Attention-deficit hyperactivity disorder (ADHD) is a commonly diagnosed condition of childhood, thought to affect 3 to 5% of all school-aged children (Buitelaar, 2002). In spite of the prevalence of ADHD, there is no consensus between child psychoanalysts and child psychiatrists about its aetiology and management. This is despite (or perhaps because of) the fact that the core symptoms of age-inappropriate hyperactivity, inattentiveness, and impulsivity (Kaplan, Sadock, & Grebb, 1994) can be conceptualized in the terms of both schools of thought. However, if we retreat to separate and distinct conceptualizations there is a risk that the lack of an integrated theory may have adverse consequences for those we attempt to treat. In order to avoid this, we need to re-examine the core psychoanalytic perspective in the context of current neuropsychiatric perspectives in order to clarify our understanding of this condition and better help the children in our care.