The Integration of Psychology, Science and Christian Counseling (Pt. 10)

As we close out this series, we see that science can give us insight into a matter that the Bible does not mention. Science does prove that ADD/ADHD is real, and it is not simply a matter of willful sin, even though it is not mentioned in the Bible.

We know that everyone is different, and that we all have a purpose in life. We can see that in the Bible, and we don’t need science to help us understand it.

We also know that we can find godly parenting principles in the Bible that teach us how to connect with each child whether ADD/ADHD or not, even though it may not always be easy (Deut. 6:6-9, Prov. 22:6). Science may not have the answer to godly parenting, but it can help us understand human nature, and that will help us connect more easily.

So we see that science is not always right, because scientists are human, and humans sometimes come to wrong conclusions about science. Nevertheless, science is not necessarily always wrong, and it can be beneficial to us.

God gave us intelligence to study and learn, and He meant for us to study and learn from His Word as well as from His world.

I have concluded that I can no longer afford to be tossed to and fro, pulled from one side to the other (Eph. 4:14). I have concluded that now is the time that I must choose whether I believe either all science, all Bible or if there is a third option that may be better.

Yes, the Bible is sufficient, after all, people got along without science for centuries. However, when we use science to help us better understand how God’s world works, and combine that with Biblical admonitions of how we should function in God’s world, we arrive at a homogeneous, integrative method of living and of counseling.

I have chosen that third option, and concluded that the integration of science and Christianity is an acceptable option.

I have concluded that I must set sail on the rising tide of integration, and devote my energies to learning how to safely integrate the two, rather than if I may safely integrate the two.

The matter is resolved, and I am moving forward toward integration.

So that’s the world as Donnie sees it.

God bless,

Donnie See

The Integration of Psychology, Science and Christian Counseling (Pt. 9)

We have been looking at those with ADD/ADHD and asking whether it is appropriate to use medication or not. If ADD/ADHD is an enhancement, why mess with it? As the saying goes, “if it ain’t broke, don’t fix it!”

Nevertheless, the sad reality is that those who have ADD/ADHD do suffer in many ways, and don’t live up to their full potential. However, is that because parents, teachers and others in authority, are not willing to look for alternative strategies for helping them reach that potential?

Do parents, teachers and others in authority continue using the same strategies, even in the face of failure, simply because those strategies always worked with other children?

When these strategies fail to work with the ADD/ADHD child, do parents, teachers and others in authority, in their frustration, hope to get better results by implementing those same strategies longer, harder, louder or more forcefully?

In short, is the medication simply something to make the life of others easier, at the expense of the one with ADD/ADHD?

We find that family counseling is beneficial for the families of those with ADD/ADHD. Effective Christian counselors understand the issues of ADD/ADHD, but also recognize the difficulty of living with someone who has it. Only the counselor who recognizes both sides of the issue is able to give insightful help to both sides.

As with every issue, understanding the other person, and finding common ground is a good beginning. Counselors can help little Tom see that Dad and Mom do love him, that they are not mad at him, and that they just want what is best for him.

Conversely, Dad and Mom must understand that little Tom is not trying to defy or disobey them. There is nothing willful about his actions, but there is just so much going on in his head that he forgets.

Counselors may also help by advocating for the child within the school system, asking the school to explore novel teaching methods or a different learning environment for Tom.[i] This may include a classroom where he can be active, yet not be distracted by (or be a distraction to) others.

Additionally, cognitive behavioral therapy may help parents learn new parenting strategies, strategies that are not immediately obvious because they are not necessary with other children.[ii]

For example, children with ADD/ADHD are not as quick to “connect the dots” and understand cause and effect as other children, but if parents present firm boundaries to the child, he or she will learn.

ADD/ADHD children do not multi-task as well as others, so parents must learn to give a single instruction at a time. Further, if the instruction can be broken down into multiple steps, it may be necessary to give the child a single step at a time.

This type of parenting is more time consuming than parenting other children, and parents must understand the rocky road on which they are traveling. Nevertheless, with patience, perseverance, and a firm hand, with a heavy helping of grace and unconditional love, both parent and child will survive, and do so without the necessity of medication.

We are getting close to wrapping this up, but we can clearly see that there is no contradiction between science and Christianity. But for now, this is enough distraction for all the things going on inside my head, and I need to get some other things done, or at least started.

I wonder if I will be able to complete any projects today.

So that’s the world as Donnie sees it.

God bless,

Donnie See

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[i] Frank Minirth, Paul Meier M.D. and Stephen Arterburn, Miracle Drugs – How They Work And What You Should Know About Them (Nashville: Thomas Nelson, 1996), 48.

[ii] Ibid. 48-51

The Integration of Psychology, Science and Christian Counseling (Pt. 8)

If ADD/ADHD is a valid diagnosis, and we have medication to correct the situation, shouldn’t we do so? Can’t we monitor the child so that he or she can be protected from the harmful effects of the medication, while giving the child all the benefits of it?

Maybe not. Because, possibly the worst side effect of taking medication to control ADD/ADHD is the diminution of creativity.

Where would we be as a society if everyone was task oriented, always completing every project, yet we had no one with the incredible spark of genius of a Thomas Edison?

Edison was one of the most creative men the world has known, but after only twelve weeks of formal education, Edison’s teacher was convinced that young Tom was an idiot, and had him removed from school.[i] Under similar circumstances today, the diagnosis would be ADD/ADHD, and help would consist of a prescription for Ritalin.

Edison was a dreamer, and early in his life, some people could already see his creative genius at work, while to others, he was simply broken.

As an adult, he was not a completer of tasks, but he did not need to be, for after he stumbled upon an idea, this dreamer handed it off to someone else for development.

However, taking a daily dose of Ritalin may have dampened or even extinguished his creativity. Edison may have become a completer of tasks, but after taking his daily dose of Ritalin, he may not have had any tasks to complete, and he would never originate many of his 1,093 patents.

One must wonder about the racing mind. One must wonder about the thoughts skipping through the mind of the one with ADD/ADHD like a flat stone across a pond.

Is this the residue of the fall of humanity? Do these symptoms indicate the presence of a bug in our software? Is this a bug, requiring someone to work through each line of code until we find, and fix, the broken line?

On the other hand, would it serve us better to view it as a feature, something akin to having optional equipment, equipment that makes the ADD/ADHD brain unique or even superior for a given task, the task that God wants the person to carry out.

How much better it would be to find a solution that leaves the person as he or she is, and enables him or her to live a productive life, and be happy with being different from others.

After all, that is the crux of the matter. Even though those of us with ADD/ADHD seem to distract others, we do not see ourselves as broken, we simply see ADD/ADHD as an enhancement. Is it proper to medicate one person, merely for the comfort and convenience of another?

That is a tough question, but it is a fair question, and one that needs to be asked.

Tomorrow we will take a look at how a Christian counselor—one who acknowledges the findings of science, and the presence of ADD/ADHD—can help these families.

So, that’s the world as Donnie sees it.

God bless,

Donnie See

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[i] Gerald Beals, “The Biography of Thomas Edison,” Thomas Alva Edison Biography, http://www.thomasedison.com/biography.html (accessed July 08, 2010).

The Integration of Psychology, Science and Christian Counseling (Pt. 7)

Yesterday I promised that I would get to the proof of the existence of ADD/ADHD that we can see in the SPECT scans, and I will. But first, just a few more preliminary details about ADD/ADHD, and a brief mention of the opponents view of it.

Even though these children have a short attention span, when participating in tasks they enjoy, such as video games, they have no problem staying focused.[i] Opponents of ADD/ADHD quickly point this out in refuting the validity of a ADD/ADHD diagnosis.

However, in understanding the role of the prefrontal cortex we find the explanation for this too. The prefrontal cortex is responsible for inhibiting the perception of extraneous events, allowing the child to concentrate.

A poorly functioning prefrontal cortex fails to do this, focus drifts, and the child becomes distracted. Highly stimulative, unusual or even frightening situations, such as video games,  keep the prefrontal cortex stimulated, engaged, and block out distractions. This enhances focus and concentration, and prevents the child from getting bored and distracted.

By observing the behavior of those with ADD/ADHD, and understanding the functions of the prefrontal cortex, one may hypothesize that this area of the brain is indeed suspect. We need a way to determine the validity of this hypothesis, and this is where the value of SPECT comes into play (finally we get here!).

The following  SPECT images dramatically illustrate a clear difference in these brains (all photos courtesy of Amen Clinics).

Fig. 1 Normal Brain

In Fig. 1, we see the brain of a normally functioning person. You will notice that this brain is smooth, has no voids, and few depressions of any kind.[ii]

Fig. 2 ADD/ADHD At Rest

In Fig. 2, we see the resting brain of someone diagnosed with ADD/ADHD while he or she is not concentrating on anything, but is at rest.[iii]

The dissimilarity in the appearance of the two is obvious, even at rest. The brain in Fig. 2 has many voids and depressions indicating that something is clearly different.

If researchers are correct about ADD/ADHD we should see a difference between a resting ADD/ADHD brain, and the same brain when it is concentrating, and we should especially see the inhibition of the prefrontal cortex.

Fig. 3 ADD/ADHD Concentrating

In fact, that is exactly what we find in Fig. 3, and it is easy to see that the voids and depressions in the already malfunctioning brain become even more pronounced. Further, a large part of the prefrontal cortex, shown at the top of fig. 3, simply disappears, just as the hypothesis predicts.

If this research is repeatable, and the visible differences generalize to the population at large, and if we find no other explanation for these differences, it is rational to believe that ADD/ADHD is a valid diagnosis, and it is not simply willful disobedience or rebellion on the part of the child.

So science and modern technology show us that ADD/ADHD is real, even though our Bible does not mention anything about it. However, simply because the science is real, does not mean that our Bible is wrong. It just means that the Bible is silent on the matter.  But what do we do with that information, if anything?

Researchers have discovered that certain stimulant medications, such as Cylert, Ritalin and Adderall can treat ADD/ADHD effectively.[iv] Exactly how these stimulants work is unclear, but researchers believe they work by increasing the available amount of the neurotransmitter, dopamine found within the brain.[v]

With more dopamine available to do its assigned task, the child is able to block out extraneous internal and external “noise” and stay on task.

If SPECT scans can detect the existence of ADD/ADHD, they should certainly show any improvement that medication brings about.

Fig. 4 ADD/ADHD Concentrating w/Adderall

Figure 4 clearly shows a brain that is functioning more normally after the person has taken the stimulant Adderall. This brain is much smoother, has no voids, and most importantly, the prefrontal cortex is no longer AWOL as it was in Fig. 3, but now appears to be functioning normally.

To the parents and teachers of the ADD/ADHD child this medication is a blessing; but to the child, this may be a double-edged sword, bringing both blessing and curse.

As with all medications, these stimulants have side effects, not the least of which is nervousness and insomnia.[vi] Cylert has the potential to cause liver damage, and all the stimulants, if not carefully controlled, can be addictive. Furthermore, there is a possibility that the medications could cause Tourette’s syndrome or involuntary tics.

However, as bad as these things may be, they are not the worst damage that can be done to the one taking these medications to control ADD/ADHD.

Tomorrow we will look at the other side of the medications.

So, that’s the world as Donnie sees it.

God bless,

Donnie See

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[i] Ibid

[ii] “SPECT Atlas Image Viewer,” Amen Clinics, http://www.amenclinics.com/brain-science/spect-image-gallery/spect-atlas/viewer/?img=NLTOP.jpg (accessed July 07, 2010).

[iii] “Images of Attention Deficit Disorder ADD/ADHD,” Amen Clinics, http://www.amenclinics.com/brain-science/spect-image-gallery/spect-atlas/images-of-attention-deficit-disorder-addadhd/#adhd (accessed July 07, 2010).

[iv] Frank Minirth, Paul Meier M.D. and Stephen Arterburn, Miracle Drugs – How They Work And What You Should Know About Them (Nashville: Thomas Nelson, 1996), 53-54.

[v] Ibid. 46-47

[vi] Ibid. 52

The Integration of Psychology, Science and Christian Counseling (Pt. 6)

Yesterday I wrote about SPECT scanners giving us the indisputable proof of the existence of ADD/ADHD. A major proponent of SPECT scans is Dr. Daniel Amen, and he has made great use of this technology.

SPECT stands for Single Photon Emission Computed Tomography, and in some ways, it is similar to MRI, CT and PET scans.[i] The SPECT scanner makes use of gamma imaging to take a series of pictures of the body, in our case the brain. The SPECT scanner images the surface of the brain, as well as the active regions of the brain, and then a computer assembles these views into a 3D image. Tomorrow we will see some actual SPECT images of brains. However, it is important to understand a little more about ADD/ADHD before we do so.

ADD and ADHD are similar in nature, and both seem to be the result of a neural dysfunction in the prefrontal cortex.[ii] The principle difference between the two is that those with ADD are more sedentary, and may sometimes be described as lazy or daydreamers. Conversely, those with ADHD are hyperactive, are constantly on the go and anything but lazy.

About 50% of those with this condition are ADD, and 50% are ADHD. Outside of that singular distinction, both groups have similar symptoms and causes. Among other things, those with ADD/ADHD procrastinate, are disorganized, have poor impulse control, fail to complete projects, are easily distracted, and learning is difficult.

You are right if you said that sounds like a normal child. Most, if not all, children exhibit many of these characteristics precisely because of the slow development of the prefrontal cortex. This may explain why some children diagnosed with ADD/ADHD outgrow it, but for others, it is a lifelong issue. An accurate diagnosis is difficult to make, but someone must make that diagnosis or risk harming the child.[iii]

When parents and teachers try to teach or correct these children, it seems as though the child performs less well, raising suspicion that the child is rebelling at best or simply stupid at worst.[iv]

In his research, Dr Amen found that activity in the prefrontal cortex of those with ADD/ADHD does not increase, as one would expect, when the child begins to focus on a task. Instead, the activity decreases. Viewing the symptoms of ADD/ADHD in light of this dysfunctional prefrontal cortex is logical.

Therefore, the harder this child tries to remember instructions or learn a new task, the less capacity he or she actually has to do so. The ADD/ADHD child has a better response to positive affirmation than to negative frustration, to praise rather than punishment.

Further, many ADD/ADHD sufferers do not feel normal, at least not normal as defined by our Creator.[v] The reduced level of stimulation within the prefrontal cortex leaves them feeling that something is missing.

Without realizing it, he or she may try to increase the level of stimulation in order to feel normal, and several avenues are available for this.

For example, some ADD/ADHD children seem excessively confrontational, and the parents of these children say the child is argumentative, as though he or she is attempting to start a fight. The child, without realizing it, may be attempting to increase the stimulation of the prefrontal cortex through confrontation.

Another way to achieve this is through risk taking behaviors, and as the child gets older, many more of these become available, ranging from rock climbing to premarital sex.[vi]

Acceptable stimulants such as caffeine and nicotine may be a form of self-medication. Conversely, the youth may use illegal stimulants, such as cocaine or meth to accomplish the same goal.

One of the problems of serializing a long piece is the difficulty of breaking it down into bite sized segments without it becoming choppy. Another problem is saying you will discuss something the next day, and then not getting to it.

It is important to know a little more about the effects of ADD/ADHD, but tomorrow I will show you the SPECT pictures that I promised you today (Sorry!).

I’ll see you then.

So, that’s the world as Donnie sees it.

God bless,

Donnie See

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[i] “SPECT.net Your Brain SPECT Resource,” SPECT.net, http://www.spect.net/ (accessed July 07, 2010).

[ii] “Motor and Prefrontal Area,” amenclinics.com, http://www.amenclinics.com/brain-science/cool-brain-science/a-crash-course-in-neuroscience/motor-and-prefrontal-area/ (accessed July 07, 2010).

[iii] Jerrold S. Maxmen and Nicholas G. Ward, Essential Psychopathology and Its Treatment, 2 Sub ed. (New York: W. W. Norton & Company, 1995), 438.

[iv] “Motor and Prefrontal Area,” amenclinics.com, http://www.amenclinics.com/brain-science/cool-brain-science/a-crash-course-in-neuroscience/motor-and-prefrontal-area/ (accessed July 07, 2010).

[v] Ibid.

[vi] Ibid.

The Integration of Psychology, Science and Christian Counseling (Pt. 5)

Yesterday I wrote about the scientific proof regarding the differences in brain function of some people. Researchers are able to see differences in the brains of those with addictions, and those without—those with antisocial personality tendencies, and those without.

But what about ADD/ADHD. Is that merely an excuse for bad behavior or worse, an excuse for bad parenting? Is ADD/ADHD a fact or a fantasy?

Regarding ADD/ADHD, people typically fall into two camps. One camp declares that ineffective parenting has spoiled the child and ADD/ADHD is a myth, while the second camp declares that ADD/ADHD is a proven medical condition requiring medication.

Yet, God did not make everyone alike, and for good reason. God created each of us with different personality types, giving each of us different gifts and talents, so that society could function efficiently as we care for His creation.

Some children are active and easily bored. These children learn best in an educational environment that provides a variety of activities while accommodating his or her personal learning style. As adults, these children typically seek a vocation that is active and varied.

On the other hand, others are happy with a more sedentary lifestyle, and for them, the old tried and true methods of education work well. These children too, will end up in an occupation that matches his or her personality or will wish they had.

Where we as a society fail our children, is by trying to force them all into the same mold, and expect them to respond identically. After all, a leopard cannot change his spots (Jeremiah 13:23).

However, one camp loudly proclaims that the differences we so readily see in children are the result of different personalities or bad parenting, and these differences neither prove nor disprove the existence of ADD/ADHD.

True enough, but if the differences are not the result of these two factors, further investigation is necessary.

Additionally, and perhaps more importantly, if we determine that ADD/ADHD does exist, then we must determine if these children are broken and in need of repair or if they are merely different?

Said another way, we could borrow a phrase from the software industry and ask, is ADD/ADHD a feature or a bug? If it truly exists, what then?

Let us deal with each question separately. First, the Bible does not mention anything similar to ADD/ADHD, but that does not mean that it does not exist. Just as we have seen that fMRI shows differences between brains, another technology, the SPECT scanner, shows us some striking differences in those diagnosed with ADD/ADHD.

Yes, the jury is in, and even a cursory examination of the facts shows that ADD/ADHD is real. I can almost hear every parent with an ADD/ADHD child (and spouse of and ADD/ADHD husband or wife) saying, “I told you so!”

Tomorrow we will take a look at the proof. You may be surprised.

So, that’s the world as Donnie sees it.

God bless,

Donnie See