Q: My therapist says that she thinks my husband is borderline narcissistic, not just ADD. I'm wondering what that is and how I might be able to tell the difference?

A from Dr. Hallowell: It is very common for an adult who has ADD to seem like a narcissist. The essence of narcissism is the inability to give or receive love. The naricssist becomes very needy, because he has little or no inner store of self-regard, and also quick to put others down, as any hint of a put-down from someone else sends him into a rage. He often performs at a high level professionally, as he is always trying to impress others and gather their admiration. But their admiration does little to nourish him, as he is a bottomless pit of unmet needs. He is unable to "metabolize" and make use of true love from others, just as he is unable to give true love.

ADD is quite a different story. People with ADD are very able to love and receive love. However, because their attention can be so easily diverted, they can seem as if they are lost in the self-absorbed state of the narcissist. And, because their tolerance of frustration is low (due to repeated failures), they can be quick to anger, like the narcissist. However, the two conditions are utterly different. If your husband is primarily ADD, rather than primarily a narcissist, he ought to be able to respond to a therapist who really "gets" ADD. He ought to feel a great sense of relief at being understood at last. He is likely seeking that kind of understanding, then when he doesn't get it, he likely disparages the person (therapist, or you, or whomever) who fails to understand him in the way he so desperately needs to be understood.

Q: I've heard that connection is important for kids, but my middle schooler seems to have real trouble connecting at school. Do you have any ideas for him?

A: Start by asking your child about kids he likes in his classes and then encourage connection with those peers at home. A small but favorite group is fine, and will give your child a group he can hang out with while at school. Also, extra-curricular activities can help. Is there an after school sports program, or music, art, theater, community service or language club in which your child can get involved? Maybe math or robotics? Rocket club? If those things don't exist, is there a way to start some sort of club of interest? One student here created a news web page for the school as a special project, then had to spend lots of time interviewing people to get their input.

How about a rock band? Sometimes a good rock band can actually be the band for the school musical, or can play for a school party or dance.

As for teachers - that can be a bit harder, but a friendly email from a parent to a favorite teacher, or a conference, can encourage a respected teacher to pay just a bit more special attention to your child (in or out of class). Sports coaches are often good mentors. Some parents volunteer to help teams and coaches in some way. Showing your own interest can encourage a teen to make the effort to become more connected.

Q: My husband has ADD, as do my step- children who visit frequently. When they come over they turn the house upside down and destroy things, making me and my own (non-ADD) kids feel used and discarded. What are some positive things I can do to help my children, my step-children, my husband and my sanity?!

A: You and your husband will need to join forces to solve this one, so first thing you need to do is sit down and think about what rules make sense. Your step-children can do better, but they may need to use different strategies than you are used to.

You may want to delineate certain areas of the house as okay to mess up (like their bedroom spaces) and others that must stay neat (like common spaces). If they forget to pick up the common spaces, consider a rule that says they can't leave the house to do anything until it's been picked up.

Include your step-kids in developing the rules. That way they'll be more invested in finding solutions that work. If you just dictate what happens, you'll be less likely to gain their compliance. Make sure they know you'll help them devise strategies that work for them, but you won't do their work for them.

Rebecca Shafir of the Hallowell Center has these ideas to help you stay healthy and happy over the holidays:

1. Schedule time just for yourself. This might include quiet time to go for a walk, meditate, do yoga, practice deep breathing; be with nature or read that book you've been putting off.
2. Reduce exposure to stressful events over which you have no control. Limit TV watching, talk radio, the Internet, and newspapers. Consider getting a good book on tape for car rides.
3. Take back control of what you eat. Reduce high fat and sugar consumption. Limit fat-laden foods at holiday parties. Resist the urge to linger around the table in the bakery department filled with tempting pastries, candy and cookies. Avoid fast food when out on shopping trips.
4. Give yourself permission to say "no" so you don't overbook. Only join in those holiday get-togethers that you either must go to or that you really want to go to.
5. Avoid over-spending and adding to your financial worries. Set a budget for gifts, food and decorations. Consider whether or not all expenditures are necessary.
6. Choose to spend time with people who make you feel good, people you enjoy and those who make you laugh.
7. Focus on optimism, expressing gratefulness and appreciation, and looking for the funny side of events.
8. Practice being fully present; to enjoy the now with gusto. This means paring away distractions such as text messaging.
9. Release excess stress by vigorous aerobic activity (doctor permitting). Try brisk walking or running, join a health club or a martial arts class.
10. Make sleep a priority. It's essential for keeping your stress hormones in check and your weight from creeping up. In fact, lack of sleep can affect hormones so much that your body may actually store extra fat when stressed. Create a bedtime routine that helps you unwind. And don't be afraid to take a power nap during the day if you need one.

The transition to college can be so difficult for teens with learning disabilities and ADHD that Dr. Hallowell wrote an entire chapter on the subject in "Delivered from Distraction". So many of these teens falter (in fact, fail) in their first year away that he titled the chapter "Major Danger Alert: College and ADD".

An educational consultant can help smooth this transition in two ways. They are knowledgeable about typical college programs and so know how to best navigate them. In addition, they can help your child learn to be a self-advocate. It is a time when students need to move away from the parental and teacher support they received in high school towards being in charge of themselves. A good educational consultant will guide a student through this transition with none of the potential for hanging on too long.

While it is an excellent idea to use an educational consultant for that important transition into college, there are things that parents can do in high school to help smooth the way. Renee Goldberg, Ed. D, is an educational consultant with the Hallowell Center. She provides these ideas for parents interested in helping their teen prepare for college:

• Make sure your college bound students understands his disability and can talk about how it affects him in a clear way. He must understand his strengths, weaknesses, and what services he will need in order to clearly ask for these services.
• Documentation must be current, which means usually no more than three years old.
• Build the expectation that your child will continue accommodations in college. Often students view college as an opportunity to move away from academic accommodations they may have had in high school. Unfortunately, this often results in poor grades, which then follow them for the remainder of their academic career. Instead, parents should outline with their student what accommodations they could seek before the beginning of freshman year.
• Work overtly on life skills. Organizing, doing laundry, finding car keys and eating right are just some of the things that you should help your child learn to do independently of you before leaving home. In addition, your child may not think of taking his medications regularly as a life skill, but it is one. Consider setting up a routine that includes a marked weekly container (each day has a different compartment) and making him responsible for filling it and taking his medication at the right time.
• Explore technology that may assist your child, for example word recognition software for kids who have difficulty writing out their ideas.

Educational consultants can help college students remotely, so you don't need to find one from your immediate geography. They can also help elementary and secondary school students obtain accommodations and utilize them effectively. If you would like more information about how an educational consultant might help your family, please call Renee or Marvin Goldberg at the Sudbury Hallowell Center (978) 287-0810.

Dr. Hallowell has two new podcasts up on the web available to all. The first covers succeeding as an adult with ADHD., the second covers special issues for those with ADHD around the holidays. To find these podcasts or to sign up to receive notification of future podcasts, go to this link.

New ADHD Moms Facebook Community: McNeil Pediatrics is sponsoring a new community called "ADHD Moms: A Place for Moms of Children with ADHD" Dr. Hallowell and other experts are contributing content to this site, and is is turning into a good place for moms to share ideas and learn more about ADHD. Patricia Quinn, MD and Debbie Phelps (Michael's mom) are some who are listed as leaders of this group.

Dr. Hallowell was in the NY Times twice this month - once in an article about whether or not Michael Phelps is a good role model for kids with ADHD (???!!) and the other about multi-tasking. The link to the multitasking article is here, while we talk more about the ADD/Phelps article at the end of the newsletter. If you have thoughts about these articles, we would love to hear them.

ADHD Meds Don't Cause Genetic Damage in Children: A new study released in the Journal of the American Academy of Child and Adolescent Psychiatry suggests that therapeutic usage of common ADHD medications does not result in genetic damage in children who take them as prescribed. The study was funded by the NIH and more details can be found at this link.

New Marriage Tips: Starting in January, we will be sending out weekly tips about making your marriage the best it can be. Everything from inspirational quotes to ideas you can use right away. To register, click on the "Update Profile/Email Address" link in blue at the very bottom of this newsletter and add a check in the new box for the marriage tips.

SuperParenting for ADHD has gone to the presses. If you are looking for a great holiday gift this season, consider pre-ordering Dr. Hallowell's latest book, and giving the recipient a print-out of our o ne page Gift Certificate. They'll find out you're thinking about them and that they'll get the book on the first day available (likely the first week of January). The manuscript, which crossed my desk months ago, was incredible. Dr. Hallowell talks about everything from the practical (ways to work with teachers, new ways to identify and think about your child's specific strengths) to the downright inspirational (the role that parental love plays in the success of children with ADHD).

Don't miss this one! Or der it now for parents, grandparents and others who are invested in the success of your ADHD child.

Dr. Hallowell will be speaking around the country on book tour in the first two months of the year but exact locations are not yet available. We will send them out as a special announcement as soon as the publisher finalizes the events.

Dr. Hallowell will also be speaking at the following locations (open to the public):
Arlington, MA - January 20, 2009
Sudbury, MA - March 3
Chicago, IL - March 23
Waltham, MA - March 26

For more information, go to this link.

SAVE THE DATE AND REGISTER EARLY APRIL 11 - Dr. Hallowell and Christine Duvivier will give a seminar entitled "Unwrap Your Teen's Gifts". This is an interactive workshop designed to help you build skills to increase your family's happiness. Enrollment is limited, and the first 50 registrants will obtain a discounted price. For complete information, go to this link.

To find out about groups happening at the New York Hallowell Center, please call 212-799-7777. Current groups include those for parents, women only, young adults and children (social skills).

For information about upcoming groups at the Hallowell Center in Sudbury, MA, please call 978-287-0810.

Dr. Hallowell was recently interviewed for an article in the New York Times about whether Michael Phelps was a good role model for kids with ADHD. Dr. Hallowell, of course, is a strong proponent that the current deficit-based model for ADHD is harmful and results in low self-esteem for children who are "treated" this way.

Other experts in the article disagree with Hallowell, which infuriated at least one NY Times reader, who copied us on the letter to the editor below. We liked his response to well that we thought we would end with it here:

"With friends like Natalie Knochenhauer and Dr. Koplewicz, we who 'have' 'ADHD" need no enemies whatsoever.

As one who had a diagnosis of his own adhd at age 65 and found the process and the news to be one of the most positive and helpful events of his life, I say that only Dr. Hallowell has it right. And, yes, I have read his books as well as a lot more on the subject. If one listens to the adhd white man's burden sort of comments such as offered by the other two you quote, you would have to say: poor fools with adhd, they haven't a snowman's chance in hell and they will be buried alive by our school system.

With near 100th percentile inattentiveness and hyperactivity, I have managed to get a Ph. D., have business executive positions, run my own consulting firm since 1986, continue research and begin writing on World War Two, Nazi Germany and the Examples of the European Union, raise and train German Shepherds, perform on stage (amateur -- light opera), blah, blah, blah. Some school failure, eh?

And ADHD, while posing some challenges, did not stop me and was not an absolute impediment in school -- quite clearly. Yes, I don't do well with subjects that require one either literally or essentially to learn by adding data to some conclusion. But I do excellently at anything that requires blitz fast insight and the ability to see the connections between the data points that everyone else is lost in. Yes, I have learned that it is dangerous to start things because unless I am very stimulated, they tend to dissipate and then evaporate over time. That is the result of people having told me as a kid and as a teen just exactly the sort of minimizing claptrap that Knochenhauer and Koplewicz offer up. I can only imagine how their own kids and clients feel.

Yes, in school I was a daydreamer. So what? That is a sin only in a system that is built on the engineering model. Last time I looked, most of us are not engineers. Having studied and worked with how people learn (leadership and organization development since 1974), there are some points that folks ought to know:

• Every learning preference has both + and - sides; the trick is to learn to compensate for the - and build on the + --for EVERYONE;
• ADHD just looks like a deficit, but is anything but that. That's because, first, we like authority and have let medical people define it and they think in terms of deficits in health. Second, most folks are linear learners: line up the data, digest each one and then regurgitate the combined glob. We 'others' however learn circularly: we are always scanning and combine what we find from the scans into insights that are strange to the data eaters. Third, our society has trouble with kids who are energetic, different than the norm. We like mass similarity, not individual fireworks. Those of us with this so-called adhd trait, when we are at rest in others' eyes, are still scanning, still attending to everything that we see, feel, hear, touch, smell, intuit. We have a surplus of attention, not a deficit. When we find stimulation (outside ourselves, in the subject matter, in other people, wherever it may be), we rocket into laser-like concentration on pulling it all together into the whole we see which is untied by the golden thread which we have seen running through the data while scanning.
• Everyone has a choice: live your life on its terms or become a victim. We do exceedingly well these days in cultivating victim thinking. We manifestly do not need the added impetus in that direction being offered by Knochenhauer and others of her misguided mindset. What we need is balance and acceptance, warts and all.

Ends do not tie off in this world for anyone, American popular mythology notwithstanding. Nobody is made of whole cloth. We with that gift of such a holisitic, organic, energized learning inclination (maybe we should call it HOELI rather than ADHD) have our crosses to bear, just like Engineers, Doctors, Lawyers, Hod Carriers, etc., ad infinitum. The ADHD wannabee rescuers like Knochenhauer (in German her name aptly means: Bone Chopper) and Koplewicz fit well the description that the character Dick Deadeye has for the Captain in Gilbert and Sullivan's HMS Pinafore: " 'e means well, but 'e don't know!" And at a much more significant level, their inability to see the gifts of HOELI means that that have failed to learn the basic spiritual truth of life in this universe: God does not make junk.

- Gregory H. Forsythe, Ph. D.

email: morlov@hallowellconnections.com

phone: 508-545-2250 Hallowell Connections or 978-287-0810 Hallowell Center (medical)

web: http://www.drhallowell.com