[Psychodynamic models about the origins, internal processing and treatment of ADHD].

At first the symptoms of ADHD can be viewed as part of the natural expressive repertory of the infant. Later they merge with pathological relationship patterns. The pathology sets in--apart from genetic vulnerability--through flawed early interactions as well as early childhood trauma. In the attachment theory the results are termed as anxious ambivalent and disorganized attachments. The further course of ADHD remains dependent on the course of the child's relationships and forms itself in symbiotic and narcissistic reaction patterns. By means of impulsive-aggressive outbursts and restless inattentive behaviour the child tries to attract attention and evade attention, express hurt and take revenge in the same instant. Likewise the child may ward off traumatic memories or even protect himself from a depressive breakdown. During its prolonged use until adolescence medication can change from good to bad object and then at best serve to hide the existence of sadistic fantasies behind a well-mannered facade.