Scattered Minds: The Origins and Healing of Attention Deficit Disorder

by Gabor Maté MD

The child who seeks constant attention is, of necessity, an unhappy child. He feels that unless he gets attention he is worthless, has no place. He seeks constant reassurance that he is important. Since he doubts this, no amount of reassurance will ever impress him. — RUDOLF DREIKURS, M.D., Children: the Challenge

may seem paradoxical, but many children will go for negative attention rather than for no attention at all.

Her anxiety about being cut off from the adult is magnified, as is her desperation for attention.

“I was a bad kid,” or “I was always trying to cause some trouble” frequently express the way adults with ADD recall themselves as children.

Manipulation and the drive to control are fear responses based on unconscious anxieties.

The parents of a child with ADD will often find themselves angry and upset.

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.

That other people do not cause our reactions is a difficult concept,

ADD children is their virtually routine negative and defiant refusal of almost any demand, expectation or suggestion the

parent puts forward. This resistance serves an important purpose and tells an important story. It, too, has meaning.

Steven has for a long time considered his abandonment of a musical career as a perverse, boneheaded misjudgment. “It was the stupidest thing I have ever done,” he said. He was surprised to find that I did not agree with him. “It was one of the most necessary things you have ever done,” I told him. “To have continued under those circumstances would have been to surrender your soul to your father. Psychologically, you might not have survived that.”

Counterwill is an automatic resistance put up by a human being with an

incompletely developed sense of self, a reflexive and unthinking opposition to the will of the other. It is a natural but immature resistance arising from the fear of being controlled.

Every parent of an ADD child has had the experience of feeling intense frustration when, being pressured for time, they have tried to hurry their son or daughter along. The greater the parent’s anxiety and the greater the pressure he puts on the

child, the more slothfully slow the child seems to become.

By keeping out

the parent’s expectations and demands, counterwill helps to make room for the growth of the child’s own self-generated motivations and preferences.

The tendency of the ADD child is to behave in ways that provoke disapproval and attempts at parental control.

Counterwill becomes maladjusted, as it does in ADD, only when adults do not understand it and try to overcome it by some sort of pressure,

Counterwill is triggered whenever the child senses that the parent wants him to do something more than she, the child, wants to do it. It arises not just when the child absolutely does not wish to do that something but also when she does wish it, but just not as much as the parent.

“I don’t have as much control over myself as I would like,” the parent acknowledges implicitly. “I am not a perfect parent, but that means we will build a stronger relationship, you and I. We will make it so strong that it will be

able to take a lot of your resistance and a lot of my reactions.”

Performs well when given one-to-one attention but is restless and unproductive when required to work independently

trouble beginning and completing tasks

Withdraws attention when parents or teachers g...

Becomes distractible and distracting when not the ce...

Requires caretaking on some tasks beyond the age when it is appropriate Has difficulty organizing school materials and belongings at home[1]

all ADD children are unmotivated. Their absence of motivation is evident

A lack of inner-directed purpose also typifies a large number of ADD adults.

Attempting to motivate from the outside betrays a lack of faith in the child and in nature. It reflects the anxiety of the parent, not the limitations of the child.

sowing in them the seeds of our own anxiety.

“People need to feel that their behavior is truly chosen by them rather than imposed by some external source,”

True autonomy requires that the parents provide a supportive structure. It is futile to expect a child to do self-motivated and organized work if the parents’ lives express a near-desperate frenzy to keep up with their own responsibilities, which is what I often see in the families of ADD children. Without structure that involves the whole family and is not just forced on the child alone, there cannot be autonomy.

It is also an important step in promoting autonomy. Words are symbols. They stand for feelings and actions. Without the capacity to put things into symbols, children are driven to act out every strong feeling

“Although punishment is ineffective in making [the child] try harder,” writes Natalie Rathvon, “it is highly effective in solidifying her view of herself as unlovable

Do no harm

Teachers sometimes forget their immense power to wound. How deep classroom-inflicted emotional hurts can go, how long-lasting their sting

In his novel In a Glass House, the Canadian writer Nino Ricci renders poignantly the private despair of a young student struggling to keep focused in an intimidating school environment.

Who are we trying to teach must precede what are we trying to teach

reaching out to the child each day, even for a brief moment,

go further than any number of sternly delivered instructions.

The point in education, as in medicine, is not just in knowing how to interfere with nature, but—most important—how to observe it without interference, how to help it unfold.

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.

professional can hardly even reach the stage of “treating”

anything unless parents first assume responsibility for their own role in the interaction.

A superficially positive self-image and true self-esteem are by no means necessarily identical.

the denial and suppression of negative emotions—hallmarks of low self-esteem!

I have not achieved enough in life. I feel that my abilities exceed my attainments. I feel I could do more. . . . I vegetate, my ambitions like rotting weeds around me. I want to paint. I want to study languages: French, German, Spanish. . . . What else? I want to exercise. I want to meditate. I want to

read. I want to see people. I want to take in more culture. I want to sleep enough. I don’t want to watch junk television any more. I want an end to the binge cramming of food into myself every evening. . . . I want to live!*