He who knows others is wise;

He who knows himself is enlightened.

 

-          Lao-tzu

 

I have mental joys and mental health,

Mental friends and mental wealth,

I've a wife that I love and that loves me;

I've all but riches bodily.

 

- William Blake

 

       

Chapter 12

CONCLUSIONS

 

Now, I understand who I am.  I am a successful person with ADD who copes well with the disorder.  The first step in coping with ADD is knowing that you have it.  Twenty years ago, few children were di­ag­nosed with ADD, and, if diag­nosed, their symp­toms were often not treated ef­fectively.  Doctors be­lieved that children outgrew it.  It was not con­sidered an adult disorder.  Today, al­though the methods used to diagnose ADD have been refined, many mental health pro­fessionals are ignorant about the disorder's diag­no­sis and treatment. Insight-ori­ented treatment ap­proaches that analyze unconscious meanings of be­haviors or the symbolism of dreams are not effective in treating it.  What works?  Psy­choeducation about ADD, understanding how one's symptoms affect oth­ers and coaching about coping strategies and alter­native ways of behaving—these are the techniques that should be tried in combina­tion with medication (if needed) and opportunities to strengthen social supports.

My choices of Glasser's Reality Therapy in the '70s, and my later adoption of a Cognitive-Behavioral per­spective, are types of psycho­therapies that seem to me to be more efficacious in treating ADD adults than tradi­tional psy­chotherapeutic methods. Both are com­patible with a coaching approach,[1] which stresses supporting clients in choosing a course of action that will help them achieve their goals and dreams.  Coaching is future oriented and does not look back at the past.

Glasser postulates that people have two basic needs: to experience love and feel esteemed.  Reality Ther­apy helps clients meet their needs by teaching them to make re­sponsible choices.  It is concrete, present-focused and deals with be­havior as a con­scious phe­nomenon. The positive relationship be­tween the therapist and client is the key to success­ful treat­ment.  Glasser invites therapists to be active partici­pants with their clients in the thera­peutic process—to "be real" instead of transference ob­jects.  They are encouraged to praise responsible client be­havior and to share their own struggles with responsi­bility; they are to dis­suade irresponsible be­havior. 

Cognitive-Behavioral Therapy challenges a client's incor­rect thinking process.  The basic premise of this approach is that thoughts about a particular event produce feelings, which in turn lead to behavioral responses.  Thus, faulty per­ceptions and interpreta­tions of an event can result in maladaptive responses.  The therapist helps clients change flawed ways of thinking that cause self-de­feating feelings and poor behavioral choices.

             

* * *

             

I have offered my own case study as an example of the process followed in di­agnosing adult ADD.  The reader is cautioned not to extrapolate or generalize about all people with this disorder based on my life experiences.  My case study is of­fered merely for illustrative purposes only.  The spectrum of behaviors and abilities that peo­ple with ADD exhibit, and the degree of symptom severity they experience, are broad, although all share some common characteristics.

I have successfully coped with ADD because:

·        Five resiliency factors were present in my life (see Garbarino, 1999):

1.    I was the only child of sup­portive par­ents who provided consistent limits and struc­ture—who set expectations for achieve­ment me;

2.    My IQ is above average;

3.    My achievements created good self-esteem;

4.    As a child, I received social support from others outside the family includ­ing school teachers and church members;

5.    I had the ability to blend masculine and feminine characteristics.

·        I was af­forded educa­tional opportunities that developed my inter­ests and skills.

·        As an adult, I have a wife and chil­dren who love and sup­port me despite my faults.

             

* * *

             

I am the last male heir in my bloodline to bear the Miller surname.  While the surname may not live on through my daughters, the Miller ADD gene pool does.  Since my di­agnosis with the disorder, one of my daughters has been diagnosed with ADD/-H, and one of my second cousins is suspected of having ADD/+H.  My heirs, and others with ADD genetic inheritance, can benefit, I hope, from the in­sights about ADD contained in this book.

             

The End.

 

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