Scattered Minds: The Origins and Healing of Attention Deficit Disorder

by Gabor Maté

7. Trusting the child, trusting oneself

A teenager should have the right to decide when and if to clean her room. If parents are appalled at the unsightly mess, they can shut the door to avoid seeing it. As long as she is not inconveniencing others, it is up to the older teenager to decide how long and with whom she talks on the phone, or what time she goes to bed.

A distinction needs to be made between what is simply personal to her, affecting only her, and what affects others as well. Her own room is strictly her business, but participation in housekeeping chores is a family affair, and a mess in the kitchen inconveniences everyone. If we want the adolescent to see such distinctions, we as parents must be able to see them first. A person becomes open to respecting the boundaries of others when her own rights and boundaries are respected.

A person whose failures are the result of decisions she makes freely is far more capable of learning from consequences than someone whose actions and reactions come from succumbing to the demands of others, or from resisting them.

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. When he is not doing this work, he feels anxious, owing to an unconscious fear of being cut off from the parent. Later—as an adult—when not doing something specific, he has a vague unease, the feeling that he should somehow be working. 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.

His frenetic activity numbs him to emotional pain and keeps his sense of inadequacy out of sight, out of mind.

Attaining self-esteem begins with finding our true impulses and raising them to the light of day.

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.

He reacts as if he was himself the victim. He feels the victim’s humiliation, his helpless rage, his shame. This is not a state of adult human fellow feeling from which he can act effectively:...

Implicit memory happens, according to the psychologist and memory researcher Daniel Schacter, “when people are influenced by a past experience without any awareness that they are remembering.”2 Unconscious emotions and conscious feelings, rapid shifts in mood and dramatic physiological changes in the body can occur under the impact of implicit memory.

Whenever we experience ourselves caught up in feelings

that seem to overwhelm us, we are likely in the realm of implicit memory—as we also are when we find ourselves quite cut off from feelings.

Their emotional and physical reactions to

witnessing the humiliation and rough handling of another human being are the reactivation of sensations first encoded during a much earlier time of their lives when they themselves were helpless and felt shame and humiliation.

There does not have to be severe trauma for neurological circuits to be encoded with emotions of exclusion, injustice and humiliation. It can happen in loving families, if a sensitive child has unconscious or even preverbal experiences of feeling alone and cut off, misunderstood and shamed.

Other well-known features of attention deficit disorder can be understood when interpreted in the light of implicit memory, notably the trouble with authority figures reported by most ADD adults. This trouble can present itself in three ways: fear, rebelliousness or a combination of both.

This is simply the implicit memory of the adult who, as a sensitive child, saw through the pretensions and weaknesses of the adult world. Around authority figures such as employers, doctors, teachers and policemen, the ADD adult will experience a nervousness and lack of confidence that cannot be explained by the actual power relationship that exists in the present.

In the interaction with authority, the implicit memory system becomes activated. One is again a child, facing powerful adults.

Fear of intimacy is universal among ADD adults. It coexists with what superficially would seem to be its opposites—a desperate craving for affection and a dread of being rejected.

As we have seen, in ADD the ability to inhibit powerful emotions is impaired because the connections of the OFC with the lower brain centers did not develop optimally. Just as hypersensitivity magnifies the sense of being rejected, so deficient self-regulation due to impaired inhibition by

the cortex exaggerates the response to rejection.

With this in mind, we can understand what comes next. The response of the infant to the fathomless anxiety of physical or emotional separation from the parent is either rage or ...

They imagine this boredom of theirs to mean that something is lacking in their partner: the reality is that they are bored with

themselves. A person not in contact with internal sources of energy and interest in the world has to search for outside sources, believing that fulfillment can come only from someone else. This is the implicitly remembered state of the infant hungry for emotional nourishment, lacking the capacity to satisfy his own needs and having to look to the parent.

A person not in contact with internal sources of energy and interest in the world has to search for outside sources, believing that fulfi...

The fear of intimacy is also a fear of the loss of self. There is the well-known paradox that the person with ADD craves real human contact, feels like an outsider and wishes to belong—but at the same time is reclusive, often preferring his own company to that of others. The paradox is due to his oscillating back and forth between two fears: the anxiety of loneliness

and abandonment, and, opposing that, a parallel sense of danger that if he commits to a relationship, he will be overwhelmed, swallowed up.

But, no matter what their conscious intentions, most people are attracted to mates who have their caretakers’ positive and negative traits, and, typically, the negative traits are more influential.”7 In neurophysiological terms, our choice of mate reflects the early relationship patterns stamped in

the neural circuits of the right prefrontal cortex, especially its orbitofrontal portion. The OFC will recognize and hone in on some-one who, on the unconscious level, activates its familiar reactions. This person, after all, will most resemble the persons whose love one so desperately craved all one’s life.fn3 We are inexorably drawn to marry the individual who is, of all potential partners, the very one most likely to trigger in us the most painful and confusing of implicit memories—as well as the warmest, happiest ones.

1. Compassionate curiosity in the search for self-insight

It is not a matter of so-called positive thinking or the naive affirmations exemplified by vows like “Today I will be kinder to myself.”

Needed are both a desire to accept the self and the courage to look honestly. Beyond that, the ADD adult also has to acquire the skills of self-understanding, the first of which is the capacity to notice each time she makes

a critical, judgmental comment against herself, to notice whenever she is seized by anxiety, to notice when her behavior does not jibe with her long-term goal.

She notices, and asks—as parents need to ask regarding their child—what the meanings are, what is being acted out, what messages the Morse co...

“I would very much like to understand why I feel so much anxiety about displeasing others.”

We can let go of what we understand; we cling most ferociously to aspects of ourselves that remain hidden to us and whose power we do not comprehend.

2. Self-acceptance: tolerating guilt and anxiety

The problem is not that we have these shifting and conflicting feelings, the problem is that we take a very conditional attitude toward them.

We wish to hold on to some, drive away the others. In this we mirror perfectly the way, when we were children, the adults in our world

preferred to see only those aspects of our personalities that did not trigg...

So self-acceptance does not mean self-admiration or even self-liking at every moment of our lives, but tolerance for all our emotions, includin...

If we saw in guilt the well-meaning friend it was—doggedly faithful, to a fault—we would make room for it. We would listen to its one-note song of warning, don’t be selfish, but decide for ourselves consciously whether we need to dance to its tune. Yes, thank you, I see what you mean. By all means stick around if you wish, but I will let my adult brain circuits judge whether I am really hurting someone else or merely serving my legitimate needs.

At least in the beginning of growth, if she does not feel guilt, she is probably ignoring her truest self.

3. You don’t punish yourself for where you find yourself

To paraphrase Nietzsche, even the wrong turns and side roads have meaning and purpose, if only to teach us which way the path to oneself does not lie.

4. Choosing a guide: psychotherapy and counseling

But pain cannot be killed; it needs to be listened to. It has a story to tell and lessons to teach.

Some development of the capacity to be alone is necessary if the brain is to function at its best, and if the individual is to fulfil his highest potential.

As we saw in the previous chapter, self-understanding and