Quick links:

• How ADHD is learned and a treatment to unlearn it
• ADHD Auto-pilot
• ADHD as a Defense Mechanism
• Changing Attentional Patterns is Not Like Sports Practice
• CAER: A New Treatment Technology
• Unlearning Emotional Patterns vs. Learning New Skills and Knowledge
• Emotional Inhibition of Skills
• How CAER Works
• What CAER Looks Like
• The Experience of CAER Treatment
• Therapeutic Process of CAER
• ADHD Treatment Follow-Up Study: May, 2000

 In order to better understand ADHD, it is imperative to see the ways in which our common, daily experiences are similar to the thinking, feeling, and behavior of an ADHD child.
Regardless of whether you are a teacher, parent, or researcher, little can be gained until you begin to see the world through the eyes of an ADHD child.

We Think Like ADHD Children All the Time

Let me illustrate by citing a personal experience.  While engaged in the relentless drudgery of writing the computer program logic and voice prompts for a program, I was having trouble concentrating.  My attention constantly drifted off after I wrote each sentence.  I continually caught myself looking out the window, going to the bathroom, making a telephone call, or looking at a magazine.

With great effort, I brought myself back to the tedious, repetitive task at hand — writing another sentence.  A large cup of espresso coffee helped increase my willful control over my attention.  With the coffee, I temporarily regained the power to make my mind do the required task for a little longer.
Finally, after hours of this struggle, I logged onto the Internet.  In just a few seconds, my attention and energy improved dramatically, though I had not changed my position at the very same computer, the very same desk, next to the very same window.

My attention went unbroken for the next hour as I searched the Internet for things that interested me.  Thinking back over this scenario, I see my experience exactly parallels that of the ADHD child.  I was forcing myself to do a dreaded task, much as a teacher forces a child to do his work in the classroom.

My writing the computer system was very similar to the ADHD child doing math or spelling.  Both of our tasks required continuous, sequential attention to detail.  Both were repetitive of a similar process with detailed variations.  Both were boring because of the repetition, and both of us were required to do the task to achieve a goal.

Though I could keep my body at the task just as the teacher keeps the child at his desk, the unpleasantness of both our tasks soon conditioned our attention to switch to more interesting things.  For the child it might be staring out the window, playing with an eraser, talking to a friend in the next row, or wandering around the classroom.  For me, it was staring out the window, making a phone call, and reading a magazine.

We both achieved relief from these boring tasks by automatically, against my conscious intention or the teacher’s will, learning to avoid the aversive tasks by shifting our attention away from them — “spacing out” or becoming distracted.  Relative to the tasks assigned to us, we each had an “attention” deficit and were being “hyperactive.”

In fact, my cup of espresso worked just like the child’s dose of Ritalin (or Dexedrine or Cylert).  Ritalin allows the child to focus his attention on his work in order to please his teacher.  Caffeine helps me to force my mind to do what I want it to do, as opposed to helplessly following my learned defense patterns and not performing a tedious task that I don’t want to do.
Both Ritalin and caffeine help us redirect our attention back to the task we intentionally wish to address.  They are both powerful central nervous system stimulants.

My time on the Internet also worked like a child’s time on Nintendo.  As many parents know, ADHD children can attend to Nintendo for hours, even though they may have been very distracted from the schoolwork that immediately preceded it.  My ability to focus my attention rebounded in exactly the same way when I logged on to the Internet.
The Internet and Nintendo share a common feature in that they have no negative history that make a person want to “space out” instead of doing the needed work.  At our chosen tasks our attention was flawless.  It would seem to take a very peculiar neurological deficit to account for such sudden variation in both of our attentional patterns.

Do I have ADHD?  I doubt it as much as I doubt that most kids labeled as such have ADHD, at least as it is normally conceptualized as a neurological disorder.  We have to give up the idea that the ADHD child’s mental processes are strange, unusual, defective or inferior.  They are just one more variation of the perceptual distortion that all of us use everyday to survive in an often-crazy world.

The child’s miserably unpleasant situation — school — continues every day, six hours per day, year in and year out.  This provides a tremendous amount of opportunity and motivation to practice attentional avoidance.  Though he probably consciously wants to attend to the appropriate tasks, at a more powerful, emotional level, against his will, his mind is being shaped in the opposite direction.  His attentional avoidance becomes extremely well trained and automatic, to the point of being out of the ADHD child’s willful consciousness and control.  It becomes more automated and out of consciousness than fingernail chewing.  He is on auto-pilot.

ADHD Auto-pilot

This auto-pilot experience is not unique to ADHD children.  We all experience it from time to time.
I can remember one Saturday morning when I climbed into my car to do some errands.  As I was heading for the store, I began thinking about ideas to include in this book.  The next thing I knew, I was pulling into the parking place at my office.
 

How had I gotten there without knowing it?  I had traveled for over ten miles of a complex route with traffic.  Like many people on their way to work, I was on auto-pilot, and my auto-pilot was set for the office.  I did not do it intentionally; several cues automatically put me in that mode.
Initially the route going anywhere from my house is the same. Only after a distance, do the routes to different places diverge.

This means that the cues I was experiencing while intending to go to the store were the same cues I would experience if I were going to my office.  I was simply following a chain.  Once this chain was operating, I followed succeeding links because nothing interfered.
 

Also, I was thinking about the kinds of things that I do when I am at work.  Since I was mentally preoccupied, as the ADHD child is, I went into auto-pilot until I found myself at work.  I followed deeply conditioned patterns and responses.
This is exactly what the ADHD child does, except that I ended up at work.  The child ends up in the back of the classroom with his hand in the fish tank.
The ADHD child’s reactions accelerate over time.  They become stronger, more efficient, quicker, more complete, and more exaggerated.  The attentional breaks become so profound that the ADHD child can no longer exert much willful control over his behavior.
 

The conditioned attentional patterns of ADHD children begin to include less and less of the child’s immediate surroundings.  When this level of attentional avoidance is reached, his behavior begins to reflect this avoidance.  Although the child cognitively understands the social expectancy for sitting in his seat, he can no longer willfully attend to and act upon this demand.
The child is responding to natural, emotionally driven impulses for escape by moving around the classroom, impulsively speaking out in class, and generally acting hyperactive – behavior commonly associated with these children.
He is reacting to the impulses as they strike him at the moment with little cognitive inhibition of those impulses to bring them within socially accepted limits.
He simply can’t break out of this auto-pilot mode.

ADHD as a Defense Mechanism

ADHD works by the same processes and serves the same function as traditional psychological defense mechanisms.  In fact, it is best thought of as a defense mechanism favored by children.
Freud talked about how repression, suppression, or denial, are ways of keeping noxious thoughts and memories out of one’s consciousness.  That is, they are attentional avoidance mechanisms that work just like ADHD.
Freud saw defenses as the patient’s active efforts to adapt, but that ultimately, if overused, backfired.  So too, it is with ADHD. The patient is an active, skilled adapter to the environmental stimuli, just as Freud saw his patients.  However, in both cases, defense mechanisms have gone awry.
Like all defense mechanisms, avoidance behavior functions as a way to spare the ADHD child the unpleasant emotions — whether they are triggered by internal or external experiences.  It does this by keeping annoyances out of consciousness.

Changing Attentional Patterns is Not Like Sports Practice

Unfortunately, for the ADHD child, athletic practices and homework do not repattern behavior in the same way.  There is a core motivational difference between these two situations.  Children go out for sports and participate in practices because it is fun.  They are seldom forced.  So, aversion is seldom part of the picture.  If practices stop being fun, performance deteriorates and the child usually quits the sport.
 

Though we tend to treat homework and school work like athletic practices, they come from a very different motivational base.  Children do not choose to be in school because it is fun.  If school ceases to be fun, performance tends to deteriorate, but the child usually cannot quit.
 

Aversive tasks and consequences are very much part of the academic learning situation.  Children are forced to continue extended, regular contact with the aversive situations — school and homework.  The same forces that caused the initial decline in performance at the un-fun point continue to degrade the student’s performance.  And as the student continues to collect un-fun experiences associated with school, his performance worsens even more.
 

What this means is that ADHD students do learn a great deal by their continued contact with educational tasks.  It is just not what we wanted them to learn.  They, like the child who goes out  for a sport, learn to optimize fun and minimize un-fun.
In an environment that is primarily motivated by punishment (this is not meant as a criticism of school but just as a statement of how these children experience it), this optimization means escaping the aversive experience by learning attentional avoidance.  We call this skill ADHD, which is not what was planned but, given the contingencies, exactly what one would expect.
 

Ultimately, it is very difficult to force people to perform well on tasks they don’t like, but that is what we try to do with students in school.  We provide them with a special teacher to continue rehearsing tasks that they don’t like, we give them more homework to practice tasks that are beyond unpleasant to them, and we give them after school tutoring programs to rehearse courses that trigger responses in them that they can’t control.
Unless these practices are qualitatively different, like Nintendo, what will be learned is finely tuned attentional avoidance.  This is why these programs so often fail.
To be successful, these programs need to present the students with qualitatively different stimuli, such as a very charismatic teacher, a different situation, or different motivational systems — not more of the same.

CAER: A New Treatment Technology

Computer Aided Emotional Restructuring (CAER) a therapy I have developed and patented is mostly a non-verbal therapy and departs from traditional therapy in two ways.  First, it is more of a do-it-yourself therapy, as opposed to a therapist imparting his or her professional knowledge.
Second, it consists of unlearning emotional patterns, i.e. destructive coping mechanisms, rather than learning new skills or knowledge.

Unlearning Emotional Patterns vs. Learning New Skills and Knowledge

CAER’s difference from traditional therapy is important. Traditional therapy is predicated on two assumptions:

1) The expression of feelings provides catharsis.
2) The problems that bring the patient to therapy are a function of a lack of some knowledge or skill.

In other words, patients are simply bottling up their feelings or they don’t understand how to do whatever it is that will solve their problems.
The task of the psychotherapy patient is to learn the knowledge and skills necessary to express feelings, to express those feelings, AND to change behaviors to prevent further buildup of negative feelings.  The therapist’s task is to teach the skills.  It is a student-teacher relationship.
 

But this is incongruent with my observations about patients, both children and adults.  Almost all of my patients have at some time demonstrated all the skills they need.  In fact, they demonstrate them in other situations, but not in the problem situation — be it school, home, marriage or the work place.
 

They may be a successful manager at work — communicating, asserting, disciplining, and listening all day long.  These are most likely the same skills they need for parenting or being an effective spouse.
In the case of ADHD children, successful skills are clearly present in some instances.  For example, they often interact well in one-to-one situations such as with an adult or with a favorite friend.  However in the problem situation, most often the classroom or the home, these skills seem to fly out the window.

Emotional Inhibition of Skills

Why is it the ADHD child is skillful in some areas but not in others?
It seems unlikely that he magically forgets skills in the classroom or when doing homework but remembers them when playing with a friend or Nintendo.  The most likely reason is that the child is inhibited by emotions triggered by the problem situation.
ADHD children have learned to respond to the problem situation with anxiety, anger, fear, or depression.  This causes two things to happen.

First, the increased emotional arousal overwhelms access to the skills required to cope with the situation.
Second, these feelings cause the child to be mentally absent from the situation, and produce more ADHD behaviors.
Traditional therapy attempts to teach the ADHD child coping skills to the problem areas in his life, tools that are already at his disposal.

This is like teaching someone to ride a bicycle on north-south streets when they regularly ride only on east-west streets.  If they do not ride on north-south streets, it seems very unlikely that it is because of some lack of skills or knowledge.
More likely, there is some barrier to riding on north-south streets, such as fear possibly resulting from crashing on a north-south street.  As absurd as this sounds, continuing to train previously demonstrated skills is what most educational and psychological therapy emphasizes.

Rather than teaching skills that are already demonstrated by the child, it would seem cleverer to remove the emotional obstacles that are in the problem situation.  Eliminating fear of north-south streets is more effective than giving bicycle-riding lessons.  This is exactly the contrast between CAER and the more skills training orientation of traditional ADHD therapy.

How CAER Works

The active ingredients in CAER is not new.  There seem to be three major elements of the CAER experience:

1) Deep relaxation,

2) Vivid imagery,

3) Juxtaposition of these two processes to extinguish the feelings produced by the images.

The CAER machine triggers a physiological response that puts most people in a profoundly relaxed, almost sleep-like state.  This happens within three to ten minutes of their very first experience with CAER.
In this deeply relaxed state, their imagery is also enhanced, much as if they were dreaming.  They can vividly relive emotionally distressing experiences.  The powerful relaxation overpowers the anxiety and eventually extinguishes it.  The image is left, willfully accessible, but no longer elicits an emotional response.  In other words, the person can then think of the previously emotionally arousing event without being emotionally aroused.

The patient is aided in this because of a process that naturally occurs in the brain.  The brain orders emotionally similar images into chains. Because of this, once the patient experiences a particular feeling state, other experiences with the same feeling tone are stimulated and thereby become accessible to the patient, one after the other.

What CAER Looks Like

The technology for CAER is a seven-foot long, five-foot high, three-foot wide, white fiberglass pod.  It looks like a giant Easter egg laying on its side.  The door on the side opens like a car door.
Inside is a foam bed with walls that are covered with soundproof foam.  In the ceiling, above the patient’s eyes, are two small red LED’s (electronic lights).  They are placed about 2.5 feet in front of the patient and horizontally about 2.5 feet apart. The patient wears soundproof headphones to listen to music or other verbal stimulus.

The patient lies in the soundproof pod, with the door closed, in total darkness.  The lights and sounds oscillate back and forth at about one round-trip per second.  The patient watches the lights by moving his eyes back and forth in time with the moving lights and music.

The Experience of CAER Treatment

For the first few moments, most people find their attention is primarily occupied by watching the lights and listening to the music.  Soon this becomes automatic and effortless.  While still fully conscious, the patient experiences a relaxing, alert, dreamlike state. Most patients enjoy the experience of  CAER.  It is very relaxing, much like sleep.

When the patient thinks about negative, emotionally loaded events, first they experience the emotions attached to that image. That is, they feel like they normally do when they think about such things.  After a while the emotional response to the imagery weakens and eventually vanishes.
Concerns that formerly elicited strong emotional responses become boring and effortful to remember.  In other words, the event becomes an emotionless memory that no longer drives current feelings, behaviors, and perceptions.

Following therapy, similar day-to-day events invoke less emotional response because they no longer have ties to similar, past, real life events.
Most children like the experience so much that they look forward to their next session.  They quickly recognize that CAER therapy makes them feel better, first while in the pod and later in the real world.  Children use words like “cool,” “wow,” and “that’s something’” to describe their CAER experience.  But toward the end of therapy, they do get bored because, after the negative feelings are extinguished, nothing much happens.

Therapeutic Process of CAER

It is not what happens to you in life that “makes you crazy.”  It is how you feel about what happens to you that “makes you crazy.”  You cannot change what has happened to you, but you can change how you feel about those events.  And that is all that counts.  You can rewrite your own history, in the emotional sense.

You can do this by erasing the negative emotional loading from memories of past experiences.  Images that are emotionally loaded automatically attract attention.  But images that have no emotional loading, by contrast, are difficult to notice.  Think about how hard it is to concentrate on a calculus textbook and how you can’t stop reading a sexy novel.

Only through the power of willful attention can we force ourselves to read a calculus textbook and do the required homework.  That’s because the calculus textbook has no emotional loading for most of us.
A sexy novel, however, seems to suck you into its pages.  The words create images that trigger positive feelings. Emotions rooted in historical experiences also have the same power to control our current behavior.  Without the ability of these historical learning experiences to elicit emotions, they have no power over our current feelings and behavior.
Extinguish the power of these images to evoke feelings and you erase their power to continue to twist our lives.  This is exactly what CAER does.  The full-color, emotional movie becomes a silent, black and white documentary of the facts of our history.
The memories are not lost, just the destructive feelings attached to them. The goal, then, is to remove the emotional barrier to accessing already present skills, rather than teaching new skills.

Experiencing these upsetting emotions while on CAER subjects these feelings to the powerful emotional extinction.
For example, the children may be instructed to think about math or social studies class.  Initially they usually find such imagery makes them anxious and angry.  In a few minutes to an hour, these feelings fade out.
In the case of the ADHD child, other people in the feedback loop, such as parents and siblings, are asked to record an audio tape.  On this tape, they make statements that precede and provoke the child’s problem behaviors.  Statements like:

“Don’t hit your sister.”
“Be quiet.”
“If I have told you once, I have told you a million times to....”
“Sit down and do your work.”
“Why are you always...?”
“Is your homework done?”
“Get in there and clean your room.”

Such statements serve to irritate, agitate, anger, or depress the child, even though they may not affect others in the same way.
Each of these tapes is then played to the child while he is in the CAER machine.  The emotionally provocative quality of the tapes is immediately apparent.  The children grimace, grunt, cuss, double up their fists, wiggle, complain, or yell while listening — an exhibition of the same emotional responses that are precursors to the child’s problem behaviors.
This happens for the first few cycles through the tapes.  As the tapes continue to play, over and over, the emotional arousal fades to deep relaxation.  The child becomes very relaxed and eventually bored with these formerly provocative statements. Teachers are also asked to make a similar tape.
After listening to the teachers’ and parents’ tapes, the words lose their emotional impact and become only words — words unadorned by conditioned emotional responses.

Also, as the powerful negative emotions fade, behavior and feelings that are normally suppressed emerge.  And the child can access skills, strengths, and abilities that previously had not been at his disposal.
When the children return to class, the angry and anxious feelings are no longer stimulated.  Typically, their performance improves because it is easier to concentrate on the material and they have better access to the skills they already have.

ADHD Treatment Follow-Up Study: May, 2000

Even though, after treating ADHD children and their families for years it was clear that CAER treatment was very effective; it was finally time to do a systematic quantitative follow-up study. The results strongly support my clinical impression that CAER makes dramatic improvements in all aspects of the constellation of symptoms comprising ADHD/ADD, without the use of medications. It should be noted that these are some of the most difficult ADHD children around. Parents don't spend the time and money to fly to Spokane until they have exhausted all closer and cheaper alternatives.

Over 2 years (98, 99) I saw 74 children, and their families, who could be clearly diagnosed as ADHD/ADD. Their ages ranged from 6 to 17 years. Seventy six percent were males the balance females. Ninety six percent had previously been treated with psychotropic medications, such as Ritalin, Cylert, Adderall, Dexedrine, Chlonadine, Paxil, etc.
We were able to contact 49  parents by telephone to administer a short questionnaire about the effects of CAER treatment on their ADHD/ADD child. To avoid a short-term placebo or honey-moon-effect, only families 6 months or more post-treatment were contacted. All families were treated with three multi-hour intensive treatment sessions over three days.

Overall results were:
 86%  rated it as Very Effective
 6% rated it as Effective
 8% rated it as No Different
 None rated it as harmful.

None of the children in the Very Effective or Effective categories had been placed on psychotropic medications. Of the children rated No difference, 58% in that category had been placed on psychotropic medications, with mixed effectiveness.
A more complete summary of the results of this study are available on my web site: www.caer.com
 The Book:

Order here

ADHD : A Path to Success - A Revolutionary Theory and New Innovation in Drug-Free Therapy by Lawrence Weathers, Most books on adhd rehash the same worn out theories and treatments. Instead, ADHD: A Path to  Success offers a new perspective on ADHD that makes sense with your own personal experience. -  it is not a deficit, defect or neurological disorder.                       - it is a highly refined, short-term coping skill that backfires.                       - takes it out of the realm of medical mystery and psychobabble.                       - describes a new, no drug, no diet, no nonsense, patented treatment technology.