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

by Gabor Maté

The ADD adult is often a night owl.

contributing factor is that the distractible ADD mind does find it easier to focus when the noises and intrusions of the day have abated, and everyone else has gone to bed.

The problem, of course, is that sleep is essential for the brain to regenerate the sensitive neurological apparatus of alertness and attention.

“Entering the mad world of dreams each night probably promotes mental health in ways we do not fully understand,” suggests Anthony Storr. “It seems clear that some kind of scanning or re-programming takes place in dreams which has a beneficial effect upon ordinary mental functioning.”

3. Nutrition

Meals are not regular, not planned with nutrition in mind and tend to be wolfed down rather than eaten.

adult with ADD is exquisitely sensitive not just to the external environment but also to the internal one.

4. Physical exercise

Lack of exercise leads to an internal sluggishness that undermines alertness and attention.

set a goal of vigorous exercise every day.

Stretching is important even for someone unable to do cardiovascular exercise. People with ADD, habituated lifelong to self-generated tension, tend to have tight muscles and stiff joints and ligaments.

5. Nature

There is matchless unity, harmony and peace in nature—all that is lacking, in other words, in the ADD mind.

6. Extracurricular duties

A large proportion of the ADD clients I have seen are juggling too many projects, commitments that leave them with nary a moment to finish a thought.

We may need to let some activities go.

7. Recreation

Re-creation needs activities that nourish the mind or liberate the body.

8. Creative expression

do not believe ADD leads to creativity any more than creativity causes ADD. Rather, they both originate in the same inborn trait: sensitivity.

9. Meditation and mindfulness

Spiritual work is the cultivation of a mindful solitude. All traditional meditative and contemplative practices, including many types of prayer, have as their purpose helping us to disengage for a time from our concerns with people, objects, desires, thoughts and fears, to actively strive for connection between ourselves and the rest of creation.

reality has aspects more profound and more universal than we tend to imagine in our harried and isolated workaday lives. The person who feels that he is not being “himself” recognizes this implicitly. Without being able to explain why, he senses there is a truer self he does not experience directly but which exists nonetheless—otherwise how would he know that he is not being that self? Intimations of the true self, a vague awareness, seeps into our consciousness, if only in the form of the dissatisfaction we feel at not being able to contact

Meditation aiming at mindfulness, at strengthening the observing

“third eye” in the mind, is a direct way of weakening the hold of ingrained neurological responses.

Any activity, from gardening to martial arts, that promotes mindful concentration will bring benefits. Adults with ADD should at least consider giving themselves some daily opportunity for contemplative solitude.

Without some sort of practice, we can no more develop the skill of concentration than we can learn to play the piano. Nothing is more difficult for the ADD mind than to meditate, or to contemplate anything with determined attention.

attention and presence of mind are the long-term goal, time and effort need to be devoted to their cultivation each and every day.

Whether they know it or not, a large number of people addicted to behaviors and substances of various sorts have attention deficit disorder,

This combination of arousal and soothing enables the nicotine addict, like the caffeine addict, to be an alert sleepwalker.

Less obvious but no less physiological are the effects on the brain of self-stimulating behaviors.

Those of us with attention deficit disorder love dopamine and endorphins.

The compulsion beckons; the addict runs to serve it.

The behavior addict knows, or ought to know, that what separates him from the drug addict’s fate is little more than good fortune.

There is a fine but clearly discernible line between addiction and passion. Any passion can become an addiction. It’s simply a question of who is in charge: the individual or the behavior.

I could not have been more focused when engaged in my addiction.

It is not possible to lull feelings to sleep and hope to be truly awake. When the addiction dominates, the true self—how one really is in the world—slumbers. To own the addiction is to begin to take ownership of the pain.

When people are response-able and not in denial, they are aware … of what they feel and they know … what has gone on inside them to generate those feelings. It is a three-part chain connected by awareness: awareness of events, awareness of interpretation of those events, and awareness of the emotional reaction following those interpretations. If the chain is broken, ownership of the feeling is lost. When the task of ownership is being performed, the chain is solid.

It has become evident that the brains of people who are prone to addiction are biologically predisposed by some imbalance of brain chemicals.

People with ADD seem to be short on dopamine, the reward chemical.

“Social isolation, the early deprivation of emphatic care, causes a permanent reduction of brain opiate receptors,”

“We so often become so preoccupied with the problem the drug use creates,” write Drs. Hallowell and Ratey in Driven to Distraction, “that we fail to consider what purpose the drug must be serving for the user.”

neither can the addiction be given the appropriate attention if the ADD is ignored and if the common origins of both remain unexplored.

of the main efforts of neurobiology and medicine should be directed at alleviating suffering.… But how to deal with the suffering that arises from personal and social conflicts outside the medical realm is a different and entirely unresolved matter. The current trend is to make no distinction at all and utilize the medical approach to eliminate any discomfort.

There is a legitimate perception that too often drugs have been prescribed with the intention of making a child more manageable from the adult point of view.

increased use of Ritalin has paralleled reductions in the number of special education teachers, psychologists and social workers in the educational system—results of the cutbacks in funding that throughout North America are considered to be among the duties of “responsible” governments.

Only people who have not witnessed or personally experienced how helpful medications can be could maintain a categorical opposition to their use. The positive effects are often dramatic and immediate.

In many other cases, the results are not so impressive. The medications will not work or will cause unpleasant side effects, such as headaches, loss of appetite, listlessness, insomnia or anxiety,* or, simply, the positive changes will not be so dramatic.

explain to everyone who chooses to try a psychostimulant that each human brain has its own chemistry; one cannot know just how it will be affected. Although as a class, stimulants have been used clinically since 1937 and are about as safe and well understood as any drugs used anywhere in medicine, each person taking them for the first time is being, in a sense, his own guinea pig.

if we are to be reluctant to use them, it should be for the right reasons, not because of misinformation, such as that these drugs are addictive if used for ADD. While they are subject to abuse, as are other legitimate medications, their administration in medically prescribed doses does not induce addiction. A better case can be made that they may prevent addictions, by correcting some of the biochemistry that predisposes a person to substance abuse, as described in the previous chapter.