Scattered Minds: The Origins and Healing of Attention Deficit Disorder

“We think that children act, whereas what they mostly do is react. Parents who realize this acquire a powerful tool. By noticing their own responses to the child, rather than fixating on the child’s responses to them, they free up tremendous energy for growth.”

“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.”

“So self-acceptance does not mean self-admiration or even self-liking at every moment of our lives, but tolerance for all our emotions, including those that make us feel uncomfortable.”

“A tone of voice or a look in another’s eyes can activate powerful implicit memories. The person experiencing this type of memory may believe that he is just reacting to something in the present, remaining completely in the dark about what the rush of feelings that flood his mind and body really represents. Implicit memory is responsible for much of human behavior, its workings all the more influential because unconscious.”

“I do not believe ADD leads to creativity any more than creativity causes ADD. Rather, they both originate in the same inborn trait: sensitivity. 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. Colin,”

“It is worth recalling here that the injudicious use of rewards and praise can be pressure tactics no less than verbal or physical coercion. As we have seen, there are three dangers with motivating by means of reward and praise. First, they feed the anxiety that not the person but the desired achievement is what is valued by the parent. They directly reinforce the insecurity of the ADD child. Second, since children can sense the parents’ will pushing them, even if under benign disguises such as gifts or warm words, counterwill will be strengthened. Third, praise and reward will themselves become the goal, at the expense of the child’s interest in the actual process of what he is doing. Children thus motivated will sooner or later learn to get by with the least amount of effort necessary to earn the praise or the reward. Short cuts and cheating often follow. Accepting”

“The family therapist David Freeman once concluded a public lecture on intimacy and relationships by saying that if there was any one thing he hoped his audience would remember from his talk, it was the awareness that one does not know his or her spouse, his or her children. We may believe we have a perfect idea of why they act as they do, when in reality our beliefs reflect no more than our own anxieties.”

“Since having a strong core self relies on acceptance of feelings, being out of touch with the emotional side puts a person out of touch with herself. What then remains to be esteemed? Only a false self, a concoction of what we would like to imagine ourselves to be and what we have divined others want us to be. Sooner or later, people come to realize that this false self — wanting what they think they should want, feeling what they think they should feel — does not work for them. When they look inside themselves, they discover a frightening emptiness, a vacuum, an absence of a true self or of intrinsic motivation.”

“The warmth and satisfaction of positive contact with the adult is often just as good as a psychostimulant in supplying the child’s prefrontal cortex with dopamine.”

“The best attitude to adopt is one of compassionate patience, which has to include a tolerance for failure.”

“Environmental influences also affect dopamine. From animal studies, we know that social stimulation is necessary for the growth of the nerve endings that release dopamine and for the growth of receptors that dopamine needs to bind to in order to do its work. In four-month-old monkeys, major alterations of dopamine and other neurotransmitter systems were found after only six days of separation from their mothers. “In these experiments,” writes Steven Dubovsky, Professor of Psychiatry and Medicine at the University of Colorado, “loss of an important attachment appears to lead to less of an important neurotransmitter in the brain. Once these circuits stop functioning normally, it becomes more and more difficult to activate the mind.” A neuroscientific study published in 1998 showed that adult rats whose mothers had given them more licking, grooming and other physical-emotional contact during infancy had more efficient brain circuitry for reducing anxiety, as well as more receptors on nerve cells for the brain’s own natural tranquilizing chemicals. In other words, early interactions with the mother shaped the adult rat’s neurophysiological capacity to respond to stress.In another study, newborn animals reared in isolation had reduced dopamine activity in their prefrontal cortex — but not in other areas of the brain. That is, emotional stress particularly affects the chemistry of the prefrontal cortex, the center for selective attention, motivation and self-regulation. Given the relative complexity of human emotional interactions, the influence of the infant-parent relationship on human neurochemistry is bound to be even stronger. In the human infant, the growth of dopamine-rich nerve terminals and the development of dopamine receptors is stimulated by chemicals released in the brain during the experience of joy, the ecstatic joy that comes from the perfectly attuned mother-child mutual gaze interaction. Happy interactions between mother and infant generate motivation and arousal by activating cells in the midbrain that release endorphins, thereby inducing in the infant a joyful, exhilarated state. They also trigger the release of dopamine. Both endorphins and dopamine promote the development of new connections in the prefrontal cortex. Dopamine released from the midbrain also triggers the growth of nerve cells and blood vessels in the right prefrontal cortex and promotes the growth of dopamine receptors. A relative scarcity of such receptors and blood supply is thought to be one of the major physiological dimensions of ADD. The letters ADD may equally well stand for Attunement Deficit Disorder.”

“There are two possibilities why your memories of childhood are so hazy,” I suggest to people. “Either nothing happened worth remembering, or too much happened that may be hurtful for you to recall.” As we shall see in a later chapter, human beings can tune out entire periods of their lives that were characterized by emotional pain.”

“Throughout the human life span there remains a constant two-way interaction between psychological states and the neurochemistry of the frontal lobes, a fact that many doctors do not pay enough attention to. One result is the overreliance on medications in the treatment of mental disorders. Modern psychiatry is doing too much listening to Prozac and not enough listening to human beings; people’s life histories should be given at least as much importance as the chemistry of their brains. The dominant tendency is to explain mental conditions by deficiencies of the brain’s chemical messengers, the neurotransmitters. As Daniel J. Siegel has sharply remarked, “We hear it said everywhere these days that the experience of human beings comes from their chemicals.” Depression, according to the simple biochemical model, is due to a lack of serotonin — and, it is said, so is excessive aggression. The answer is Prozac, which increases serotonin levels in the brain. Attention deficit is thought to be due in part to an undersupply of dopamine, one of the brain’s most important neurotransmitters, crucial to attention and to experiencing reward states. The answer is Ritalin. Just as Prozac elevates serotonin levels, Ritalin or other psychostimulants are thought to increase the availability of dopamine in the brain’sprefrontal areas. This is believed to increase motivation and attention by improving the functioning of areas in the prefrontal cortex. Although they carry some truth, such biochemical explanations of complex mental states are dangerous oversimplifications — as the neurologist Antonio Damasio cautions: "When it comes to explaining behavior and mind, it is not enough to mention neurochemistry... The problem is that it is not the absence or low amount of serotonin per se that “causes” certain manifestations.Serotonin is part of an exceedingly complicated mechanism which operates at the level of molecules, synapses, local circuits, and systems, and in which sociocultural factors, past and present, also intervene powerfully. The deficiencies and imbalances of brain chemicals are as much effect as cause. They are greatly influenced by emotional experiences. Some experiences deplete the supply of neurotransmitters; other experiences enhance them. In turn, the availability — or lack of availability — of brain chemicals can promote certain behaviors and emotional responses and inhibit others. Once more we see that the relationship between behavior and biology is not a one-way street.”

“As parents, we may as well accept that we will “lose it” at times. Perfect equanimity is beyond us. Temporary breaks in the relationship with the child are inevitable and are not in themselves harmful, unless they are frequent and catastrophic. The real harm is inflicted when the parent makes the child work at reestablishing contact, as in forcing a child to apologize before granting “forgiveness.” There”

“Whenever we ascribe a motive to the other person, as in “you are doing this because...,” we discard curiosity and immobilize compassion.”

“For a person with ADD, tuning out is an automatic brain activity that originated during the period of rapid brain development in infancy when there was emotional hurt combined with helplessness. At one time or another, every infant or young child feels frustration and psychological pain. Episodic experiences of a distressing nature do not induce dissociation, but chronic distress does—the distress of the sensitive infant with unsatisfied attunement needs, for example. The infant has to dissociate chronic emotional pain from consciousness for two reasons. First, it is too overwhelming for his fragile nervous system. He simply cannot exist in what we might call a state of chronic negative arousal, with adrenaline and other stress hormones pumping through his veins all the time. It is physiologically too toxic. He has to block it out. Second, if the parent’s anxiety is the source of the infant’s distress, the infant unconsciously senses that fully expressing his own emotional turmoil will only heighten that anxiety. His distress would then be aggravated—a vicious cycle he can escape by tuning out.”

“Judgment or blaming is not the point. Understanding is.”

“The three conditions without which healthy growth does not take place can be taken for granted in the matrix of the womb: nutrition, a physically secure environment and the unbroken relationship with a safe, ever-present maternal organism. The word matrix is derived from the Latin for “womb,” itself derived from the word for “mother.” The womb is mother, and in many respects the mother remains the womb, even following birth. In the womb environment, no action or reaction on the developing infant’s part is required for the provision of any of his needs. Life in the womb is surely the prototype of life in the Garden of Eden where nothing can possibly be lacking, nothing has to be worked for. If there is no consciousness — we have not yet eaten of the Tree of Knowledge — there is also no deprivation or anxiety. Except in conditions of extreme poverty unusual in the industrialized world, although not unknown, the nutritional needs and shelter requirements of infants are more or less satisfied. The third prime requirement, a secure, safe and not overly stressed emotional atmosphere, is the one most likely to be disrupted in Western societies. The human infant lacks the capacity to follow or cling to the parent soon after being born, and is neurologically and biochemically underdeveloped in many other ways. The first nine months or so of extrauterine life seem to have been intended by nature as the second part of gestation. The anthropologist Ashley Montagu has called this phase exterogestation, gestation outside the maternal body. During this period, the security of the womb must be provided by the parenting environment. To allow for the maturation of the brain and nervous system that in other species occurs in the uterus, the attachment that was until birth directly physical now needs to be continued on both physical and emotional levels. Physically and psychologically, the parenting environment must contain and hold the infant as securely as she was held in the womb.For the second nine months of gestation, nature does provide a near-substitute for the direct umbilical connection: breast-feeding. Apart from its irreplaceable nutritional value and the immune protection it gives the infant, breast-feeding serves as a transitional stage from unbroken physical attachment to complete separation from the mother’s body. Now outside the matrix of the womb, the infant is nevertheless held close to the warmth of the maternal body from which nourishment continues to flow. Breast-feeding also deepens the mother’s feeling of connectedness to the baby, enhancing the emotionally symbiotic bonding relationship. No doubt the decline of breast-feeding, particularly accelerated in North America, has contributed to the emotional insecurities so prevalent in industrialized countries. Even more than breast-feeding, healthy brain development requires emotional security and warmth in the infant’s environment. This security is more than the love and best possible intentions of the parents. It depends also on a less controllable variable: their freedom from stresses that can undermine their psychological equilibrium. A calm and consistent emotional milieu throughout infancy is an essential requirement for the wiring of the neurophysiological circuits of self-regulation. When interfered with, as it often is in our society, brain development is adversely affected.”

“Young children cannot possibly understand the motives of adults. It means little to a young child that the parent feels love for him if that parent keeps disappearing at almost any time. The child experiences a sense of abandonment, a subliminal knowledge that there are things in the world much more important to the parent than he, the child, that he is not worthy of the parent’s attention. He begins to feel, at first unconsciously, that there must be something wrong with him. He also begins to work too hard to get his needs met: demanding contact, acting out or trying to please the parent to gain approval and attention.”

“ADD is also found more commonly in people whose first-degree relatives are alcoholics or suffer from depression, anxiety, addiction, obsessive-compulsive disorder or Tourette’s syndrome.”

“People with ADD are forever told that they are “too sensitive” or that they should stop being “so touchy.” One might as well advise a child with hay fever to stop being “so allergic.”

“Sensitive children come to be called “difficult” because adults have trouble understanding their temperament and because parenting methods that work with other children are frustratingly inadequate with this group.”

“Environment does not cause ADD any more than genes cause ADD. What happens is that if certain genetic material meets a certain environment, ADD may result. Without that genetic material, no ADD. Without that environment, no ADD. The formative environment is the family of origin.”

“From early infancy, it appears that our ability to regulate emotional states depends upon the experience of feeling that a significant person in our life is simultaneously experiencing a similar state of mind.”

“The psychoanalyst Erik H. Erikson devoted a chapter in his Pulitzer Prize—winning book, Childhood and Society, to his reflections on the American identity. “This dynamic country,” he wrote, “subjects its inhabitants to more extreme contrasts and abrupt changes during a generation than is normallythe case with other great nations.” Such trends have only accelerated since Erikson made that observation in 1950. The effects of rapid social and economic shifts on the parenting environment are too well known to need detailing here. The erosion of community, the breakdown of the extended family, the pressures on marriage relationships, the harried lives of nuclear families still intact and the growing sense of insecurity even in the midst of relative wealth have all combined to create an emotional milieu in which calm, attuned parenting is becoming alarmingly difficult. The result being successive generations of children in alienation, drug use and violence — what Robert Bly has astutely described as “the rage of the unparented.” Bly notes in The Sibling Society that “in 1935 the average working man had forty hours a week free, including Saturday. By 1990, it was down to seventeen hours. The twenty-three lost hours of free time a week since 1935 are the very hours in which the father could be a nurturing father, and find some center in himself, and the very hours in which the mother could feel she actually has a husband.” These patterns characterize not only the earlyyears of parenting, but entire childhoods. “Family meals, talks, reading together no longer take place,” writes Bly. “What the young need — stability, presence, attention, advice, good psychic food, unpolluted stories — is exactly what the sibling society won’t give them.”

“Even without world wars, revolutions and emigration, siblings growing up in the same home almost never share the same environment. More accurately, brothers and sisters share some environments — usually the less important ones — but they rarely share the one single environment that has the most powerful impact on personality formation. They may live in the same house, eat the same kinds of food, partake in many of the same activities. These are environments of secondary importance. Of all environments, the one that most profoundly shapes the human personality is the invisible one: the emotional atmosphere in which the child lives during the critical early years of brain development. The invisible environment has little to do with parenting philosophies or parenting style. It is a matter of intangibles, foremost among them being the parents’ relationship with each other and their emotional balance as individuals. These, too, can vary significantly from the birth of one child to the arrival of another. Psychological tension in the parents’ lives during the child’s infancy is, I am convinced, a major and universal influence on the subsequent emergence of ADD.A hidden factor of great importance is a parent’s unconscious attitude toward a child: what, or whom, on the deepest level, the child represents for the parents; the degree to which the parents see themselves in the child; the needs parents may have that they subliminally hope the child will meet. For the infant there exists no abstract, “out-there” reality. The emotional milieu with which we surround the child is the world as he experiences it. In the words of the child psychiatrist and researcher Margaret Mahler, for the newborn, the parent is “the principal representative of the world.” To the infant and toddler, the world reveals itself in the image of the parent: in eye contact, intensity of glance, body language, tone of voice and, above all, in the day-today joy or emotional fatigue exhibited in the presence of the child. Whatever a parent’s intention, these are the means by which the child receives his or her most formative communications. Although they will be of paramount importance for development of the child’s personality, these subtle and often unconscious influences will be missed on psychological questionnaires or observations of parents in clinical settings. There is no way to measure a softening or an edge of anxiety in the voice, the warmth of a smile or the depth of furrows on a brow. We have no instruments to gauge the tension in a father’s body as he holds his infant or to record whether a mother’s gaze is clouded by worry or clear with calm anticipation. It may be said that no two children have exactly the same parents, in that the parenting they each receive may vary in highly significant ways. Whatever the hopes, wishes or intentions of the parent, the child does not experience the parent directly: the child experiences the parenting. I have known two siblings to disagree vehemently about their father’s personality during their childhood. Neither has to be wrong if we understand that they did not receive the same fathering, which is what formed their experience of the father. I have even seen subtly but significantly different mothering given to a pair of identical twins.”

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

“I’m a people pleaser” is the routine self-description of ADD adults. “I’m always so conscious of what the other person might need from me. I feel guilty if I disappoint someone. I can never say no.” Or, “I am the kind of person whom everyone calls to tell their troubles to. I can’t do that myself, though. I would feel guilty, thinking of all the people in the world who have suffered much more than I can even imagine. I shouldn’t need help.” To”

“It may be said that no two children have exactly the same parents, in that the parenting they each receive may vary in highly significant ways. Whatever the hopes, wishes or intentions of the parent, the child does not experience the parent directly: the child experiences the parenting. I have known two siblings to disagree vehemently about their father’s personality during their childhood. Neither has to be wrong if we understand that they did not receive the same fathering, which is what formed their experience of the father. I have even seen subtly but significantly different mothering given to a pair of identical twins.”

“As parents who make every effort we can to raise our children in loving security, we do not need to feel more guilt than we already do. We need less guilt and more awareness of how the quality of the parent-child relationship can be used to promote our children’s emotional and cognitive development.”