Scattered Minds: A New Look at the Origins and Healing of Attention Deficit Disorder

by Gabor Maté

poor attention skills, deficient impulse control and hyperactivity.

hallmark of ADD is an automatic, unwilled “tuning-out,” a frustrating nonpresence of mind.

A few people with ADD have extraordinary mechanical skills and are able to dismantle and assemble complex objects, pieces of machinery and the like almost intuitively. Coordination difficulties affect most others, particularly in the area of fine motor control.

Like many others with ADD, I have little ability to conceptualize in three dimensions or to divine the spatial relationships of things,

to some activities a child may be able to devote, if anything, compulsive, hyperconcentrated attention.

hyperfocusing that excludes awareness of the environment also denotes poor attention regulation.

hyperfocusing often involves what may be described as ...

Passive attention permits the mi...

on automatic without requiring the brain to e...

energy. Active attention, the mind fully engaged and the brain performing work, is mustered only in special circumstances of high motivation. Active attention is a capacity the ADD brain lacks whenever organized work must be done, or when ...

immobilizingly difficult is to arouse the brain’s motivational apparatus in the absence of personal interest.

second nearly ubiquitous characteristic of ADD is impulsiveness of word or deed, with poorly controlled emotional reactivity.

Hyperactivity is the third salient characteristic of ADD. Classically, it is expressed by trouble keeping physically still,

fidgetiness

fingers tapping, thighs pumping, nails being chewed, teeth biting the...

individual with ADD experiences the mind as a perpetual-motion machine. An intense aversion to boredom, an abhorrence of it, takes hold as soon as there is no ready focus of activity, distraction or attention.

The restlessness coexists with long periods of procrastination. The threat of failure or the promise of reward has to be immediate for the motivation apparatus to be turned on. Without the rousing adrenaline rush of racing against time,

inertia prevails.

On the other hand, when there is something one wants, neither patience nor procrastination exist. One has to do it, get it, have it, experience it, immediately.

Frequent and frustrating memory lapses occur every day in the life of the person with ADD.

many people who seem to be high achievers despite their ADD.

Although poor social skills generally accompany ADD, this is not universal.

One type of ADD child is socially adept and wildly popular. In my experience, such success hides a lack of confidence in important areas of functioning and masks a very fragile self-esteem,

Adults with ADD may be perceived as aloof and arrogant

To interview adults with attention deficit disorder is often to be ambushed by jokes.

consciously absurd associations pepper life histories that in themselves are not much to laugh

At a certain point on the human continuum, the characteristics associated with ADD become intrusive enough to impair a person’s functioning to one degree or another.

if certain genetic material meets a certain environment, ADD may result.

This feeling of duty toward the whole world is not limited to ADD but is typical of it. No one with ADD is without it.

The ADD mind is afflicted by a sort of time illiteracy, or what Dr. Russell Barkley has called “time blindness.”

It’s as if one’s time sense never developed past a stage other people leave behind in early childhood.

Only two units of time exist for the small child: the now and the not-now.

Ask people with ADD how long it will take to perform a particular task, and they will notoriously underestimate.

“preoperational stage,” when everything is observed and interpreted from only one point of view, the child’s. “The preoperational child, in his egocentric manner, believes that he can stop time, speed it up, or slow it down.”

With ADD we witness a delayed or permanently arrested maturation of the balanced time sense most people achieve by adulthood.

Underdevelopment best explains another time-related malfunction of the ADD brain, the chronic incapacity to consider the future.

He lives as if his actions had no implications for the future,

Self-regulation implies that someone can direct attention where she chooses, can control impulses and can be consciously mindful and in charge of what her body is doing.

We are born with no capacity whatsoever to self-regulate emotion or action. For self-regulation to be possible, specific brain centers have to develop and grow connections with other important nerve centers, and chemical pathways need to be established. Attention deficit disorder is a prime illustration of how the adult continues to struggle with the unsolved problems of childhood.

Emotional Intelligence,

“being able to motivate oneself and persist in the face of

frustrations; to control impulse and to delay gratification; to regulate one’s moods and keep distress from swamping the ability to think

Reactions can be gratifyingly mature at one time but distressingly immature at another. If some deeply unconscious anxiety is triggered, a person may respond with the lack of emotional self-regulation characteristic of an infant.

infant/toddler mode

reflects incomplete development of pathways in the cerebral cortex, and between the cortex

and lower areas of t...

We can probably localize much of the organic basis of ADD in what is called the right prefrontal cortex, the area of the brain just behind the forehead.

MRI pictures have shown smaller than normal structures in the right prefrontal areas of ADD patients.

ADD group showed excessive “slow wave” activity during directed tasks such as reading or drawing. As would be expected normally, the non-ADD group had increased fast-wave electrical responses to the same task. In other words, in the ADD group electrical activity in the cerebral cortex, or gray matter, slowed down just when it would have been required to speed up.

may seem paradoxical to consider that hyperactivity of mind or body can be caused by an underactivity of the cortex.