Frequently Asked Questions

Yes.  The common link is that many, if not most, health and wellness issues – whether physical or mental – can be traced to the lasting influence of early childhood experiences.  It’s no longer controversial, at least not in the scientific literature, that human physiological and psychological development is heavily dependent on and influenced by the nurturing environment in the first few years of life.  When children have the right environment for development, they tend to grow into healthy adults.  When those necessary conditions are not available, for whatever reason, disease and disorders are more likely to arise later in life.
It’s the same principle as with any living thing, really:  the right conditions need to be present in order for the innate potential of a grain of corn, or a baby bird, or a human infant, to grow and mature according to nature’s intended blueprint.  Inherited factors may play a part, but the simple biological fact is that genes only express and realize their potential through interaction with the environment – and that’s where things can and do go so easily awry, especially in a stressed-out and increasingly fractured society like ours.

The psychiatrist Thomas Hora said:  ’When you get the ‘what’, you know the ‘how’.’  In other words, what we do about a problem will have a lot to do with how we understand that problem in the first place.  So my interest is in helping people understand all these issues in a new way; and from that understanding, the solutions will arise naturally.
In North America, we tend to be too oriented around trying to fix problems without first seeking to understand them, where they come from, what they’re really about.  That leads to superficial approaches that don’t get at the heart of whatever problem we’re trying to solve – for example, trying to change a child’s behaviour (with ‘time outs’, punishments, and so on) without understanding what that behaviour means about the child’s development, and what conditions, if we worked consciously to provide them, would foster natural development and improvement.

‘Blame’ always assumes that somebody is doing something bad deliberately or willfully.  I know from my own parenting that many things I did as a parent, things I now regret or wish I’d done differently, had nothing to do with ill intention on my part – just a lack of knowledge or of consciousness.  They also had to do with stresses on me that I wasn’t aware of, or didn’t have the inner resources to deal with at that time; and also with parenting styles and problems that tend to be passed on from one generation to the next.
None of this is anyone’s ‘fault’ – it’s just how it seems to go for human beings. So it’s never appropriate to blame individual parents.  People do their best, often under very difficult circumstances.  But it is important to understand the simple scientific fact, which is not controversial, that children’s emotional and psychological surroundings shape their development in crucial ways – both in terms of brain development and personality development.Given what I’ve already said about the impact of stress on parents and their children, it’s clear that adding blame to the mix is worse than useless for parents:  it’s completely counterproductive, since being blamed or blaming yourself is a surefire stressor (especially when you’re already doing your best, as the vast majority of parents are.)
What is useful is to understand what the conditions are that children need for their optimal development.  And, as best we can, we need to strive to provide those conditions for our kids, whether on the individual parenting level or on the social policy level.  If our kids are already grown, it’s possible to look honestly at the stresses they may have absorbed when they were younger without at the same time blaming ourselves for it.  Compassion, for them and for ourselves, is the key.

One can receive the treatment that Western medicine has to offer, and gratefully so, and at the same time there’s no need to restrict oneself to that approach.
In my view, diseases like cancer, rheumatoid arthritis, and multiple sclerosis – among others – are rooted in people’s lifelong emotional patterns.  This contradicts the Western medical notion that diseases have a life of their own.  Diseases are not autonomous or independent from a person’s life, and real healing requires examining and understanding what hidden stresses and emotional patterns may have contributed to the onset or spread of these diseases.
People can and should turn to Western doctors for treatment, especially to alleviate symptoms and make life more livable.  But at the same time, no one should think that the answer ends there or that that’s all there is to it.  The Western medical approach is valuable and has plenty to offer, but it’s also narrow.  Most Western doctors, no matter how skilled or well-intentioned, haven’t got a clue about the stress-disease connection because they haven’t looked at the evidence.  Medical schools don’t teach the latest findings in psycho-neuro-immunology, which is the field of research that looks at the fascinating connection – the unity, rather – between emotions, the nervous system, and the immune system. (And incidentally, this applies to all the subjects I write about:  addiction, ADHD, parenting.  People often go to pediatricians, for example, and ask them about how fix their kids’ behaviour problems – the problem being that pediatricians, for the most part, know nothing about that.  They’re not trained in normal child development, they’re trained in diagnosing treating childhood diseases.)
Of course, in our society most of us have been brought up to believe in the doctor as an authority figure, and people often feel that they lack the knowledge, confidence, or faith in themselves to ‘challenge’ their doctor’s approach.  Add that to the fact that many people with chronic diseases have a history of suppressing their own needs and a deep reluctance or fear of displeasing others – incidentally, which is one of the key stressful ‘emotional patterns’ that can predispose someone to disease in the first place – and you have a situation where advocating for one’s own care can be a real challenge for people.  (If you do find that you’re afraid of displeasing your physician, you might want to look at that as a great example of your self-defeating – and self-stressing – ways of being in life and ask yourself, what’s that all about?)
The good news is, your doctor doesn’t need to support or believe or even know anything about the perspective I’m advocating.  Why would he (or she)?  It’s not part of his training or the language that he speaks.  You wouldn’t go to a car mechanic for a back rub.  So I wouldn’t worry so much about whether or not your doctor is ‘on board’.  If so, great.  But it’s far more important to do the work yourself to identify and understand, with compassion, your own tendency to take on more than you can handle, to take on other people’s emotional needs, to suppress your own needs, and so on.  You can look at the ‘stories’ or interpretations that run your life, and the stressful impacts of those stories.  You can recognize when your body is saying no, and consider what it is saying no to. You can be curious and compassionate with yourself.Your doctor can help you with what she can help you with; for the rest, look elsewhere.  That includes looking within for your body’s own wisdom, and also looking to other resources outside the Western medical system, whether they be therapy, or spiritual or personal growth work, or alternative treatments that appreciate the mind-body unity.  See my Resources page for some ideas of where to start.

There’s still a lot of resistance, on a systemic level.  Medical training hasn’t nearly caught up with the actual evidence that’s available, whether culled from the abundant contemporary scientific literature or from the wisdom of the ages (which has, of course, always understood that mind and body are inseparable.)
At the same time, within Western medicine there is certainly some movement and some encouraging signs.  There are Western-trained doctors and academics like UCLA’s Daniel Siegel and Northwestern University’s Bruce Perry (head of The Child Trauma Academy in Houston) who have done wonderful research, and of course practitioners like Andrew Weil and Deepak Chopra who have done much to publicize new approaches.  There’s a growing emphasis on nutrition, on brain development, on the importance of the environment.  There’s the work of Jon Kabat-Zinn on mindfulness in healing practices.  So yes, there’s a lot more popular force these days behind these approaches that seek to open up medical practice and take it beyond the limited biological, technological paradigm.
The enthusiastic response to my books and to the work of others working in these areas gives me a real sense that something else is, in fact, possible.  When I present to audiences of academics or professionals (e.g. psychiatrists) they tend to be very positive about what I’m saying – it’s just that they’d never heard or seen the evidence before.  It’s new to them.  It’s not what tends to get talked about at conferences; it’s also not part of the journalistic literature.  The media prefers simple genetic explanations (no matter that such explanations are generally shown to be bogus) than a more nuanced understanding of how the environment shapes brain development.  That says more about the institutional inertia of the system, of the profession, and in our culture at large, than about people’s individual interest level or openness.The public is definitely very hungry for a different, broader perspective.  People know intuitively that what they’re getting from Western medicine does not speak to the totality of their experience.  Hopefully, a critical mass is building that will cause the dam to burst even more and have this material permeate how we train health professionals in this society.

Generally speaking, anyone genuinely interested in humanity and its problems will want to look at humanity on both the individual and social levels, because the two can’t be separated.  More specifically, people’s well-being is very much related to their socioeconomic status.  Social injustice, racial oppression, and economic exploitation – to say nothing of war and occupation, and their attendant traumas – have important implications for people’s health.  So one cannot work for health in a population without addressing what’s happened (and still happening) to them politically and economically.
For example, the rate of prostate cancer among Black males in the U.S. is the highest in the world, whereas their genetic relatives in Africa have nothing close to that cancer rate.  So we’re clearly not talking about a genetic problem, we’re talking about the effects of stress; and that stress is imposed by historical and social and economic factors, and it gets handed down through the generations – not genetically, mind you, but nonetheless biologically.  That’s just one example of how history and societal conditions interact with individual human biology to create a widespread health crisis, and there are many other such examples.
Furthermore, what keeps people stressed in their lives has a lot to do with what they’ve internalized.  People who aren’t liberated from disempowering beliefs about themselves and the world are by definition stressed people, because those negative beliefs are inherently stressful and counter to good health and wholeness.  In that sense, liberation (or wellness) is actually about distinguishing and letting go of outmoded ideas and structures in the mind – which is, of course, the first step in any kind of political liberation.  ‘Free your mind and the rest will follow’, as the saying goes.  Or, as Marianne Williamson wrote, ‘The revolution that will save the world is ultimately a personal one.’
I think it works both ways, paradoxically enough:  we need to work for a healthier society if we want to improve individual health, and at the same time how are we to create a healthier society unless we take on ourselves, our own development, our own physical and spiritual and mental health as individuals?  People who get involved in trying to change the world don’t always recognize this, and that’s a pitfall that makes them less effective.  Particularly in progessive/left politics, you find a lot of oppositional energy, a kind of automatic resistance to authority, which comes from unresolved anger about childhood pain.  And then of course you have hard right-wingers, who invariably are in denial of their childhood pain, their deep anger and fear and shame, which is why they can come across as cold or unfeeling.
Whatever your political commitments, it comes down to this:  any automatic or unconscious emotional reactivity is bound to be a detriment to effective communication.  Even when you’re speaking the objective truth, people who aren’t already on your ‘side’ don’t hear your words or the facts you’re presenting – they only hear the shrillness or stridency in your tone.  So if you want to be effective as an activist for positive change, that’s another good reason to get your own ‘stuff’ sorted out.

No, I’m not;  I am saying that all addictions come from emotional loss, and exist to soothe the pain resulting from that loss.  Trauma and abuse, as we define them, are certainly surefire sources of loss but they’re far from the only ones.  The human infant and toddler is a highly vulnerable creature, and emotional stresses of all kinds in the rearing environment can create long-lasting wounds in the psyche that a person will later try to soothe or numb with addictive behaviour.  In addition to things that do happen that shouldn’t happen, like abuse, there are things that (developmentally speaking) ought to happen that don’t.  For instance, any sustained sense of emotional disconnection with the parenting figure – which can often happen when the parent is excessively stressed or preoccupied over a period of time – has the capacity to have this sort of impact, especially if the child is constitutionally very sensitive.  In a stressed society like ours, with fewer and fewer supportive resources for parents, this is more and more common.
So many of us, whether or not we were acutely traumatized or faced extreme adversity as kids, have these sorts of lingering challenges to contend with.  We can and should be grateful things weren’t worse, but we shouldn’t discount or minimize the pain we carry from childhood even if it didn’t result from severe neglect or abuse.

First of all, I wouldn’t put it in terms of “good” and “bad”, which can have the sort of moral connotations I consider unhelpful in talking about addiction.  I do write in the book that my addiction “wears dainty white gloves” compared with the problems my patients are living with.  That is, clearly a habit like mine is likely to have far milder consequences for my physical health, relationships, and social status than someone else’s dependence on crack, for instance.  I wouldn’t want to trade places with any of the people I’ve treated in the Downtown Eastside – the lives they’ve led have been far harsher and more unkind than mine, and they’ve had far fewer options available to them, by and large.
I do, however, place my addiction on the same continuum as theirs, and that’s important because I firmly believe – and the scientific research supports this – that there’s really only one addiction process.  Addictions are separated from each other only by degrees of severity, which are obviously tied to socioeconomic factors and personal history.  And any addiction has the capacity to fester and grow into a dynamic that can wreak havoc in someone’s life, to their self-esteem, their relationships, and so on.  The fact that some addictions are frowned upon and criminalized in our society (e.g. hard drugs), while others are more or less tolerated (e.g. alcoholism, tobacco smoking), and still others are encouraged or rewarded (e.g. workaholism, the quest for power or wealth) – that’s a rather arbitrary set of standards that has more to do with our culture’s self-delusions than with the truth of addiction per se.
So while the differences between me and my patients are obvious, I’ve chosen to focus on the similarities – the obsessive preoccupation, the negative impacts, the relapses, the rationalizing, the feeling of nagging emptiness at the core of the addict’s experience of life – in order to make this point about the addiction process, to which none of us can claim to be immune.

Again, I’d rather not speak in terms of “good” or “bad”, but if by “good” you mean positive, healthy, nourishing, then I’d say that if it’s good, it’s probably a passion and not an addiction.  Passions can be very consuming of time and energy, but they also feed your soul, your sense of being alive, your feeling of wholeness as a person.  Addictions provide fleeting pleasure or gratification, but never leave you satisfied.  And the same activity could be a passion for one person and an addiction for another.  One might be a wine enthusiast, enjoying the refined pleasures the drink has to offer, while another person’s “love” for wine masks a fear of his own mind in its sober state.
To take a non-substance example, someone who’s passionate about social activism might work tirelessly for a cause, while her colleague may have a workaholic relationship with the same activity.  It all depends on the energy with which one pursues the activity, and what happens when the activity comes to an end.  There may be a letdown after a big event, but does the person feel a sense of basic worth in the absence of the adrenaline and the long hours?  Does she find comfort in the other parts of her life?  Or is she left irritable, restless, and less at ease with the people in her life?
The activity or feeling to which one is addicted may be in itself considered postive or laudable, but the energy of addiction always turns a “good” thing into a harmful one.  In the end it’s not about the object of addiction, but about the relationship one has to it.

When I speak about spirituality, I don’t mean any particular belief system so much as an awareness that one’s mind and personality, through which one has come to view and process the world, are conditioned and constrained by experience – and that there’s more to who you are than that.  Connecting with a “higher power” may just mean connecting with your own sense of being, that awareness that’s more expansive and universal than your habitual stream of thoughts, feelings, memories, and associations that have so far “defined” you as this or that.  You don’t have to “believe” anything to make that connection – you may only need to give up the belief that you’re all alone, you know yourself already, there’s no hope, etc.
If spiritual belief discomfits you, then don’t believe; instead, open yourself to the possibility that you could experience yourself and your life in a different, healthier way – that however difficult it’s been so far, “it ain’t necessarily so,” as the song goes.  But it’s also very helpful and healing if you can come to understand that you are not alone, that there is something greater within and without to connect with than your usual everyday mind, whether you see that as nature, or compassionate humanity, or a “higher power”.
It’s also worth remembering that even spiritual work can become addictive, particularly if one becomes attached to the religious practices or institutions it’s housed in, or the belief systems associated with them.  Anything that the ego can latch onto and say “Aha, now I’ve found the answer!” is likely to feed addictive tendencies, even if the expressed purpose is to move away from those tendencies.  Remember the ancient spiritual wisdom that “a finger pointing at the moon is not the moon itself” – focus on your own journey, your own experience, and not on the particular method or system you’ve chosen to help you on your way.

When someone comes to a doctor with rheumatoid arthritis, it’s not enough that they get prescribed an anti-inflammatory; they should also be engaged in a conversation about the life stresses that triggered the episode of inflammation, as invariably turns out to be the case.  The ultimate aim, of course, is to help people develop the capacity to say no to unwanted stress so that their body doesn’t end up having to say it for them.
One may wish to explore and accept the full range of medical treatments available – and at the same time one needn’t believe that that’s enough, or that’s where one’s options end.  In addition to whatever physical modalities or treatments are offered or accepted, when the time is right and the person is ready, there’s tremendous value to cultivating a real understanding of how one has lived one’s life, maybe in ways that haven’t been supportive of oneself.  That exploration can provide insights and possibilities for change that can greatly improve the quality of one’s life, with or without a serious disease.  Healing (which, in its origins, literally means “making whole”) is a matter not just of physical modalities but of understanding how we generate stress, and learning how not to generate stress.
Both in the literature and in particular examples that I’ve witnessed very close-up, there is ample evidence that this kind of approach can promote healing, prolong life, and most importantly improve the quality of life for people with illnesses.  There are people who have lived much longer, or much healthier, than their medical prognoses would have predicted.
I hope that health professionals will also find this information valuable in providing better and more comprehensive care.

Well, first of all, blame has nothing to do with it, so let’s take that out of the equation. As I’ve written above, blame is a useless commodity in trying to understand or deal with a complex problem, whether one blames oneself or something/someone else (one’s parents, one’s genes, etc.) It’s common to confuse blame with responsibility, which I am advocating and which has nothing to do with blame. Responsibility has to do with taking ownership and, just as the word sounds, with “response ability” – the ability to respond effectively and intelligently, in a way that makes a difference.

I understand that. Look, language has limitations. It’s very tricky to speak about something like “cause” without sounding like I’m personalizing the issue, or pointing the finger – “you brought this on yourself.” That’s not at all what I’m saying. What I am saying is that through no conscious will of your own, and for perfectly understandable reasons that had to do with your own emotional survival and thus were valid at the time, you have developed a personality style that has turned out to be bad for your health in the long run. The inability to say no, the need to take on other people’s problems as your own, the driven need to always be “nice” or “helpful” or “positive” or not “rock the boat”, even if that means suppressing one’s own emotions – these traits are all responses to early childhood experiences and circumstances, over which the child has no control. It’s not even a conscious choice; it’s more of an automatic decision the young self makes in order to stay afloat in stressful emotional waters. Over time, if those patterns get reinforced and become rigid parts of the personality and remain unexamined, they can have detrimental effects on immune system functioning, even to the point of serious illness. They first emerge as responses to stress, but in the long run they themselves are incredibly stressful to body and mind (which are inseparable, as I discuss in the book.)
So yes, in a sense I am saying you created the conditions for your disease, but only with two crucial asterisks attached to the words “you” and “created”. You certainly didn’t create it deliberately, nor did you create the external conditions you grew up in; and in a way it wasn’t really you, if by “you” we mean the part of your mind or soul that makes conscious, rational, purposeful choices. Rather, over time, your emerging personality did what it needed to do to stay intact, and it developed some strategies that have backfired over time. It didn’t know any better, and there’s no point in regretting or belabouring this – only in using this knowledge to empower yourself now.
Taking responsibility means recognizing that you’re the one who can now begin to recognize those patterns (which until now have remained hidden and automatic) and start to do the work to change them – which is really just the work of honouring and (literally) embodying your own, true, authentic self. Sometimes it takes a catastrophe to bring us back to ourselves, to what’s really important. For some people that takes the form of a loved one dying or a horrible accident. I know this may be hard to accept right now, but you might want to consider the view that your disease has actually come along to bring you back to yourself. The great spiritual teacher A.H. Almaas talks about “a part of you that loves you so much that it will make you suffer greatly, to teach you – because what else can it do? That’s its job.”
It’s my belief that diseases like cancer, ALS, multiple sclerosis and so on, that cause so much suffering for people, all come along to teach something – and that if the lesson is learned, with compassion for oneself, then the “teacher” has done its job and can then take a hike. That’s not a guarantee, but I’ve seen many examples of people who have taken on their illnesses in this way and either survived or far outlived what medical science would have predicted, or at least greatly improved their own quality of life while alive. And the research literature confirms this.

I don’t think it’s as simple as that, or if it is, I certainly don’t have the insight to draw a one-to-one link like that. No personality “causes” disease. But the more emotionally repressed we are, the less we can say “no” to the world’s demands, the more we take on, the more stressed we also become. It’s that stress, then, that contributes to the onset of disease in a major way–not the personality directly. In my experience, people with ALS tend to be among the most emotionally repressed of all the patients with these sorts of illnesses – the most heavily defended against their own experience of anger and pain from childhood – but that’s not a medical fact, just a general impression.  Again, that is not their fault–it’s simply how they learned to survive their childhoods–and how we survive our childhoods shape our personalities. (Remember, too, that I don’t claim that emotional stress “causes” disease, but rather that it’s a major predisposing factor, laying the groundwork for disease to arise.)
I do think it’s useful to listen to the language used by disease sufferers themselves, which can have an eloquent, poignant, and sometimes eerie precision in describing how their personalities and emotional worlds prefigure their diseases.  There a few examples that I cite in the book, including Jonathan Swift, author of Gulliver’s Travels, who actually predicted his own dementia (he later died of Alzheimer’s disease) in his poetry, and also in his conversations:  on a walk with a friend once, he pointed to a decaying tree and said, “I shall be like that tree; I shall die first at the top.”  Jacqueline du Pré, the world-famous cello prodigy, once told her sister Hilary in childhood, in a secretive whisper, “Hil, don’t tell Mum but… when I grow up, I won’t be able to walk or move.”  In both cases, these sensitive souls were not just making uncanny future predictions; they were expressing in metaphor what they already felt inside, what their world was like.  These premonitions can also be stored in the unconscious; take my ALS patient who, after a lifetime of recurring nightmares of being buried alive, walked into a doctor’s office following her diagnosis to see a poster that said “ALS is like being buried alive.”
Since the mind and body are inseparable, it’s perhaps not surprising that these premonitory metaphors can grow into concrete physical realities, but it’s still striking – and a reminder of the importance in medical care of really listening to people’s stories, their experiences, their very language, for clues about how they experience the world.

People usually seek diagnosis after recognizing in themselves a litany of the salient symptoms: frequent, involuntary and frustrating tuning-out or absence of mind; difficulty concentrating unless very interested in something; being bored easily; beginning one thing but going on to another before completing the first; problems keeping order physically in one’s room, on one’s desk, in one’s car; often, difficulty being on time; poor impulse control, manifested in speaking out of turn, interrupting others in conversation, impulse buying, and in a tendency towards addictive behaviors; finally, in many but not all cases—and less in women—physical hyperactivity, difficulties sitting still, and fidgetiness.

As I point out in the book, there are many options, and they don’t need to be mutually exclusive. Some may find medication helpful, but they should never be the only treatment. In my view, ADD is not an inherited condition, contrary to the commonly held opinion, but originates in early childhood stresses during the first years of crucial brain and personality development. Hence, counseling to unravel family issues and issues with self-esteem is always important. Physical self care, exercise, nutritious diets, good sleep hygiene, outdoor activities are all important. Mindfulness practices, like meditation, are very challenging to the ADD mind, but extremely helpful.

 Not at all.  It’s a common mistake to think that everything that’s biological is genetically caused.  Biology is greatly affected by what happens in a person’s life, in her family, in the society around her, and so on.  For the most part genes don’t predetermine or “cause” anything that happens – they just lay out a set of potentials that might happen, given the right (or wrong) environmental inputs.  Especially in early childhood, our brains are very much affected by social and psychological relationships.  And, in fact, for its lifetime the brain is in constant interaction with the environment.  So something can absolutely be biological without therefore being written in genetic stone.

 I’d say, forget the label.  If you recognize these traits in the child, and if you don’t want him specifically diagnosed and labeled, you can still go ahead and work on the environment so that it’s more conducive to his development.  Depending on his age and his particular needs, what that looks like will vary, but generally speaking:  look at the (internal and external) stresses in the family, at the quality of the relationships he’s surrounded by, at the amount of structure and security the family environment provides, and so on.  ADD kids are, temperamentally, highly sensitive creatures – that’s what predisposed them to developing ADD in the first place – so they’re often the canaries in the coal mine.  When something’s even slightly off in the surrounding environment – stresses in the marriage relationship, for instance – it will trip these kids’ emotional alarms much more readily than other kids’.  It can take courage to face all of those questions, but if you do, and change what can be changed, and the child will automatically respond for the better.

First of all, I’d say that if my analysis doesn’t resonate with you, there’s probably no point in looking to my book for help.  If, on the other hand, you are interested in pursuing this line of inquiry, there are two things you might want to consider.
One is that like many people, you may simply not be aware of the stresses you’re under.  As I explored in When the Body Says No, people are very often much more stressed than they’re consciously aware of because they’re so used to it.  As a consequence they don’t distinguish or notice their stress, because it seems normal to them.
The other is that, like I said before, these kids who develop ADD tend to be highly sensitive – sometimes exquisitely so.  Just as a sensitive Geiger counter is going to detect smaller seismic disturbances than a less sensitive instrument, so too will sensitive kids pick up on stresses in the environment that may not affect a more stolid or placid child.  Consequently it takes less stressful stimulation to cause emotional pain in a sensitive child.  And I make the case in the book that ADD traits like tuning out and distractability first develop as emotional defense mechanisms against this kind of distress.
All the more reason, then, to take a careful look at the child’s environment with an eye to uncovering hidden stresses, so that you can address them.

I deal with the question of medication at some length in the book, so I suggest first of all that you take a look at that – in particular Chaper 31.
The first thing to understand is that the purpose of medication should never be to control behaviour or to improve grades or other external results; the proper aim is always to help the child function in the world and feel better about herself.  Improved performance may ensue from that outcome – and if so, great – but the focus needs to be on enhancing the child’s own experience of life.  That also means that medication should never be forced on the child, or given in the face of the child’s determined resistance, and would ideally be administered with her consent and participation.  And the child should never get the impression that approval or acceptance from the adults in her life is contingent on her taking medication.  Any short-term gains would be far outweighed by the disastrous long-term consequences, because healthy development (which is what the ADD child needs in the long run) requires trusting, loving, non-coercive relationship.
Secondly, if you do go the route of medication, there’s no reason to stick with a medication that has unwanted side effects, like the “zombification” you’re worried about.  Each medication is different and every brain is different, so individual drugs are going to affect people in different ways.  There are also variations in dosage that can be tried to eliminate side effects.
Overall, as concerned as I am about their overuse and misuse, I’m not against medications in treating ADD.  I’ve prescribed them – in fact I’ve taken them – and have found that they can be helpful, if they’re prescribed and taken in a judicious, targeted, and insightful way.  They are never “The Answer”, but they can certainly provide some help, as long as it’s understood that the long-term goal needs to be healthy development, not just the management of symptoms.

Not really, I’m happy to tell you.
Look, first of all, it’s called a “disorder” for a reason – and I make clear in the book that I don’t consider it a disease, but rather a disorder – which is simply, it dis-orders things in one’s life, creates a lack of order or workability.  So I’d simply ask:  does it create disorder in your life?  If it doesn’t, and your life and personality are working for you, then there’s no problem and therefore nothing to fix.  On the other hand, if you notice that there are aspects that cause consistent and unwelcome consequences in your life, then it’s something you probably want to look at.
Second, so-called “ADD traits” are not the same as the positive traits you’re talking about, and addressing the one won’t inhibit the other.  It’s a common misconception, borne of the fact that people who have ADD tend to be highly sensitive – but it’s actually that very (inborn) sensitivity, not the ADD, that’s the source of you being so creative.  Sometimes artists with ADD are afraid that they’ll lose their ability to think in a rapid-fire, free-associative way, which they consider vital to their creative process.  But that doesn’t go away when you properly address the ADD component.  What do go away, or become more manageable, are the more problematic aspects like impulsivity, or impatience, or  interrupting people, or forgetfulness, or disorganization, or tuning out.  Those aren’t functions of a creative mind but of an immature brain that’s stuck in some early stages of development; if anything they can be impediments to your true creative self-expression.  Addressing your ADD traits should get some of that out of your way so that you can be more effective in your life and your creative pursuits.  And that’s what it’s all about, after all – not “fixing” your personality, but making life more manageable and enjoyable.

Of course not.  Peer relationships are part of natural human socialization. What’s developmentally unnatural, we claim, is that peer relationships have become the primary relationships in childrens’ lives – the relationships they care most about, have the highest emotional stake in, and the primary guiding light for their behaviours, culture, norms, and so on.  This only seems “normal” to us in our society because we’ve lost touch with how nature meant things to be, which is for kids’ primary, orienting relationships to be with adults.  Within the context of stable, secure attachments with responsible adult caregivers, peer socialization can happen in a safe and natural way.

Yes, they have.  As long as humans have existed, we’ve been exploiting each other’s vulnerabilities to gain dominance.  And certainly, children have not been exempt from that tendency.  What’s different now is that the preponderance seems to have increased significantly – everywhere you turn, in virtually every school system, it’s now considered an epidemic on the rise.  It’s possible that we’ve become more sensitized to it, but that can’t on its own account for the dramatic rise in indicence of late.
What’s also different is that kids used to look upon bullies as outsiders and misfits, whereas nowadays bullying behaviour is often a sign of social power and status.  You find entire groups of “popular” kids picking on the unpopular ones – the “strong” many persecuting the weak “few” – and this is considered normal.  Technology and social media, which are very much geared and marketed toward strengthening the peer culture, give kids an additional power to do each other significant emotional harm.  We’ve never seen such levels of childhood and teen violence and suicide as we do in today’s Western society, particularly in North America.
All of this results, we argue, from the peer culture taking precedence over safe, orienting attachments with adults.  And all of the anti-bullying “education” programs in the world won’t make a difference unless this fundamental, and disastrous, phenomenon is faced and dealt with.