What do ADHD, low empathy, and narcissism have in common? Potentially, more than many people realize.
When we consider the negative chatter around “drugging children” for ADHD, what gets lost? Compassion for these children. Compassion for their families.
Many children with ADHD suffer cognitive impairments far beyond the classroom. They suffer impairments that distort any reasonable person’s idea of a “happy childhood.” I’m referring to impairments that, in fact, also threaten to negatively shape the course of their entire lives, especially their relationships. These impairments include deficits in empathy, reciprocity, reflection, and remorse.
What’s more, in the wrong mental health professional’s hands, a child lacking empathy and having sense of entitlement can invite a dire diagnosis: narcissistic personality disorder—or even psychopath. (When Your Child Is a Psychopath, an extremely hidebound and punishing look at the phenomenon.)
If that child also has ADHD, there is a good chance that the first-line medication for ADHD, the neuro stimulants, can enhance empathy—along with all the other “higher-order” brain functions. This is not hard to understand, but it is not common knowledge. ADHD treatment can help the child have access to these brain functions.
In this post, Taylor J, the host of the “You, Me, and ADHD Book Club,” shares this story of her eldest child’s recent ADHD diagnosis and treatment.
Taylor had despaired that her daughter would grow up to resemble her own parents: narcissistic and lacking empathy. Generally speaking, empathy deficits form the foundation for narcissism.
Taylor and her husband tried to teach empathy to the girl, but the lessons never took hold. Or, so they thought.
By Taylor J.
The Number One most profound thing I’ve learned about ADHD is this: it can create trouble connecting “cause” with “effect.” And that can create a world of trouble.
For example, a student will not see his poor study habits as the reason for his poor grades. Instead, he’ll blame a “mean” teacher. A wife will not see that her cutting, sarcastic words caused her husband to withdraw emotionally. Instead, she’ll call him “cold.” A young man will not see that his reckless driving and speeding caused a car accident. Instead, he’ll blame barely there weather conditions.
It doesn’t take a genius to see that continually failing to connect actions with consequences will wreak havoc on a person’s life. Worse, it can kill the potential for relationships.
I saw this play out starkly in my 10-year-old daughter. I call her “The Firecracker.”
I Vowed To Be Different From My Parents
First, let me give you some background.
My parents are horribly mentally ill, and they refuse treatment. Instead, they blamed everyone else for their troubles—and drowned their sorrows in alcohol, drugs, and pity parties. Even when I was in the hospital—sick or with a new baby—my parents could only talk about themselves. I found their utter lack of empathy horrifying.
When I married and started a family of my own, I vowed to be different. Yet, in raising my first-born child, the oldest of four girls, I watched helplessly as every lesson about empathy I tried to impart seemed to bounce cleanly off her soul.
What do I mean by that? Well, she would exploit others. She would set up games where everyone had to treat her like a queen visiting from another planet—or convince friends to “share” their favorite toys and clothes. Forever.
I even caught her in an elaborate kindergarten “protection racket” at one point: taking her sister’s money to keep monsters away. (She’d already made 6 dollars!)
She would take—but never give. Her friends would give her presents, invitations, or compliments. Yet she never saw any need to return the favor.
In fact, she would complain if a compliment missed a detail, or if the gift didn’t fit just right. She would even go to a friend’s house and critique their clothes or décor for them! “You really shouldn’t have that dollhouse—it’s for babies. You should get a Barbie dollhouse.” Seriously? Where did you learn this?
I was asking the wrong question. As I came to learn much later, hers wasn’t learned behavior. It was innate.
No “Cause and Effect”—Only “Mean Parents”
My husband and I explained, repeatedly, that her words hurt other people: “How would you feel if Ginny came to your house and said your dollhouse was for babies?”
The Firecracker, looking confused, would reply, “But my dollhouse is not for babies, so she would never say that!” We would punish her for saying cruel words—and she never understood why she was being punished. We were just “mean parents.” The type she might be complaining in the future to a therapist—who won’t have the full picture.
There was more. She would explode over the tiniest frustration. Itchy seams on her socks. Bedcovers not being straight. Her oatmeal being the slightest bit “too watery.” Her low frustration tolerance would set her off on an explosive tantrum—and others were always to blame.
Sporadic Bursts of Caring—and Low Frustration Tolerance
I remember when she was only one year old, screaming at the shape-sorter because she couldn’t make the block go in the way she wanted it to. We did see sporadic bursts of caring from her— we could just never predict when they would happen.
Her first words upon meeting her sister: “I’m going to watch out for her, and make sure she doesn’t run out into the street without me!” At age 3, she started punching a preschool classmate who came up and shook her baby sister’s car seat carrier (while I was talking to a teacher). She was afraid he would hurt the baby’s “soft spot.”
When I was violently ill with another pregnancy, she proclaimed to her sister, “Don’t worry. When Mom throws up, I’ll make you a sandwich.”
Words, however, rarely met actions.
The Firecracker screamed at her sister for adjusting her stuffed-animal display. My second daughter would dissolve into tears, and ask, “Why doesn’t she love me?” The Firecracker’s response? Her sister’s sobs were disturbing her reading time.
Without the larger context, you might take this as typical sibling rivalry. But it was much more troubling.
I had started to wonder if I was raising a narcissist.
A Shocking Change
My husband and I both have ADHD. We both take medication. I know full well the dramatic changes in cognition and behavior the medication provides.
But when The Firecracker was finally diagnosed with ADHD this past July and began medication treatment, even I was not prepared for the change that followed.
I gave her the first dose of Ritalin. Two hours later, as we were returning from the grocery store, she said, “Mom, you can’t carry all that. Let me help you!” She grabbed two grocery bags and the diaper bag. “You need to ask for help when you need it, mom!”
Then, when the baby started crying: “Oh, honey, come here and let me hug you! Don’t worry, mom, I’ve got her—I know you’re making lunch.”
When I had to change plans that she’d been looking forward to: “Aw, that stinks, but I know you didn’t try to make it hard for me. We can go tomorrow.”
To be clear: My daughter had not become some creepy “good child” automaton. She was still herself. But a better emotionally regulated version of herself. A more content version of herself.
This much was obvious: She was as relieved as we were with the changes.
“It’s Going to Be Okay”
Five hours later, the medication had worn off. The Firecracker came to me, tears streaming down her face, screaming, “Mom! This is awful!!! The baby won’t stop crying! [The baby had cried for one minute.] Is this what it felt like all the time when I wasn’t on medication?”
I took her by the shoulders, looked her in the eye, lowered my voice, and said, “Don’t worry. It’s going to be okay. Yes, this is what it was like all the time. Take your next dose, then sit here and watch something on TV while I set a timer. When the timer goes off, your next dose will have kicked in.” I wiped her tears and turned on something funny.
Half an hour went by. When she felt better, she looked up at me, and said, “Mom, maybe you should get me a puzzle book to work on when I’m angry. Then I can calm down without yelling at anyone.”
I watched the rest of the night as she spoke lovingly to her sisters and forgave them when they committed the grave sin of touching her stuff.
Relief At Connections Made
As she was reading her favorite book before bed, she looked up and said, “Mom, now I understand why Eragon sighed so deeply when he saw his brother: He was afraid his brother would become a rider, too!” Even the stories were becoming more clear.
Remember, this is just the first day of ADHD treatment.
I asked my husband to tuck the girls into bed that night. Then I turned on the shower and broke down into sobs as the water washed over my face. With immense gratitude and relief, I finally realized that my daughter was not a narcissist. She actually did take in the lessons about compassion and empathy that we were teaching her, but she simply couldn’t access them when she needed to.
My daughter had been suffering from a treatable brain condition, not an incurable evil that was lurking behind her smile.
Maybe my parents can be helped to change their narcissistic behaviors, too. I can only hope that they’ll reach a point where they’re willing to try treatment.
So, the next time you hear someone gasp at the thought of putting a child on medication for ADHD, please remember my Firecracker. Please know that it is beyond the control of many people with ADHD, including children, to make certain cause-effect connections.
Please know that, since beginning to take stimulant medication, my girl is happier and healthier than she has ever been. (More about that in a future post from Gina.)
The Firecracker’s Comic: Overcoming a Struggle
I’ll close with this amazing comic that The Firecracker drew for school. I had nothing to do with this. My daughter loves graphic novels, including authors such as Raina Telegmar, and has created dozens of comics in that style.
Recently, her class read a story called The Dot, about overcoming a difficult struggle. In response, they were to write about a struggle that they overcame. This is my girl’s story.
This phenomenon is more common than the mental-health profession seems to realize. That is, the association among ADHD, lacking empathy, and narcissistic behavior.
This post (ADHD and Empathy: A Study, Book Excerpt, and Empathy Defined) tackles the topic from several angles:
1. Defining empathy (it’s not what most people think).
2. Excerpting a passage on empathy and relationships from Is It You, Me, or Adult A.D.D.?
3. Sharing details from yet another study pointing to a connection between dopamine and cognitive empathy.
A sneak preview of the study: It confirms my observation that stimulant medication often enhances empathy in people with ADHD.
But wait. This happens not because the medication “creates empathy.” Rather, the medication enhances dopamine transmission. That, in turn, allows some people with ADHD to focus on and access this “higher-order” brain function. In fact, it is one they have always possessed but haven’t been able to reliably access.
Empathy sounds simple. But it’s really a complex phenomenon. In fact, some people with ADHD have trouble reining in their empathy; medication often helps them, too. As with many ADHD-related challenges, it’s all about the self-regulation.
How about you? Have you noticed a difference in your child’s
expressions of empathy or mood-regulation post-treatment for ADHD?
I welcome your perspectives.