It is estimated that as many as 5 million children in America are being medicated with psycho-stimulants for Attention Deficit Disorder (ADD) and/or Attention Deficit/Hyperactivity Disorder (ADHD). Parents frequently seek psychotherapy for their child up to one and a half years after medication has been tried due to a high degree of symptom recidivism. The parents should be engaged in the therapeutic work, if at all possible. An intricate web begins to unfold as the current parent-child relationship resonates with the parents' relationship with their own parents, siblings and childhood experiences. Working with the parents is essential if one is going to know anything about the cross-generational dynamics involved and if real and helpful change is going to occur. Conscious and unconscious parent-child dynamics of hyperactive behaviour in children are discussed. A clinical case illustration is described. Alternatives to medicating children are also described.