Enough is Enough Series, #5 – The ADHD Fiction is Exposed. The French Have Got this one Right.

Robert Berezin, MD
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The time has come that the ADHD fiction qualifies for my ‘Enough is Enough’ series. It’s time to stop addressing pharmaceutical psychiatry on its own terms: its fraudulent and corrupt ‘science,’ its spurious ‘evidence base,’ and its imaginary psychiatric ‘diseases.’ I’m done with this. Let’s get real. (See – “Bad Science Creates false and Dangerous Beliefs.”)

Marilyn Wedge, Ph.D., in her wonderful article published in Psychology Today online on March 8, 2012 — “Why French Kids Don’t Have ADHD” — shows that that the discussion is over. The basic fact is that ADHD doesn’t exist in France, where the incidence is less then 0.5% of school-aged children.

In contrast, almost 20% of boys in the US have been diagnosed with ADHD. One in five boys – a 37% increase since 2003. Perhaps boys in the US contracted some contagion which is spreading exponentially — but, fortunately, the boys in France have been spared. Or, the inconvenient truth is that the whole thing is a fiction. If so-called ADHD doesn’t exist in France how can it be a brain disease? Yes, there can be symptoms of hyperactivity and concentration; but it is created by psychosocial causes, not biological ones, and the treatments should be appropriate to the cause.

The number one responsibility of all societies is to raise their children well. Ideally, there should be intact families, and an intact village. Yes, it takes a village to raise a child. Children must be raised with boundaries and love. To provide the best holding environment for our children has to be our parental imperative. We need to encompass the full scope and grasp of the forces of life as accurately as possible to provide the necessary guidance to our children every step of the way until adulthood. Life is difficult, and its exigencies must be appreciated. This is very hard work.

In France, as Marilyn Wedge points out, “From the time their children are born, French parents provide them with a firm cadre — the word means “frame” or “structure.” Children are not allowed, for example, to snack whenever they want. Mealtimes are at four specific times of the day. French children learn to wait patiently for meals, rather than eating snack foods whenever they feel like it. French babies, too, are expected to conform to limits set by parents and not by their crying selves. French parents let their babies “cry it out” (for no more than a few minutes of course) if they are not sleeping through the night at the age of four months… French parents have a different philosophy of discipline. Consistently enforced limits, in the French view, make children feel safe and secure. Clear limits, they believe, actually make a child feel happier and safer — something that is congruent with my own experience as both a therapist and a parent. Finally, French parents believe that hearing the word “no” rescues children from the “tyranny of their own desires.”

With variations of course, this is the correct model of raising children. It is a good balance of boundaries and love. This is how children “learn self-control early in their lives.” The French correctly understand that the causes of children’s symptoms are psychosocial. When symptoms of so-called ADHD exist, where children are out of control, the treatment is psychotherapy and family counseling. The full implication of this is that there is no need to consider some genetic biological disease that doesn’t exist.

In contrast to France, the intactness of our culture has dangerously deteriorated. The divorce rate in the United States is 53%. Single parents have more than tripled as a share of American households since 1960. Today, one third of American children – a total of 15 million – are being raised without a father. Nearly five million more children live without a mother.

These are just the broad outlines. With all the difficulties of blended families, alcoholism, drug addiction, child abuse, child sexual abuse, emotional abuse, parental sickness and deaths, physical disease and disability of both parents and children, emotional difficulties of parents; i.e. trauma of all kinds. It is well documented that these conditions leave children sadly prone to serious problems in life.

Yes, certain children can spin out of control behaviorally or mentally. This does not mean there is a biological disease. Never mind that no biological basis has ever been found. The real explanation is certain kids with an active temperament (in combination with other aspects of temperament) may be prone to getting out of control, and being difficult to handle. This kind of symptomatic expression is exacerbated when they are subject to trauma. (See – “No, There is No Such Thing as ADHD.”) Yes it is additionally true that some of these active kids are sensitive to certain food additives, artificial colors and preservatives, so it is simple common sense to avoid such things. This does not suggest there is a brain disease. Active children are not a disease, many of these kids of this temperament become great athletes and leaders.

Other kids with different temperaments will develop different symptoms in relation to trauma from difficult family lives — depression, anxiety, phobias, obsessions, compulsions, psychoses. These symptoms reflect different temperamental orientations of the child. These other symptoms likewise are not biological diseases. (See — “The Nature-Nurture Question.”)

I should point out that such symptoms don’t necessarily reflect parental abuse. There are many inadvertent causes — as well as life tragedy causes, as well as hidden characterological causes — in well-meaning parents. This is not about parental blaming, but about the well-being of our children.

I repeat. The evidence is in. You can’t have it both ways. The French situation with so-called ADHD shows conclusively that it is psychosocial, and not a brain disease. In fact all psychiatric symptoms in children are trauma-based, and not some biological-neurological disorder of the brain. American Psychiatry has gone off the deep end. Once damage has been done, it is hard work to recover our best selves. We shouldn’t be drugging our children. Treating children with family therapy and psychotherapy is not only the real treatment, but it is inspiring and exciting to see patients thrive and fulfill their authenticity and their ability to love. This puts them in the very best position to raise their own children in a wholesome manner themselves.

Family therapy, behavioral interventions, boundaries, and intelligent school interventions are what make such a difference in the well-being of children who are out of control. Parents would be far better off to watch a few episodes of “Super Nanny” on television to see how boundaries and love can transform these out-of-control kids. This is such a contrast to submitting to psychiatric ADHD experts, who preach that children are biologically brain-damaged. American Psychiatrists today drug our children with — of all things — amphetamines, and their cousins. It is unconscionable. (I won’t go into what a destructive drug amphetamines are at this time.) It has to stop.

We are in deep trouble as a society. We have lost our way with raising our children. We have to re-establish a clear pathway to do our #1 one job right. It is very hard to raise kids. You cannot love well in the absence of the provision of respectful boundaries. As a society we have fallen way short of this. I believe most people mean well and need a responsible and responsive place to turn when problems develop. I believe raising our children well should be the number one priority of our society.

Psychiatry has abdicated its responsibilities to be a constructive force. Instead of operating out of wisdom, it has become a profession of drug pushers, supported by bad science, powerful drug companies, and destructively misguided psychiatrists and their apologists. As a psychiatrist, I am beyond troubled. We, as a society, have to focus on the children, and recover from the harm done by bad psychiatry that has lost its way. The French have got this one right.

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76 COMMENTS

  1. Bravo! Wholeheartedly agree. As a psychotherapist, I have NEVER seen a supposed case of “ADHD” or child behavior issues without also finding trauma, attachment trauma, parents with high levels of anxiety or just inappropriate and permissive parenting. We must stop “diagnosing,” drugging and stigmatizing these children when the parents must be addressed as a very likely cause of this problem. Parents do not want to hear this “blame” but where else should this blame be placed? And, actually, it is the parents’ lack of ability to handle blame that is another source of the problem.

    • My goodness. What a hideous, angry, oversimplified, anti-parent generalization. I am aghast but not surprised to see such a negative, anti-parent, blanket statement come from a ‘mental health’ professional.

      I invite interested MIA readers to read the body of work by Ross W. Greene, PhD, originally of ‘The Explosive Child’, who did NOT vilify parents and families but sought instead to genuinely understand why some children experience extreme behavioural issues. He succeeded and his work is a testament to what a psych professional can do with a genuinely open, inquisitive, unbiased mind.

      http://www.livesinthebalance.org/

      Liz Sydney

      • Common sense would tell you child rearing can be a bug. I’m wondering if some of this isn’t single mom syndrome. Some families, you know, lack the strong figure to do the disciplining. I’m not saying a woman can’t managing the disciplining angle, I’m just saying sometimes it helps to have both parents.

        “The Explosive Child” sounds suspiciously like intermittent explosive disorder. Yeah, sure, it can be tough being a kid. The DSM 5 just picked up a temper tantrum disorder, by the way, but we kind of expect that from children, don’t we? As for childish parent disorder, there’s always been a little of that going around, too, hasn’t there?

        The basic point is, even if there was something to this “behavioral issue” business, giving the kid speed is not the way to deal with it. Duh. Giving adults speed is kind of problematic in itself. A “behavioral issue” is not a “headache”, and speed is not sugared aspirin. We shouldn’t be giving cocaine class drugs to children, in some cases only two or three years of age.

        • Hi Frank,

          ‘The Explosive Child’ is the title of Greene’s first book. He apparently came to regret the title, I think in part because it got wedded to psychiatry’s made-up, fantasy DSM ‘disease’ diagnosis of that ridiculous Intermittent Explosive Disorder (IED), which is as factually based, useful, and explanatory a diagnosis as ‘schizophrenia’ and such. That is to say that IED is another ridiculous label, this time attached to children who exhibit behaviour that adults don’t like.

          And, no, single motherhood is not a syndrome. There is no one ‘type’ of child produced by single parents, and two parents don’t necessarily raise their kids any better or worse than one parent.

          • True enough, search the DSM-5, and there is no single mother disorder within, and the same holds true, in the world, for ADHD despite the DSM.

            Even with the DSM, there was no ADHD officially until the DSM-III came out (1980), and officially it’s still what do we do with children who are not born students (a problem with all children really). Then it becomes pick up a few learning skills or a psychiatric label and a drug, we value higher education so much.

            “Behavioral issues” skirts the fact that children are not mini-adults, and here we are, with these labels, expecting them to be just that–mini-adults. However hard you try, there is going to be this essential difference. Now when we’re talking about grown children, the labeling and drugging might not be such a big issue, but, hey, we’re not going after the oxymoron here, are we?

      • Harper should not use the word “blame” in my opinion. But, parents are often the cause of their children’s distress in large part. Who else would be neglecting and abusing the thousands of people who report such childhood trauma along with receiving mental illness labels? If not mostly parents.

        But identifying parents as a causative agent is not the same as blaming them. As John Read says, abusive and inadequate parents are subject to severe pressures of their own, including past internalized abuse and neglect from their own parents (the grandparents), lack of knowledge about how to effectively parent, poverty, work stress, addictions, and so on. We can see then that parents do not mistreat children mostly because they are evil or “bad”, but because they have been through difficult experiences themselves and are not able, at the time that they mistreat their children, to be the best parent that they could be.

        • It is also true that parents’ inability to take responsibility – again, a better word than blame – is a significant part of the problem.

          This is seen most prominently in the many thousands of NAMI parents who cling to the illusion that a mysterious brain disease is ruining their children, while the child sits at home, drugged up, unable to have relationships, for year after year.

          Meanwhile, via this fantasy the parent maintains the denial of the possibility that their inadequate caretaking might have figured quite prominently in their offspring becoming so inadequately troubled.

    • I should also have noted that any psych professional who has “never seen” child behaviour issues without also “finding” pathological parents is unable to see beyond his/her own profound biases and agendas. Woe be the children in the “care” of such professionals.

      And let’s remember that the labels, diagnoses, and drugs were created by the ‘mental health’ professionals, not by parents. No, parents are not to blame here.

      That comment – evidently from a psychotherapist – blames, shames, and pathologizes parents in a single sweep. Isn’t this exactly the opposite of the kind of dialogue that MIA is trying to promote?

      Liz Sydney

        • Hi firewoman,

          Thanks. I’m unconvinced that ‘ADHD’ exists. I agree that MIA isn’t great on children’s issues. Post authors rarely take a firm stand against drugging even though the evidence is clear. Also, there is a lot of parent-blaming on a lot of comments, which isn’t helpful. I think individuals have a right to their voice on that. I do take issue, however, when a psych professional blames parents offhand, because to do so is deeply troubling on many levels.

          • Thanks. I agree people certainly have the right to talk about parents causing behavioral issues in children (and agree parents are often at the root of child problems, so it is something that clearly IS important to talk about). What bothers me is the hyperbole that EVERY case of “ADHD” is due to parents, and if you try to present alternate viewpoints that suggest there are kids who may truly have these issues independent of parents/environment, some posters think it is okay to personally attack you, as I have experienced here. Just wish this issue in particular would get treated with some more balance (and some people would show a little more respect).

          • Even when parents are heavily involved, they are never the only cause. Many factors in today’s world put kids under great stress, including peers, teachers, the media, and so on. But, it is realistic to say that parents are very important both for kids who grow up to be emotionally well and often, but not always and to varying degrees, for kids who grow up to be seriously emotionally troubled.

          • It may exist all right, but as a syndrome, not as an independent entity, the same way schizophrenia and depression do. They aren’t independent entities, either, but collections of signs and symptoms brought out by a probable variety of agents. If psychiatrists were real doctors, they’d know the identities of some of these instigators and be able to treat them properly, rather than medicating their patients into somnolence.

      • Actually I didn’t pick up any “shaming” (though there may be a bias towards the nuclear family as a social model). It should be remembered in any case that much trauma that some describe as “caused” by family authority figures (not talking about overt abuse) is better described as oppressive cultural “norms” being mediated by family figures as part of the “upbringing” they are expected to impose on children on behalf of “society.”

  2. I witnessed an interesting ‘ADHD scene’ about a year ago in London.

    I was in the waiting room of a dental surgery and from behind the door I could hear the dentist talking to a patient about money.
    At the same time sitting next to me was a tired mother with a very naughty little boy.

    Next thing the dentist came out with a scowl on his face and he saw the boy. He went straight over to him and started chatting and joking and the child changed immediately.

    After about two minutes the dentist went back into his consulting room and the boy remained happy and pleasant.

  3. I am extremely moved by this plea for sorely needed respect for the well-being of our kids. Indeed, this has been a long time coming. We are talking about generational abuse, paid forward as second nature now. Kids eventually grow up to be adults, and this seems to have been happening on a pretty large scale for a while now, which could explain why our leadership is so in question now, as the world as we’ve known it appears to be crumbling.

    I imagine there are a lot of traumatized people running the world now, traumatized right out of their hearts, no moral compass. I think it’s evident when you look at the world, and the horrible struggles and suffering that are purely human-inspired, and by no means natural, at least not to my mind.

    You bring up a variety of abuses which are epidemic in American society. Hardly a day goes by now where I’m not reading about parents killing their child, or forgetting about them in a hot car, or throwing them in a closet and starving them, or stuffing them in freezers, or, most recently, overdosing in their toddlers presence, both parents at the same time. I believe they were in their 50’s, not young’ns.

    And that’s the extreme stuff. Subtle abuse has become a way of life, I’m sad to say. Vulnerable people pay for it, in the end, and children are the most vulnerable of all. At the same time, they are quite powerful, by nature. I think that has interesting relevance to how they are treated in certain environments.

    I think it’s all programming, false beliefs based on highly oppressive messages from all over which we internalize to our detriment–media, etc. I believe it’s a matter of aligning with our true nature, and leaving behind the need to comply with social norms as the bar for sanity–family, community, whatever in this vein, to fit in and be “accepted.” That’s actually crazy-making, square peg in round hole.

    Kids who are rejected, punished, or shamed by their families for being who they are will have quite a chip on their shoulder as adults, until they recognize their own true merits, as distinct from the family programming. I believe that’s healable, those negative messages, but they can be hard thought habits to break if there has been a lot of repetition of this same over the years, from not recognizing this post trauma.

    I think it’s one reason psychiatry can fall under the gun, given that it re-creates the exact same trauma of alienation. Marginalized first, by family, then reinforced by psychiatry, then embedded in society. All that very dangerous stigma for not fitting into the family, or simply being made to feel that way, gaslighted. Causes chronic internal torture, until people can only numb themselves, for the sake of survival.

    I practically gasped when I read “American Psychiatry has gone off the deep end.” That is truth–a hard truth, perhaps, given the paradoxical implication and tragic irony, but it is poetic in resonance, because it is exactly right. “Off the deep end” says it all. I applaud this courageous assessment of your own field, Dr. B. That takes guts and true insight.

    As far as families and diverse societies go, the family thing is hard, people tend to fervently resist looking at themselves, and their role in dysfunction. That can lead to violence in many ways, vindication, etc. It can be scary to call out abuse, and where healing becomes courageous, because we learn to trust post betrayal.

    Wonderful stuff, as always Dr. B. This gets me thinking about all sorts of things, in a forward-moving and clarifying way. You’re on it as usual!

  4. My family and I are French citizens. I roll my eyes at this trope (that I see repeatedly in the American press) that idealizes French children and French parenting. It is laudable that the French have avoided the ADHD trap (if in fact they have), but the real French family is as three-dimensionally good and bad as every other family on Earth.

    The French rate of psychotropic drug use is alarming (one study cited one in three adults), for example. The French eat a lot of junk food, smoke a lot, drink to excess, and schools are quite brutal for children by other Western standards. French society as a whole tends to be extremely rigid in its views, and French families are absolutely not warmer or more supportive than any other group. And, today, the French family is more culturally diverse than ever, making any generalizations impossible. Also, the French are as happy to pop ‘pills for ills’ as any other group where BigPharma has an important presence.

    Maybe it would be more useful and helpful to identify groups of people in any nation who resist the long arm of conventional medicine and ‘mental health’ treatment, and who support their children, and go from there. Cultural stereotypes just aren’t useful today.

    Liz Sydney

    • Just wanted to let you know that I am with you Liz in both your response above to Harper West above, and this response here. What is happening in terms of the dx and medication of children with ADHD is truly horrifying. However I find that Dr. Berezin’s posts that explaind what he believes to be the causes of different conditions that get labelled as psychosis, scizophrenia, ADHD etc., (while containing a lot of good stuff), are full of simplifications and over generalizations. Why his posts are disturbing to me is that he is a professional – a psychiatrist- who presents his theories as if they are ‘facts’. Our community has suffered enough from the `over confidence’ (to put it politely) of psychiatrists who claim to know things to be true that they can not possibly know. I think it is sad as I think he could have so much to offer if he approach these topics with more humility and openness. I actually think MIA should put disclaimers or do something on posts (from professionals in positions of power) when they present theories as facts. In my opinion posts like these (and responses like Harper West’s response) can really undermine the credibility of MIA.

      Mr. Berezin could

      • ” In my opinion posts like these (and responses like Harper West’s response) can really undermine the credibility of MIA.”

        I totally agree. The answers will need to come from science — real, honest science, or knowledge for the sake of knowledge — not industry science which is what we have right now, and not dogma, or individual bias or prejudice.

        • These disorders, and there are so many of them, in the DSM are voted into existence by psychiatrists in committee. Nobody had to vote pneumonia into existence. It’s there whether you like it or not. What kind of science are you talking about? The science of imaginary diseases? Every time I hear somebody saying something like, “Are you getting oppositional?” I have to wince. Where is the science in “conduct disorder”? If all criminals are “sick”, huh, I guess there must be some kind of “science” there. Maybe not. I just don’t think there is any way to get real science out of imaginary diseases, try as you might. You can go to great lengths to try to prove that some of these disorders exist, but science isn’t about proving theory, science is about disproving theory. Given bias, that is, closed minds, I don’t see a lot of fruitful science in research being done for the sake of getting FDA approval for the latest pharmaceutical product. There isn’t a lot of credibility in pharmaceutical research and development. Certainly, some of the phonier disorder labels have been developed for the sake of the drug, and not the other way around.

          • “What kind of science are you talking about? The science of imaginary diseases?”

            When I say “science,” I mean real science…the pursuit of knowledge for its own sake where hypotheses are tested and validated by objective metrix. For example, multiple sclerosis used to be known as “hysterical paralysis” until science, real science, established it to be an autoimmune condition. Ditto for lupus. Science has also provided effective non-drug treatments for SAD (annually recurring depression)….e.g., light and vitamin D. Thanks to REAL science, we understand and are able to treat autoimmune encephalitis, or inflammation of the NMDA Receptors which involves severe psychiatric disturbances such as psychosis and catatonia. Science allows doctors who care to learn to understand the etiology of conditions such as NMDA Receptors Encephalitis and treat them effectively instead of labeling someone with schizophrenia and bombarding them with drugs or psychoanalysis that insists that it was all the fault of bad parents. Science, unfortunately moves slowly, very slowly. Even more unfortunately, science is often opposed simply because it challenges some people’s preferred narratives or guild interests. When someone says “ADHD invariably involves parenting issues and such,” he is basically telling us that his toolbox is rather empty. In contrast, Dr. Perlmutter has provided effective non-drug interventions for children with ADHD and autism (among others), and he does not think much of the parent-blaming enterprises.

            Not that parenting should ever been taken off the table. Dr. Berezin’s article raises important questions that need to be investigated and answered. I really would like to know what it means that there is no or less ADHD in France. But what does it really mean? Is it because they do not recognize the symptoms and just voted it out of existence? That’s no more an answer than voting something into existence to push drugs. Are French parents better at parenting resulting in fewer ADHD symptoms? Let’s find out. But pending that, we know this…France and the European Union are way ahead of the US on environmental matters. The number of toxic substances banned in the U.S. is negligible compared to what is banned in the European Union. It is inconceivable that living in a toxic soup does not play a role. More need for real science —- environmental/ecological medicine — to provide answers.

            My comments speak for themselves. Nothing that I never posted can be legitimately characterized as an endorsement of imaginary illnesses. That is strawman argumentation at its worst, regrettably much too common on MIA, to the detriment of its credibility.

          • I disagree. Especially as all it takes to make a “disease” is a vote. Hypochondria, for instance, the disease of thinking one has a disease evolved into somatoform disorder. Thing is, “diseases” are not thoughts. MS is a physiological disorder. Hysterical paralysis, on the other hand, can mean a number of things above and beyond any suggestion of having MS. Syphilis is no longer accounted a mental disorder. Why? We know it is a sexually transmitted disease. I don’t believe anybody knows of any “mental disorders” that are sexually transmitted. I would question whether SAD was any more a “disease” than ADHD. The pressure of proof, by the way, is not on me. Although pneumonia may be a disease, I don’t think this automatically assures the “disease” status of every other form of discomfort, in other words, I don’t think we’ve got a straw man argument. I think in one instance, you’ve got disease, and in the other, you haven’t. Simple enough.

          • “I disagree. Especially as all it takes to make a “disease” is a vote.”

            No it does not. Only psychiatry votes diseases into existence; medicine or real science do not. We know MS to be an autoimmune condition because, after many years, science proved it to be so. Until that happened, the pseudoscience of psychiatry labeled it a psychiatric disturbance (“hysterical paralysis”). As we learn more, we are discovering that numerous physical factors cause psychiatric symptoms.

            What exactly do you mean when you say “The pressure of proof, by the way, is not on me.” If you are asserting that a condition has a psychological rather than physical cause, the burden of proof is indeed on you. In the Justina Pelletier case, the psychiatrists tried to psychiatrize a condition that was physical (mitochondrial illness) because in their considered opinion, mitochondrial illness was bunk or crock . All this argues for real science which is my point.

          • I’d say there is more pseudo-science being employed in the field than real science, at least, according to your accounting. They are catching more people by far with psychiatric so-called disorders than physiological disorders, in the realm of psychiatry anyway. Physiological disorder is the rarity, in psychiatry. unless of course, one has spent enough time in psychiatric treatment, and then it’s a certainty. I’d say you are kind of making an argument, because some people do have physical conditions, for pseudo-science instead.

          • “I’d say you are kind of making an argument, because some people do have physical conditions, for pseudo-science instead.”

            Sorry Frank, I cannot be any clearer…there are only so many ways to say that 2 plus 2 equal 4. I do not dispute that true science is rare and works very slowly, but true science has to be the goal. And, as should be self-evident, I am not arguing for psychiatric drugs which are, indeed, the worst environmental toxin. The focus of the psychiatry reform movement should be to insist on honest/true science, to expose and fight industry corruption; it should not be to foster non-scientific dogma and myth-making. The DSM 3 made everything worse, but fictitious nonsense existed way before, such as the hysterical paralysis label that, amazingly, you seem to think has some validity. The fact that a pro-science argument should be controversial on a site that has “SCIENCE” as its credo is beyond mind-boggling.

          • I don’t think psychiatry can be scientific. First, I don’t think psychiatry is dealing with real disease entities. Second, most of the research being done today is propelled by bias of one form or another.

            I never thought hysterical paralysis had any validity. You started out by pointing out that MS was sometimes confused with hysterical paralysis. I was pointing out that, unlike hysterical paralysis, or any so called “mental illness”, MS was an actual physical illness.

            Psychiatry all too often presumes any damage the result of disease rather than psychiatric drugs. Problem, psychiatry also presumes disease. I don’t think that is the kind of thing you can easily untangle, and part of the problem stems from scientism, the thinking that science has the solution for all our problems.

    • I pretty much agree, though it is important to note that SOME kids diagnosed with “ADHD” are suffering from trauma and poor parenting, even if that’s hard for the parents to hear. But my observation is that the majority of “ADHD” diagnoses are a result of unrealistic expectations of kids by institutions like public and private schools. And the idea that letting kids “cry it out” as babies causes decreased “ADHD” diagnosis rates is absurd in the extreme. I think the only real point is that French parents appear less likely to be willing to excuse a child’s behavior based on the idea of “bad brain chemistry.” I do think that’s a healthier viewpoint, as it empowers the child, parents and teachers to actually work on making improvements in behavior. Additionally, French kids, as I recall, don’t go to school until later, which is associated with much lower ADHD rates.

  5. We shouldn’t be labeling and drugging children. In this matter, as in others, they are still innocent of their parent’s offenses. If the French are reluctant to drug children, that is the way it should be. We’re talking about drugs. For recreational use, or otherwise, toxic chemicals.

    Psychiatrists, the pharmaceutical industry, and school officials are behind this little epidemic of child abuse. One good point about your post is that it puts the emphasis back on child rearing again. No drug is an effective substitute for a parent. Leaving the kid with the chemical nanny should be a no no. There is a kind of abuse that that chemical nanny is applying that the home security system won’t pick up.

  6. Also agree with Liz. I have stopped commenting here, in part, because of some of of these gross overgeneralizations and attacks that usually ensue if you say think that ADHD has any construct validity (even if you don’t think of it as a disorder that should be remedied with drugs). I think the contributions of people like Steve McCrea on this topic should be given more spotlight- would give MIA far more credibility than these hyperbolic pieces. Enough is enough (of this hypocrisy that MIA promotes half of the time)

    • I take exception to your statement that MIA promotes hypocrisy half the time. ADHD does not have any construct validity. I spent 12 years in public education, went to college, and taught for 15 years and not once did I ever see a student that I would label with this insidious excuse to drug children. It didn’t even exist until the 1980’s when psychiatrists with ties to the drug companies voted it into existence for the wonderful DSM.

      • “I take exception to your statement that MIA promotes hypocrisy half the time.”

        Seriously? We’re swimming in hypocrisy, duplicity, false disclosures, illusion, holograms, etc, from start to finish–at the core of the system all the way to the outer layers of activism, and everything in between. This is the exact problem in all of this, why nothing gets done, fixed, or followed through on, in any way that authentically supports change. And especially, it is why people don’t heal hanging around any of this.

        When we keep staring at the shadows, we not only give them power, we will, in addition, only create more of them for ourselves, until it eventually becomes our entire reality. That needn’t be the case, but it does require integrity to heal and grow past that, whatever one’s personal opinion about anything might be.

      • ” It didn’t even exist until the 1980’s when psychiatrists with ties to the drug companies voted it into existence for the wonderful DSM.”

        Much has happened since the 1980s, including the diminishing nutrient content of our food and increased toxicity of our environment. The exploding rates of autism are strongly indicative of environmental etiology. The same may be behind “ADHD.” By that I mean “ADHD” the symptoms, not the label, or DSM, or drugging.

        • Yeah. Drug company profits have soared. I would suggest that any toxicity to the environment doesn’t compare with the toxicity of psychiatric drugs used in standard practice. We’ve actually been doing a few things, limiting nitrogen emissions for one thing, that have been good environmentally, however cleaning up the air and water isn’t going to clean up those chemicals people shouldn’t be ingesting in the first place. Much has happened since 1980, sure, this drug companies need to profit has sent the “mental illness” rate skyrocketing. Otherwise, things are pretty much the same.

          • What utter tosh. Lead was taken out of petrol (gas) some decades ago in the UK, precisely because it was linked to `hyperactivity` in children. Lead is toxic to the brain – and mercury is 1,000 times more toxic than lead – and it’s used in vaccines and in amalgam fillings in teeth.

            Whilst I am very much in support of MiA’s campaigning journalism, you have to be careful of hyperbole. There are those who are not `mentally ill` because they’ve been parked on psychotropic drugs for years, or had an adverse reaction to these drugs, or suffered childhood trauma – some people appear to be `mentally ill` because of real physical illness that is simply not being investigated or treated.

            Don’t undermine a perfectly good campaign by making false claims. Even the WHO and UN publish reports that recognise the damage that environmental toxins cause to the bodies and brains of children.

          • Some of the biggest toxins in the environment are psychiatric drugs. I’m not saying there aren’t toxins out there. There have been, there are, and there will be. I’m just saying that psychiatric drugs are pretty potent, and you can’t take a pill several times a day, for years at a time, and not expect consequences. These consequences are not things psychiatrists educate their patients about. They are responsible, in some respects, for the negative outcomes that are so much the buzz.

          • I can’t leave a reply next to your latest reply, but you still fail to retract your statement:-

            `I would suggest that any toxicity to the environment doesn’t compare with the toxicity of psychiatric drugs used in standard practice. `

            As someone who has a great deal of knowledge about environmental toxins, I can tell you that you are deeply ignorant if you think that any psychiatric drug is close to being as toxic as mercury or PCBs. You are talking nonsense. There is real science showing the neurological damage that continues to be done by these toxins. Read a few reports – such as the TENDR review.

          • I certainly wouldn’t encourage anybody to ingest lead or mercury, nor for that matter, lithium.

            There is also documented evidence that gray and white matter loss attributed to “illness” is actually the result of psychiatric drug use.

            Eating mercury in fish is one thing, and it is one thing I’m not encouraging, however, it is probably less toxic, in the long run, than taking psychiatric drugs multiple times a day over an indefinite and extended period of time.

  7. Robert, yes the French think about some things differently.

    Though I do not agree with this book, it is still very interesting, and to a point it is quite entertaining:

    https://www.amazon.com/Bringing-Up-B%C3%A9b%C3%A9-Discovers-Parenting-ebook/dp/B00MNNAODK/ref=dp_kinw_strp_1

    She talks about letting babies learn to connect their sleep cycles together. And what this comes down to is “Le Pause”.

    You can read it for yourself. I feel that by US and UK standards, most French, or at least Parisians, would be diagnosed as Autistic. They just have a certain degree of detachment in how they conduct themselves. I feel that it is even noticeable in their writings.

    But Robert, though I strongly oppose the concept of ADHD, as well as the concept of Autism / Asperger’s, I also strongly object to your article and to the writing of this Marilyn Wedge.

    What you and she are both doing is lionizing The Middle-Class Family, that which is already held up as the norm and the ideal. And this is where the problem starts, because The Middle-Class Family is not only allowed to abuse children, it is expected to. It is just that most people don’t call this abuse, they call it Good Parenting.

    Fortunately some children will somehow escape, or there will be some kind or another of mitigating circumstances.

    If we really cared about children and did not want our whole society to believe that they and everyone else has an innate defect, then we would organize things completely differently, so that the power of parents over children is severely constrained.

    Selling pedagogy manuals and child development books is how The Middle-Class Family started. First it was Rousseau’s Emile, then Moritz Schreber and the Sit Up Straight Machine.

    https://en.wikipedia.org/wiki/Moritz_Schreber

    https://www.amazon.com/Soul-Murder-Persecution-Morton-Schatzman/dp/0394481488/ref=sr_1_3?s=books&ie=UTF8&qid=1474064602&sr=1-3&keywords=soul+murder

    In their day these were seen as good, and of course For the Good of the Child.

    But always they serve the parents.

    Some people don’t understand that this would be so, with the new pedagogy manuals which talk about things like empathy, attachment, nurturing, and communications skills.

    But these are all profoundly manipulative. Consider Rousseau.

    http://www.nospank.net/fyog10.htm#needs

    There was a great video interview with this Mayim Bialik. Remember, the Middle-Class has children in order to provide legitimated adult identities for the parents, and at the core of this are the pedagogy manuals and the child development theories.

    But they have taken the video down. But even the title her book, that should be enough to prove my point, that the Middle-Class Family exploits children:

    https://www.amazon.com/Beyond-Sling-Real-Life-Confident-Attachment/dp/B00DEKLSHW/ref=sr_1_3?ie=UTF8&qid=1474065559&sr=8-3&keywords=Mayim+Bialik

    Children cannot just be, they have to measure up to Bialik’s standards of public presentation. Otherwise what? Who knows. Most middle-class child abuse involves doctors.

    So if they aren’t being taken to the doctor because they have ADHD, they’ll be getting taken to the doctor because otherwise the parents might be accused of being bad parents because the kids look like they have ADHD. Talking about “parenting”, only makes the problem worse.

    No one can ever stand with children, and still be talking about “parenting”.

    So I am opposed to what you are trying to say in your article.

    Nomadic

  8. Is this website acceptable only if you agree? Or is it a forum for discussion? I don’t know if the French are better parents than others, I don’t know whether ADHD is or isn’t CAUSED by poor parenting, trauma in the family or in society in general but I do question a society where partnerships formed to do that parenting are discarded in over 50% of cases, where people run from taking responsibility for their own well-being to grab at spurious pseudoscience marketing, where schoolteachers recommend drugs to keep bored, restless children quiet instead of examining the education process itself. I am concerned that my grandchildren need a parent to go to bed with them so they will sleep, that they dictate their menu at mealtimes, that any correction of bad behaviour constitutes oppression. I worry that little children are offered choices they are not competent to make, leaving them anxious and afraid because they don’t feel safe. And I hear these worries from other grandparents all the time. My children, as I did before them, went to bed and went to sleep, ate what was put in front of them, and had boundaries within which they could make choices but nonetheless the major decisions were made by the grownups to keep the kids safe.
    As for trauma, it doesn’t have to even be seen by others but that doesn’t mean it isn’t there and destructive. As a child, my parents threatened to divorce over the entire period of my late childhood and adolescence. For that entire period I was afraid, I was NOT SAFE. I agonised about how I would choose which parent, would they both hate me, would I stay near my friends etc etc. And my parents weren’t abusive or violent and didn’t actually do it. Most didn’t then, they had a responsibility and they lived with it, worked it through and lived happily enough together for the rest of their long lives. The instant gratification that somehow we are `entitled’ to be `happy’, to face no pain, has led to a society that looks for the easy way and this has led to a pill for everything including childhood.
    I did well in school though was often distracted, restless, talkative and, at times, dreamy. In fact under today’s regime it’s likely I would have been considered to have ADHD and been medicated. I was in fact a `gifted’ kid with a love of sport and activity, in a huge class (normal then) of 50 children and I was bored.
    I believe we, as parents DON’T always get it right, we DO, despite meaning well, sometimes harm our kids, teachers DO too often opt for the easy way, education systems DON’T take enough care of what kids really need, but service the status quo because it’s easy – and we MUST take responsibility for it. Denial won’t do! There is no shame in getting something wrong, there is enormous shame in continuing be wrong when we know, and there is enormous shame in acting like an ostrich and allowing harm to continue, to protect our self esteem over the welfare of the next generation.
    That our society uses drugs instead of discipline for a condition that was manufactured by a group of people who agreed on a market for selling dangerous drugs is to me an indication of the disintegration of that society.

  9. Hi Robert,

    I really enjoyed your article. I think it could be argued that culture is THE great cohesive force in humanity. It certainly creates a sense of belonging. My father was a person who was born in a single homogenous culture, and I think there were advantages.

    One great advantage is the ‘common sense’ that a group with a common history and outlook has. Without boundless hopes for a new and better reality and with its own history as its guide, such a group sees through absurd ‘new’ claims about human beings. Our new and obviously manufactured culture is being foisted on us from all sorts of PC directions, including psychiatry. What was true last year is now not and what wasn’t now is. And people’s focus is shifted away from what is always required of them as humans. This is actually producing an increased sense of unreality and insecurity.

    Liz, you seem to revel in the idea of this sort of cultural disappearance. I suspect that you, yourself, are not French. Nor really anything else. And your loss, I think, is the loss most of us do now face – to our own detriment.

  10. This article with video tells a rich story. The kid is fine, there was no intention to harm, and I wouldn’t even call this necessarily abusive or traumatic, although perhaps a case might be made for that, I don’t know. And the witnesses did seem traumatized, from their reactions of horror and disbelief.

    However, I do believe that it’s certainly child endangerment, as did the witnesses, obviously. Overall, I do know it illustrates how stupid adults can be regarding their children, and bring them at least close to harm, if not fully, including fatal–without even realizing it. This is what concerns me: “without even realizing it.”

    I believe a strong case could be made here that, even though she is thinking and believing that something is fun and innocent and because it is desired by the child, it is ok. Somewhere, something needs to shift with the mother. She needs to wake up to something, to grow in awareness, to own something about herself. Is there any doubt? And I imagine she will not understand this. I would hope to be wrong about this, but from all accounts, she will not get it. Two of her kids are already part of the system, in foster care.

    No, this is not everyone, I’m not making a generalization, I’m talking about this one mother, in this story. Still, I imagine she is not the only one who cannot understand when she, and perhaps other adults around, are, in fact, putting their own kids in harm’s way, and say something to the effect that this mother said to onlookers–“Mind your own business! It’s my kid and I’ll do what I want with them! I know how to raise my own kid!” That is a conundrum, and leaves everyone around them feeling totally powerless, which, I think, would be the point. WAKE UP CALL!

    https://www.yahoo.com/news/m/8b471c4a-dd4a-3978-a7d7-b7ae21e4b0d0/ss_charges-filed-after-shocking.html

  11. Psychiatry has “overlooked” the central fact of human nature and core driver of human behaviour: that they are conscious organisms. Hence their behaviour cannot be understood without reference to what they are conscious of. A rather serious oversight for the putative science of the mind. Akin to a doctor addressing a fracture by vague references to mysterious chemical imbalances and genetic abnormalities while dismissing as irrelevant the patient’s account that they fell from a tree.

    The remarkable Italian educator Maria Montessori (1870–1952), who developed the Montessori method of child education wrote, “An interesting piece of work, freely chosen, which has the virtue of inducing concentration rather than fatigue, adds to the child’s energies and mental capacities, and leads him to self-mastery … As soon as children find something that interests them they lose their instability and learn to concentrate.”

    Montessori children often have to be accelerated entering the public school system. Visitors to Montessori classrooms are often astonished, even alarmed by their quiet as children assiduously concentrate on the tasks provided by their learning materials – without suasion from teachers. The focus and discipline come from within.

    Filmmaker Stanley Kubrick noted how important interest is in learning and gave the example of a boy doing poorly in school but has memorized every score of every game of his favourite baseball team for the past fifty years.

    Though only part of the problem-answer in an essay titled ‘A Teachin’ Deficit Disorder’ James J. Campbell, M.D. argues that many cases of ADD and ADHD are the result of deeply flawed reading instructional methods e,g, ‘whole language,’ widespread in America’s public schools today. He provides several case studies in which private tutoring by a different method produced dramatic improvement. I’ve saved the article but it’s not posted stand alone, only encapsulated in this report (he changed the title once and may have done so again):

    http://www.nrrf.org/learning/attention-deficit-disorder-poor-reading-instruction-is-there-a-connection/

    As Breggin and others note, by locating the problem in the child such diagnoses are convenient and validating for parents, teachers and other authorities as their parenting styles, teaching methods and administrative prowess are not called into question. The problem lies in the child. And it is the child whose psyche must be partially disabled with Ritalin et al or increasingly electroshock to conform to their expectations. Breggin notes that even advocates acknowledge these disorders tend to mysteriously disappear at the onset of summer vacation.

    • Akin to a doctor addressing a fracture by vague references to mysterious chemical imbalances and genetic abnormalities while dismissing as irrelevant the patient’s account that they fell from a tree.

      Excellent! May I repeat that? ( I probably will.)

      I have also asked for years, why not “teaching disorders”? Maybe taking speed would make the teachers taking it more interesting.

      • Oldhead, Check out Ken Robinson’s, (educator and speaker par excellent,) evaluation of the western education system! `If you expect children to sit down for hours doing low grade clerical work, you can hardly be surprised if they get fidgety.’ Our education system is designed by government departments to train children for employment that means their taxes will pay the wages of the government officials that design the education..
        A camel is a horse designed by a (apologies) government department.
        80% of Americans (see Western cultures generally) hate their jobs…Most people endure their lives…industry wants creativity and people quick to adapt to change but the education system produces conformity…society needs outspoken innovators and leaders but we call children with these qualities, `oppositional’, `disruptive’, `brain disordered’ and set out to crush them. I think if we don’t value these attributes we cannot be surprised when those who do supercede us. I also suggest that the world leaders of today, who are the major corporations including big pharma, were nearly all kids like that but without meds or morals.
        We ignore history at our peril, short sighted grasping for money, bad memories and lack of historical perspective, as well as the suppression of outrage, WILL bring us down. I won’t be here to see it, but within 50 years I believe it will all be over and chaos will rule until the next tyrant, promising order, takes over.

      • Absolutely oldhead. Don’t mean to get officious but I am writing about all this, have an early draft registered with the US Copyright office, hence as long as I can use it as my own I’m cool with your use of it.

        “Teaching disorders”and speed!! Love it!! That one’s definitely yours.

  12. I am french and I have to disagree with you. You could certainly deem the situation here less worse than in the US. But it is far from ‘got right’. Children are diagnosed with ADHD and given toxic drugs, though in smaller proportion. I am one of those children whose life has been destroyed after wounding up in a shrink cabinet at 13 years old (in my case for OCD)
    The hell and the devastation i went through are beyond words. I am currently too unwell to go in much detail, but i just could not let such a naive sugar coating of a gruesome truth.

    It might be less worse, but that is the end of it. Pharma’s grip is firmly established in here. If im not mistaken, France is one of the biggest psych drugs consumers in the world.

  13. Expanding my comment on Dr. Gold’s ‘The ADHD Dilemma: that appeared on MIA recently, to wit:
    Yes, ADHD does exist, but it is not a disease or disorder. Ask any parent, Teacher or Clinician that deals with children diagnosed with ADHD, and they will tell you that ‘something is wrong with their behavior’. Years of research and millions of dollars expended to discover any empirical evidence that would qualify ADHD as a disease or disorder, and none has been found. Kids diagnosed with DSM 5 criteria for ADHD are perfectly normal kids, both physically and mentally….why….take away the DSM 5 behavior, and what you have left is a good kid. These kids are dancing to a different drummer.

    Here is a bit more about the different drummer to which our kids are responding.
    “Within every patient there resides a doctor, and we as physicians are at our best when we we put our patients in touch with the doctor inside themselves.” Albert Schweitzer, M.D.
    The ‘different drummer’ is the ‘Doctor inside themselves’ that Dr. Schweitzer refers to. We humans do and say thing because we get something out of it, either consciously or unconsciously. So what is the Doctor inside our kids, telling them to do? This is the subject of my hypothesis for the cause of ADHD (BEHAVIOR) and a new paradigm for co-morbid behavior problems. ADHD is a behavior problem and does not need chemical intervention for diagnosis or treatment.
    I’ll ask MIA if they would be interested in a Article that would include the hypothesis.

  14. French Kids Do Have ADHD: An Interview with Elias Sarkis, MD “Dr. Sarkis returns to France on a regular basis. He said that ADHD does most certainly exist in France. Not only are there clinical studies showing the prevalence of ADHD in France, but Dr. Sarkis also has a friend, a psychiatrist, whose child has ADHD. His friend’s daughter had lifelong difficulties in school, an unplanned pregnancy, and then dropped out of school. Her mother is now watching her child so she can return to school.” http://www.huffingtonpost.com/stephanie-sarkis-phd/adhd-france_b_1906184.html

    • Len

      All this tells us that France has similar environmental conditions (such as stress, trauma, poor parenting, poor educational programs, and environmental toxins etc.) as the United States and therefore produces similar physical and emotional responses from the children that mimic behaviors that get labeled ADHD – NOTHING MORE, NOTHING LESS!!!

      Richard

    • Yeah, also, the higher divorce rates are prob my favorite thing about modern American culture. To a large degree, our grandmothers stayed because they had to. Economic dependence, cultural backlash, and patriarchal laws. I know countless women of my generation, mothers included, who are far better off because they got to get out.

  15. “Yeah, also, the higher divorce rates are prob my favorite thing about modern American culture. To a large degree, our grandmothers stayed because they had to. Economic dependence, cultural backlash, and patriarchal laws. I know countless women of my generation, mothers included, who are far better off because they got to get out.”

    I agree 100%, and no word should ever be removed.

    also:

    https://www.amazon.com/Way-We-Never-Were-Nostalgia-ebook/dp/B001FSJ994/ref=dp_kinw_strp_1

    and:

    https://www.amazon.com/Anti-Social-Family-Radical-Thinkers-ebook/dp/B00MDHRQQO/ref=sr_1_1?s=digital-text&ie=UTF8&qid=1474233589&sr=1-1&keywords=anti-social+family

    Nomadic

  16. I only want to add to the healthy discussion that “ADHD” symptoms aren’t always the result of psychosocial causes or trauma. Often, they are the result of normal kids being expected to act abnormally by adults who have unreasonable expectations for the age. Most kids don’t “get ADHD” until they enter school, because “ADHD” is basically a description of a kid who doesn’t fit in well to the standard school classroom’s structure. While good discipline and structure in the home can help with this, it’s also very possible to have kids engage in an educational environment that doesn’t demand they act like they’re not kids.

    Just as an interesting side note, kids in France are not expected to attend school until 7, as I understand it. This may be a huge factor in the lower diagnosis rate.

      • Or an entrepreneurial kid, young adult or older adult who can deceive the authorities and run a highly profitable business selling their meds to people who aren’t as smart as they are – or someone who figures a prescription for speed means avoiding high street costs and the police, and makes the do gooders feel virtuous.

    • “…“ADHD” symptoms aren’t always the result of psychosocial causes or trauma. Often, they are the result of normal kids being expected to act abnormally by adults who have unreasonable expectations for the age.”

      That is, indeed, psycho-social trauma. Especially because it is chronic in childhood. It can easily become a lifestyle habit in adulthood to be a square peg trying to fit into a round hole, if that is what is expected of us as children, until we wake up to what has influenced us in this regard. Then, we can shift those judgments, because that’s what they end up being, a slew of self-judgments from an internalized panel of judges, from feeling that we’re not being who we are SUPPOSED to be, based on what we learned as kids.

      Imagine how the neural pathways would develop in a kid that lives with that kind of high stress to be someone who they are not, while their own sense of self/natural spirit is being invalidated thoroughly. We really have no choice but to be who we are spiritually, but when we pretend that we are someone else, the truth leaks out, one way or another. That can be a very debilitating split causing grandiose anxiety.

      When we own our true nature, we come out of denial, and that is healing, although it can be disorienting at first. All part of the process of healing and awakening to our true sense of self. That is a process to trust.

      There can be all kinds of coercion in this dynamic, subtle and overt. Threats of being punished or deprived for making a poor grade in school–and often a poor grade by high achievers would be a “B”–is 24/7 stress, which can easily lead to cheating, for example, for the sake of survival. That can become a habit in life, if it goes unchecked.

      Plus, a kid who is subject to “abnormal” expectations will, more than likely, impose that on others. Sometimes people develop good awareness and sensitivity to others as a result of their empathy from their experience, but often people who have been abused themselves lack empathy for others, so they will merely repeat what they learned from the adults around them.

      There is a quote in my film from Walt Whitman, which says,

      “There was a child went forth every day,
      And the first object he look’d upon, that object he became,
      And that object became part of him for the day or a certain part of the day,
      Or for many years or stretching cycles of years.”

      I find it to be relevant to what we’re talking about here. Kids learn from the example of the adults around them. That becomes the neural map of their brain, what else would it be? We are fluid and mercurial by nature, however, so this can be shifted fairly easily. That’s transformational healing, our self-identity changes, along with our perceived roles in the family and community.

      Although, I will say this–psych drugs make us rigid, they seem to fix and embed neural pathways, so I believe they actually undermine our ability to learn and make changes. That’s the impression I’ve gotten over the years. I believe we actually lose our neuroplasticity on psych drugs.

      So in essence, we can’t heal trauma, until we get our fluidity of thought back. I don’t think that can happen on psych drugs. They get people good and stuck, and end up not being able to change negative thought habits. So much damage done by these pills, it’s over the top.

      • And btw, being rigid in thinking is one’s downfall, because life is not rigid, but ever-changing, so they will not be able to keep up with changes, and particularly, with radical social, political, and economic change.

        Psych drugs aren’t the only thing which cause rigid thinking, many things do. In fact, Psych drugs create neural rigidity by artificial means, and that can be corrected by withdrawing from the drugs.

        But I think that, even more to the root of the problem is the idea that, perhaps, these drugs are used to curtail fluidity in thought in order to match clinical rigidity, at least on an unconscious level, I can see how this would be. As we all know, free and creative thinkers tend to be labeled, stigmatized, and shunned in the “mental health” community. God forbid a client evolve past their therapist in awareness. It will not be tolerated!

        (It’s ironic to write this here because I consider Dr. Berezin to be quite independent in his thinking, and courageous in his truth-speaking. However, an established reputation and long held position makes it a bit easier to be authentic in a rigid world; whereas for us plebeians, it’s a professional death-wish).

        And when an entire community is rigid in its beliefs, it hasn’t a prayer. That can only be mass delusion.

        Awakening is, therefore, in order for change to occur with ease. It will occur regardless of anyone’s objections, because that is the nature of life and of human beings. But it is WAY more challenging when it happens against rigid, unwavering thinking and fixed beliefs. That can cause quite a bit of chaos, for which people are hardly prepared.