Way back when, when we were desperately trying to figure out what the problem was that was making it so incredibly hard for a very smart, very conscientious, very curious,very creative, and very nice little boy to get through a day of school without a meltdown of some kind, I was continually surprised that none of the psychologists and social workers reached for the diagnosis I was prepared to reject out of hand.
Looking back, when we finally felt we had a handle on things, I came to two conclusions.
One was that the professionals, deliberately or reflexively, had probably been avoiding ADHD as the easy answer, because of the concern that ADHD had been over-diagnosed and kids diagnosed with it over-medicated in the ten years before.
The other was that my determination to resist that as the diagnosis wasn’t just based on my knowledge of the kid needing help. It also wasn’t based on my own feeling that ADHD was a fad diagnosis that was being applied irresponsibly or recklessly as an excuse to drug normally rambunctious little boys into submitting to the dull routines of classroom discipline.
I’d had a student with ADHD, a good, hardworking, B+/A student who visited my office early in the semester to explain to me why he might have some trouble completing work on time and why it might look sometimes like he wasn’t paying attention. He assured me, however, was going to try his hardest and he was taking Ritalin and it was helping.
“Ritalin,” he told me, “Saved my life.”
He did have some trouble. It did look sometimes like he wasn’t paying attention. He did try his hardest. He finished all his work and earned an A.
This was just before we became parents.
So if I’d seen the signs of ADHD myself, I would have thought immediately of my student.
I just wasn’t see what I thought were the signs.
But one of the (small) good things about going through what we’ve gone through is that we’ve had to learn things about how the mind works and how the behavior is regulated. And one of the things I learned is that I didn’t actually know what ADHD was.
The first thing I didn’t know was not to call it ADHD.
Hyperactivity is a different just not always separate issue.
I wasn’t mentally pronouncing the silent and/or:
It’s not always written with the and/or, but it should always be thought of as containing it.
One of the possible diagnoses we were given, the one that seemed to us to explain the most and the one that gave us strategies to work with and suggest to teachers, was Sensory Integration Disorder.
The problem the kid had to deal with was not that he couldn’t pay attention, it was that he didn’t know what to pay attention to. There was so much information coming at him every single minute of the day that his thought-processes just short-circuited and then shut down.
To get an idea of what I think it was like for him, watch the scene in the restaurant in Sherlock Holmes before Watson and Mary join him for dinner and Holmes, sitting there all alone with his thoughts, has nothing to do but observe the people all around him. He almost runs screaming from the place right there because he observes everything, all at once.
This suggests a new twist to the Holmes-Watson relationship. The movie, to the extent that it is faithful to the mythos, shows us that Holmes is dependent on Watson as his one connection to a normal, late Victorian, middle-class, adult life. And part of that connection is the help Watson provides Holmes in focusing. In the original stories, Holmes chides Watson, “You see, but you do not observe.” But the movie Watson must be constantly reminding Holmes, “Stop observing, man, and just take a quick look. That’s usually enough.”
Most of us are Watson-like. We are bombarded by the same over-abundance of information as Holmes---as an experiment, walk into any room and try to see everything in it all at once; keep in mind that before you’ve “seen” anything, your brain has already sorted out thousands and thousands of bits of information in order to turn the play of subatomic particles into recognizable solid objects so you’re already close to overload before you’re conscious of “seeing” anything---but we deal with this by ignoring almost all of it.
The trick is in “knowing” what to ignore and what to pay attention to.
Someone, like Robert Downey’s Holmes, can’t ignore anything without significant mental effort and may actually only be able to pay attention afterwards. They can’t see what they need to see until they’ve withdrawn to someplace quiet where they sit and think it all over while smoking a pipe. A lot of their lives are three-pipe problems.
I’m using “seeing” here as shorthand for sensing. We observe by taking in information collected by all our senses. We see, hear, touch, smell, and thanks to the connection between our noses and our tongues, taste our current situation all at once. All that information has to be assembled, sorted, rejected as not necessary or applied immediately to making decisions about what’s going on around us and how to react. Someone with sensory integration disorder gets hung up in the sorting. Which means that for a lot longer time than the rest of us (fractions of seconds make the difference) they are seeing, hearing, touching, smelling and tasting everything and all at once.
That has got to be maddening.
And it explained a lot, about being in grocery stores, in shopping malls, on the school bus, in a classroom. Remember how busy the walls of your grade school classrooms were? Imagine trying to follow what the teacher’s writing on the blackboard while you are also reading the names of all the Presidents, all 50 states, the calendar, the map, the charts, the the health posters, the titles of the books on the shelves, and while you are counting over and over again the stars on the flag and the flowers on the teacher’s dress and meanwhile listening to the noises out in the hall, the shifting in their seats and the whispering and sighing of your classmates, and the birds chirping outside the windows.
The important point, however, is that it is all being taken in.
There isn’t an attention deficit here. There’s attention overload.
Quizzed later, a kid with this problem, can, Holmes-like, tell you everything he’s observed.
This is a kid who, while you thought he was zoned out or lost in deep thoughts about the cultural lives of elves and dwarfs, caught that fleeting grimace of pain on your face as you went to lift his sleeping little brother out of his car seat and asks you later, “Are you all right, Dad?”
The psychologist who suggested the problem was sensory integration disorder was a friend who couldn’t take on the case and he really was offering it as a suggestion for whatever counselor we eventually found as something to look into. But it sounded like the kid we knew and it gave us something to work with or, rather, towards---smaller and quieter classrooms, a seat near the front of the room, teachers who knew to speak in softer voices, one-on-one tutoring with a special ed teacher who understood that the point wasn’t to teach the kid what he’d missed in class but help him figure out what he’d actually learned but couldn’t separate from the thousand other pieces of information he’d also taken in and in effect memorized.
It was a big first step, even though sensory integration disorder didn’t turn out to be the problem or, I should say, the main problem.
Ironically, our psychologist friend also warned us to be wary of what he thought was becoming the new fad diagnosis.
As I said, over time we learned a lot of things, and, to finally get to the point, one of the things we learned was that in looking out for a misdiagnosis of ADHD I was looking out for signs that would not be there if ADHD actually was the problem or a problem.
I was looking at a kid who paid too much attention not at one who couldn’t pay any attention.
But people with ADHD (or AD/HD or ADD) don’t have a problem paying any attention.
They pay lots of attention.
Just not to what teachers and parents and most of their peers think they should be paying attention to.
Attention Deficit/Hyperactivity Disorder is a terribly named disorder. The reason is simple: There is not an actual deficit of attention. We’re used to thinking of illnesses as resulting from a shortage of something – people with a thyroid disease are missing TSH, just as people with scurvy are missing Vitamin C – but ADHD doesn’t seem to work like that. Instead, recent evidence suggests that people with ADHD have plenty of attention – that’s why they can still play video games for hours, or get lost in their Legos, or devote endless attentional resources to activities that they find interesting.
What, then, is the problem in people with ADHD? The disorder is really about the allocation of attention, being able to control our mental spotlight…
If I’d read something like that nine or ten years ago, it would have been a light bulb moment.
As it is, Lehrer’s post is an excellent clarification of things I already knew but haven’t always been able to keep in mind because I’ve been busy dealing with other problems.
Now I’ve got an answer to a question I got asked the other night.
“Do I have any super-powers?”
We were talking metaphorically about exceptional talents and abilities that one brother saw his younger brother possessing that he didn’t.
My muddled answer was that very few of us, including and especially his father, possess superpowers and the way we get through life is to be like Batman---we work hard and train ourselves to use the talents and abilities we do have to maximum effect. Which, I think, was the right answer not just at the moment but generally. Hard work and patience and making the effort to know ourselves, our abilities as well as our limitations, trumps having superpowers or as Roy Hobbes’ father puts it:
“You’ve got a gift, Roy. But if you rely too much on your gift, it’ll fail you.”
But he does have a superpower. A gift. A gift that is wrapped up in a curse but still there to be unwrapped.
He pays attention.
As Holmes would put it, “He does not see, he observes.” Watson would clarify, “He observes, he just needs to learn how to see.”
It’s faddish to say that a lot of well-known geniuses, particularly in the sciences, may have had Asperger’s. This is said because Asperger’s kids are, like these geniuses, notoriously smart but socially clumsy. They’re happier and more comfortable dealing with things and concepts rather than people.
There’s probably some truth to this, although I think that being a genius makes it hard for other people to deal happily and comfortably with you.
The eccentricities and social ineptitude (often to the point of being a psychopathology) of some artists and scientists might very well be an effect as a cause. Early in life they might have learned that most people don’t want to have anything to do with them, that most people actually regard being smarter than average as a hostile act, and there’s no point in trying to get along and play well with others. This includes teachers. While many teachers dream of the day when a truly talented and brilliant student will show up in their class, there are plenty for whom the appearance of such students is a nightmare. They appear to them as bigger challenges to their control of the classroom than class clowns, bullies, babies, and other natural disrupters of order and decorum.
Every Asperger’s kid is himself before he’s an Asperger’s kid. Not every Asperger’s kid is brilliant. Not every Asperger’s kid is nice.
But you can see how having Asperger’s can be, if not conducive to genius, then useful to being one.
If you don’t care what other people think---because you just don’t grasp that they aren’t thinking like you do or about some things with the same passion and intensity that you do---then in societies that don’t place a particularly high value on intellectual or creative achievement, which is to say most societies, it’s easier to go about doing things that make you in most other people’s eyes something of a weirdo.
The first thing a genius who cares what other people think of him learns is that it’s probably best to keep some things to himself.
An Asperger’s kid can’t keep it to himself so he’s going to do some things that will help him in his career as a genius besides being smart. He’s going to try to do the work that interests him and he’s going to talk about it enough and in all kinds of company that he’s inevitably going to talk about it with someone else who shares his interest and passion and can help him refine his thinking and channel his efforts. No genius in any field works and succeeds alone.
Being smart is a collaborative achievement.
So maybe it’s true that many successful scientists and artists have had Asperger’s.
This morning, though, I’m thinking that’s it’s maybe more true that many have had more than a touch of ADHD.
If ADHD isn’t the inability to pay attention but instead the tendency to pay too close attention to what other people consider the wrong things, then it would certainly be useful to any one devoting their time and energy to figuring out the behavior of subatomic particles or the exact right shade of green to use on one leaf in one tree in the far background of a painting or a shot in a movie to be able to pay too close attention.
Not every one with ADHD is brilliant. Not every one with ADHD can learn to pay attention to the “right” things even with the help of medication. It’s not a superpower. If there’s a gift in having ADHD it’s wrapped up in a curse. Hard work and patience and making the effort to know ourselves, our abilities as well as our limitations, and knowing not to rely too much on our gifts are the keys to success.
But I like the quote from William James, the founder of American psychological studies and, incidentally, the novelist Henry James’ brother, that Lehrer finishes off his post with. James, describing a colleague who was apparently an archetypal absent-minded professor, said, “He is not absent-minded. He is just present-minded somewhere else.”
That’s what I look at around here.
A kid who is not absent-minded.
He is just present-minded somewhere else.
“Are you all right, Dad?”
“Yeah. Why do you ask?”
“You were making that face.”
Be sure to read all of Jonah Lehrer’s post, The Attention-Allocation Deficit.
Thanks to Andrew Sullivan.