Fusion Academy: Childhood Narcissism and ADHD-Like Behavior

When I listen carefully to how parents describe their kid’s ADHD-like behavior, their descriptions often touch upon normal and not-so normal levels of childhood narcissism:

• If he can’t solve a problem immediately, Jonah has a meltdown.
• Maria is so emotional. When she’s calm she can focus and get homework finished. When she’s doing her drama-queen thing, forget about it. The night is a write off.
• There’s no two ways about it, Jamal is a perfectionist. If he can’t do something perfectly, he avoids it like the plague.
• It’s bizarre. Frank insists that he is a good planner, puts his full effort into his homework, and keeps track of when his assignments are due, when all the evidence is to the contrary. Is he a pathological liar? Maybe he is he suffering from amnesia or something?
• At home Susan is fine. She gets her homework done and generally tows the line. But at school, her teachers say she is argumentative, zones out, and only applies herself if they continuously push her.
• Michael will sit forever attempting to solve a problem with a questionable strategy rather than admitting to being confused and asking for help. He is so stubborn.
• When things don’t go Gary’s way, he becomes real mean. Last week at soccer practice, a kid scored a goal against him when he was the goalie. He can’t shake it off. If I have to tell him one more time to stop calling that kid names, I’ll be locked up for what I end up doing.
• Last year, Caley had a first grade teacher who really got her. Ms. Parker was so good at feeding her ego and giving her special help and attention. My ADHD kid turned into a normal kid that year and we took her off her meds! How about that! This year is a completely different story. She says her second grade teacher has it in for her. Every other day, she is sent home with behavior slips. We started her on meds again. What happened?
• George just won’t shut up. The kid talks endlessly and is so needy for attention that I don’t know what to do. He won’t even let me go to the bathroom on my own. I am going out of my mind!
• It is like I am a short-order cook. Samantha will stubbornly refuse to eat pasta one night, then the next claim it is her favorite dish. On her off days, I throw together a meal so she will eat something. She is wafer thin. Despite constant reminders to pick up her dirty clothes, I went upstairs last night only to find them strewn all over the floor. On top of this, just before bedtime she announced to me she had a science test she had not studied for. Welcome to my world!
• During his regular school day when there is set structure and routines, Ernesto does fine. But in his after-school program, the daycare worker jokingly told me he acts like a Tasmanian Devil. He can’t handle unstructured play situations where the other kids are out there with their behavior and feelings. He seems to need a tame classroom environment where the other kids are calm and sit peacefully for him to behave right.

Evidence of narcissistic struggles are nested in these snippets of information I have collected over the years in my work with kids who have been brought to me because of suspected ADHD. In my book, Back to Normal: Why Ordinary Childhood Behavior is Mistaken for ADHD, Bipolar Disorder, and Autism Spectrum Disorder, I painstakingly go through most of the core symptoms of ADHD and show how closely they resemble aspects of childhood narcissism. For now, let me give you a flavor of this approach by picking apart some of the examples I have provided.

Take Jonah’s situation. He falls apart emotionally when unable to immediately master a task. One hypothesis is that this is a symptom of ADHD (not that a single indicator is positive proof of a disorder). Difficulties with retention of information needed to successfully execute a task—say the twelve-times table—may predispose Jonah to tear up his math sheet and storm out of the room. However, another hypothesis is that he demonstrates a good dose of magical thinking. He believes mastering tasks should somehow be automatic—not the outcome of commitment, perseverance, and effort. Jonah’s self-esteem also may be so brittle that it fluctuates greatly. For instance, when Jonah anticipates success, he productively cruises through work, eager to receive the recognition that he expects from parents and teachers. He is on a high. He definitely feels good about himself. Then in the face of challenging work, he completely shuts down, expects failure, outside criticism, and wants to just give up. He feels rotten about himself. His life sucks. Wild swings in productivity sometimes are evidence of nothing other than shaky self-esteem in kids. These are kids whose overall feeling about themselves is too dependent on outside praise and criticism. When they experience success, they believe they are outstanding individuals, yet when they experience failure, they believe they are worthless individuals.

Does George’s incessant talking and invasive behavior suggest that he is neurologically compromised, or does his overriding need to be seen, heard, and recognized propel him to be annoyingly demonstrative?

Does Michael’s refusal to abandon an ineffective problem-solving approach reflect difficulties with cognitive processing, or is acknowledging his limitations and reaching out for help experienced by him as intolerably weak?

Does Samantha exhibit the disorganization commonly seen in ADHD children, or a sense of entitlement whereby she resists accommodating to the needs of others, believing that others should accommodate to her by giving her special dispensations?

Caley’s dramatic downturn in classroom behavior may or may not be due to the reemergence of ADHD. Maybe the overarching issue is her struggle to be “one of the gang” in the classroom, whereby sacrificing her personal autonomy to fit in and comply with rules and routines seems psychologically out of reach?

Does Ernesto have impulse control problems or are his emotional boundaries underdeveloped? Does he absorb the feelings of those he comes into contact with in ways that disorganize and frazzle him?

For that matter, does Gary have impulse control problems, or does he have a proverbial chip on his shoulder, quick to retaliate against those who shame him?

When we truly listen to parents and refrain from shoehorning their descriptions into nifty behavioral phrases, overlaps begin to emerge between ADHD phenomena and childhood narcissism. To truly tease apart what is a bona fide case of ADHD, rather than evidence of typical narcissistic behavior in kids, takes time, sensitivity and rock-solid awareness of childhood developmental tendencies. If we confuse the one for the other, kids may be unnecessarily put on medications and be deprived of the outside help they need to bolster and stretch their emotional development.

Excerpt from Back to Normal: Why Ordinary Childhood Behavior is Mistaken for ADHD, Bipolar Disorder, and Autism Spectrum Disorder/ Enrico Gnaulati Ph.D., Beacon Press, 2013.

Dr. Gnaulati will be presenting at the Fusion Academy & Learning Center campus in Pasadena on January 19, 2014.

Dr. Enrico Gnaulati is a Columbia University educated psychologist in Pasadena who specializes in child and adolescent assessment and therapy, and parenting consultation. He has published widely on topics related to child development and children’s mental health in professional journals as well as in The Atlantic, Salon.com, and Alternet.org; and he has been featured on KPCC and other media networks.

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