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At the heart of the moral model beats the conviction that willpower controls all human emotion, learning, and behavior. Under this model, the cure for depression is to cheer up. The cure for anxiety is to suck it up. And the cure for ADD is to try harder.
Put differently, love works. Positive human relationships work. The human connection is indispensable. I call it “the other Vitamin C,” Vitamin Connect. And if you do not get enough of it, you will languish and never thrive.
Now is the time to tell the whole truth, that embedded in what can be so problematic we can find strength. Embedded in the mind of each person who has ADHD, or depression, or bipolar disorder, or an anxiety disorder, one can find talents and strengths. It is upon those talents and strengths that the most successful treatment is built. Now is the time to blow the lid off the model that merely identifies pathology and to replace it with the more accurate—and hopeful—model that not only acknowledges the problems but also seeks and identifies the strengths as well.
ADD is a neurological syndrome whose classic defining triad of symptoms include impulsivity, distractibility, and hyperactivity or excess energy.
The hallmark symptoms of ADD are easy distractibility, impulsivity, and sometimes, but not always, hyperactivity or excess energy.
They have lots of projects going simultaneously. They’re always scrambling. They procrastinate a lot and they have trouble finishing things. Their moods can be quite unstable, going from high to low in the bat of an eye for no apparent reason. They can be irritable, even rageful, especially when interrupted or when making transitions. Their memories are porous. They daydream a lot. They love high-stimulus situations. They love action and novelty. Just as this kind of problem can get in the way at work, it can also interfere with close relationships.
(1) deficits in attention and effort, (2) impulsivity, (3) problems in regulating one’s level of arousal, and (4) the need for immediate reinforcement.
If you think of ADD as a basic problem with inhibition, it helps explain how ADD people get angry quicker. They don’t inhibit their impulses as well as other people. They lack the little pause between impulse and action that allows most people to be able to stop and think.
Due to repeated failures, misunderstandings, mislabelings, and all manner of other emotional mishaps, children with ADD usually develop problems with their self-image and self-esteem.
Month after month, year after year, the tapes of negativity play over and over again until they become the voice the child knows best. “You’re bad,” they say in many different ways. “You’re dumb. You just don’t get it. You’re so out of it. You really are pathetic.” This voice pulls the child’s self-esteem down and down, out of the reach of the helping hands that might be extended, into the private world of adolescent self-reproach.
An important, and often overlooked part of both learning disabilities and ADD is the social consequence of having them. ADD can interfere with one’s interpersonal life just as dramatically as it does with one’s academic or job performance. To make friends, you have to be able to pay attention. To get along in a group, you have to be able to follow what is being said in the group. Social cues are often subtle: the narrowing of eyes, the raising of eyebrows, a slight change in tone of voice, a tilting of the head. Often the person with ADD doesn’t pick up on these cues. This can lead to real
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“Girls can have ADD as well as boys. Hyperactivity is the old name for the syndrome. More recently, the label ADD was invented to focus on the symptom of attention inconsistency these kids have. A lot of girls who have it never get diagnosed. Instead, they’re just thought of as shy or quiet or even depressed,
Primary symptoms are the symptoms of the syndrome itself: distractibility, impulsivity, restlessness, and so forth. The secondary symptoms, and the ones that are most difficult to treat, are the symptoms that develop in the wake of the primary syndrome not being recognized: low self-esteem, depression, boredom and frustration with school, fear of learning new things, impaired peer relations, sometimes drug or alcohol abuse, stealing, or even violent behavior due to mounting frustration. The longer the diagnosis of ADD is delayed, the greater the secondary problems may become.
The themes of ADD run throughout: inconsistency, and inconsistency again, creativity, provocative behavior, winning personality, varying motivation, exasperating forgetfulness, disorganization and indifference, underachievement, impulsivity, and the search for excitement rather than discipline.
By then his self-image had solidified around such ideas as “I’m lazy”; “I’m a born B.S. artist”; “I never really come through when I should”; and “I’m talented, but I don’t dare to give it my best shot in case I might fail.”
How many of us with ADD have felt, as we whirl around from one project to the next, trying to stay abreast of the mounting mass of details, that our brains were about to split? And then we look down to find our projects rolling around, like balls upon the floor. Most adults with ADD are struggling to express a part of themselves that often seems unraveled as they strive to join the thought behind unto the thought before.
So many adults with ADD have piles, little mess-piles, big mess-piles, piles everywhere. They are like a by-product of the brain’s work. What other people somehow put away, people with ADD put into piles.
It is not always as obvious as the examples above. For many adults ADD is a subtle but definite part of who they are, like a red thread sewn into a pinstripe suit, changing its look but only visible upon close inspection. The red thread may be a thread of distractibility, or of impulsivity, or of disorganization, sewn into a stripe of creativity or gregariousness or industry.
These are a few of the areas in which mild ADD may interfere with an adult’s life: underachievement; reading one’s interpersonal world accurately; getting started on a creative project, or finishing it; staying with emotions long enough to work them out; getting organized; getting rid of perseverative, negative thinking; slowing down; finding the time to do what one has always wanted to do; or getting a handle on certain compulsive types of behavior.
But ADD precedes the plot. It adjusts the lighting and sets the stage. If the lighting is too low or significant props are missing from the stage, the story cannot be fully comprehended. Before getting the story going, before developing the plot lines of one’s ongoing narrative of introspection, it is worthwhile to have a lighting specialist and a propman check the stage out.
She had an abiding sense of having to strain to get it, whatever it was, as if she were nearsighted and had to strain to see the blackboard.
Without the perspective of ADD, Laura’s history would make one think of a perfectionist personality, which indeed she did have, and a diagnosis of obsessive-compulsive disorder or some kind of anxiety state. But if she had ADD as the starting point of these problems, with the anxiety and perfectionism occurring in the wake of ADD, that would cast a new light on things.
These examples of what I would term “random failure” were incredibly unnerving to me and contributed to a sense I had of myself (and probably still do have) that every success I had prior to that moment was proven, by that moment, to have been a sham, and a fake, and a hoax on everyone including me, which led me to the inevitable question, “Why don’t you just admit that you are of limited intelligence, even less vision, and give up?” For some reason, I didn’t.
While we all need external structure in our lives—some degree of predictability, routine, organization—those with ADD need it much more than most people. They need external structure so much because they so lack internal structure. They carry with them a frightening sense that their world might cave in at any moment. They often feel on the brink of disaster, as if they were juggling a few more balls than they’re able to. Their inner world begs for reassurance, for signposts and guidelines.
The sense of growing panic, the feeling that gibberish is being passed off as coherent conversation, the fear that the world is engaged in meaningless discourse masquerading as meaningful exchange—these are the blurry states individuals with ADD negotiate each day.
‘But you don’t understand,’ I said, ‘my whole life is like that. I see something that I mean to do and then I don’t do it. It’s not only trivial things like the cough drop; it’s big things, too.’
People in treatment for ADD usually still struggle with issues of organization, impulse control, and distractibility. But more difficult than that, they struggle with the secondary symptoms that years of living with undiagnosed ADD created. These are symptoms such as impaired self-image, low self-esteem, depression, fearfulness of others, mistrust of self, skittishness in relationships, and anger over the past. These wounds heal very slowly.
The impact of ADD upon sexuality is poorly understood. However, we have seen many people in our practice, both men and women, who complain of either an inability to pay attention during sex well enough to enjoy it, or the opposite: a hyperfocused hypersexuality. Those who appear to be hypersexual may turn to sex as a form of intense stimulation to help them focus. Many adults with ADD are drawn to high-stimulus situations as a means of alleviating boredom or clearing their mind of distraction.
What I call the “tapes of negativity” can play relentlessly, unforgivingly, endlessly in the mind of the person with ADD. It is as if they click on as the sun rises and click off only when the unconsciousness of sleep shuts them down. They play, over and over, grinding noises of “You can’t”; “You’re bad”; “You’re dumb”; “It won’t work out”; “Look how far behind you are”; “You’re just a born loser.”
a pretty good short description of ADD: You don’t mean to do the things you do do, and you don’t do the things you mean to do.
