Ausgabe 12/23

ADHD – a challenge for a cooperation of Waldorf education and anthroposophic medicine

Meron Barak

The disorder is in a consistently rise since 2000 and according to various reports, the rate of diagnosed children and youth ranges from 9% to 15% in Western countries. This disorder appears in all countries of the world and the ratio between girls and boys ranges from 1:2 to 1:3 (more in boys) - and tends towards 1:3 - more in pre-school boys. Historically, the disorder has undergone many transformations in the understanding of  it, and therefore it can be seen as a modern, culture-dependent and "young" phenomena that is not yet sufficiently understood.

The disorder manifests itself in three main clusters of symptoms:

1. attention deficit disorder 2. Impulsive behavior 3. Involuntary movements. In the previous psychiatric diagnosis manual (DSM-R4) it was customary to divide the disorder into three subtypes:

 1. Attention deficit disorder, without hyperactivity and impulsivity (Attention Deficit Disorder = ADD).

 2. A disorder, only with hyperactivity and impulsivity (Hyperactive Impulsive Disorder).

3. attention deficit disorder of the mixed type, attention deficit disorder, impulsivity and hyperactivity, which is also the most common of the three and accounts for approximately 70% of cases (attention deficit disorder = ADHD).

The factors which responsible for the disorder which are known today are mainly genetic (in approximately 70% of cases), which cause to impaired  activity of dopamine and other neurotransmitters in the brain (in the frontal cortex, in the basal ganglia and cerebellum), depression during pregnancy, drinking alcohol during pregnancy ,using cell phone during pregnancy, multiple ultrasound examinations during pregnancy, head injuries, birth distress during the childbirth and exposure to screens.

 Attention deficit disorder has multiple accompanying disorders and in order of frequency they are: autism, learning disabilities, sensory dysregulation disorder (in 50% of children), anxiety disorder (in 50-70% of children), depression, post-traumatic disorder, conduct disorder, tic disorder, epilepsy. The inner experience of the child suffering from attention disorder is characterized by a poor short-term memory (therefore he will have difficulty learning from the mistakes he makes, he will have a tendency to repeat the same mistakes over and over again), he will have difficulty internalizing what is taught in the class, his notebook will usually be sparse or empty and he will often feel disconnected from the learning and social happenings in the classroom. In many cases, and especially if he is not diagnosed, he will receive repeated punishments from his educators and parents and as a result he will develop poor self-confidence, continuous frustration because he strives and tries, but continues to fail again and again. From there the path to the experience of "I am not successful", "I am rejected" and "I am not loved" is short and he will adopt - according to his constitution - the behavior and the image of the "clown" or "thug" in order to survive socially. In such situation he often adopts an internal position according to which "the world is an object that I have to fight with and struggle with" and can also develop chronic anger towards those around him and sometimes even a violent behavior (especially if he has a choleric temperament).

If the child does not get an effective treatment, and especially if he also suffers from sensory dysregulation disorder and/or anxiety, he may grow up to use during his adolescence psychoactive substances which will be used as a self-medication.

Focused on the three systems of the child diagnosed with ADHD, it is possible to see how the activity of the nerve – sense system and the activity of the metabolic– limb system are not coherent and not coordinated: the child will receive an  impression and his legs will generally move frantically and without a coherent connection to the impression he received (as opposed to the healthy process of imitation  where the three systems works in coherence).

The combination of the toxic stress that most children are exposed today as a result of educational approaches that encourage achievement and competitiveness, the massive exposure to electronic media that brings with it both powerful psychological content and powerful sensory impressions, causes the child to be emotionally overwhelmed in the rhythmical system which does not allow his ego to organize his world of feelings and digest to the end  the impressions and the psychological content which he absorbed. As a result, the ego which is responsible for the creation of inhibitions[1] in the three systems finds itself in the periphery instead of in the midline of its body: in the nerve - sense system - excessive distraction is created as a result of an inability to inhibit background impressions (the attention disorder), in the rhythmical system - restlessness and an inability to inhibit immediate gratification (impulsivity) and in the metabolic – limb system the limbs appear frantic and meaningless limb movements (hyperactivity) as a result of the inability to inhibit involuntary movements. In addition to what was described above, the massive exposure to electronic media causes the child to withdraw from the phenomena of the natural world and the physical world (in this context it is interesting to notice to  Steiner's reference on the karmic aspect of this phenomenon[2]). The intensive use of headphones and smartphones during motor activity (such as walking) which is so popular today, intensifies the problem and causes a dissociation of the 'ego' activity between the nerve - sense system and the metabolic limb system[3]. The understanding that this dissociation occurs, can also leads to the insight that activities that create an integration between the sensory and motor activities (such as: singing a canon in a choir, riding horses, climbing a wall, surfing waves and juggling) may provide an adequate response to this dissociative process.

A rational treatment for ADHD/ADD should be individually adjusted according to the constitution, temperament and diagnosis of the sensitivity of one or more of the systems among the three systems in the child (for example, a child with a choleric temperament and a particularly sensitive metabolic system will receive different treatment than an introverted child with a melancholic temperament and a sensitive nervous system). In order that the treatment of the disorder to be effective, it must include reference to all areas of the child's life. On the nutritional level, it is important to ensure a breakfast with a minimum of sugars and the elimination of preservatives and food dyes, with much root vegetables, ensuring the quality and duration of sleep according to age, individual activities with the father and mother separately and preferably outside the home (in order to encourage trust and to empower the self-confidence), limiting screen time and at the same time  encouraging craft and manual activities, leisure time activities that strengthen the integration between the motor activity and the nervous activity, like: playing an musical instrument, parental guidance with the aim of reducing the level of tension in the family and finding ways to empower the child.

In the class, it is important that the educator combines the healing gesture alongside the educational gesture in the meeting with the child, making a special effort to strengthen trust with the child, positive reinforcements and very emphasized, singing in a choir with two or more voices or canon singing (an important practice that strengthens the inhibitions and the integration between the sensory system and the motor system). The main therapies that have been found to be effective are the rhythmical massage which softens and 'opens' the life forces in the nervous and sensory system and enable the ego to find itself in the 'middle', curative eurythmy and music therapy, which also include practical exercises that strengthen the integration between the nervous system and the metabolic system. There are a  variety of anthroposophic and homeopathic medicines which  strengthen the presence of the ego in one or more of the three systems (and helps the child to strengthen his inhibitions), and in the case where the child is treated with stimulants there are some medicaments which can minimize their side effects.

Recently published research findings testify to the co-morbidity of ADHD and allergic[4] and autoimmune diseases are currently creating a new paradigm in the field of neuroscience - a paradigm that leads to the understanding that the healing of neurological disorders such as ADHD depends on a balanced interaction between the nervous system and the metabolic system, and thus actually bringing to light Steiner's approach on the interaction between the nervous sense system - and the metabolic limb system[5].

Since one of Steiner's intentions to develop anthroposophy was to merge a human and spiritual cultural impulse into the cultural fabric in which we live, it would be right to relate to the disorder also in the light of the growing digital culture , which is responsible for a significant part of the suffering children which are diagnosed with the ADHD/ADD.

Therefore, the challenge to create deep and effective ways of treatment for ADHD with the cooperation of anthroposophic medicine and  anthroposophic education is laid today for us as a therapists and educators.

 


[1] Inhibitions are one of the activities of the ego in the soul and in the body

[2] Rudolf Steiner, lecture from March 1st,1924, GA 235

[3] Rudolf Steiner, 'The invisible man within us', lecture from february,11th,1923

[4] Association of Food Allergy, Respiratory Allergy, and Skin Allergy with Attention Deficit/Hyperactivity Disorder among Children, Nutrients, 2022 Jan 21;14(3):474.

[5] Rudolf Steiner, 'curative education', lecture from June 30th,1924, Rudolf Steiner press.

Kommentare

Es sind noch keine Kommentare vorhanden.

Kommentar hinzufügen

0 / 1000

Vielen Dank für Ihren Kommentar. Dieser wird nach Prüfung durch die Administrator:innen freigeschaltet.