Skilled at the Art of Falling Apart

Phil Mollon’s new book “The Disintegrating Self: Psychotherapy of Adult ADHD, Autistic Spectrum, and Somato-psychic Disorders” has some interesting things to say about ADHD and autism and the role therapy has in helping deal with these states caused by neurobiological factors.Traditionally psychotherapy has dealt with these conditions poorly through a lack of understanding of their causes.

You don’t have to look far to see the damage brought about by well meaning interventions which actually compound the shame many people feel when their behaviour doesn’t conform to conventional expectations. It is therefore reassuring and refreshing to read Phil Mollon’s explanation of the neuroscience that confirms a neurobiological core to difficulties that can impact the core of a person’s way of functioning in the world. The circuitry of the frontal lobes in the brain do not work properly in a person with ADHD for example and this means that inhibitory functions of the brain, regarding impulses, are not working properly and this can have a profound impact. Many people are made to feel that it is their fault and this simply isn’t the case.

Mollon is clear that being the partner, parent or in the family of a person with these difficulties is almost impossible at times and certainly a struggle. It helped to hear that the most important task for family members is to survive these difficulties and develop coping mechanisms. Moreover, this is also what the person suffering needs the most. His view is that people who have borderline personality disorder or are bipolar, have ADHD in 70% of cases.

Many adults share features of ADHD and autism and their impaired frontal lobe functions can mean increased vulnerability to panic, anxiety and depression. The level of disintegration people experience can be significant. Finding a level of acceptance of these difficulties has profound implications for long term well being. It’s important to know that an acceptance of the biological aspects to these conditions does not preclude a way of finding help for disturbing feelings using traditional psychotherapy. However, it is important that there is an understanding of the neuro biology of what the individual is dealing with.