Scattered Minds: The Origins and Healing of Attention Deficit Disorder

by Gabor Maté

self-acceptance are the first responsibility of the adult who wants to foster his own growth, which really is no different from what any parent owes a child.

The adult with attention deficit disorder has not lost the inborn temperamental sensitivity he carried into this world. No less than for children, conditions in his environment continue to have a direct and major impact on his emotions and thought processes

Without the right conditions, the brain cannot develop new circuits or the mind new ways of relating to world and to self.

1. The physical space

Although many ADD adults assert that they function well in the midst of the physical chaos around them, the fact is that they are too sensitive not to be affected by it. Neglecting to honor their physical environment is to neglect themselves.

The best plan, I find, is not to insist that any one task be finished but to impose a strict time limit in which to work. When the appointed time period is over, stop.

ADD adult might as well accept from the beginning that he will keep failing at it for some time to come.

2. Sleep hygiene

Something in the ADD adult dreads going to bed and turning the light off. The fear is of being alone with one’s urgent mind for even a few short minutes.

The fear of being alone with the mind is, I believe, an implicit memory of finding oneself, in infancy, cut off from contact with the parent.

During sleep also, the mind integrates events from the waking hours.

3. Nutrition

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

The ADD child completely falls apart when his blood sugar is too low, becomes hyper when it is too high,

4. Physical exercise

Lack of exercise leads to an internal sluggishness that undermines alertness and attention. Exercise releases substances in the brain that are necessary for mood stability, motivation and attention and, in the long term, makes the chemical apparatus that manufactures these substances more efficient. I recommend that people 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. Simple stretching exercises done for a few minutes daily are tremendously freeing

physically and psychologically.

5. Nature

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.

If a mind in a different relationship to itself is a goal, we need to clear some ground for its development. We may need to let some activities go.

7. Recreation

There is a difference between entertaining diversion...

Re-creation needs activities that nourish the mind or liberate the body. What these may be will vary from person to person, but universally ADD adults deny themselves regularly scheduled times for mental and physical regeneration.

8. Creative expression

For creativity, a temperamental sensitivity is indispensable. The sensitive individual, as we have seen, draws into herself the unseen emotional and psychic communications of her environment. On some levels of the unconscious, she will, therefore, have a deeper awareness of the world. She may also be more attuned to particular sensory input, such as sound, color or musical tone. Thus the sensitivity provides her with the raw materials her mind will rework and reshape. Thus sensitivity contributes to the emergence of attention deficit disorder, as well as to creativity.

If self-esteem means esteeming the self, the individual’s deepest creative urges must be honored. The self-parenting part of healing ADD must, I am convinced, involve paying attention to one’s need to create.

Not everyone would be able to earn a living in his chosen

field of creative expression, but I always urge people to identify the direction in which their creative energies would naturally flow, and to allow them expression. Many ADD adults don’t have to search for anything new in following this advice; they just have to reconnect with something they had lost contact with long ago.

9. Meditation and mi...

The third pillar of a balanced human existence is spiritual work. This could take place in a religious context, but not necessarily. Spiritual work is the cultivation of a mindful solitude.

Enormously beneficial to everyone, spiritual work is essential in the self-treatment of ADD.

The search of the fragmented ADD mind for oneness must, therefore, involve also the

spiritual quest, however an individual may wish to define that for him or herself.

The ADD mind is most uncomfortable with meditation, is intensely bored with it. It’s all the more amazing to me that recently I have actually come to enjoy and look forward to it. It becomes fun, after a while, to watch the fretful and anxious mind do its backwards flips, somersaults, and disappearing tricks—to ...

“Pay precise attention,” writes Mark Epstein, “moment by moment, to exactly what you are experiencing, right now, separating your reactions from the raw sensory events.”2 Meditation is one way of acting on the neurophysiology of ADD. It is an important way, but not the only one. 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.

Contemplative solitude is different from being alone in a room, reading, listening to music or being lost in reverie. It means putting some attention on one’s life, one’s thoughts and feelings. Like...

The best attitude to adopt is one of compassionate patience, which has to include a tolerance for failure. When it comes to changing unhealthy habits or instituting healthy ones, writes Weil, “whether you succeed or fail is less important than making the attempt.”3

for gambling, compulsive sexual roving, chronic impulse buying, workaholism, excessive physical training, danger-seeking pursuits like drag racing or for nicotine or cocaine, alcohol or marijuana.

Whatever behavior or substance one is addicted to, the treatment of attention deficit disorder cannot make headway until one accepts the fact of the addiction and takes steps to end it. 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. Until that happens, the pain owns the addict and the addiction rules him.

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.

We see, then, that the pain the substance abuser does not want to feel has as its original source the same experiences that deprived her of the chemical she is trying to replenish

The harder these people work to compensate for their deficient biochemistry through their respective addictions, the more they perpetuate the emotional emptiness that only the ownership of their problem and the recognition of its causes in past and present will begin to fill.

While they stick with their addiction, they are being no kinder to themselves than the parents who are unable to give up theirs even to help their child.

While attention deficit disorder cannot be successfully treated as long as the addiction continues to dominate, neither can the addiction be given the appropriate attention if the ADD is ignored and if the common origins of both remain unexplored.

There is no path toward oneself that leads away from the pain.

The irony is that the energy ADD adults expend on their attempts at sameness is wasted, as is the anxiety parents generate over their child’s differentness.