Aram Cargill on ADHD, Autism, and the Seven Pillars of Mental Fitness

[00:00:03] Hi, I'm Dr. Russell Thackeray and welcome to Resilience Unravelled, a podcast with new ideas, new thoughts, and new thinking about resilience. Guests with remarkable stories, products and services that can really power up your own mindset and resilience. You can also go to our site for more information, to ask questions, or to access some of our resources at resilienceunravelled.com. Let's get started.

[00:00:33] Hello and welcome back to Resilience Unravelled. And I'm proud to be a guest who is sitting in the dark by the looks of it because it's late where he is. This is Ephraim Ebstein. First of all, evening Aram, how are you? Good evening. Yes, 11 o'clock on this side of the earth, Australia, Melbourne. Thank you for having me, Russell. Absolute pleasure. Melbourne's a lovely place, but of course you forget the time difference, don't you? There you go. Thanks for joining us. Look, Aram starts off. Tell us just a little bit about you as a person. Who are you?

[00:01:03] Uh, let's start with I'm a father of not five of my own and four step children. The founder of BBM, which is brain benefit movement. Predominantly a protocol for those with ADHD to improve executive function through improving self-regulation and now an author, which brings me to the seat in front of you, Russell.

[00:01:29] And yeah, not sure what else people need to know, but yeah, father of nine, clinician in around ADHD and self-regulation. That's your background. That's your background. Is that your, uh, clinician around ADHD? That's the professional background, is it? That's what I am now. My very, very first professional background was a musician, which was a little bit how BBM came to bat came about, but brain benefit movement came about because I have a daughter with autism

[00:01:59] and two sons with ADHD. And during COVID I was lucky enough to have my own incubator lab to be able to examine how early childhood development worked and how the brain came about. It's not my first vocation and my professional background, but I now have five international journal papers published in and around mental fitness and BBM brain benefit movement. Okay. Where to start then?

[00:02:29] Should we start with ADHD? Is that okay? Would you mind that? No, that's fine. Look, cause it's in the news, it's everywhere. There's this argument, there's this argument that there'd been an explosion of ADHD or maybe that we're just able to be aware of at least date. I suppose the first test is what is it and how, is there actually a test for it that proves you've got it as it were? And I know those questions might be quite inexact, but go with me on that.

[00:02:56] There's self-determinant tests, which is set by the DSM. So yes, there is a test for it, a framework that gives us strong indicators that ADHD is occurring. Yeah. But as we are moving forward into this new era, we're getting a lot of ADHD-like symptoms coming up as ADHD, but aren't necessarily ADHD.

[00:03:20] There's a lot of people, we hear all sorts of weird and wonderful things around ADHD, that it's a superpower, that it's not real. But at the end of the day, it is true that we haven't found a genetic gene that determines that somebody has ADHD, but every indicator is that it is hereditary. Yeah. So that is within there. We just haven't found the gene sequencing.

[00:03:46] From my experience, it is a gradient. ADHD is a label, but what ADHD looks like for you and what it looks like for me, if we had it, could be completely different. Yes. And there's a lot of comorbidity within ADHD, like oppositional defiance syndrome, all these

[00:04:08] other coinciding morbidities that we assume potentially come along with ADHD, how much of them are behavioral, how much of them are neurological, how much of them are physiological, and how much of them are environment, distress, and trauma, I think is sub and all of the above. And I think this is part of the problem, isn't it? That you can have the symptoms of ADHD without necessarily having ADHD in that sort of potentially

[00:04:37] clinical, I haven't got air quotes going on here, sort of measurement thing. Can you give me things? Because people talk about having a lack of attention or hyper-focus, but that doesn't, so what's, so that doesn't mean you've got ADHD. So what's the thing that, where does having the symptoms tip into actually having the, that neurocognitive label? So obviously we're registering across a range of dimensions and we'd expect certain tendencies to

[00:05:07] show up to varying degrees across those dimensions, if that makes sense. So when we start to see a pattern within those dimensions and an underlining link, then it becomes more apparent that it is actually ADHD. And the other important thing about this is also that rather than a one-off diagnosis is

[00:05:31] that the history, so the prevalence and the persistence of these, for lack of a better word, traits or behaviors are presenting. And then we can make a more informed decision about how to start addressing it and whether we want to place the label as ADHD upon the individual. Yes.

[00:05:58] It's interesting there that you just paused when it came to the word diagnosis, because it's actually the, it's so new, isn't it? It's actually quite hard to really find a language to, to do the, to actually describe it in a sense, isn't there? Yeah. Look, the label is useful to start as a starting point, but as I said, how ADHD shows up for one person, how it shows up for another is different.

[00:06:26] So if we, I look at it simply as an impairment in executive function, whether that results in ADHD or not is, is besides the point for me. It's about improving the person's ability to self-regulate, which will then in turn assist in developing the cognitive facilities that allow the individual's kind of executive functions

[00:06:53] to start to improve, which is for example, immediacy and being able to engage in delayed gratification, which is hard for most people who have ADHD. So whether that's ADHD or it's a nervous system, that's overloaded for me personally, it doesn't really matter. So what I'm looking for is symptoms that are showing that people have to stress around that

[00:07:19] want to address and start to make those symptoms evolve and develop more functionally. Yeah. And we just address them. Yeah. And that makes sense, isn't it? Because there's been a, there's been a sort of a rush to medicalize the whole area, hasn't there? And I know you, you talk about ADHD without meds and I think that's really interesting, but before we get there, can, for the sake of, for people who may or may not know, or may not be clear, can you just differentiate for me, ADHD versus autism and the sort of major

[00:07:48] differences between those two things? Yeah. Yeah. So they are starting to tend to put them onto the same spectrum. So both of them are referred to as neurodiversity. Yeah. So the brain just working differently, which is correct. But ASD, autism is far more insular and self, the individual becomes far more self-referential

[00:08:18] and introverted, but also that the anchors for their behavior and the way that they interact with the world are quite different. There is an overlap the way that ADHD. So for example, a lot of people with autism will have ADHD, but those with ADHD don't necessarily have autism. So you'll get a much higher percentage of people with autism presenting ADHD.

[00:08:48] I see. Much less ADHD presenting autism. Now, my daughter who has autism, the biggest thing for us, and that's, we were talking just before we came on Russell about, I'm the founder also of BBM brain medicine movement. So in dealing with her, she was a level three autism, which is the highest level is only one, two, and three. Yeah. But we caught it early when she was only 18 months. Wow.

[00:09:18] And so now being six, most people can't tell that she's got autism or is autistic. And one of the simple things your listeners will understand, the biggest thing that we've done to assist her in her development is manage her expectations. So her expectations can be very juvenile and very reward driven as we discussed with ADHD,

[00:09:45] but it's two things that need to occur. One is to prepare expectation, i.e. what is going to be happening so that they're aware of it before time, even preparing the day for tomorrow today, just letting those seeds gestate so that she can get used to because the thresholds are very difficult for both people with autism where the environment starts to change.

[00:10:11] And when I say thresholds, even literally going from one room to another or entering in and out of an elevator, but I also just mean thresholds. Metaphysically, psychologically, just threshold, crossing a threshold, it becomes unsafe and challenging. So with autism, what we do with our daughter is simply to one, prepare expectations, but become very vigilant where expectations are forming where they shouldn't be.

[00:10:41] Because that happens with kids a lot, regardless of whether they've got ADHD, they start to form wants and needs. And we need to be really aware of that so that if there's unrealistic expectations starting to form or ones that will start to create distress, that we are met and we're on top of it prior. And at the same time, in a way of doing that is almost a sleight of hand to seed a different

[00:11:09] type of expectation, if that makes sense. So it's a matter of seeding expectations as well as making sure that expectations are not arising that shouldn't. Okay. So let me just unpack this a bit, if I may. Yeah. Because I think when I think of expectations, I think of it as a sort of a cognitive process. And I look at the idea of this is that, this is a cat that's going to meow or whatever it might be. But if you're four or five or six, those expectations, and also sometimes there is

[00:11:37] about expectation about the world around you and all that sort of stuff. Is it the same for a youngster who's four, five and six or two or whatever it is, but their expectations are about, if I do this, I get that. Can you just explain the word? Because expectation for me seems a very mature word for someone who's two, for example. And I am not a specialist in this area at all. My level of psychology is not developmental child stuff. So I'm quite intrigued as to how that might work for a child.

[00:12:05] The expectation that I would get a treat if I was doing something, the expectation that we are going to go in our car, but we've happened to organize that we're going with a friend and it will be a different car. Yeah. It's because you use the car analogy there. So all is done. There's an expectation we're going in our car. Because as I said, thresholds are really difficult for them to negotiate and their nervous system requires safety. Okay.

[00:12:34] So it's like a future pacing type approach. Is that your... That's correct. You're laying the world out for them. So when they walk into it, it's as they expected. That's correct. Oh, good. I've never had expressed that way before. That makes a lot of sense to me. Just apropos of nothing. I happen to know and have quite a lot of experience with people who have autism and adult people often work in jobs like IT and those sorts of things. What is it about the feature of autism that allows people to be in the highly mathematical sphere?

[00:13:04] Is there something about brain development that does that? Yeah. Yeah. So the crossover with where we talked about ADHD, hypervigilance and hypertension is very much part of both of those neurodiversity. Yeah. So being able to hyperfocus is an ability with those with ADHD and with autism. So they will, for with autism, will fixate on things. Yeah. Yeah. And loops.

[00:13:34] So if it's a, if it, if it's something that's prosperous and effective in the world, that can be really beneficial. And they will be able to hyperfocus on a particular issue and really dedicate themselves to it. And they notice detail that a lot of neurotypical people would probably miss. Yes.

[00:13:55] So they're able to, to see connections, follow through on subject matter that is of interest and within their, if it's within their field of vision and comfortability, then they're going to engage it really fully. Yeah. And I suppose that makes sense because when you do, because actually sometimes that social interaction you mentioned earlier is something you can't control. You can't understand. The expectation is so random because there's a sort of view, isn't it?

[00:14:25] There are some of these tech bros who are out there making stacks of cash at the moment that they are neurodiverse. And this has been, and this is probably them creating their own publicity, isn't it? This is where sort of the idea of this being a superpower has come from, but it's really more about functioning in the real world, isn't it? Rather than actually, because there are people who have autism have really low functioning as well. And so I'm guessing there's this, the first time you've described level one, two, and three,

[00:14:50] I'm guessing that those three differentiators mean that there can be a vast range of symptoms and conditions. Huge. And it seems to be part of the problem that, because of course, before we used to have things like Asperger's and such, and it was, and now because everything's just become autism, it's really quite hard to differentiate. I'm not sure how useful that's been in the DSM two years. Yeah. The way they've started to mix ADHD and autism together is, in my view, it's problematic.

[00:15:18] The labels have become too broad. So the issue becomes one, as you said, there's a huge gradient. So there's a varying degree. The other thing about it, even within those gradients, how it shows up is still particular to the individual. And there's also a lot of bearing factors. If the home environment is not conducive, then that contributes to the state. Yeah. And then so the way that it shows up will be different.

[00:15:48] Yeah. It's all those bearing factors that then will compound or support potential neurotypical activity or behavior that can make every showing of it very particular to the individual and the individual situation and predicament that they find themselves in. So that's interesting because I was talking to an autistic person, maybe autistic on the side of ADHD as well.

[00:16:18] And we were talking about resilience and they were telling me that they experienced much higher and quicker burnout because of that. And they use the phrase burnout and this is their own opinion, their own condition. It's not representative of the whole of the community. But I was quite interested in that idea that somehow that the feature of this lack of neurotypicality means there is more burnout. Because what they were saying is they're having to cope with a neurotypical world.

[00:16:44] And actually, there's such a high degree of complexity and difficulty for them that the process of coping and being resilient can actually just wear them out. Is that, I'm not saying is that true, is that your experience and I think people you've worked with as well? I would totally concur with that. As we just, the words I used before was obviously safety is a really important thing. The negotiation. We just talked about negotiation of knowing what future is coming, but also we talked about

[00:17:15] hyper, whether it be hyper activity or hyper focused, the world is, it becomes more intense with that when the input is being dealt with in that way. Yeah. The load on the nervous system is much, much greater. And I, but, and that's why I think ADHD is starting to show up in other people. Or neurotypical people, ADHD like symptoms, because the way that our world is now, there is a

[00:17:44] pervasive base load of pressure and stress that is just prevalent across the board. So we're not shooting, sitting in front of the TV, people assume that's relaxing or getting their own self sovereignty to be able to scroll at their own volition. And then the nervous system is still not going into total restoration or gestation.

[00:18:12] Those two states are not actually being able to occur. So there's already a base load for people with neurodivergency. That base load is what your friend or client was saying makes total and complete sense because if they're dealing with an environment that isn't conducive to the condition, then just the base load alone, the starting point is much, much higher. And so there's no rest.

[00:18:41] There's no rest point within that. But from my standpoint, that's what's starting to occur for everybody. So I'm interested because of course, your country has been world leading, I think, in terms of its approach to social media. And I think as a kid's under 18 or under 16, they've been banned from social media. And it's a shame they haven't done games as well.

[00:19:06] But is this going to be a benefit for neurodivergent people to actually have lost that ability to be scrolling and absorbing themselves in social media? Yeah. Potentially it can be extremely distressing at the beginning because as we just said, if there's an expectation and the parents have been utilizing technology as a wet nurse, so to say, it's going to be, there's going to be a huge withdrawal process. Yeah. And it's going to cause great distress on the nervous system.

[00:19:35] Also the family's finding out a way to pacify or engage that individual effectively, whether they have the resources, because there's a lot of this comes down to resources. And whether you've got a child with neurodivergency, the whole world has put the burden of babysitting and engagement of their children to technology. And that becomes a little bit resource dependent.

[00:19:59] If you've got parents who are working a lot or don't have money to do family activities, which is a lot of the world now, because to participate in anything costs money. So if you're not financially endowed to be able to do that, and that's not a small contingency anymore and it's growing. So what is the path of least resistance? The engagement of technology. Yeah. So technology can be beneficial if utilized in the right way.

[00:20:30] My experience is that scrolling and short reels is, and I know it extremely clearly because my son who had ADHD is now starting not to show signs because we're using brain benefit movements.

[00:20:50] But early on, one of the first signs was, is we allowed him on YouTube, but he was able to get from YouTube because YouTube now introduced shorts. Yes. And he started stuttering and this was the early stage development. And we'd already just, he was the child we had after my daughter with autism.

[00:21:13] So there was a lot of freak out for us because we thought we had a, as soon as he started stuttering, it was warning bells went off. We took away the iPad and within four days he stopped stuttering. Wow. We then got lazy and the iPad came back and the stuttering came back. We went in and out four times.

[00:21:37] It was, it was so obvious that it was the scrolling that was whatever was triggering the suffering.

[00:21:53] And now he doesn't stutter, but literally when I say stutter, I mean, and I, and it became so evident that it was directly related to the fast scrolling. And consuming very short snippets of content that the brain was not dealing with in early development. It's not empirical evidence, but it's enough evidence for me.

[00:22:22] As I said, even on the third time, just because once children get a taste of it, they want to get back in. So we fight with the over six month period, it would come back in. It might not come back in straight away. And then he would start stuttering again. And we had to, and now we have no iPads in the house. There is not a single iPad in this house. We do not allow children to get onto technology in any way, shape or form. But yeah, there's nothing I can say. I just think that what you're doing in Australia is great.

[00:22:51] So you've created a book called the seven pillars of mental fitness. Why have you written this? Mainly because, as I said to you, because I have nine children, I believe that, especially with high school,

[00:23:14] the bastion of their wellbeing and development of their character should be part and parcel of the education system. And it's a wonderful opportunity to develop one's character, one's ability to actually deal with the world and deal with themselves. So, as Russell, you remember when education used to be part and parcel of developing, unfortunately, women weren't really invited into education 200 years ago.

[00:23:44] But it was higher education was also about developing character. Yeah. The discourse around the education was very much about developing character. Yeah. Yeah. Virtue, values and character. For me, I see that high school could offer that same opportunity if it was taken. If we didn't just have mental health and wellbeing and character development as bolt-ons or electives,

[00:24:08] but were seen as an integral part of the education of our bastion of our young, it would be very effective. It's not the only reason. I've also written this book because, as I just said, we've got huge amounts of people showing ADHD-like symptoms that don't actually have ADHD. But this kind of prevalent low-pressure stress that we're not even aware of is creating distress within the nervous system

[00:24:36] and people not being able to actually reset, recover, or replenish themselves. And it became evident to me that we need to be more proactive. So the word mental fitness, to me, suggests a far more proactive approach rather than dealing with symptoms or trying to address certain issues that are showing up because we're starting to lack mental health.

[00:25:06] Well, the book attempts to address that we have internal capacity because what I see is we do have a mental health problem, but more than that, and not just that, we have a problem of internal capacity. We're not developing the internal capacity to deal with the world around us because it has been calibrated and designed through the engagement of technology, basically, which has got nothing to do with the most people's nervous systems

[00:25:36] now are so much more comfortable dealing with a two-dimensional digital environment than another individual because another individual might reject you, might disagree with you. And most people now like no longer are gaining the capacity. Most young people, especially, even if they've got something at work, would much prefer to text rather than ring anybody. Yeah.

[00:26:02] So what I see is that there is a downgrading of internal capacity. And I'm not sure if you're aware, Russell, that in the, around about 1943, we used to have the word mental hygiene. And then it turned to mental health after the Second World War, when they wanted to place that responsibility from the government

[00:26:31] and making it a community type mandate and relumping it back onto the individual's responsibility. And so that word mental hygiene, because it wasn't mental health, it was mental hygiene, but that was when it was seen as a, just like a fitness regime in schools or whatnot, same type of thing.

[00:26:53] So for me, there's the real need for us to move back to mental nutrition, mental hygiene and mental fitness. And for it to be, for lack of a better word, institutionalized so that the state is becoming aware of their responsibility to their citizens to actually make sure that infrastructure and framework is there to assist the individuals with it.

[00:27:18] And as I said, when money ran out after the Second World War, it was no longer a mandate that was run within the community. It was displaced and referred to as mental health and something that you can take care of individually yourselves. It is interesting, actually, in this country, the NHS now does talk about mental hygiene again and actually has practices for it, but it's not part of school curriculum. So just, so think about the book, it's called Seven Pillars and Mental Fitness.

[00:27:45] Maybe you could just start by running us through the seven pillars and then maybe we can pick one to explore in a bit more detail. Yeah, all right. Good test of memory for you. Yeah. So the pillars, they work on, it works on three separate layers. So we've got the first core layer and then we've got a regulation and then we've got an execution layer.

[00:28:08] So vision is the first and vision is, the whole book is looking at all these type of what we would normally refer to as a mechanism. We're looking at it through a biological lens, a physiological lens. So when we say vision, it's not in the usual sense of like one of my career aspirations or whatnot. It is looking at as having orientation so that the individual has orientation.

[00:28:36] The second layer is regulation, which comes into, which is attitude. And attitude is dealt with within the book much way as the mechanism really for mindfulness is that it is the internal weather within the individual. It is the filter through which input is coming. Yeah. And utilizing that if you, if there's changes in your attitude, that is a signal by which that you can start to redirect yourself.

[00:29:06] So just by noticing your attitude, if it's not in line with one, the values by which you would like to conduct yourself, it's a great barometer of how that internal climate is operating. Yeah. And then we obviously, there's awareness, adaptability, grit, which obviously is a fairly new word.

[00:29:32] And there's not enough time on this podcast to go into the difference between discipline, but realistically continuity is, grit is seen as the continuity of effort when reward is not actually present. We talk a lot on here between grit and resilience. So that's, that's absolutely fine. That makes sense.

[00:29:59] And then you said the last, and then you said the last area was execution. Yeah. Execution, grit is part, is part of that cycle. So grit, recovery and connectivity, which is basically connection. Yeah. Those three are the execution. Yeah. So I come from, for me, psychology, there's a large shift that needs to happen in psychology, which is seems to be happening where we're starting to come through a physiological lens rather than a behavioral lens.

[00:30:29] That signal is first. Yeah. State is second. Yeah. Then is story. Then behavior. Not where we've got to, where the signal and state in psychology, the importance and the hierarchy of them have been misplaced because a person's state is going to quite often determine the story.

[00:30:56] They tell themselves also the ability to access or be able to do it. So the whole book is around about the bandwidth within the physiology to actually even access or grasp these concepts here. So we're looking at through it, through a neurobiological lens. Yeah. Not a psychological lens. And the other part of it is that, for example, you say for in this book, we treat resilience, not as a core trait.

[00:31:24] Resilience is the fruit of other killers and tears. It's not the seed. Resilience is a result of other things being put in place. If that makes sense. Makes total sense to me. Yeah. I'll give resilience being a skill at all. So it's at that level, isn't it? It's meant to be more than that. Who did you write the book for, Aaron?

[00:31:48] I wrote it, one, for clinicians, practitioners, and holistic practitioners as well. So there's a lot of neuroscience in there. There's a lot of performance psychology in there. And then, as I said, there's coming back at psychology through a neurobiological lens or saying physiology first.

[00:32:14] It's really maintaining that the hierarchy, that physiology has to be retained at the top of the pyramid or at the base of the pyramid, whichever way you like to look at it.

[00:32:26] But I also wrote it for those people who are on a journey of self-discovery to better themselves and to increase their, what I refer to, what many people refer to as the window of tolerance to gain a greater window of tolerance with inside themselves. Because we can have all the insight in the world, have all the intentions in the world and all the moments.

[00:32:51] But at the end of the day, if our nervous system and our physiology is being triggered, we revert back to old behaviors, old reactions and old react. We conduct ourselves, we fall to the level of our physiology, basically, back to the way the nervous system is reacting to the inputs that are coming from the world.

[00:33:10] So we've got to, when you ask about why I wrote the book as well, also within psychology, outside the aha moments, I do believe that training and practice has to become part and parcel of any psychological practice. If we're dealing with an, with a bio or biological organism.

[00:33:30] And that when we're talking about the therapy room, a practice has to come into place in terms of the realizations, the epiphanies, or the kind of inciting a behavioral change. A practice has to be linked to it for true lasting change to actually happen.

[00:33:56] And as you would know, many of the old cultures have rituals. A practice for me is coming into something intentionally and then following through with a set of designed. And where I come from, they will be through the body rather than the brain to actually create change. That makes sense. So I know the book was launched on the 1st of June. So where can people be?

[00:34:26] Yeah, we've not had the post. It will be. Okay. It will be. No. Okay. Nevermind. I'll have to re-edit this bit now. Okay. So where can, so where can people get hold of the book? So it'll be released on the 1st of June, which is next Monday. Do that bit again, please, Aaron. Yeah. This will come out after the 1st of June. I don't want to timestamp it. Sorry. So let me just do that section again. Where can people get the hands on the book, Aaron?

[00:34:53] Amazon, as we all get a lot of our books. And it also is available through NetGalley. It has its own ISBN number. So retailers, libraries. If you went into a library and requested it, a lot of libraries have to actually action your requests. It is available. So it is available outside Amazon, but predominantly right now, we've talked a lot about digital.

[00:35:19] The most engagement, the easiest path for people to actually gain product, to look on Amazon. Aaron Cardial, Seven Pillars of Mental Fitness. And yeah, it is available there. And if people want to find out more about your work and how to contact you, where would they do that? AaronCardial.com is my website. If you want to look up more about ADHD or neurodivergence stuff, my papers, if you just look up Aaron Cardial BBM, which stands for Brain Benefit Movement, those papers are published.

[00:35:49] That paper is published in the American Journal of Neurology. And then there's two papers on the seven pillars of mental fitness. One is in the Japanese Journal of Medical Research. And the other is the International Journal of Family Medicine and Healthcare. So if you just type in my name, my papers, research will come up. And my name and website is, yeah. Brilliant. Look, thanks for spending time with us today. It's been great.

[00:36:16] And I do appreciate it because I know it's late at your part of the world. That's been great. Thanks for spending time with us. AaronCargill.com is the place you need to go. And there's quite a lot of interesting stuff on there. So thanks for spending time with us today. Thank you. You take care. Hi, I hope you found that episode useful and entertaining. If you want to support our work, please go to resilienceunravel.com. And you can become a member there as well.

[00:36:45] You can also send us a question there and even apply to do a podcast. You can also leave a review on Apple Podcasts or any of the other podcast hosts of your choice, as well as getting hold of some useful resources about resilience and a whole lot more. Join us next time on the next edition of Resilience Unraveled. See you then. Thank you.ame