Tuesday, November 07, 2006

Here's an article on God's view of Ritalin:

Ritalin and Judaism

by Sara Yoheved Rigler
Our children's aptitudes, our attitudes, and the spiritual challenge.







"I'm the world's most relieved mother," Julie told my friend Linda on their way home from a meeting. "For years I've known that my son Avi is ADD, but I couldn't bring myself to give him Ritalin. Then, a few months ago, his school threatened us that either we give him Ritalin or he'd have to transfer to a special school for kids with learning disabilities. We decided that the side-effects of Ritalin are less terrible than the side-effects of being a failure all his life. So we started giving him Ritalin. We can hardly believe the difference. Avi went from being last in his class to being first in his class in six weeks!"
Linda listened intently. When she got home, she phoned me and recounted the conversation. "What do you think I should do?" she asked. "My 10-year-old Benny's a smart kid, but he gets terrible grades. I know that he has an attention deficit, but I've never wanted to pump chemicals into my child. But Julie's statement that the side-effects of failure are worse than the side-effects of Ritalin really got to me."
I had read some of the studies on methylphenidate (marketed under the brand name Ritalin and its longer-lasting versions Concerta and Metadate ER). According to these studies, a varying percentage of children taking methylphenidate evince symptoms of obsessive-compulsive behavior, robotic behavior, nervous habits, insomnia, and depression.
"Have you ever tried alternative strategies," I suggested, "like eliminating sugar from his diet, or making sure he gets more sleep, or using one of those computer programs that retrain brain waves?"
"Are you kidding?" Linda snorted. "I'd have to change the whole family's diet. And I'd have to get him to bed by 8:30, which is almost impossible. And those computer programs are expensive and take months to work, plus they only work if the kid plugs away at them for a half hour every day, which means my nagging him to keep up with it. I'd rather research the Ritalin option."
A few days later, Linda called me again. "We're going to do it!" she exclaimed. "Julie is right. Whatever the side effects, Ritalin is better than a lifetime of failure. I've already made an appointment to see a pediatric neurologist."
Children feel like failures only when their parents make them feel like failures.
I suggested that as part of her research into the matter, she should call Rabbi Leib Kelemen, an expert on child-rearing.
Rabbi Kelemen told Linda that he is not categorically opposed to Ritalin, but he is opposed to using it without first trying the other solutions, such as diet and sleep. He also recommended that she read a book, which he would lend her, that presents both the pros and cons of Ritalin. Then he made two crucial spiritual points:
Ritalin really does work and her son would probably zoom to the top of his class, but he would be forever deprived of the struggle to succeed and the personal growth that comes from struggle.
Children feel like failures only when their parents make them feel like failures. If Linda would redefine her son's success in terms of sterling character traits rather than grades, she would be giving him a ladder he could successfully climb.
The next day, Linda called me again. "The scariest part of this whole thing," she told me, "is that on my way over to pick up the book, I was totally bummed out. I already had euphoric mental images of how much easier my life would become with Benny on Ritalin. The new Benny would listen to me without interrupting, would do his homework without a battle, would study with me without having to get up every five minutes, and would bring home a report card with A's instead of C's and D's. I knew the book would document all the medical and psychological reasons not to give him Ritalin, and I didn't want to hear it!"
FIXING THE CHILD
How could a loving and devoted mother like Linda not want to hear the precautions against giving her son a drug that the Drug Enforcement Administration (DEA) has rated as one of those with the most potential for abuse and addiction?
In 2001, almost 10% of American school children and 15-20% of school-aged boys were taking stimulant medication such as Ritalin. In 2003, pharmaceutical companies announced that the total ADHD market in the United States was approximately $1.8 billion, exceeding the national spending for antibiotics and asthma medication for children. From 2002 to 2003, the market for the various forms of methylphenidate grew by 20%.
Yet the Ritalin Rush has triggered some sobering responses. The International Narcotics Control Board (INCB) issued a warning in 1997: "Concerns have been raised that doctors are resorting to methylphenidate as an 'easy' solution for behavioral problems which may have complex causes." Two years later the INCB cautioned: "In the Americas, particularly in the United States, performance enhancing drugs are being given to children to boost school performance or to help them conform to the demands of school life."
"Something is wrong when society finds it expedient to give psychoactive chemicals to millions of children."
As Dr. Peter R. Breggin, a staff psychiatrist at John Hopkins University, has written:
Many more people now understand that something is wrong when society finds it expedient to give psychoactive chemicals to millions of children. They suspect that the diagnosis of ADHD may be little more than an excuse for giving drugs to control children instead of meeting their genuine needs. They believe that our children require improved family, school, and community life rather than psychiatric diagnoses and psychoactive drugs.
...A large, ever-increasing segment of America's children are being subjected to drugs to control their minds and behavior. No such experiment in mass drugging has ever before been attempted in the history of any society or nation. Never before have so many parents been told that their children need psychiatric drug treatment for difficulties at school and in the home. This unprecedented situation is not the result of some inexplicable increase in "mental illness." It is, instead, the result of an increasing failure to identify and to meet the needs of children in our homes, schools, and communities, as well as a growing tendency to seek quick and seemingly easy medical cures to difficult individual and social problems. [Talking Back to Ritalin, pp. 4-5]
This is not to say that no child ever really needs Ritalin. Some children's hyperactivity is so disruptive in the classroom that a medical solution may be indicated.
From a Jewish perspective, however, the point is that behind some of the diagnosis and treatment of ADD is an undiagnosed and untreated syndrome that affects the parents, teachers, physicians and children, namely "The Quick Fix Syndrome."
QUICK FIXES AND THE EASY WAY OUT
Over the last four decades, the modern West has become a pill-popping society. Can't sleep? Pop a pill. Feeling depressed? Pop a pill. Need to be alert to study for exams? Pop a pill. The assumption behind this quick-fix mentality is that no one should ever have to suffer or struggle.
Rabbi Kelemen's answer to Linda represents a different worldview: Struggle builds character, and improving character traits is the very purpose of life in this world.
Real greatness is gauged by struggle and striving.
Real greatness is gauged by struggle and striving. No one earns admiration for dropping from a helicopter onto the top of Mt. Everest. Why? Because the point is not to be at the top, but to get to the top. The man who holds the Guinness record for being the tallest in the world is a curiosity; the man who holds the world-record for the highest pole-vaulting is a champion.
Yet the drive to seek quick solutions and easy answers is a paramount human temptation. The earthly body always seeks repose, while the soul always seeks growth.
Just yesterday, a mother told me that her first-grade daughter has been fidgeting in class. Both the child's teacher and principal recommended putting the little girl on Ritalin "so she'll learn good habits of sitting and paying attention in class." By the time she starts second grade, the educators told her mother, the child would be used to good behavior and could go off the drug.
This replacement of drugs for genuine education is even more dangerous spiritually than it is physically. The unique human faculty of exercising free choice is developed every time a person chooses between right and wrong. A first-grade child exerting her self-control by sitting still in class for five minutes is worth much more than a whole day's drug-induced attentiveness.
For many, Ritalin is regarded as a means to an end: succeeding in school. But even here, in the first grade classroom, the true purpose of life must be clearly discerned and valued. Choosing good, or in this case a brief act of self-discipline, is the goal of life, not learning pages of arithmetic.
Admittedly, it's hard for children to sit still. Our sages assert: "According to the effort is the reward." And what is the reward for that child's effort to control her penchant to squirm around? She will learn that she is capable of choosing self-control, and when she is a teenager tempted with drugs and an adult tempted with stealing from her corporation, she will know that she is in control of her choices. And that's why she-like all of us-is here in this world.
Parents who try the more arduous solutions before resorting to Ritalin also receive a reward: the development of their qualities of patience, forbearance, unconditional love, and moral strength to go against the societal current. A parent who decides, "My child's ethical development is more important to me than a report card I can brag about," has truly scaled a spiritual Mt. Everest.
FAILURE AND SUCCESS
When Rabbi Kelemen told Linda that her children wouldn't feel like failures unless she made them feel like failures, Linda protested, "How can Benny not feel like a failure when he brings home dreadful grades?"
Rabbi Kelemen countered: "Does he help out around the house?"
"Well, yes," Linda answered.
"Is he kind to his siblings?"
"Most of the time."
"Does he come home when you tell him to?"
"Usually."
"Well, then," Rabbi Kelemen concluded, "he has a lot to feel successful about. It's your job to make sure he knows it."
This advice is reminiscent of the fable about the proud archer who brought his friend into the forest and showed him that he had hit the bull's-eye on every tree. "How did you do it?" the friend asked, impressed.
"Simple," the archer answered. "First I shot the arrow, and then I drew the target around it."
If parents value good character traits more than academic success, we will raise self-confident children who know what is truly important in life.
While this ruse is a cop-out for adults, it is an essential technique for good parenting. Rather than criticize failure, parents have to praise whatever small good their child accomplishes. The results are two-fold: the child repeats and amplifies the praised behavior, and the child grows in self-confidence, which is a sure-fire prescription for a successful life.
Parents more interested in good children than good grades have to become expert at drawing the target around virtuous actions. He came home from school with a C on his spelling test and a wounded bird he wanted to save? Bull's eye! She can't understand her algebra homework, but she volunteered to take care of the neighbor's baby when the neighbor had to rush out? Bull's eye! The section of his report card grading academic subjects looks dismal, but in deportment and interpersonal behavior he scored high? Bull's eye!
If we parents value good character traits (honesty, kindness, enthusiasm, etc.) more than we value academic success, we will not only raise children who are happy and self-confident, but we'll also be teaching our children what is truly important in life. A child who learns that honesty is more important than grades will never cheat on a test -- or in business later in life. A child who learns that kindness is more important than grades will never make fun of a slow-witted classmate -- or give his job priority over his family later in life.
But, we protest, if my child doesn't get good grades, he won't get into a good college, and his earning potential as an adult will be compromised.
Not necessarily true. Many self-made millionaires did poorly in school, but had the self-confidence to become enterprising entrepreneurs. Behind every successful adult is a parent drawing bull's eyes.
An epidemic is sweeping our society, and it's not ADD or ADHD. It is addiction to ease and a skewed definition of success. And the cure for this epidemic has no dangerous side-effects.

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