Resilience has been a topic of focus, research, and discussion in the fields of education and mindfulness for several years. The capacity to recover from setbacks is integral to living a happy and successful life. Two of the most important skills needed to build resilience are the ability to manage problems and the ability to build relationships. What if you are genetically predisposed to have difficulty with either of these skills?
Dr. Mark Bertin is a developmental behavioral pediatrician and an assistant professor of pediatrics at New York Medical College. He is a frequent lecturer for parents, teachers and professionals on topics related to child development including autistic spectrum disorders, ADHD, parenting and mindfulness, and also leads mindfulness classes for interested families. He spoke with iBme intern Owen Henderson about how mindfulness can help kids with ADHD and high-functioning autism develop resilience.
First, can you talk about what ADHD and high-functioning autism are, as they are often misunderstood.
Dr. Bertin ADHD is a medical condition; the genetics of ADHD are almost as strong as the genetics of height. It is a developmental disorder that affects a skillset called executive function. Executive function is a cognitive set that has to do with anything that requires management in life — attention is certainly a piece of that.
We have to manage a plethora of things every day: our behavior, time, projects, emotions, our health, communication, social situations, and more. So, ADHD isn’t just a school problem, as it is so often presented; it really affects just about everything a child engages in.
Autism is another medical condition. It results in a delayed development of social intuition. People with autism don’t intuitively understand all the non-verbal levels of communication. There is a lot of nuance to monitoring facial expressions, the tone of voice and humor, and more.
What does mindfulness mean to a developmental behavioral pediatrician?
Dr. Bertin Mindfulness has become part of everyday life for me now. The more I sit with mindfulness it becomes simpler and it also becomes deeper — it’s a bit counterintuitive to the mind. I always try to define it without using all of the mindfulness jargon, but it becomes hard to avoid: mindfulness to me is trying to live life well.
My most recent and simple definition of mindfulness would be unbiased awareness. This awareness is just seeing life as it is with more clarity. But most people teaching and practicing mindfulness nowadays are using the term to describe this bigger umbrella of practices, which includes working with compassion, ethics, and wisdom.
How can this view of mindfulness be applied to those struggling with ADHD?
Dr. Bertin There is a misconception that both mindfulness and ADHD are solely about focus. They are like two sides of the same coin: mindfulness is about this practice of helping manage the challenges and ups and downs of life skillfully, while ADHD is, in short, a management disorder.
Mindfulness can really support ADHD care top to bottom. There is research being done on the benefits of mindfulness practice on the emotional component of ADHD. Most people don’t recognize that emotional reactivity is part of ADHD, because managing emotions with ADHD is difficult. Managing emotions is difficult for anyone, but that struggle is magnified for people with ADHD.
Quite often ADHD is a stress-producing disorder because if you’re having difficulty managing day-to-day life that is going to cause you to feel stressed. If you are feeling stressed and swamped, it will be even harder to manage day-to-day life, and a ruthless cycle can begin. Mindfulness can be a wonderful tool to settle the cycle.
One basic premise of mindfulness is gaining the perspective to stay settled during difficult times so you can handle emotions like stress. That concept of seeing things with clarity and noticing where we are caught up in habit and reactivity allows for space that is certainly quite useful when people are trying to manage their emotions.
There are an awful lot of exciting inquiries about the pairing of ADHD and mindfulness, but there is still a lot more research that needs to be done.
How do you navigate kids with ADHD through self-compassion practice?
Dr. Bertin Here is a great one-line description of ADHD: it’s not a disorder of not knowing what to do, it is a disorder of not doing what you know. People with ADHD are just as bright and capable as everyone else, they just have this management disorder. So, the way in which you view ADHD drastically affects the way the diagnosis will affect your life.
The unbiased awareness of ADHD is knowing where ADHD is undermining you and knowing what supports are going to benefit you and what your strengths are. The premise of self-compassion practice is really saying that we tend to be really much harsher on ourselves than anyone else. That has long-term implications about our resilience, about our well-being, and about our ability to set goals and stick to them. ADHD, for many people, really undermines self-image and self-confidence and that inner critic can be really overwhelming and loud. The core practice of self-compassion is seeing your inner critic and accepting it as a habit — and then working with it directly. So, helping kids with ADHD build a self-compassion practice can be really foundational.
In my experience teaching classes for people with ADHD, the most challenging part is forming the routine of meditating. That’s where ADHD is a reflection of everybody’s experience, but magnified: everybody has trouble with starting their meditation practice and quieting down the mind. So, in order to start a practice successfully, there needs to be this piece of self compassion
If people already have a certain delay in development in either management or social intuition, how will looking inwards fix the problem for them?
Dr Bertin Mindfulness isn’t necessarily about going inward to fix these problems, but to relate to them better. It is about recognizing our problems and working with them differently.
For example, people with ADHD often talk about how it is really hard to have a conversation in a noisy distracting environment. Practicing mindfulness doesn’t necessarily mean you suddenly have this laser focus. Instead, it might be that you let go of the self-judgement enough to be able to say to whoever you are talking to: “if we’re going to have a serious conversation let’s go outside.”
Moreover, it might help people with autism develop perspective and understand social situations in a more nuanced way. It also just might also help them navigate social situations once they start looking at it that way too. But, it isn’t the same thing as fixing problems, or curing them.
Is there anything you want to say about resilience?
Dr. Bertin Resilience is your ability to bounce back from challenges. We all need to develop that capacity for managing life’s challenges, so that we can continuously bounce back. Mindfulness can help us all relate to our problems with less friction, and more peace.
From there, we can build resilience.
Dr. Mark Bertin Full Bio
Dr. Mark Bertin, a board-certified developmental behavioral pediatrician, studied at Cornell University and the UCLA School of Medicine before completing general pediatric training at Oakland Children’s Hospital in California. After several years in general pediatrics, he completed a fellowship in neurodevelopmental behavioral pediatrics at the Children’s Evaluation and Rehabilitation Center (Rose Kennedy Center) at the Albert Einstein College of Medicine in New York.
Dr. Bertin is an assistant professor of pediatrics at New York Medical College and serves on the faculty of the Windward Teacher Training Institute. From 2003 to 2010, he was Director of Developmental Behavioral Pediatrics at the Westchester Institute for Human Development, working in their foster care program. He is on the advisory board for Reach Out and Read, a national organization promoting child development and literacy, as well as with Common Sense Media. Dr. Bertin is a frequent lecturer for parents, teachers and professionals on topics related to child development including autistic spectrum disorders, ADHD, parenting and mindfulness.
Dr. Bertin also leads mindfulness classes, having attended trainings at Jon Kabat Zinn’s Center for Mindfulness in Medicine among others, and he incorporates mindfulness into sessions on an individual basis for interested families. Dr. Bertin’s books The Family ADHD Solution and Mindful Parenting for ADHD integrate mindfulness into evidence-based ADHD care, and he is a contributing author for the textbook Teaching Mindfulness Skills to Kids and Teens.