Use “ADHD” To Seize This Galileo Moment
Measure what is measurable and make measurable what is not so.
Galileo Galilei ~1640
Centuries ago Galileo changed the way we think about systematic observations, and that consequence became a scientific Renaissance. His work upset a few believers.
A similar, remarkably parochial disdain exists today with ADHD diagnosis & medications, and it’s going to take a serious change in thinking to bring about a change for ADHD medical practice.
Let’s consult for a moment with Galileo.
The pervasive, unmentionable problem: appearances define the current diagnostic standard of care. The resultant treatment thinking provides limited maps for ADHD mind travel. Too often whimsy and outdated belief systems drive patient care. Treatment failure, or it’s associated outcome, treatment inadequacy, provides cause for concern with an associated call for improved answers based on science with critical thinking.
Without science, common sense is conjecture.
The Challenge | The Lesson Opportunity
Collectively we stand on the frontier of an inevitable Mind Renaissance – if we can move forward from Neo-Freudian labels to data-driven, measured mind-solutions that address biological brain complexity beyond simple diagnostic assumptions. “ADHD” diagnostic inadequacy begs that crucial next question about the entire diagnostic process for mind science – and that’s not an overstatement – more in a moment.
Remember this history. Galileo introduced advanced measurement tools [including the telescope] to a fundamental observational science based on experience with no tools. His telescopic measurements challenged a globally accepted and incorrect solar conclusion that ultimately changed belief systems based on centuries of previous superficial observations.
Copernican mathematics preceded his visual affirmations but existed in reality beyond ordinary conversation.
The sun does ‘look like’ it rotates around the earth. But when the earth and sun were measured accurately around 1616 with his telescopically advanced technology, Galileo confirmed the Copernicus measurements, the now well known Heliocentric Reality. His discovery contrasted markedly with emotionally held beliefs based upon Geocentric Appearances for thousands of years. Data matters. At that time, absent science, the Church ruled belief systems – with the threat of death.
Why Consider “ADHD” Labels?
Common beliefs about ADHD treatment failures arise from a combination of public dissatisfaction and professional diagnostic-appearance protocols. Professional medication rules target those accepted and limited diagnostic [and treatment] perspectives. Much like the world’s assumptions about the sun before Galileo introduced the telescope, critical biomedical information about ADHD diagnosis and treatment isn’t only missing, more often than not it’s overtly disdained.
As a consequence, without a scientific foundation in the midst of popular belief, we often don’t use easily available technology, we don’t test for biomedically helpful answers, and too many prefer to remain in denial, to metaphorically kill the biomedical technology Galileo-Mind Messengers – the innovators, the contemporary evidence experts. As a result, the public sentiment often takes a firm destructive stand against using ADHD medications for adequate medical treatment, and often with good reason if our current traditional models prove inaccurate.
What Is The Problem?
Quite reasonably you may then ask: “What is the problem with ADHD medications? Why are so many people so negative, or hesitant, when stimulant medications can prove remarkably useful for many?”
The accurate answer: Vagary, born from appearance criteria, drives the current inadequate ADHD medical standard of medical care. It bears repeating: This standard of care operates on beliefs about those appearances, not about biomedical, functional data.
The consequences for that secondary disbelief, confirmed after the fact of primary inaccuracy, drive a force of entropic change for global societies. This inadequate-data diagnostic and treatment perspective reaches far beyond “ADHD” medications for children. If we don’t use mind -assessment tools at our disposal based upon those old, inaccurate beliefs, it’s a global problem.
Three Outstanding Issues Bear Evidence-Review
1. Labels: Current Labels for “ADHD” Overlook Medical Reality
Currently, ADHD diagnosis and treatment protocols overlook critical information about the biomedical complexity of ADHD. “ADHD” labels (Hyperactive, Inattentive and Combined) describe behavior, but they do not address measurable medical challenges that affect brain function. Molecular and cellular activities as a result, for example, of immunity issues, are relevant, measurable complications that compromise balanced brain function and impair working memory. Executive function suffers.
For a more accurate example, despite the existence of world literature confirming the link between damaged brain functioning and immunity issues – such as gluten and casein sensitivity – remain astonishingly controversial. Remarkable, but true.
2. Function: Many Omit Brain and Body Function When Considering Treatment
Thousands who do struggle with “ADHD challenges” meet the current criteria for diagnosis, then attempt treatment and suffer from side effects of medications. Treatment will improve if drug treatment includes measuring how brain function and working memory affect executive functioning. For example, the symptom of Hyperactivity may be corrected by medication, but underlying executive functioning may nevertheless remain markedly impaired. But Executive Function is the invisible metaphoric mother of ADHD behavioral symptoms.
Medication impediments always involve biomedically measurable, somatic details.
Remember: Function requires the Reality of Time. Labels, on the other hand, are reductionistic, categorical and static. Humans hate labels for these reasons and have for centuries.
Once you label me you negate me.
~ Soren Kierkegaard
Labels encourage the less informed to overlook the complexity of the combination of brain and biomedical functions. Inattention may seem to improve, but avoidance and procrastination, (more directly associated with brain function) may nevertheless remain off the treatment radar – now diagnostically considered as Avoidant Personality Disorders[!].
Measurements that address deeper, more utilitarian medical imbalances such as genetic metabolic imbalances or specific medication duration of effectiveness [DOE], provide valuable information for both physicians and patients – and ultimately minimize inaccurate medication practices.
3. Cognition — The Essential “ADHD” Problem – Is Overlooked and Denied as Significant
Balanced cognition – reacting appropriately to make timely adjustments to ever-changing Reality – distinguishes the human thinking process from that of cows, cats, and even well-trained hunting dogs.
Intelligence is the ability to adapt to change.
~ Stephen Hawking
Paradoxically, ADHD is now a behavioral diagnosis, observable from the outside. Cognitive self-observation, an inside measure, is not reported or considered for diagnostic accuracy. The inevitable result: the current system of “ADHD” diagnosis and treatment overlooks the very objective of therapy: cognitive activity, executive function. This unacceptable consequence perpetuates vertical medical management systems, encourages treatment failure, and suggests the belief that anyone is a diagnostic expert from the use of such superficial protocols. – Thus the pervasive stigma that drives parents to avoid appropriate treatment.
Ultimately, balanced cognition, with informed mutual awareness [between medical professionals and patients], will soon become the treatment objective when managing “ADHD”/Executive Function. Why? Using cognition for elemental treatment criteria simply works better.
A most concerning by-product: If patients themselves don’t comprehend the reality of objective, cognitive targets, then participation with medical care becomes illusory – a disappointing game of guesswork.
The Behavioral Paradox – The Process of Metacognition Denial
Because diagnosis is “hyper-focused” on more obvious behavioral issues, the subtlety of internally experienced cognitive impairment remains overlooked. It is noteworthy that the current DSM code does not consider cognition to be impaired unless one suffers from dementia or brain trauma. With the current Diagnostic Statistical [DSM] system protocols, with it’s inattention to cognitive markers, the entire medical treatment system in place for thousands, completely misses essential treatment objectives.
For example, labels inherently overlook the issue of the timing and sequence of working memory –- how people manage their reality through thinking, acting and remembering on a timeline. This internal cognitive disability can cause individuals to act without thinking, repeatedly think without acting, or entirely avoid reality by avoiding thinking or acting in time.
He’s out of it.
You heard this expression when you were a kid: “He’s out of it.” The underlying meaning of that ubiquitous phrase: he’s out of time with changing reality and doesn’t recognize that timing problem. As you read this, you will immediately recall this phenomenon.
The new standard: associated thinking challenges should become part of standard clinical evaluations to serve as measures to identify what is happening cognitively inside of each person’s psychological reality.
ADHD & Metacognition: A New Way of Thinking
Metacognition is a new, more accurate, more functionally useful word from the ADHD literature that connects biomedical reality, brain function, diagnoses, and reality-based, customized treatment strategies. Metacognition involves thinking about thinking – diagnostic observations of the thinking process delineated in these videos.
When we think about thinking or the functional process of thinking in various real-life circumstances, treatment targets do improve. As Galileo’s telescope changed the way we measured solar observations, we can now remeasure the cognitive mind. The process of looking for a different, improved set of answers enhances metacognitive understanding of ADHD.
We must now walk with Galileo by asking the following questions;
- Is the person thinking too much – disorganized? Key question.
- Are they acting without thinking?
- Are they avoiding segments of reality?
A “yes” to any of the above may indicate a de-synchronization in brain functioning and working memory – and can encourage improved ways of thinking that can change the course of treatment. Executive function, dealing with changing reality remains the primary target. If your timing is off, you won’t look intelligent because you can’t perform syncrhonistically with the changing universe.
All these issues are detailed more comprehensively in New ADHD Medication Rules. It’s a book about synchronizing brain science with common sense.
Diagnostic & Medication Treatment Corrections
Applying metacognition, or thinking more carefully about the biomedical process of thinking, encourages several important improvements in both targets and process. These links will take you to Video Examples.
- See this brief 3:22 min Introduction to the Video Playlists.
- ADHD Medication Diagnostic Overview [in these video reference points] – targets must include executive function imbalances – brain function is the new target, beyond appearances.
- Medication management must include an understanding of metabolic and biomedical processes that modify metabolic rates – e.g. genetics, immunity, drug interactions, food, sleep, duration of effectiveness, co-existing psychiatric conditions.
- Medical awareness of changes within the Therapeutic Window of each medication must be customized using brain function measures for every patient at every medication check.
- Recognition and correction of nutritional and endocrine imbalances that impede medication effectiveness is imperative.
- Essential, long overdue changes with medication dosing strategies then arise as the Reality-driven standard of care.
Those who currently suffer from executive function challenges will directly benefit from this new thinking.
Fresh neuroscience evidence changes thinking. Details matter.
Galileo would be pleased that you agree with him.
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I especially liked this Podcast because it provided a wealth of valuable brain health research and tips in an approachable, easy-to-listen-to format. The rapport between the Guest Speaker (Dr. Braun) and Host (Dr. Parker) was evident, and I hope to hear another Podcast with this Guest Speaker!
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