The overstimulated state of dyslexia: perception, knowledge, and learning

When the Analytic Patient has Attention Deficit Hyperactivity Disorder

Most analysts are now treating or can expect to treat adult patients with cognitive deficits such as attention deficit hyperactivity disorder (ADHD), based on the prevalence of this syndrome in children and its continuation into adulthood. ADHD is a cognitive disorder considered by nonanalytic and analytic writers to be a dysfunction of affect regulation and behavioral inhibition. Analysis deals with these issues, and most analytic theories address affect regulation. Manifestations of ADHD can mimic the clinical expression of intrapsychic conflict, in which the cognitive deficits are embedded. If these symptoms are interpreted primarily as transference resistances without acknowledging the cognitive contribution, the patient may experience a resurgence of feeling misunderstood and shamed, helpless and defective. Confusion in the countertransference is a hallmark of analyses in which cognitive deficits are intertwined with psychic conflict, sometimes leading the analyst to compartmentalize the cognitive and the conflictual and to miss aspects of the patient and the process. Appropriate action within the analytic frame may be needed to help the patient seek information, specialists, or coaches to deal with limitations in executive functioning. A variety of technical considerations and confusions in the countertransference are illustrated.

Psychosocial experiences associated with confirmed and self-identified dyslexia: a participant-driven concept map of adult perspectives

Concept mapping (a mixed qualitative-quantitative methodology) was used to describe and understand the psychosocial experiences of adults with confirmed and self-identified dyslexia. Using innovative processes of art and photography, Phase 1 of the study included 15 adults who participated in focus groups and in-depth interviews and were asked to elucidate their experiences with dyslexia. On index cards, 75 statements and experiences with dyslexia were recorded. The second phase of the study included 39 participants who sorted these statements into self-defined categories and rated each statement to reflect their personal experiences to produce a visual representation, or concept map, of their experience. The final concept map generated nine distinct cluster themes: Organization Skills for Success; Finding Success; A Good Support System Makes the Difference; On Being Overwhelmed; Emotional Downside; Why Can't They See It?; Pain, Hurt, and Embarrassment From Past to Present; Fear of Disclosure; and Moving Forward. Implications of these findings are discussed.