Scattered Minds: The Origins and Healing of Attention Deficit Disorder

by Gabor Maté MD

Completely lacking in the ADD mind is a template for order, a mental model of how order comes about. You may be able to visualize what a tidy and organized room would look like, but the mind-set to do the job is missing.

To begin with, there is a profound reluctance to discard anything—who

The adult or child with ADD can barely restrain himself from interrupting others, finds it a torture waiting his turn in all manner of activities and will often act or speak impulsively as if forethought did not exist.

The impulsiveness may express itself as the purchase of unneeded items on a whim, without regard for cost

or consequence.

The hyperactivity may also take the form of excessive talking.

Some adults with ADD have told me that they speak so quickly partly because so many words and phrases tumble into their minds that they fear forgetting the most important ones unless they release them

at a fast rate.

The restlessness coexists with long periods of procrastination. The threat of failure or the promise of reward has to be immediate for the motivation apparatus to be turned on.

On the other hand, when there is something one wants, neither patience nor procrastination exist. One has to do it, get it, have it, experience it, immediately.

An adult with ADD looks back on his life to see countless plans never fully realized and intentions unfulfilled.

in early childhood most of them literally climb all over adults and generally exhibit an almost insatiable desire for physical and emotional contact. They approach other children with a naive openness, which is often rebuffed.

Many are recognizable by their compulsive joking, their pressured, rapid-fire speech, by their seemingly random and aimless hopping from one topic to the next and by their inability to express an idea without

exhausting the English vocabulary.

To interview adults with attention deficit disorder is often to be ambushed by jokes.

Children with ADD frequently act the part of the class clown.

“If you have many of the features of ADD,” I say to people, “and if they produce a lack of order in your life, then you have ADD. What is

order? A sense of organization. A consciously planned sequence of activities. Knowing where things are and what you have done and what remains to be done. And what do we call a lack of order? Disorder.”

Conflict can have an addictive quality:

This feeling of duty toward the whole world is not limited to ADD but is typical of it. No one with ADD is without it.

The emotional climate was too unpredictable and confusing.

regret what I did not do: give my children the gift of a mindful, secure and reliable parental presence. I wish I had known how to allow myself to relax, to release myself from the compulsions driving me and to fully enjoy the wonderful little persons they were.

couples choose each other with an unerring instinct for finding the very person who will exactly match their own level of unconscious anxieties and mirror their own dysfunctions, and who will trigger for them all their unresolved emotional pain. This

Ask people with ADD how long it will take to perform a particular task, and they will notoriously underestimate. A kind of magical thinking dominates,

In our model, the drivers have no capacity to regulate themselves. They rely on the order kept by a policeman

Traffic flow, in short, is alternately inhibited in one direction while being permitted in another. There is order. Now imagine that the policeman falls asleep on the job. There will ensue tremendous activity as cars from all directions attempt to move through the intersection, their drivers increasingly frustrated, their horns joined in a deafening cacophony. Despite all the commotion, there is little progress. Fewer and fewer cars are able to move purposefully. There is disorder.

The cerebral cortex in the frontal lobe is not able to perform its job of prioritizing, selection and inhibition.

some people are not able to experience the full flowering of their potential. We have only to inquire what conditions sustain unfettered human development and what conditions hinder it.

ADD is also found more commonly in people whose first-degree relatives are alcoholics or suffer from depression, anxiety, addiction,

People with ADD are hypersensitive. That is not a fault or a weakness of theirs, it is how they were born. It is their inborn temperament. That, primarily, is what is hereditary about ADD. Genetic inheritance by itself cannot account for the presence of ADD features in people, but heredity can make it far more likely that these features will emerge in a given individual, depending on circumstances. It is sensitivity, not a disorder, that is transmitted through heredity. In most cases, ADD is caused by the impact of the environment on particularly sensitive infants.

The word matrix is derived from the Latin for “womb,” itself derived from the word for “mother.”

The first nine months or so of extrauterine life seem to have been intended by nature as the second part of gestation.

Because the formation of the child’s brain circuits is influenced by the mother’s emotional states, I believe that ADD originates in stresses that affect the mothering parent’s emotional interactions with the infant.

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weeks, the infant’s gaze follows the mother’s eyes more closely than her mouth movements, thus fixating on what has been called “the visible portion of the mother’s central nervous system.” The infant’s right brain reads the mother’s right brain during intense eye-to-eye mutual gaze interactions.

viewing enlarged dilated pupils elicits larger pupils in the observer. In a developmental study, infants smiled more when a female experimenter’s eyes were dilated rather than constricted. . .

Positive emotions are associated with increased electrical activity in the left hemisphere.

It is known that depression in adults is associated with decreased electrical activity in the circuitry of the left hemisphere. With

Maternal depression is associated with diminished infant attention spans.

The emotional sensory radar of the infant has not yet been scrambled. It reads feelings clearly.

A mother who is anxious may react with alarm when the infant breaks off contact, may try to stimulate him, to draw him back into the interaction. Then the infant’s nervous system is not allowed to “cool down,” and the attunement relationship is hampered.

Each time we scream at someone in traffic, we are telling a story from the earliest part

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chronically high levels of stress hormones such as cortisol have been shown to cause important brain centers to shrink.

Attention deficit is thought to be due in part to an undersupply of dopamine,

Both endorphins and dopamine promote the development of new connections

unequal division of emotional labour is, I believe, one of the main reasons why more women than men become depressed.

If we are to make sense of all the stressed lives—the depressions, the increased prevalence of alcoholism,

these adults with attention deficit disorder experienced in their childhoods,