Interpreting the inner world of ADHD children: psychoanalytic perspectives

ADHD is increasingly seen as associated with cerebral dysfunction and caused by it. This development is concomitant with an emphasis on medication, behavioural treatments, and parent training programmes. In contrast, psychoanalytic therapy has receded into the background and is often viewed as inefficient or even noxious. This paper argues that such views are based on a misunderstanding of the scope of psychotherapy. Though much more systematic research is needed to establish its efficacy, it can inform on the ADHD child’s emotional experiences. It can shed light on the connections between his/her inner world and symptoms, such as attention deficits, hyperactivity, and impulsivity. On the other hand, it cannot establish causality in the individual or general case. If we recall that the diagnosis is based on a list of symptoms, not of etiology, we realize that this limitation applies to any scientific perspective on ADHD. Psychoanalytic treatment is one of several approaches to understanding ADHD and helping the child cope with it. This is achieved by the psychoanalytic method, a hermeneutic approach with which the analyst interprets the child’s behaviours and communications as they emerge in the session. The implications of such an approach are discussed.​​​