ODD & Oppositional Rising

Part of the ADD/ADHD Cormidities series
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Small Blessings

by Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC

Fortunately, most of us with ADD do NOT have full-blown, comorbid, diagnositic ODD – Oppositional Defiant Disorder – a protracted “terrible twos,” on steroids!  

Almost ALL of us, however, ADD or not, have a small – perfectly “normal” – part of our personalities that balks unless the task is totally appealing in the moment we are “supposed” to take it on.

Part of developmental maturity is learning how to “postpone gratification” and work with what some therapists and self-help gurus call “the self-saboteur.”  (I prefer to think of it as “learning how to bribe our Inner Three-Year olds.”)  

In any case, and for whatever reason, those of us who qualify for an ADD diagnosis, even those who aren’t particularly impulsive otherwise, seem to struggle with “postponing gratification” more than the neurotypical population: sort of like having “ODD Rising.”

ABOUT ODD Rising

“ODD Rising” and “Oppositional Rising” are my terms for what I refer to as “a high oppositional piece” in an ADD symptom profile.  ODD rising is significantly below the diagnostic threshhold for ODD, yet severe enough to make us feel a little crazy as we wonder what it is, exactly, that is stopping us from achievement commensurate with our level of intelligence or education.

I keep up with the ODD field, as I keep a keen eye on all of the ADD Comorbid diagnoses, but ODD itself is not my speciality. 

My focus is applying what I learn from related disorders to help those with Attentional Spectrum Disorders work with whatever it is that is going on with them: learning to drive their very own brains.

AFTER I offer a brief introduction to diagnostic ODD, the remainder of this article will introduce the “oppositional piece” concept. I will revisit ODD in future articles exploring ADD comorbidities — conditions that frequently accompany an ADD diagnosis, to a statistically significant degree more often than in the neurotypical population.

If you are a parent of a child with diagnostic ODD:

At the bottom of this article, and peppered within it, are some links to information you may find helpful, like the American Academy of Child and Adolescent Psychiatry’s ODD Resource Center, and the link to their “ODD search page” below. My ideas and concepts below may help you understand and work with some of your reactions, but probably won’t be particularly helpful with theirs.

I wish there were something I could tell you that would ease your child’s passage, but I’m sure you have already tried, with little to no success, much of whatever I might suggest.

• My heart goes out to you.
• I know that NOBODY understands (or believes)
  what you go through every single day.
• ALMOST EVERYBODY seems ready to jump in to tell you
  what you are doing ”wrong” as a parent.
• They hold forth with their plain vanilla parenting tips
  with tut-tut-tuts and rolled eyes, blissfully unaware of the arrogance of their opinions.
• Maybe these words will encourage one or two of them, at least, to withhold judgment – even to offer a bit of emotional support.

 

So what Is Oppositional Defiant Disorder?

Briefly, ODD is a disorder marked by varying degrees of chronic aggression, frequent over-the-top emotional outbursts (often accompanied by a rage componant), a high tendency to argue for its own sake, to ignore, if not openly defy, even the most reasonable or innocuous requests, and to engage in intentional behavior designed to annoy.

Hold that Thought

Before you follow that thought that sounds something like, “Isn’t that the definition of a typical teenager?” I want you to understand that, while these tendencies do occur in children and teens who are develeloping neurotypically, individuals with diagnostic ODD are way outside any idea of “normal” behavior that most of us might ever expect to see.

Psychiatrists frequently say that ODD characteristics are “beyond age-appropriate behavior norms,” which doesn’t BEGIN to describe the severity of the symptoms.

As with ADD, there are many ideas about what causes ODD, whether it is even a “real” diagnosis, and what to DO about it, with relatively few definitive answers.

Risky Business

According to this linked article on the ADDitude Magazine website, some professionals believe that up to 40 percent of children with ADHD are at high risk for developing ODD, possibly related to the high incidence of impulsivity frequently accompanying ADD, especially problematic in children with gross motor hyperactivity as a key piece of their symptom profile.

Other professionals believe ODD develops as a maladaptive coping mechanism in reaction to the frustration and emotional distress of living with ADD/ADHD, coupled with the paradoxical effect of “traditional” parenting techniques, which inadvertently “fan the flame.”

Medical Professionals say that approximately half of all ODD preschoolers will have outgrown the problem by the third grade (roughly, age 8) — which slides very neatly over the other, more daunting reality:  after the third grade, the other half of the ODD childhood population is likely NOT to outgrow it without some serious effort expended on their behalf.

Early intervention seems particularly important with ODD. If left untreated, oppositional behavior can evolve into conduct disorder and more serious behavioral problems that can follow a child into adulthood, quite possibly into a life of crime.

Oppositional Rising?

I borrow a concept from the astrology community to talk about what I call a “high oppositional piece” – the “ODD rising” many of us in the ADD universe seem to experience, with various degrees of severity,

Whether you believe in astrology or not is immaterial. Many of its concepts are aptly descriptive, providing useful metaphors and analogies that help to explain and discuss human behaviors without pathologizing them.

It’s interesting to note that there are almost as many schools of thought about astrology as there are about ADD – but we’re only going to pay attention to the ones that embrace the idea that there’s an up side and a down side to almost everything, and that understanding what we were born with gives us a great deal of “free will” in handling it!

So what is a rising sign?

Let’s back up half a step. With apologies to serious astrologers for the unsophisticated explanation, one’s sun sign is the one you might look up in almost any newstand magazine that has an astrology column.  Since your sun sign is based upon the time of your birth, it’s pretty easy to look up a “horoscope”  where some astrologer gives you a general paragraph or two about what the stars say about everyone born with the same sun sign for any particular month.

Your sun sign is the “context” or “basket” in which you hold your life.

For those of us with ADD, our metaphorical “sun sign” is ADD!  It does seem to be the basket in which we hold an awful lot of almost everything.

And, just like a room full of Scorpios or Libras (or any other sun sign in the Zodiac) will have enough characteristics in common that they all can sort of relate to that generalized magazine horoscope, those of us with ADD can sort of relate to many of the descriptions we read about what’s going on with us — with a whole lot of individual differences totally uncommented upon until we delve MUCH more deeply into either arena. 

In astro-speak, your rising sign is “the face you present to the world” – which leads me to “oppositional rising”

• The first step in managing ODD is making sure that the ADD/ADHD is under control, along with any comorbid anxiety, depression, and bipolar disorder,  That is exactly what has to happen to be able to manage ODD Rising too.

• The next step is understanding the nature of this oppositional piece and the extent to which it causes trouble with our ability to reach our goals and manage our lives — no matter whether we present it to the world or grapple with it alone, trying our darndest not to let it show.

Going through “NO DAMNED WAY!” to get to “yes”

I’m sure you know somebody who seems to have an argument for just about everything – most of us do.

Have you ever noticed that if you can simply let the idea drop without comment or further attempts to persuade, your nay-sayer frequently has a change of heart that might as well be an about-face? (That is, unless you simply can’t resist pointing out that they have had a change of heart – in which case, they’ll argue with you forever!)

The WORST thing you can do to those with ODD Rising is to attempt to push them to a change in point of view they are simply not ready to embrace!  They’ll dig in and defend every single time.

That’s exactly the tactic that is necessary to work with our own oppositional pieces: pay no attention to the man behind the curtain of no-no-no!  Leave him alone and he’ll probably come around on his own – as long as you don’t make a federal case out of it when he does.

It’s not ABOUT “logic” or “convenience”  or “selfishnish” or “grubbing for power” — or anything else that those who are fairly amiable folks might believe.  After ALL, you easy going fella’s would never be so intractable without a darned good reason, and only the psychologically unhealthy among you would refuse to even listen to points of view that might allow you to see the subject differently, right?

Wrong!

Old Television Sets

I’m sure some of you will find this difficult to believe, but “back in the olden days” televisions had NO remotes.

We actually had to walk across the room to change the channel on our television sets, turning a mechanical knob affixed to the front of the set itself.

Some TV sets came with knobs that turned more easily than others, but even a young child had enough hand strength to twirl the dial. You amiable, agreeable folks are like those old TV sets: it doesn’t take much to change your channel.

Try to imagine what might happen if one of those young children changed the channel with the remnants of a very gooey peanut butter and jelly sandwich all over his hands, gumming up the works.  Let’s pretend that happened right before your entire family left for vacation.  “Turn off the TV, Steven, we’re ready to leave right NOW.”

By the time you returned, whatever was gumming up the works was rock solid. The dial is now stuck.  FIRST you have to warm it up, then you have to wipe it off — and until you do, changing the channel suddenly becomes a difficult process indeed.

Those with ODD Rising have a channel changer that’s “stuck” — it doesn’t move without a great deal of energy and effort.  They need time to “warm up” to the new idea and to “wipe off” the remnants of their old point of view.

Like my father used to say – all the time – “If it doesn’t go, don’t force it!”  

Although I’m fairly certain he was referring to mechanical processes, not cognitive ones, it turns out to have been a pretty good mantra for just about everything.

Try it on for size!

Cingulate Inflexibility

With advance apologies to my colleagues in the neuroscience fields for the oversimplification, in the next article in this series, we’re going to take a look at what has to happen in our brain to be ready-willing-and-ABLE to “change our minds,” which is not too very different from changing a channel on an old television set (in concept). So stay tuned!

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Related articles

• ABOUT ADD Comorbidities – Comorbid or Co-occuring?
• Overfocusing: Cognitive Inflexibility and the Cingulate Gyrus (Stubborn or STUCK?)
• ODD & Oppositional Rising
• ADD Seldom Rides Alone
• Remembrance of Selves Past
• ABOUT ADD and Sleep Struggles
• Differential Diagnosis - distinguishing ADD from Comorbidities

Oppositional Defiant Disorder

• What Is Oppositional Defiant Disorder?  (ADDitude Magazine)
• Oppositional Defiant Disorder (succumbingtomyawesomeness.wordpress.com)
• Multiple Articles about Children with Opposition Defiant Disorder (American Academy of Child & Adolescent Psychology)

UPDATE 12/16/2012: For anyone who doesn’t understand what *real* ODD affect looks like, click: I am Adam Lanza’s Mother for an empathy lesson you will NEVER forget.

ODD Power Point Presentation (with access to more):

• Nbb powerpoint for edu 503 (slideshare.net)

• Adding Letters To The Alphabet Soup (littlefallofrain.wordpress.com)
• Help For The ADHD Mom & Child (kidsincowtown.wordpress.com)
• Is It Lying or Is It ADHD? (rakadd.wordpress.com)
• ADHD-related impulsivity(Attitude Magazine)
• Nevada Equine Assisted Therapy (sucessfuleducationforfosterchildren.wordpress.com)
• Sociopathy (psychopathresistance.wordpress.com)
• Parent Training and Conduct Disorder Outcome (brainposts.blogspot.com)