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

by Gabor Maté

“It has no conditions of worth attached to it.”

caring, wrote Rogers, “which is not possessive, which demands no personal gratification. It is an atmosphere which simply demonstrates I care; not I...

low self-esteem and merciless self-criticism are so much part of the ADD personality that it would be difficult to know where ADD ends and low self-esteem begins.

Workaholism, drivenness and inability to say no—all endemic in the adult ADD population—are some of the examples discussed in this chapter.

Above all, it is apparent in the perfectionism and in the dejection and discouragement he experiences when he fails at a task or loses in a game.

The conventional view is that the low self-esteem of ADD adults is a natural consequence of the many failures, lost opportunities and setbacks they have experienced since childhood, owing to their neurophysiological deficits. Plausible as it sounds, this explanation accounts only in small measure for why people with ADD think so very little of themselves.

That people do judge themselves so harshly reflects low self-esteem, not low achievement. Self-esteem, we must realize, is the quality of self-respect that is evident in a person’s emotional life and behavior.

People who have a grandiose and inflated view of themselves on the conscious level are lacking true self-esteem at the core of their psyche. Their exaggerated self-evaluation is a defense against their deepest feelings of worthlessness. The professionally successful workaholic suffers from low self-esteem, no matter what his conscious and projected self-image

image may be.

some adults with attention deficit disorder who exhibit great self-confidence in specific areas of functioning and are high achievers according to social standards.

What are some of the markers of low self-esteem,

Craving the good opinion of others.

Frustration with failure. A tendency to blame oneself excessively when things go wrong,

accepting mistreatment without resistance. Argumentativeness—having

having to be in the right or, obversely, assuming that one is always in the wrong.

being afraid to say what one thinks for fear of being judged. Allowing the judgments of others to influence one’s emotions or, its mirror opposite, rigidly rejecting what others may have to say about one’s work or behavior. Other traits of low self-esteem are an...

inability to say no. The need to achieve in order to feel ...

abusing body or soul with harmful chemicals, behaviors, work overload, lack of personal time and space all denote poor self-regard. All of these behaviors and attitudes reveal a fundamental stance towards the ...

Self-esteem based on achievement has been called contingent self-esteem o...

Contingent self-esteem evaluates; true self-esteem accepts.

Acquired self-esteem is a false imitation of true self-esteem: however good it makes one feel in the moment, it does not esteem the self. It esteems only the achievement, without which the self in its own right would be rejected. True self-esteem is who one is; contingent self-esteem is only what one does. ADD adults don’t have low self-esteem because they are poor achievers, but it is due to their low self-esteem that they judge themselves and their achievements harshly.

do not venture to embark on activities and projects where success is in doubt. They feel safer not trying, because their poor self-regard is terrified at the risk of failure.

Healthy development of self-esteem needs the atmosphere of what Carl Rogers called “unconditional positive regard.”

Absolutely universal in the stories of all adults with ADD is the memory of never being comfortable about expressing their emotions.

almost none recall feeling invited or safe enough to bare their souls to their parents.

On the other hand, many recall being hyperaware of the parents’ difficulties and struggles in the world, of not wanting to trouble them with...

“an amazing capacity to perceive and respond intuitively, that is unconsciously, to this need of the...

patterns of relationships that required the child to take care of the parent emotionally,

Not performance as such but the attitudes of the adult world toward performance defined how many children learned to value themselves.

I had a facility with something, or if I enjoyed it, it could not be worth much.

Unless it was pure blood, sweat and tears, it could not have value.

Sooner or later, people come to realize that this false self—wanting what they think they should want, feeling what they think they should feel—does not work for them.

Women with ADD are especially prone to give a higher priority to protecting the needs of others than to respecting their own. “I don’t know how to say no. I’m always so worried about what the other person is feeling,”

The need to be needed at all costs comes from one’s earliest experiences. If the child does not feel accepted unconditionally, he learns to work for acceptance and attention.

The adult has no psychological rest because the infant and child had never known psychological rest. He has a dread of rejection and an insatiable need to have his desirability and value affirmed by others.

truly important person is one who considers himself worthy enough to grant himself at least one hour each day that he can call his own.

from the neurophysiological point of view the self simply does not exist. There is no neurobiological “self circuit”

What we see as the self is really a construct,

Self-esteem does require a degree of self-regulation, which the neurophysiology of ADD sabotages. The child or adult easily flung into extremes of emotion and behavior does not acquire the mastery over impulses that self-esteem demands.

Submerged beneath a surface rippling with superficial and childish impulses are truer impulses for meaningful activity, the assertion of her autonomy, the pursuit of her own truth and human connectedness. The deeper these have sunk, the less one knows who she is or in which direction her path lies. Attaining self-esteem begins with finding our true impulses and raising them to the light of day.

feelings I have heard from many others with ADD: a painful hyperconsciousness of injustice, accompanied by ineffective rage or by

shamed silence.

there is a celebration of attention deficit disorder as a condition that bestows a special kind of human empathy on individuals affected by

something more painful than empathy and something less effective, too: they speak of identification. When a person empathizes, he can understand another’s feelings and even share them, but he is conscious of himself as a separate individual, capable of taking independent and useful action. When he becomes identified, that boundary disappears.

This is not a state of adult human fellow feeling from which he can act effectively: it is a state of memory.

What we take for present-day reality represents, in many situations, reactivated early memories stored in the implicit memory system,

Implicit memory happens,

“when people are influenced by a past experience without any awareness that...

The ability to bring consciously to mind specific events, feelings or ideas is only one form of memory, named explicit memory.

For short-term memories to fix in the brain for storage in long-term memory, they have to be encoded. There are many components to any experience, Daniel Schacter points out, physical and emotional: sights, sounds, words, actions, feelings.