I had a half-hour conversation with him last night around this very issue. "Grandpa, I'm falling behind here. I'm not able to learn as much." And I said, "Liam, this is a great opportunity for you to go and learn what you want to learn." Yes, we have to do a little bit of this and a little bit of that. But school's done by 1:00. Half of it was nonsense anyway. You're not going to get anywhere near from the teacher what you used to get. Don't worry about that, because look at all these other things you could learn. What do you want to know?
Russell Barkley: So I introduced him to Kahn Academy and the other online learning courses that go from K through college. Showed him all the things. And I said, "Look at that course. There is one on environmental biology. Here's another one on music. And here's one on music theory. And just look at the array of things." It's like being in a buffet line. What do you want to eat?
Nikki Kinzer: Right.
Russell Barkley: Right?
Nikki Kinzer: You get to choose.
Russell Barkley: And you're right. And guess what? Do that now. Because when school gets back in session, you're not going to have this opportunity. I left him with this, "Liam, don't tell me what you can't do. What we're not doing. What you've given up. What we're not able to do for you. And look around at what could I do be doing with this now? I've always wanted to learn about the weather or about birds or about animals or whatever." It doesn't matter. Whatever it is, now's your chance. Right? And follow that passion right now. Because they can't take that away from you. You are learning. You may not be learning what they want you to learn, but you'll pick that up very, very quickly.
Russell Barkley: He's going to start doing that now. He's bookmarked an hour a day to just explore new topics and do a deep dive into them.
Nikki Kinzer: That's great.
Russell Barkley: Based on whatever the passion is. I'd rather have you do that than worry about so much about the schooling. We all got to get it done. I'm not belittling that. But I just think we're way, way overemphasizing that.
Nikki Kinzer: Now you earlier were talking about Taking Charge of your ADHD. So that's a book that you had out earlier this year? Is that correct?
Russell Barkley: It's actually in its fourth edition.
Nikki Kinzer: It's in its fourth edition? Oh, gee.
Russell Barkley: It came out 20 years ago.
Nikki Kinzer: I'm sorry.
Russell Barkley: And the fourth edition was published last month, yeah.
Nikki Kinzer: Okay. That must have been what I had read.
Russell Barkley: The fourth edition of Taking Charge is last month. And the 12 Principles is next week.
Nikki Kinzer: Okay.
Russell Barkley: Yeah.
Nikki Kinzer: Okay.
Russell Barkley: Sometime in the next week or so. Yeah, and they're both out there. Plus I have one for adults on Taking Charge. And I have another one for people who live with adults called, When an Adult You Love Has ADHD. Very clever title there.
Pete Wright: I wonder-
Nikki Kinzer: Right.
Pete Wright: In that light, Russ, you spend time writing this book. And it's a book, you distill these 12 disciplines for children. How has that impacted the way you think, if at all, the way you think about adults and ADHD? Has it given you any new insights?
Russell Barkley: Let me just give you two of the ideas, then, if you don't mind Pete, about what ... ideas that apply equally across the lifespan. All right, number one, ADHD destroys the biological clock. There is no internal clock. And if it's there, it's not functioning well and it doesn't matter, because it won't guide you. And that is why ADHD is the worst disorder in psychiatry for time management. There is no disorder.
Russell Barkley: It is four times worse than any other disorder as to what it does to human time management. To the ability to be on time, in time, over time. It's gone. Time escapes them. And I have a picture where I show parents. Here's a normal clock for typical kids or typical adults. Here's a clock for ADHD people. All the numbers are in a pile at the bottom of the clock. There is no time. What are you talking about? I show them the Dennis the Menace cartoon where he's staring at his father very puzzled about why his father is setting the grandfather clock, because Dennis is saying, "Isn't it always now? What do you need this device for?" It's always now. And there's another great one of this kid who's waking his mother up at 3:00 in the morning to say, "Mom! Mom! I got to have a diorama of the Hoover Dam by 8:00 tomorrow!" Right? I mean, you just left everything to the last minute. Because he lives in the now. That's where they live.
Russell Barkley: And what do we do? We give them time intervals, time limits, deadlines, assignments. You got 30 minutes to do this, you got a week for a book report. So I tell parents, the minute you put time into a task, you just disabled your child.
Russell Barkley: How do we compensate for no internal clock? We make it external. And the adults have to do this, too. There must be an external marker of time. There's a one foot clock you can get on Amazon with a red disk. And you set it for any interval within the hour and it shows your child how much time has passed and how much time they have left. You can use ... by the way, analog clocks are better than digital. Digital does not give you the flow of time the way an analog clock shows you where you are within time. We also tell parents that there are timing devices you can get at the ADD Warehouse that will help cue you. So there's all kinds of things. There's calendars, there's Outlook, your Google Calendar. There's all kinds of ways of programming time so that it's outside of you and yet gives you that sense of that flow.
Russell Barkley: But you just need to know that they live in the now. And as my friend and colleague Virginia Douglas said back in the '80s in Canada, "If you don't manage the now, you don't manage these kids." Don't talk about next week, summer reading, next month, the book report. You break that into tiny baby steps. You do a piece of that a day. Right? And we'll cross the bridge of time. We'll put a brick a day in the bridge. But do not point out the future. Because they can't cope with that. They have no sense of time. Now, granted, they will get a small one. But even in adulthood, the sense of time in an adult with ADHD is markedly abnormal compared to what normal, typical people have.
Pete Wright: Well, and that's something that I think is really ... I mean, I'm really resonating with that experience. Because it feels like something that, for me, time is not something that I've ever been able to internalize. Which means I've never been able to climb the mountain of understanding of time. I've only been able to master the skill of technology that helps me to automate it. Right? To see it, to keep it present. It never has made sense. But I've got a skill that I can reach out to.
Russell Barkley: I've heard that from so many adults with ADHD. "Time escapes me. I don't know what you people are talking about." You know how one person put it? He said, "If you want to know what my life is like, I'm adrift on the ocean of time with no rudder."
Pete Wright: Yeah.
Russell Barkley: I'm just being bounced around by the waves of the now and whatever they take me and the currents go. I just get pulled along by the nose. Because I can't grapple with it. I can't use time to guide me, the internal sense of time. Which we all use. And time management is the single best predictor of adult effectiveness in our occupation and educational lives. Because everything about adult life is time sensitive.
Pete Wright: Right, right.
Russell Barkley: Boy, you talk about a disabling symptom, it's this one. One, time escapes them, make time physical, make it external. Put it in the visual field. Keep it in the now. And then break large time assignments into quotas and baby steps. And do a little piece a day. That's how we deal with time.
Russell Barkley: Number two, working memory. Holding in mind what we're doing and how we're going to do it. That's part of the frontal lobe system, right? That is shot. It's like old men, you go to the mailbox and you forget to get the mail. You're just being told by the now. Having ADHD is like being old, like me, times 10. Your working memory is going. It is gone.
Russell Barkley: What can we do? Same principle. Make it outside the brain. In tech speak, offload working memory. What do I need to be doing here? What are the steps to doing that in the now? All right, it's on a card. It's on sticky notes. It's in my day calendar. It's in my journal.
Russell Barkley: And by the way, low tech is a better storage device than high tech. By that, I mean, don't get into these digital recorders and programing your schedule into your computer, because you won't. Right? And you won't charge up the digital recorder. And you'll forget where the charging cord is. And it will be under your car seat or the dog will eat it. We've discovered that high tech doesn't work well for people with ADHD, because it comes with a certain burden of its care.
Russell Barkley: Low tech is better. The notes, the journals, the charts, the Week-At-A-Glance calendar. This all needs to be offloaded in front of you here. And that's true for kids and it's true for the adults, as well. Get it out of your head, get it on a storage device. And it will guide you. Just as my ... I have a do-list in my kitchen of what I plan to do today. And I wrote that to externalize it so that I stay under control and not get pulled by the now to all these other things that I could easily engage. Just two suggestions out of the book for both kids and adults.
Pete Wright: We will put a link to the book in the show notes. But we have a deal, right, for listeners?
Nikki Kinzer: 25%. Yes.
Pete Wright: We love it.
Russell Barkley: How did you get ... I don't even get that.
Nikki Kinzer: Yes! Lucy. Your publicist, yes.
Russell Barkley: I'm calling Lucy.
Pete Wright: That's right.
Russell Barkley: Well, congratulations everybody. There goes my royalty.
Nikki Kinzer: That's right. She's giving it away.
Russell Barkley: That's right. She just gave away my royalty. Yeah. Thanks.
Nikki Kinzer: I have to say, Dr. Barkley, it has been such a pleasure listening to you speak, having you here on the show, answering our questions. Thank you so much. And thank you, so much, for all of the work that you've done for this community. Years of research and books and resources. And I just thank you. Thank you so much.
Russell Barkley: You're very kind. Very kind. Thank you, both.
Pete Wright: Thank you so much, Dr. Barkley, for hanging out with us today. You are such an incredible asset to our community. And your expertise has changed the lives of so many. We so appreciate you. On behalf of Dr. Russell Barkley and Nikki Kinzer, I'm Pete Wright, we'll catch you next time right here on Taking Control, The ADHD Podcast.
