Scattered Minds: The Origins and Healing of Attention Deficit Disorder

by Gabor Maté

Nature’s own agenda is hindered when parents foster what the developmental psychologist Gordon Neufeld calls acquired self-esteem, that based on external evaluations.

So, if the parent has lost it, it is his responsibility to restore the interpersonal bridge. This should not take the form of abject apologies, and promises not to be “mean” any more. Assuredly, we will lose it again—no point pledging not to. Restoring the bridge simply means acknowledging that we see what has happened and understand how the child might feel about it and hearing nondefensively what the child has to say. When she expresses her feelings about the negative interaction—and even if she does so in a form difficult for the parent to take—the parent does not explain himself or try to justify his behavior. He just listens with empathy.

Not only the parents but other siblings as well seem to revolve in emotional orbits around the child with ADD. They naturally come to resent the control he or she appears to wield over the family.

The parents need the child to be in balance only because they are not. But because the parents are not independently in balance themselves, the child cannot be.

Self-regulation is not the absence of anxiety, at least not in the very beginning, but a person’s ability to tolerate her own anxiety.

Dr. Freeman defines unfinished business as “a present emotional reaction shaped by a past experience.

Try as they might, poorly individuated parents cannot successfully foster individuation in their children. They are likely to have unsatisfactory relationships with their partners, especially after children begin arriving to upset the fragile emotional balance between them. They are also likely to fuse emotionally with one or another of their children. There may be the semblance of a close relationship between parent and child, but in reality the child’s individuation is hindered, as he grows up feeling automatically responsible for the parent’s feeling states.

“I feel like I always have to be on,” one mother complained. “If I am even slightly off, everything goes to pieces.” No one can be “always on.” But a giant stride forward is made when parents recognize the need to monitor their own emotional states and the level of tension in the entire household. If children swim in their parents’ unconscious, it is good to make sure that the water stays clear. Or at least as clear as possible.

The key to doing so is learning to give the child not the attention he is asking for, but the attention he needs.

According to the Economic Policy Institute in the U.S., the average work year is now 158 hours longer than it was three decades ago. “An extra month has been tacked on to what in 1969 was considered a full-time job!”

In reality, the child cannot cause the parent’s rage. She may have inadvertently triggered it, but she is responsible neither for the capacity for rage in the parent nor for the existence of the trigger. The parent acquired them before the child was born. The uncooperative behavior may belong to the child, but the rage belongs to the parent.

Counterwill arises in anyone who has not yet developed a mature and conscious will of her own.

Like a psychological immune system, counterwill functions to keep out anything that does not originate within the child herself.

Like all natural phenomena and all stages in the child’s life, counterwill has a positive purpose. It first appears in the toddler to help in the task of individuating, of beginning to separate from the parent. In essence, the child erects a wall of no’s. Behind this wall, the child can gradually learn her likes and dislikes, aversions or preferences, without being overwhelmed by the far more powerful force generated by the parent’s will.

Counterwill may be likened to the small fence one places around a tender young shoot to protect it from being eaten. The vulnerable little plant here is the child’s will. Without that protective fence, it cannot survive. In adolescence, counterwill serves the same goal, helping the young person loosen his psychological dependence on the family.

“Far from being depraved, counterwill is bequeathed by nature, to serve the ultimate purpose of becoming a separate being,” says Dr. Neufeld. “Counterwill, the dynamic, should not be identified with the child’s self. This is really important. It is not the person that we are getting to know when we get to know the resistance. Nature designed the child that way. It is really Nature that has a purpose, not the child.”

Stop the pay, stop the play.”

The children most at risk for problems later in life are those who feel so threatened that their counterwill falls completely silent. Many a good little boy or good little girl grows up to be a depressed and troubled adult.

Parents who do not take the child’s opposition as a personal challenge to their authority will avoid the contests of power that make everyone a loser.

Say a child responds to a parental command with rude, unacceptable language. Instead of punishing the expression, the wise parent shows some empathy for the resistance. “You didn’t feel like being bossed around today. It made you want to do the opposite of what I said. I can see that. But next time, I want you to tell me without using those insulting words.”

“It’s a lot easier for a child to comply,” Gordon Neufeld points out, “when they know at least you understand what they experience.”

Attempting to motivate from the outside betrays a lack of faith in the child and in nature.

The child has transferred his conscious striving for acceptance from his parents to his peers. Recalcitrant at home, he is desperate for the approval of his playmates, a desperation more often than not met with rejection.

“Keep in mind that rapport and limit setting go hand in hand,” Stanley Greenspan advises. “As you increase limit setting, you need to increase empathy.”

We try to make our kids act as truly socially responsible people at the expense of their emotional security and their autonomous sense of self. This may result in compliance, but not in the internal, organic growth of true morality and social responsibility. We can no more foster genuine socialization this way than we can balance a pyramid on its apex, upside down.

Many still cringe as they recall humiliations, the cutting and sarcastic remarks of their teachers, the punishments for misbehavior they did not deliberately initiate and for inabilities they did not know how to overcome.

ADD students have a volcanic amount of pent-up kinetic energy.

What we are anxious about we try to control, and when we can’t control we may throw in the towel.

First and foremost, teenagers with ADD have an immense need to be heard. Until they feel that their point of view has been listened to and that the legitimacy of their feelings has been accepted, they will simply not move toward any examination of themselves. These young people have a deep sense of being misunderstood, deeper than they realize. Every criticism they hear, every blaming word—anything they interpret as at all judgmental—activates in them feelings of shame, which they try to defend themselves against with all their might.

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.

If you persist in throttling your impulses you end by becoming a clot of phlegm. You finally spit out a gob which completely drains you and which you only realize years later was not a gob of spit but your inmost self. If you lose that you will always race through dark streets like a madman pursued by phantoms. You will be able to say with perfect sincerity: “I don’t know what I want in life.” – HENRY MILLER, Sexus

In the ADD child, low self-esteem is manifested not just by the self-putdowns he may utter, such as “I’m dumb.” 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. Nor can he accept not being in the right. The fragile and self-rejecting ego is unable to endure any reminders of its fallibility. Many people with attention deficit disorder retain that fragility into adulthood.

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.

What are some of the markers of low self-esteem, besides consciously harsh self-judgment? As mentioned above, an inflated, grandiose view of oneself—frequently seen in politicians, for example. Craving the good opinion of others. Frustration with failure. A tendency to blame oneself excessively when things go wrong, or, on the other hand, an insistence on blaming others: in other words, the propensity to blame someone. Mistreating those who are weaker or subordinate, or accepting mistreatment without resistance. Argumentativeness—having to be in the right or, obversely, assuming that one is always in the wrong. Trying to impose one’s opinion on others or, on the contrary, 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 overwrought sense of responsibility for other people in relationships and, as we will discuss shortly, an inability to say no. The need to achieve in order to feel good about oneself. How one treats one’s body and psyche speaks volumes about one’s self-esteem: 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 that is conditional and devoid of true self-respect.

In the majority of adults I have interviewed, it was evident that the inability to accept themselves was heavily reinforced throughout childhood by their parents’ expectations of better performance, and by their disappointment and disapproval at the absence of it.

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. Being wanted becomes a drug. Self-esteem is preempted by its false shadow, contingent self-esteem. What one does and what others think of it take precedence over who one is.

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

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.”

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. From that arises a close identification with the powerless, with the underdog—the people Dostoevsky called “the insulted and the injured.” The goal for the ADD adult is to move from the helplessness of identification to the empowered state of empathy.

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.

“Like a child” is precisely how many ADD adults describe their sense of themselves in relationship to authority.

The implicit memory of early fear conditioning probably contributes to the specific neurophysiological impairments of ADD. An example would be the loss of mental clarity, to the point of mental paralysis, experienced during situations of emotional stress. It would account for the well-known “examination amnesia” of many students with attention deficit disorder.

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. The reflexive shrinking away from intimacy undermines the ability of the ADD adult to find what he would find most healing: mutually committed loving contact with another human being.

The ADD adult does not know the difference between refusal and rejection. When he hears no from a lover, a friend, an employer, it’s as if the universe is negating his right to exist.

The withdrawal dynamic has been called defensive detachment by Bowlby. It has one meaning: so hurtful was it for me to experience your absence that I will encase myself in a shell of hard emotion, impervious to love—and therefore to pain. I never want to feel that hurt again.

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.

Such a person is presented with a choice between two alternatives, neither of which is satisfactory: one either choses the relationship and gives up the self, or retains the sense of self but gives up on the relationship—and, in some cases, on almost all social contact. The unsolved problem is how to be oneself in contact with other people. People desperate for a relationship will surrender their sense of self, their true feelings, for fear of being rejected; when they have gained the relationship they may pull back, as Trevor repeatedly has, in order to reconnect with that precarious sense of self. This dynamic is often seen after the most intimate act of all, sexual intercourse, when following deep attraction and union, there is an alienation and a drive to separate which men, particularly, may experience.

One gauge of persistent problems with intimacy in an ADD relationship is the couple’s sexual life—or the lack of it. “Non-existent” and “What sex life?” are two of the common replies my questioning around this subject tends to bring. The lack of sexual intimacy is in most cases an unmistakable sign of mutual emotional shutdown. Interestingly, I see this not only in families where one of the adult partners has ADD, but also where one or more of the children has it, even if neither parent does. In the latter case, this marker of absent intimacy between the parents speaks volumes about the emotional alienation and tension in the midst of which the child exists.

Strength is an inner quality; power is a matter of relationship. I may have strength, yet at the same time I may be powerful in one relationship and utterly powerless in another. “Which partner in a marriage has to ‘put up’ with stuff?” I said. “The less or the more powerful one?”