A social relational critique of the biomedical definition and treatment of ADHD; ethical practical and political implications

Attention deficit hyperactivity disorder (ADHD), its existence and treatment, is a contentious matter. The dominant view in medicine considers that ADHD is a psychiatric disorder. My position is to challenge this from a social relational orientation. I explore here a critique of the psychiatric disease model of causation and treatment, particularly the use of medication. A series of prejudices based on a political and social constructionist orientation are offered to address the ethics, politics and practice implications of the practitioner critical of the biomedical model of diagnosis and treatment especially the use of medication. This device is employed in order to invite critical reflection and further debate in a field dominated by the medical and genetic arguments in support of ADHD as a psychiatric disease. The implications of more open debate are explored, together with directions for more politically and ethically informed practice with children and their families.     

Chapter 1: Healing the Healer’s Art: A Letter to My Professors

ABSTRACT

This article seeks to articulate a problem I’ve noticed in the field of psychoanalysis—namely, the problem of closed-mindedness and reluctance to tolerate the coexistence of contradictory truths. I believe this problem is inhibiting the field from reaching its full potential to heal and continue to discover effective methods of healing. I call upon psychoanalysts and students of psychoanalysis to confront their own biases and attempt to open their minds to the possibility that all schools of psychoanalysis (i.e., Freudian, Kleinian, Kohutian, Jungian, etc.), as contradictory as their teachings and methods may seem, teach valid truths and valuable insights, the knowledge of which can only help us to become better healers. Essentially, the more we open our minds and welcome ideas from all subgenres of psychoanalysis, the more tools we have in our toolbox, and the better we will be able to treat our patients. If we insist that one school of psychoanalysis is superior, and reject the validity of differing viewpoints—if we are caught up in pride and the politics of our field, we are ultimately doing ourselves, our colleagues, and our patients a disservice.     

A series of n-of-1 studies examining the interrelationships between social cognitive theory constructs and physical activity behaviour within individuals

Objectives: Research supports the ability of social cognitive theory (SCT) to explain physical activity (PA) behaviour, but most studies have examined this theory between individuals in large group studies. The aim of the present study was to examine the interrelationships between SCT constructs and PA within individuals of varying activity levels.

Design: Correlational n-of-1 studies.

Methods: Six adults aged 29–65 with varying levels of PA provided daily measures of PA, and completed probe measures over a four-week period of SCT constructs (e.g. barrier self-efficacy, goal setting, planning, social support, outcome expectations, perceived barriers, enjoyment). Data were analysed using cross-correlational time series analysis.

Results: Cross-correlation analysis showed that at least one SCT construct was associated with PA in five participants, although no individual had the same pattern of associations across the study. On some occasions, SCT constructs predicted subsequent PA, but at other times, PA engagement caused a subsequent change in the SCT construct. There were also examples of PA and SCT constructs being concurrently associated.

Conclusions: SCT factors are associated with variations in PA behaviour, but the cause and effect of these relationships within individuals is complex.     

INHALING PASSIONS: ART, SEX AND SCENT

In the last decade or so, a number of artists have strategically integrated olfactory elements into their artwork to address the emotional, physiological and cultural complexities of eroticism. By reassessing and converting the supposed abnormality of scents into something ubiquitous, offering critiques of and alternatives to the cultural mandate of the deodorized body, and expanding the range and depth of the olfactory imaginaire, these artists have posited a dynamic, pivotal relationship between scent and sexuality.