I'm Just a Little AD/HD and other Fables!

By Ron Weinstein

From an evolutionary point of view, the human species has survived because of natural selection acting on a wide range of variability. It started as a simple equation. You couldn't adapt, you died and your genes died with you. Over the millennia, with the advent of "more evolved" cultures, and with life-saving technology more available, survival in general has become less of an issue as greater numbers of "less well adapted" individuals survived. Subsequently, the quality of life has become more important. Achieving a reasonable quality of life is often problematic for adults with AD/HD since our behavior, whether we live reactively or proactively, and the life choices we make may present roadblocks. Therefore, whatever we can do to develop "appropriate" behaviors, to live proactively and to make reasonable and thoughtful decisions, should improve the quality of our lives. 

Since our behavior is not totally ruled by our genes, the close transmission of culture between child and caretaker has become a primary developmental factor. The importance of this transmission is reflected by the fact that the human species, unlike other species, has an extended period of dependency on a caretaker (as defined by the term "neotony"). We try to conform to our caretakers' standards to stave off being rejected (i.e. left to die) by them. However, trying to maintain the bond with our caretaker can result in "dysfunctional behaviors" (i.e. co-dependency, denial, etc.). This is especially true for someone with AD/HD, who often has difficulty interpreting social cues, facial affect and body language. The dilemma faced is to either conform (adapt to their standards) or rebel (risk dying, figuratively). To avoid disruption in the child-caretaker bond, we quickly learn to minimize any disruptive behavior. In any case, our emotions, our feelings and our ability to be in touch with (or accept) who we are (our AD/HD) is impacted.

The opening line in M. Scott Peck's classic book, The Road Less Traveled is "Life is Difficult!" If life in general is difficult, it is particularly difficult for the adult with AD/HD. When someone asks "how are you?", the most frequent response is "I'm fine!" Although this is often not an honest response, it is understandable. Some adults are not aware of the impact that AD/HD has on all aspects of their lives, other's may experience difficulties but may be in a state of denial, other's may ascribe the problems they experience to something more acceptable, like depression, and still other's need to maintain a perfect image. I will admit that there are probably a few AD/HD individuals who are truly "fine"!

As one who has been trained as a bio-behavioral scientist and who has been working with AD/HD individuals for many years, I've never been particularly fond of generalizing about human nature. There is always someone who says, "hey, that doesn't apply to me!" However, since specific criteria need to be met in order to qualify for a diagnosis, we should be able to make some generalizations concerning anyone who is AD/HD. Working with AD/HD adults around the world, it is rare that I meet an individual with AD/HD who is truly and honestly "fine". Problems with self-esteem, depression, anxiety, unfulfilled hopes, dreams and desires, and relationships run rampant. Despite the material "success" achieved by some, few of these individuals have achieved what I consider to be success — a sense of accomplishment, serenity, humility and balance in their lives. In my opinion, this is the result of the paradigm generally accepted by many professionals — that AD/HD runs along a continuum from mild to severe. I believe that this has allowed denial to run rampant and has created a false sense of wellness in much of the AD/HD community. 

If we accept this paradigm, those who believe they fall in the "mild" category, usually go about the business of living with few concerns related to AD/HD. "I just have to be more organized and pay attention" they say. Since they are only "a little bit AD/HD" relative to someone who exhibits "severe" symptoms, they are managing "just fine". This is despite the fact that in order to receive a diagnosis, their symptoms must have created significant difficulties in their lives and have continued to do so.
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A model based on a continuum from mild to severe is counterproductive. It is the antithesis of individuality since it groups all of the AD/HD symptoms and behaviors together, and in essence, creates an average (unrealistic) picture of the AD/HD individual. We can compare this to the often inappropriately used composite or grouped educational scores when determining academic performance or achievement. These composite scores obscure the range of individual scores which usually provide the only meaningful information on which to base our interventions. Therefore can we say that someone's AD/HD is mild because they don't exhibit a high degree of impulsivity or hyperactivity? Does a high level of hyperactivity or impulsivity mark the individual with having a severe form of AD/HD? Not at all. The difficulties we may experience may be quite different, but they are still difficulties nonetheless.

The first step towards improving the quality of our lives is taking a good, honest look at ourselves as individuals. For those of us with AD/HD, this requires accepting the fact that while AD/HD may not be a "disorder, per se", it is most definitely a "disability". Furthermore, while being AD/HD may define who we are, we still have to define our AD/HD! A more productive view of ourselves would consider the degree of severity or intensity of each of our AD/HD characteristics. Like a graphic equalizer, where each sound frequency has a range, the essence of the total sound is the result of the various levels of the individual frequencies. We have to identify and manipulate the individual frequencies (symptoms) to achieve our goal. Only in this way can we identify our AD/HD profile. We can determine our strengths and use these to support the areas we find difficult rather than just trying to improve those areas in which we struggle. 

In much of the literature on AD/HD, achieving success depends on being goal-oriented. This is quite a task for someone with AD/HD who generally can't figure out how to get somewhere, because they often don't know where they are! Furthermore, it's not only not knowing how to get there, it's often not having a place to go! Confusion is one thing, aimlessness is something else. "If I could only find a purpose in life, I wouldn't be aimless". Somehow it seems that when we try to find a use for our lives, we tend to get used. When we try to find our function in life, we become no more than functionary or mechanized. Understanding and accepting ourselves can help us avoid these traps.

Many of us may not realize that we all have choices. We can choose to live our lives in a "mechanical or ordered" way according to a plan. This plan may have predetermined goals where productivity is measured as the greatest output for the least input. For many AD/HD adults who live their lives in this manner, the structure and consistency may temporarily provide a haven. We may or may not notice (or accept) that in order to maintain this order, we self-medicate with rage, alcohol, depression or anxiety. Living this type of ordered, goal-oriented life requires that we believe we can control the outcome of our labors. 

This type of reasoning is often beyond the pale of someone with AD/HD who responds immediately to changes in either their internal or external environment. Relying on standards and expectations of others leaves us vulnerable to follow the trends of the moment or the conventions of the crowd. What happens when we don't meet other's expectations or our own? Work may become our drug of choice and the sense of accomplishment, serenity, humility and balance is lost. Our quality of life diminished.

For adults with AD/HD, working on self requires developing a set of internal personal standards for determining what is important to you. Due to the very nature of AD/HD, these internal standards are difficult to establish. It requires a sense of self, an attachment to feelings and being comfortable knowing that your feelings are valid and appropriate. It also requires that you acknowledge and understand how your AD/HD impacts your life. If you observe children, you'll quickly notice that those who are AD/HD often rely on the judgement of others. Even when they appear to be oppositional, upon close examination, they are usually not confident in their convictions. After a lifetime of responding to the world in a manner quite different from non-AD/HD individuals, we begin to question (if we are capable of being honest with ourselves), what we feel and whether our feelings are appropriate. Even the false bravado of an impulsive AD/HD adult is often tinged with self-doubt. 

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The ability to communicate clearly and effectively is a case in point. For example, let's consider that words are signs. However, words are more like numbers than like rocks since they can't persist through a change of location. You can take a rock from New York City to New Orleans and it's still a rock. If you move the number 5 from its location between 4 and 6 to a new location between 8 and 10, then it is no longer 5, but 9! So with words the context and their use makes all the difference. If we are only "mildly" AD/HD, and don't acknowledge that we may have difficulty with word retrieval, we don't seek to understand how our AD/HD may have contributed, for example, to the failure of our relationship, our job, etc.

Conflicts often arise out of innocence - the joke gone wrong. How often has playful teasing as an act of love become instead a step towards fighting. A joke in order to be funny requires some sort of double entendre, some play on words, that places an entirely different significance of the punch line. The danger is that if we play a joke on someone, that joke can be misunderstood. Unless it is genuinely and successfully ambiguous to begin with, it cannot be a good joke. If someone doesn't get the joke, doesn't take it in fun, then an injury has been committed. There may be a response in kind, then a further reaction, then reprisals, then revenge, then recriminations.....and by then anything can happen. And it all started because of a joke. "You didn't get what I meant, I didn't mean to hurt you," one protests. "It was only a joke...." What it comes down to is the failure of the other person to understand your true intentions. They may attribute some other intention that changes the meaning of what was done. We may go through many relationships or jobs before we acknowledge that being verbally impulsive, or stimulus seeking, is at the root of this problems! Sometimes, we never stop to consider our actions.

The Ojibwa, a Native American tribe, offer a solution to discovering who we are. When it came time, a father led his son into the woods to leave him to fast, to be alone, and to ponder the meaning of life. Since this was a time of self-discovery, the boy was not told what he might expect to encounter. No socially approved image was offered to him. Rather, he was given the understanding that he would have a vision, his own vision of who he was to be and what he was to do with his life.

The boy going through this initiation rite was told that whatever this vision was, whatever her learned about himself and the world, should be trusted and accepted. When he returned, his vision would be honored by the tribe, simply because it was his and because he had discovered it for himself and claimed it as his own. 

Sometime we need time alone to discover who we really are.   
 

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