Hi everyone, Joseph Pack. Today’s episode is a little different.
Because something happened recently that got under my skin. A comment. A public one. Made on a LinkedIn post I shared about my four-year-old son. Now normally, I ignore this kind of thing. I let it go. But not this time.
Why? Because the comment wasn’t just personal. It wasn’t just wrong. It was dangerous. It was arrogant. And it revealed something bigger about how we talk about ADHD, about mental health, and about so-called experts.
So I want to break it down — and dismantle it.
Let me start by reading you the original post I shared:
"The consultant paediatrician just suggested diagnosing my 4-year-old autistic son with ADHD so he can go on meds. AT FOUR YEARS OLD!!!
Thankfully my wife took the appointment, not me. Otherwise I would have exploded.
No, he will not be going for an ADHD diagnosis.
Why?
Because the only reason he'd need one is to get a prescription for medication. And I will NEVER EVER put him on ADHD drugs.
Instead he's:
* Attending a specialist school for autism that will accommodate his needs (rather than drugging him to fit in)
* On a specialist diet, that is working exceptionally well
* Allowed to be himself (running between each mouthful, bouncing all day, other traits that don't need to change)"
Now, here’s the full comment — word for word — that Sarah Templeton, a counsellor and so-called ADHD expert who works in the prison system, left under that post:
“Joseph Pack come back to me when he's arrested. Sorry, but that's what you are risking by not medicating an ADHD child. Never mind risking them not being able to focus and concentrate in class so they won't achieve their potential educationally. Never mind leaving them open to low self-esteem when they lose friendships by saying things impulsively and wanting everything their own way. There are literally 100s of reasons why not giving an ADHD child the chance to be their best self with medication is going to impact them. I understand your viewpoint because it would've been mine before I was diagnosed 10 years ago and spent the best part of 10 years working with ADHD kids and adults. My viewpoint then and yours now comes from not understanding what ADHD medication does for the brain so absolutely no judgement from me but strongly suggest you read any of my books which will help you understand what the medication actually does and why it is life changing for any ADHD child.”
Alright.
Let’s walk through this.
Because what you’ve just heard is a textbook example of what Nassim Taleb calls epistemic arrogance — overconfidence disguised as certainty. Advice given as a blunt instrument. And that’s what we’re going to break down.
I suspect also that this comment was reactionary and emotional. I'll let her decide if that's true or not.
Part One: "Come back to me when he's arrested."
Let’s just acknowledge how wild that is.
She doesn’t know my son. She knows he’s autistic. She knows he’s non-verbal. She knows he’s four. She knows he’s in a specialist school. She knows he has loving, neurodivergent parents who advocate for him daily.
But she sees ADHD — and imagines handcuffs. That’s not expertise. That’s projection. And a gargantuan bias based on her particular niche of ADHD work.
She works in prisons — that’s her lens. But working in a trauma-saturated system doesn’t mean every child who reminds you of someone ends up there.
Let’s talk numbers. There are roughly 97,700 people in UK prisons. About 25% — or 22,000 — are estimated to have ADHD.
Sounds significant, right? Until you consider: there are around 1.9 million adults in the UK with ADHD.
So, more than 1.88 million ADHD adults are not in prison.
It’s like saying: “Everyone who drowned last year drank water — so water must cause drowning.” Classic correlation confusion. Not something you'd expect from a so-called expert.
No. Environment matters. Trauma matters. Poverty, exclusion, racism, under-diagnosis — they matter. Medication? It’s not the magic bullet Sarah wants it to be.
She's at risk of sounding like pharmaceutical salesperson.
Part Two: "Never mind risking them not being able to concentrate…"
This is where things start to sound like a pharma brochure.
Yes, focus matters. Yes, some kids benefit from stimulant meds. But not all. And not without cost.
But let’s talk about this idea that Ronnie’s going to fall behind educationally if he’s not medicated. That he won’t reach his "potential."
He’s four. He’s non-verbal. He’s autistic. He’s not struggling with algebra — he’s learning how to exist in the world. He’s attending a specialist autism school designed to support exactly that: not to churn out doctors and lawyers, but to help children like Ronnie feel safe, regulated, and understood.
We are not focused on his academic milestones. We’re focused on his joy, his connection, his ability to be in his body without distress. That’s his curriculum. That’s his success. My wife and I will NEVER force academic success above happiness, joy, and the ability for him to be himself. It feels like Sarah wants to medicate him into compliance so he becomes a good little tax paying member of society one day.
And no — I’m not interested in numbing his instincts so he can sit still and appear more “teachable.” That’s not support. That’s control. That’s asking a sensory-seeking child to deny himself in order to fit a mould he was never built for.
I’ve coached kids who say meds make them feel flat. Like their personality has been sucked from their body. I've seen side effects from chronic mouth ulcers to cardiovascular damage.
I live with ADHD. I can’t take meds for health reasons. That’s why I built a method — for people like me. People who don’t want to or can’t go down that route.
And again: Ronnie can’t tell us how medication makes him feel. So no — we’re not gambling with his emotional world just to appease someone else’s idea of "achievement."
Putting him on drugs now isn’t support. It’s sedation. It’s compliance training. It’s an attempt to make us feel more comfortable — not him.
Sarah genuinely seems to think there's something wrong with him and that the meds fixes that. Isn't that everything the ADHD advocates are trying to fight against?
Crazy stuff.
A Word on Long-Term Medication Risks
There’s another thing that’s missing from this entire conversation: the long-term physical risks of ADHD medication. Something I’ve never heard Sarah acknowledge publicly.
There’s a massive Swedish study — published in JAMA Psychiatry — that followed over 278,000 people with ADHD. And what they found should be part of every parent’s decision-making process.
After just 3 to 5 years of ADHD medication use, participants had:
* A 27% higher risk of cardiovascular disease
* A 72% higher risk of hypertension
* A 65% increased risk of arterial disease
And these weren’t short-term effects. Even beyond five years, the risk remained elevated:
Each additional year on medication increased the risk of CVD by 4%.
So when someone calls medication “life-changing for any ADHD child” and pushes it as the default — without even mentioning these risks — that’s not responsible. That’s not expert advice. That’s omission.
Especially when we’re talking about kids. About children like Ronnie who can’t speak for themselves. We’re not just giving them a pill. We’re setting a long-term trajectory — one that could lead to very real health consequences years down the line.
And when you’re making decisions for someone who can’t yet make them for themselves — don’t you want the full picture?
Part Three: Beyond the Bullet Points
This is where I want to shift the tone — away from dissecting every line of Sarah’s comment, and towards something deeper.
Because here’s the truth: this isn’t about me being offended. It’s not even about Sarah, really. It’s about dismantling the idea that what she said represents solid, professional, unquestionable truth.
It doesn’t. It represents overconfidence. It represents a narrow worldview. And most importantly — it represents the danger of mistaking one’s experience for universal authority.
She’s not a psychiatrist. She’s a counsellor. That’s fine. That’s valuable work. But let’s not confuse it with medical expertise. She can’t diagnose. She can’t prescribe. And yet she speaks with the certainty of someone who believes her anecdotal experience gives her the moral high ground.
That’s arrogance, not authority.
Let’s also be clear: saying publicly that a child you’ve never met — a four-year-old — is on a path to prison unless medicated, isn’t just unprofessional. It’s reckless. It tells me everything I need to know about how she sees children like my son. And about what she values: compliance over context, obedience over curiosity.
Her comment isn’t compassionate. It’s controlling.
And I’m not here to say I’m right and she’s wrong. I’m here to say: the conversation is bigger. ADHD is bigger. Ronnie is bigger.
And if you can’t start from a place of humility — if you can’t admit that you might not have the full picture — then you shouldn’t be advising parents at all.
The Expert Problem — And Why Psychology Suffers From It Profoundly
(If you're listening to this as a podcast, you can check out the accompanying post or show notes to see a brilliant visual that perfectly illustrates this concept — a graphic split down the middle: on one side, "Things That Don’t Move" like surgeons and plumbers — true experts with clear outcomes. On the other side: "Things That Move" — economists, political scientists, and yes, psychologists — where overconfidence often leads to failure. It shows how humility and acceptance of ignorance lead to stronger outcomes, while arrogance and overconfidence lead to fragility. That is exactly what we’re dealing with here.)
Let’s go even deeper.
Because there's another critical issue we need to look at: the reliability of the very research this entire expert class depends on.
Roughly 40% of scientific studies don’t replicate — and in psychology, that number is often even higher. I've seen some say it could be as high as 99% in certain strands of psychology. What does that mean? It means that nearly half the time, when someone tries to repeat a published study’s results, they fail.
Even worse, incorrect or flawed studies tend to get cited more than correct ones. Why? Because incorrect studies are often more “exciting” — they confirm biases, stir controversy, and generate headlines. As Ted Gioia put it in his essay on the death of the expert: “False research spreads faster because it's more seductive.”
This isn't just a glitch. It’s a systemic flaw. And it means that the very foundation of many so-called expert opinions in psychology — ADHD included — is built on shaky ground. The appearance of authority, without the robustness of truth.
So when someone like Sarah Templeton says, “Read my books,” I have to ask: what are those books built on? Clinical experience? Possibly. But how much of that is selectively interpreted? And how much of the 'science' she's referring to is part of this unreproducible, citation-chasing machinery?
This is why humility matters. This is why overconfidence is dangerous. And this is why we must challenge the entire framework that tells us to blindly trust 'the expert'.
Because there’s something bigger at play here — something Nassim Taleb calls the expert problem. And nowhere is it more visible than in psychology, and particularly ADHD.
Taleb writes:
“Let us ask the following questions: Would you rather have your upcoming brain surgery performed by a newspaper’s science reporter or by a certified brain surgeon? On the other hand, would you prefer to listen to an economic forecast by someone with a PhD in finance from some 'prominent' institution such as the Wharton School, or by a newspaper’s business writer? While the answer to the first question is empirically obvious, the answer to the second one isn’t at all. We can already see the difference between 'know-how' and 'know-what'."
This distinction is crucial. Because what Taleb is saying is that when you're dealing with things that don't move — like brain surgery — expertise is real, measurable, repeatable. But when you're dealing with things that do move — like human behaviour, psychology, ADHD — it becomes much murkier.
“Simply, things that move, and therefore require knowledge, do not usually have experts, while things that don’t move seem to have some experts. In other words, professions that deal with the future and base their studies on the non-repeatable past have an expert problem.”
Psychology deals with prediction based on messy, incomplete, non-repeatable past experiences. There are no guarantees. There are no universal outcomes.
And yet — people like Sarah speak with the confidence of an electrician working on a fixed, regulated system, in a field that is nothing like that. ADHD isn’t wiring. It’s not a circuit board. It’s a moving target — dynamic, unpredictable, shaped by emotion, environment, development. To talk about it with that level of certainty is not expertise. It’s hubris.
That’s not harmless.
“Expert problems (in which the expert knows a lot but less than he thinks he does) often bring fragilities, and acceptance of ignorance.
Translation: overconfidence in uncertain fields creates damage. Especially when there’s no accountability for being wrong.
Sarah Templeton believes she’s helping. I believe she’s contributing to the exact fragility Taleb describes — making families feel powerless, pushing single-path solutions, and ignoring the chaos and complexity that defines real people’s lives.
And if you ask me, the real experts in ADHD? They’re not always the ones with books or clinics or TEDx talks.
They’re the people living it. The parents. The kids. The adults who’ve navigated it — medicated or not — and made sense of it for themselves.
Where I stand
I’m not an expert. I’m a dad. I have ADHD. I’ve coached kids, worked with families, built a method that helps people without drugs. That doesn’t mean I know everything. It means I’ve paid attention.
And most importantly: I know I’m biased. Toward drug-free strategies. But I own that. I keep testing it. I keep listening.
Sarah? She doesn’t seem to know she has a bias. That’s the difference.
My son is not a statistic
Ronnie is four. He’s non-verbal. He’s sensory seeking. He’s wildly active. And he is allowed to be exactly who he is — safely, lovingly, supportively.
He’s not a case study. He’s not a future prisoner. He’s a boy.
And if there’s one thing I want this episode to leave you with, it’s this:
The future isn’t fixed. Especially not for neurodivergent kids. And anyone who tells you otherwise — no matter how well-credentialed, how many books they’ve written, or how loudly they shout — does not deserve your trust.
This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit drugfreeadhd.substack.com
