Psychoanalytic Psychology, Vol 39(4), Oct 2022, 302-310; doi:10.1037/pap0000416
This article discusses the attention deficit/hyperactivity disorder (ADHD) syndrome in children, from a regulation-based perspective, as a neurodevelopmental deficiency that develops into mental difficulties. Based on research indicating the existence of early markers to ADHD, we propose that the neurodevelopmental difficulty creates certain characteristics in the mother–infant/toddler relationship. We propose the term “mental sustaining” to describe the capacity to delay response in order to allow stimuli to be perceived and absorbed internally. In children with ADHD, the neurodevelopmental impairment of the regulatory function hinders the capacity for “mental sustaining,” potentially creating a vicious cycle in the child’s relations with its caretakers. We draw on the thinking of Wilfred Bion, proposing that this vicious cycle might affect the quality of the internalization of alpha-function in a manner that results in various functional deficiencies. Three such deficiencies prominent in children diagnosed with ADHD are discussed in light of Bion’s theory: the proclivity for idiosyncratic interpretations of reality; difficulty in automation of mental and motoric actions; and a tendency for excessive need for material gratification (the “bottomless pit” phenomenon). This article wishes to join the contemporary literature that understands children with ADHD from an inclusive theoretical perspective that links neurodevelopmental and psychoanalytic approaches. We propose a psychoanalytic understanding of this neurodevelopmental syndrome relying on Bion’s concepts. The contribution of this article to existing psychoanalytic literature lies in its description and discussion of psychic mechanisms that are part of the characteristic psychic landscape of children with ADHD, as well as the presentation of potential etiologies of these mechanisms. (PsycInfo Database Record (c) 2022 APA, all rights reserved)