Tuesday, March 31, 2020

ADHD and Procrastination in Middle School — Broken Promises to Self and Others


So, there's this rut we ADHD kids get into, that parents and teachers often don't seem to be able to understand. Term after term: assignments get missed; work quality decreases or stays the same while peers' work keeps improving; "attitude" devolves toward defiance or indifference or both. The level of executive functioning required for success keeps increasing, but not being taught, or not being taught at the micro-chunked level that we would need in order to embrace, retain, and employ it. As it stands, the increasing cognitive load and workload force us to ignore "extra" assignments—like using a planner well, or keeping a binder organized with labelled dividers—in order to feel like we have a chance in hell of successfully completing actual coursework. Organizational requirements in middle school feel like the coast guard yelling down at you as you bob in the bay to comb your hair so you look nice while you drown.



Thus, around the middle of the term, and toward the end, alarms are raised. Emails and calls go home about missing assignments and poor work quality. At best, there's a wack-a-mole quality to mid-term grades, with, say, a D in science last term raised to a B this term, but now math is a D, and English is a C-. Any statistician would see that pattern and assert that there is a shortage of resources in this system: one area cannot improve without a descent in another area. Yet, we often blame the student... for trying to do what we said!—we freaked out about science last semester, and science improved! It's pretty reasonable for the student to ask "What do you want from me?!" at that point...

But I still haven't gotten to the rut I mentioned.



The tragic disconnect between such students and the adults around them seems to be this: by the middle of 7th grade, every term has had this freak out in the middle, when everyone starts pointing fingers at the student and bemoaning the ascendant calamity. The student generally does the best they can, scrambles and lunges, under intense pressure, and (between that and the grade inflation of most independent schools or the low-low-bar in most public schools—the former to support statistics that prove the school is giving families the success they are paying for, and the latter to support statistics that prove the school is successfully educating a vast diversity of learners) emerges with a report card that no one loves, but that doesn't feel tragic to the student. So why all this brouhaha every term? It always comes out OK; I dip, then I rise. Why you yellin'?



Parents and teachers are at wits end, because their entreaties seem to have no effect. Students say, and genuinely mean, "I will do better!" and they usually do! But nowhere near better enough. 



Neither party seems to realize the facts of the situation. 



The student does not understand that the mid-term slump is a hole out of which they will soon not be able to dig—somewhere between 8th and 12th grades, that last-minute burst of energy will not pull them back into the passing zone. They also do not understand that the actual learning they are doing, especially in math, is increasingly foundational to future work, so passing without learning is another set-up for a future crash-and-burn. 



Thus, it is important for parents to understand that it is a developmentally inappropriate expectation for almost ANY teenager to be motivated to change a behavior based upon a future possible negative outcome. They are wired for immediate positive reinforcement, and future positive reinforcement only when it is very compelling. Dire warnings based upon the experience of others do not feel salient, and this is quadruply so in teens with ADHD.
Our teens are hard-wired for a severe case of something akin to what psychologists call "optimism bias."  Simply put, positive reinforcement is MUCH more effective than negative reinforcement. An expected reward seems to remain present in the mind much more effectively during the day, when choices count, than a dreaded punishment, which may only actually come to mind when they are actually suffering it, and, worse, the thoughts may be more resentment than reflection... and this resentment often inspires more rebellious instincts than any desire to do what one is told! In fact, the desire to change behavior might actually be inhibited, because that means admitting defeat and giving the oppressor what they want.



Most parents do not understand that the myriad iterations of "I meant to do that" and "I don't care about this" and "that teacher is a jerk" do not represent students willfully avoiding work they do not want to do, but choosing an ego-saving assertion of choice in a matter where they probably have little to no actual choice at all. What appears to be a poor choice or defiance is actually more usefully perceived as a symptom of ADHD. What's more, developmentally, any middle schooler is desperate to put aside childish things. The honest answer as to why a student with ADHD didn't do the work is probably deeply humiliating, and therefore may not even be consciously accessible: either "I don't know" or "I can't, even when I try." Students mean it when they promise; it feels do-able; people around them are doing it; they will just work harder! And it doesn't happen. Of course, they then say they didn't want to do it in the first place.



If students can only pull themselves together at the end of the semester when the terrible outcome finally feels immediate enough, it is not just because they finally "get it" but may be because their brain is literally not stimulated enough to muster the actual focus needed to produce the work until they are at risk of immediate dire consequences. Abstract notions of future suffering don't fire up the neurons in the necessary way to keep the student on task... so they put off the impossible until it is possible. 



Intrinsic motivation is great—best kind, first choice! But, so far, there are only two solutions I know of when ADHD is the primary barrier to school achievement for a bright student: sitting with the student to redirect them, repeatedly, for the entire, or almost entire, course of a carefully laid out work plan, or providing profoundly compelling positive extrinsic motivation. Either one of these can provide an experience of success that can build momentum for future positive change.





Otherwise, we are left hoping that the student will somehow come to understand themself, and adapt, naturally. The best hope for this probably comes from, at least, describing this whole dynamic to them, to see if it resonates.


The following is an admittedly somewhat-frantic email I recently sent to a former student, who has already heard all of the above, who is still firmly entrenched in the cycle above, and who had just sent me a "good intentions" email after their parent insisted they contact me. Any tutor will tell you, this email is too long for a student with ADHD, and many others... unless that person is at a tipping point, genuinely hoping for change, and maybe kind of feeling like the jig is up:

Hey ____!
Good to hear. The key question is: how? How will you do those things? 

A lot of students decide to change a behavior (or to start a new behavior), and making the decision is all they do, and nothing changes.
"I'm just gonna do better"
or
"I won't turn anything in late"...
these good intentions rarely add up to change unless actual actions are taken AT THE TIME THE DECISION IS MADE to support those changes. 

The Friday check-ups with teachers are the best part of this plan. Nice! :)
  • Are they actually scheduled? 
  • Have you set up any kind of reminder (phone alarm? calendar notification?) to make sure you get to them? 
Please do these things right away, if not! 

Teachers have very limited resources (time being the most important resource), so please please make sure you show up (even online), and I'm telling you right now, if you don't give yourself reminderS (plural), you probably won't.

The problem for most of us is, the behavior change idea is a big decision: I WILL DO THIS instead of THAT. 

Yet the actual actions involved in that decision are tiny, and there are hundreds of them each week, even each day: Every hour, you will be at a crossroads, and each little decision will not feel important, but it IS: 
  • Play the video game now and get work done later? No big deal. 
  • Meet with the teacher today or tomorrow? Tomorrow is fine. 
  • Do my work completely and well, now, or fix it up later? I'll fix it up later...actually, who cares, maybe I'll do the next one better....teachers like to see improvement, anyway...
ALL OF THOSE RESPONSES IN THE MOMENT ARE LIES WE TELL OURSELVES AND THEY ADD UP TO NO CHANGE IN BEHAVIOR and NO CHANGE IN OUTCOMES

I apologize for yelling; it's because I am talking to you and also myself. I have suffered so much humiliation in my life because I could not understand this thing I'm trying to describe to you. I want better for you!

So, please, take action now to remind yourself throughout your day that you need to turn toward getting work done, and done well, first, and away from all other things except family responsibilities and genuine self-care. BTW if you use family responsibilities and genuine self-care disingenuously, as an excuse, I fear I'm useless to you.

Do these things:
  • Put on a bracelet, a watch, a rubber band or something else you will see over and over during the day, to remind you to think "Am I doing the most important thing right now?" and, if the answer is no, do the right thing, right away.
  • When you learn to ignore the bracelet, or rubber band or whatever, get a new one that looks different, put it on the other wrist, or something else to refresh the reminder.
  • Put a post-it or a note on the TV, on the game controller, on the computer--lots of people make a reminder their desktop background--and anywhere else that you tend to go to relax or avoid schoolwork. It can be blank or it can say "FIRST THINGS FIRST" or whatever you need to hear.
  • If you look at that post-it or note, and say to yourself, "I have been working; I need a break!" take a DIFFERENT kind of break that doesn't seduce you like those things do. Take a walk; play with a pet; make something; get a snack... AND whatever you do, consider setting a timer and putting it somewhere you will have to walk to to turn it off. A phone in the pocket is too easy to quiet quickly. 
  • If you look at that post-it or note and say to yourself, "I hardly have any work; I can do it in like ten minutes!" then prove that to yourself by doing it right away. 
  • If you look at that post-it or note and say to yourself, "Who cares. Stupid notes. I'm throwing that away..." just don't do that today. Throw it away next time. This time, double check if you have work to do, and do it right away. Right now, you only have to worry about this one time. Next time, you can get fed up and do whatever. This moment is just about doing the right thing one more time, even if it feels pointless or unimportant, or like someone else's stupid idea of what you should do.
  • REAL TALK: Procrastination is not a time-management problem; it is about dealing with feelings! You can google it. If we are honest with ourselves, when we avoid important work moment by moment, it is always because the work causes emotional pain: "I don't actually know how to do this." "I can't do this well even if I want to." "I don't even know what I'm supposed to do and that is embarrassing because I'm supposed to know" ... or WHATEVER. We who procrastinate have to learn to face the truth about these feelings, and ask for help from people who will not judge us, and who know what we need to know. We have to find those people and make the most of those relationships. YOU are in charge of deciding who those people are. I am volunteering to be such a person, reachable by email or text, but it is up to you to decide if you want me in that role, sometimes, always, once-in-a-great-while, or never.....
Wishing you the very best of success, and hoping to hear from you again, ____!

Mike

Friday, June 14, 2019

Please Read the Report Before You Meet the Kid (Things Helpers Need to Know)



So, why is there ever resistance to reading about a new student’s learning profile before meeting them? A teacher may say, “I like to get to know students first without any preconceived notions” or a parent may say, “Would you like the report? I realize you may want to draw your own conclusions first and I respect that...” In the parent’s case, I think it is just a wise marker of respect, signaling a certain deference to the professionalism of the teacher. Yet, because of what is at stake here, I hope more parents will find other ways to do that. And I definitely hope that excellent teachers will reflect upon the fact that 

  • Their very excellence and professionalism is what protects them and their students from any sort of “bias,” or “prejudgment”—any negative narrowing of the lens through which a student is perceived—as a result of reading a neuropsychological assessment, or pass-up notes from colleagues. 
  • There have surely been other excellent teachers all along each student’s journey, and those teachers’ reactions to a struggling student as they have gotten to know them are mentally paired with the student’s self-concept as much as the reactions of less-experienced teachers. That is, if school has been primarily a place of struggle and failure, if we react to the student even in subtle ways that they have seen before--ways that even skilled, kind teachers have reacted--we are still reinforcing the student’s sense that this year will be just like last year and the year before... Basically, what could be an opportunity to signal a genuine new beginning has unnecessarily become just the opposite. 


As a learning specialist once upon a time, it was a key part of my job to try and ensure that all agreed-upon accommodations for students were in place “from day one.” This, to me, should be the very minimum we do to pave the way for student success. I’m asking reflective teachers to help us do much better than that.





For many students, school is a relentless ramping-up of the pace of assaults upon their self-esteem. Whether it is a challenge with reading, writing, math, processing, retention, production, behavior, or any combination of these, as academic demands increase in volume and complexity, experiences of inadequacy, helplessness, different-ness, hopelessness, and failure increase as well. A kind peer can be a beacon of hope in a sea of despair; a kind teacher who can systematically prove to a student their worthiness, their unique strengths, and the sheer normalcy and manageability of their challenges, can be a fortified life raft in that sea, perhaps even delivering the student all the way to a shore they've never known.





In those first days of school, working with a teacher who likes to give everyone a “clean slate,” the student who is an outlier in one or more areas is probably clinging to the tiniest desperate hope that this class will be different, that this teacher will be different, that they themself will be different. Thus, they can be incredibly sensitive to moments that confirm the dreaded status quo. A teacher deprived of the foreknowledge of challenge areas for that student may just have a benign pause, a little moment of mental processing when they first notice a student struggling: the student might take in anything from a few extra blinks, to a friendly “oh, this is tough, huh?” or just a quick subtle surprised look. Of course these are incredibly minor compared to destructive accusations of laziness or lack of effort the student may have received in the past. In fact, the sheer weight of the student’s awareness that nearly all of their peers perform with ease particular tasks that are so hard for them likely far outstrips the familiar microhurts of the teacher’s tiny moments of recognition.





Yet, the teacher has the opportunity to explicitly send messages from day one that run counter to all the evidence of hopelessness the student sees around them. In spite of accommodations which are, of course, given without fanfare, from day one—in the same way that a student might be gently reminded to put on their glasses—there will still be moments of struggle, and these are much more emotionally fraught for a student with learning differences than they are for a peer. By knowing the exact contour of that student’s challenge, at least as far as it is understood up to that point, the teacher can not only avoid the moment of concern or surprise which deflates the child, but can immediately signal a genuinely hopeful new start.



When the child struggles and looks for a reaction, the informed teacher seamlessly redirects the student’s attention to a genuine strength that the student has revealed in their effort, and immediately presents an alternate approach to the task, not as a crutch or an easy way out, but as a logical next step in helping the student manifest the aforementioned strength in the completion of the task. When this is done reflexively and repeatedly, the teacher is not only signaling a possible new stage of growth and joy as a learner in this new classroom for that student, but also modeling a key ingredient of the kind of grit and resilience that almost any student needs to learn to survive. 


Rather than hitting a wall and thinking “See? This always happens. I’m dumb. It’s hopeless...,” we learn to think “Oh! A wall! Of course I hit a wall; I’m trying to do hard things. That’s an important part of school and learning! So where’s the loose brick? Is there a side door or a low spot? Is there something useful to do to the left, right, or behind me, so I can come back later feeling stronger? Can I get a boost from somebody or offer a boost so maybe they’ll help me with one later? Do I have wings I keep forgetting about?...”


My firm belief is that previewing what others have noticed about our new students won’t make us blind to the special perspective and insights which our singular new relationship with that student will bring. We are not a collection of binary switches processing an assembly line of clones, a few of which are stamped defective and thereby assigned to the reject pile. We bring our whole selves to the work, and the students are kind of forced to bring their whole selves to school, try as they might to hide in plain sight. Let’s have all the tools and scaffolds we can at the ready for our most vulnerable students, from the first moment we see them; that way we can save some of the mental bandwidth we might use to figure out the basic contours of their learning style, and instead apply it to being ace strengths-detectives, relentlessly reminding each student of their unique awesomeness, while demonstrating the fine art of resilience and grit, and how one forthrightly gets what one needs from the various institutions we all must navigate.


Wednesday, March 20, 2019

ADHD + Medicine from the Inside (TMI Digression 2)

I was diagnosed with ADHD just before my 50th birthday. I was a little shocked at first, and even more so when medication was recommended soon thereafter.




Six months later, the honeymoon is over, medication-wise, but I cannot deny that my life has changed in wonderful ways. I still bounce between grief over half-a-century of unnecessary self-loathing, judgment, and shame, and tremendous gratitude that the page seems to have turned, at last. I am also grateful that the things I managed to learn, as an adult, to survive and thrive with undiagnosed ADHD, have made me so valuable to my students, who are getting something I did not get, and the healing in that for me is impossible to overstate.




My students’ experience with ADHD medicine has always been hard to glean--I’m either told it “helps” or not told anything at all--just as their individual experiences of ADHD itself are pretty inscrutable. It is very difficult for them to describe, because they know no other way of being: it is the water they swim in. It has also been, I now know, the water that I swim in. But I think I might be more able to describe the contrast, in my own life. It has clearly impacted my personal interactions, as well as approaches to tasks, and productivity in general, in pretty profound ways, explained hereafter.




The primary difference between my experience and what I thought my students were experiencing--and what educators are often told they are experiencing--is that my distractibility is primarily internal. That is, external distractions do make it harder to focus, sometimes intensely so, but this really doesn’t touch on the key debilitating and emotionally crushing piece, which is that often I could not tell my brain what to think about. Productive focus has always meant that a huge, invisible mental effort was dedicated solely to batting away intrusive thoughts, and when the executive part of my brain doing that got tired and took a breath for a second, the intrusive thoughts¹ immediately pounced and filled that exposed bandwidth with associations and worries and musings, until something environmental or internal randomly happened to redirect me to the task at hand. When I’ve asked students about this, they generally identify with the experience.




So, what follows is my before and after experience with medicine. After several months trying a few different combinations, I have been on the same regimen for about three months now. I say “the honeymoon is over” because it is clearly up to me to make the most of what the medication gives me. I can still fall into compulsive behavior; I still have emotional ups and downs; I still struggle to eat right and exercise. The medicine gives me precious, new executive control of my own mind--I can aim it where I want, keep it there, and utilize far more bandwidth for the area of focus than I have ever known. This is a revelation. But it is also ALL the medicine does for me. Which is, actually, a good thing, in the long run. Lastly, I need to say that this is a snapshot of today--it may continue to change for better or worse, and if you are reading this after March 2019, you might check for updates!

Right now, today, much has changed:

Interactions

I noted in the previous blog post how shocking it was to be able to listen to folks’ entire verbal contributions in meetings, without associations from things they say constantly carrying me away into my thoughts without asking my permission. Now, a rising mental association is simply an opportunity to reflect, not a slippery slope into oblivion, and to my amazement I can reflect with focus, while maintaining focus on what is being said, simultaneously, because I have so much more mental bandwidth to work with now. It is like switching from trying to function while running through a dastardly funhouse to doing it while moseying through a quiet meadow.




I have long considered myself an introvert, and I think that is true, but not nearly so much as I had thought. The accumulated anxiety from years of randomly not hearing what people say, or not remembering key details that I did hear, because they went in and out of my head so quickly that nothing stuck, has made me interaction-avoidant. The message people get is often that I don’t care enough to listen, or to note, things they say, and it is off-putting. I’m sure I have seemed self-involved, uncaring, disinterested, or worse, at times when I actually felt the polar opposite of these. In fact, the anxiety that grows around this dynamic makes it self-perpetuating and self-reinforcing.

The flip side is the hyperfocus that comes with really caring, which makes me notice and remark upon details and subtleties of the conversation and environment that the other person whom I care about so much may not have noticed at all, and I can sound super-nerdy, quirky or random, and when I see that familiar bemused expression on their face, I retreat. These are things that echo in my adulthood more than they are actually present--I have learned to be me and be OK, for the most part--but I think the cumulative experience has shaped me a great deal. Very early in my experience with medicine, I began to find social situations less overwhelming, and less worrisome. I seemed to have the bandwidth to calibrate my interactions casually to the people around me, and I was no longer so afraid of missing what people said, and being off-putting in that way. I care a lot about people, and now that doesn’t express itself in hyperfocus or anxiety as much as a genuine happiness to see and interact with them. We meet in the meadow instead of the funhouse.





I have had the same umbrella for this entire rainy season. That has never, ever happened before. It is a bigger deal than it sounds.


Sequential Tasks

In the mornings I make breakfast and lunches for my two daughters, as well as myself, get them up, and dressed, and try to exercise and finish up whatever dishes need to be done. A year ago, I had learned that this took me 60 minutes to do without exercise and dishes, 90-120 minutes with. I would decide how ambitious to make each morning based upon how much time I managed to give myself by waking up early enough. Once in the kitchen, that room became the boundary that kept me on task. Whatever direction I looked, there was something to do within this set of tasks, and I did whatever I saw until I was done. This meant I was doing everything at once, darting across the kitchen countless times, and opening and closing cabinets as well as the refrigerator and freezer over and over again. If anyone tried to talk to me I would probably forget what I was doing, be unable to restart where I had stopped, and fall behind schedule incrementally. This meant that anyone saying anything more than good morning to me would be greeted with a sigh at best, exasperated frustration at worst. That is not a nice greeting, but it is very hard to maintain a cheery demeanor when being productive always feels like juggling fine china. I am grateful that Emily has endured me for a decade.




Now, I can actually do these things one after another. I open the fridge and take out all the things I need, and I put back things all at once at the end. If I have time, I do dishes, then lunches, then breakfasts, then wake up the girls and instead of running away to finish the chores, I can actually visit with the girls while supporting them to stay on task (which is strangely hard for them...) on many mornings. These things take about half the time that they used to, and rather than juggling china mentally, it is like hiking up a familiar trail; if I get stopped it is obvious where to go when I start again, and though there is exertion, there is usually not much stress.




On my way out the door in the morning, not only am I able to think through whether or not I have everything for my day, but I remember to do that. Of course, remembering was not really the problem before as much as simply having either no ability to muster an idea of the day ahead and the necessary supplies for that day, or not being able to spare the considerable time it would take to do so. I think we sometimes remind kids to “think through” what they need, not realizing that remembering to do so doesn’t mean it is something they can actually do.

Productivity

As addictive as screens and video games seem to be for so many, I think people like me probably experience an additional layer of compulsion. This has been greatly reduced for me, if not stripped away, by the medicine. My primary compulsion of this sort–my Fortnite, if you will–is pinball. For years, I have known where all the machines are near any workplace, school, or other place I regularly spent time.




The interactive, high-speed, kinetic nature of the game, combined with the patterns of shots that one strategizes while playing, make for an immersive in-the-moment diversion that completely removes me from other cares and concerns. By contrast, the electrified tightrope of perpetual mental exertion to focus, produce, navigate, and interact in the world of work and people is desperately tiring and simply doesn’t turn off by itself. In the past, I am embarrassed to admit, I have regularly driven 45 minutes in order to play pinball for 15 minutes during an hour break. There was a desperation to it; the moment my hands moved to the flipper buttons, the relief was palpable... Simply put, I don’t need that the way I did before. I find myself with a 90 minute break and a start instinctively to pack up to go play, but then realize I’d rather get some in-depth analytical work done for a client. Making that choice used to mean enduring that tightrope for hours longer. Now, it means, getting that work done, and feeling the satisfaction of a job well done, before maybe taking a little walk and continuing my work day refreshed.

______________________________________

New Challenges

There are times, now, when I find myself wondering if the medicine is still working, because I am already so accustomed to it. But I have a built in reminder system–all I need to do is miss a good night’s sleep, and its effects are greatly reduced. I’m reintroduced to the Mike I knew for five decades, who works so very hard to muster hyperfocus when he needs to get things done,² and who has learned myriad self-supports to function (relatively) effectively in the world, and I am again grateful for the medicine’s support.



When I first started the current medicine, I had no appetite until the end of the day, and struggled not to overeat in the evenings after starving all day. But I adjusted, and then my appetite actually returned, for good and ill.




I am bone-tired at the end of the day, and it is sometimes sad that my family gets that version of me, while the world gets a much sharper one. But in the past caffeine did the very same thing, frankly, just much more acutely and erratically, with far less benefit (nowadays I drink about 3-4oz in the morning, and that’s all—it’s pretty clear I was self-medicating with caffeine all my life). The good news is that I now have the resources to notice and act on this, to learn to bring my whole self into my day, and then into my home as well. It was just too much before.


All of these things may change, of course, and I may have to go back to an unmedicated version of myself in the long run, but at least I will be armed with the knowledge of what efficient cognition can be like; perhaps I will learn to meditate after all, knowing better the benefits I am after.



And I do hope that many others, too, who may not yet realize what is possible for them, because their struggles are the water they swim in, will find the tools to step out of the storm, out of the funhouse, out of the swamp, out of the pit, and into a place of calm and light, of clarity and joy.
______________________________________


1. Anyone who meditates probably recognizes the “intrusive thoughts” idea, and I do believe meditation is likely very helpful–I have really tried it, repeatedly, and will surely do so again. I also think that people without ADHD who assert that meditation is “the answer” are a little like healthy people who prescribe positive thinking for the terminally ill. Frankly, I am excited to try meditation again, with medication, because it feels like it may actually be possible for the first time.

With or without medication or meditation, as a wise colleague reminded me back in December, best practices for overcoming ADHD will be integrated approaches, using combined methods to combat a complex problem: things like therapy, direct instruction, nutrition/exercise, medication, meditation, etc. Not one, but many.

2. It is clear that the incredibly attentive, nuanced work about which I care so much– one-on-one academic help for students –has been an ideal, naturally-occurring hyper-focus environment for me, for years. I’m assessing, planning, translating, observing, communicating, suggesting, inviting, calibrating, and improvising moment-to-moment, and it feels like my most perfect niche, as a human and a professional



Friday, November 23, 2018

Tutor, Toot Thyself! (TMI Digression)

Adult ADHD, you say?


     About a month ago, I was in a group of some nine people around a conference table. Each person was sharing some personal experience while the rest of us listened. I had been in this situation hundreds of times before, and you probably have, too, but something was very different for me this time. As I shifted my gaze from the third speaker to the fourth, I realized with some surprise that that gaze had been steady and continuous on each speaker so far, and I had registered everything that each had said. This never happens for me, unless

a. the meeting is a high-stakes work meeting during which hyper-vigilance and anxiety combine to enable hyperfocus,

or

b. a particular speaker catches my emotions by stating something with which I identify strongly, or care about deeply...


But this day I was simply listening--carefully, attentively--to all that each person said, without interruption from thoughts of insecurity, thoughts about the food or fun to be had later that day, or even just a series of thoughts sparked by a reference the speaker had made, which would then hop like a stone skipping across a stream from association to association to eventually alight upon some bizarrely impractical and unrelated topic... until the person finishes speaking and I mentally return to the room, frustrated and curious about what I’ve missed, though also resigned to missing the majority of the rest of the group’s reflections as well: that has always been the way for me, as long as I can remember.


As startling as that experience was, the one that followed on its heels was the one that brought me to quiet tears; the very thoughts I just described--my reflecting in that moment during that meeting on that very experience--did not behave as my thoughts always had. When I noticed I was hearing everything, and reflecting attentiveness with my affect and gaze, unintentionally, I immediately thought, “Well, this will stop now that I’ve noticed it.” But it did not

While the fourth speaker continued, I realized that I was still hearing what she said, even as I had these internal thoughts, because the thoughts did not carry my mind uncontrollably into further associations and musings, like that skipping stone, but instead they proceeded along this one parallel track, upon which I noticed my experience, confirming and reflecting on it briefly before filing it away for future reference, and then effortlessly returned my entire focus to listening. Limited to these two tracks--listening and reflecting narrowly--I could actually follow both simultaneously and effectively. It was a completely novel oasis of blessed mental agency.


I asked Emily, my wife, later that day, if what I had experienced was “normal,” or at least, if she experienced meetings in that way. I honestly expected her to say “sometimes” or “not really,” because I simply couldn’t fathom an experience of the social world that was so profoundly different for some of us, making it so much harder and stressful to participate in life. Had I been working against some sort of chronic executive handicap in all my interactions, all my life? Was I possibly more than just a scatterbrained, narcissistic mansplaining underachiever? Surely not.

But Emily narrowed her eyes a little and nodded, saying that she thought it was probably normal to focus that way. I was flabbergasted and pretty emotional; it was shocking in the moment, to be sure, but its implications for my life’s work, and for my perpetually difficult relationship with myself, were kind of unfathomable.


Several months back, someone I trust strongly suggested I get screened for ADHD, and to my amazement, the screening came back positive, and the experience I described above was my first glimpse of what medicine might do for me. It was the high point, so far, of a difficult process, but one that I wouldn’t want to miss.

I am still working out the implications. For one thing, I don’t really know how to make it up to myself, at least not yet. I have been so cruel, and so judgmental. In adulthood, I’ve come to see myself as nice, and reasonably responsible, with really good intentions. And I often say that kindness is the most important thing, which I do believe... but part of me has always been deeply ashamed of the gap between what all the adults around my youthful self saw as my “potential,” and the actual productivity I’ve mustered over the last half-century. And that shame becomes cripplingly acute when my absent-mindedness hurts the people I love. I judge myself as chronically unkind because I’m a self-centered spaz, who can’t get anything done for anyone, including himself, and is destined to tread all over loved one's toes in perpetuity.

But it’s not over yet.





Before that meeting experience happened, I had actually suffered an agonizing increase in the symptoms of ADHD during the first week of medication. I would be making lunches for the girls and I’d suddenly find myself brushing my teeth above a banana and an orange on the bathroom counter. I’d soap up half a dirty dish, then write half an email, then edit a death metal playlist, then put blueberries in the blender, then wash the rest of that original dish, all with one sock on. It was dizzying and frustrating. I went to take some recycling out, saw that Emily’s car was dirty, and was halfway through the nearest car wash before I realized I had been a little impulsive, and called home to say where I was. I sent an angry work email without a moment’s thought about the consequences, and then followed up with four more in rapid succession, backpedaling and explaining and making things worse and better at the same time, but mostly worse.



Then the pendulum swung to attentive, and it was like I could see and hear for the first time. Though the outward craziness I just described was new to me in its intensity, my inward cognitive experience has always been much like that. I have come to understand that the primary breakthrough in my late twenties that enabled me to return to college was about learning to systematically construct and maintain the necessary elements to induce hyperfocus--the flip-side, superpower of inattentive ADHD--when I needed to. It is fragile and tentative, and very difficult to re-access when the house of cards is toppled (say, by someone innocently saying “Hi!” or chomping a chip nearby). At my last job, I could be writing an email when someone would innocently knock on the door and politely say, “Is this a good time?”... and I would immediately have absolutely no idea how to end the sentence I was in the middle of. I could reread what I’d written before all I wanted, but that sentence would never have an end. I would have to come up with a completely new direction for the email--presumably with the same overall objective, but no clue what my original argument or chain of logic might have been. So I always said, “Yes, now’s a good time. Sure...” because the damage had been done (and at the time I thought it was a personal flaw and shame that my focus was so fragile).



But the pendulum has swung back now. That attentiveness in conversation and meetings lasted for about a week. One wonderful, brief week. It didn’t swing all the way back to loony; I am not freakishly inattentive and compulsive, but I am very much the same old Mike whose brain is a bucking bronco in a funhouse. As you can imagine, knowing what one kind of attentiveness might be like, I am quite disappointed, and very eager to get it back if I can. I keep telling myself that, worst case scenario, at least I now know what it’s like and I can be kind to myself when I can’t focus, gently nudging myself back toward that place which was once utterly alien, but now feels familiar, if remote--like a warmly remembered early-childhood vacation spot. And we’re not done trying medicines to see if there’s a healthy, robust solution in that realm for me. We shall see! I’m also working on meditation and other kinds of self-care to try and bolster this reorientation of my heart and mind, because that’s a good idea anyway, and it may be all I have if the medicine doesn’t work or the trade-offs just aren’t acceptable.

---------



Thus, I find it hilarious and a little uncomfortable to realize that I am not, in fact, the empathic genius I imagined I was, identifying and commiserating so effortlessly with my students. And how has it been that all of the coping strategies I developed or learned to survive college are so valuable to my students with attention challenges? Well, it seems that now we know.

To be fair, hyperfocus and a penchant for demonstrating deep care in a dangerous, alienating world have enabled me to build a remarkable skill set as an academic helper, in addition to this foundational, constitutional starting place. I have not simply stumbled into my life's work through an accident of nature, and I am not only valuable to students with attentional challenges, but much of my empathy is quite a bit more honestly come by than I'd thought!

I want to highlight a few insights this revelation has brought to my practice, in particular.


1. Please, please, please let’s be thoughtful when we see a student doing “fine” relative to her peers. She may be much more capable than is obvious, putting profound energy and resources into independently overcoming attention or other learning challenges in order to do as well as she is doing. If we judge OK-ness primarily by regarding a child’s achievement in relation to the mean achievement (by some arbitrary academic measure(s)) of her peer group, then we are likely to be doing her a tremendous disservice. Her potential may actually be in the 99th percentile by those same arbitrary measures if she can only access the tools she needs to understand herself and enable full manifestation of her strengths--by addressing the challenges that hinder her, no matter where she falls among her peers unaided. That achievement bar should be personal and individual, unrelated to group means and norms!
2. ADHD guides for parents and teachers are constantly suggesting the breaking down of tasks into smaller steps or chunks. I have always absorbed this from a deficit point of view: the poor child lacks the working memory to hold all the parts of the task at once; they lack the grit to be motivated through the overwhelming onslaught of instructions and looming effort of a project or task, so we must spoon feed their fragile productivity engine.

These things may be true to some extent with any given student and any given complex task. But my own experience is actually quite different. Smaller chunks present multiple intermediate opportunities to experience success and achievement along the way toward completing an overwhelming task. These are motivating, and create momentum. As I climb the mountain that is a book report + presentation, or a research project, if I keep looking toward that mountain’s summit, I will feel my fatigue increasing and my enthusiasm waning MUCH more rapidly than I perceive the summit coming closer to me. If, instead, I watch my feet, making sure that my steps are careful and solid, and occasionally I lift my gaze to look backward toward where I have been, I see MUCH more immediate progress, and this keeps me going. Tiny chunks feel way better, in addition to being more cognitively manageable.
3. Finally, so far, I hope to explore with students the possibility of focusing less on “dealing with the inattention” and more on “fostering and directing the hyperfocus.” I need to be careful with this third idea, because one colleague of mine suggests that I am actually quite atypical in some ways that should keep me from carelessly asserting that others will be able to do as I have done. There were two atypical things about me that may have helped me fly under the radar (in addition to the fact that the ADHD “radar” was under construction when I was in school):

  • I was not hyperactive, 
        and,
  • though, like many kids with attention issues, I could only really focus in areas in which I was highly motivated/interested, I was freakishly interested in many, many things! I have met lovely students who have only been able to hyperfocus on sports, Fortnight, and social drama. Every academic subject was like cognitively swimming through chilled molasses, motivationally speaking. Yet, this hyperfocus in these areas really is a major superpower in ADHD, and my gut tells me that there is a way, at least for many of my ilk, though probably not all, to learn to wield this ability, intentionally. For me, it was about many things, including: using the heightened social stakes of study groups in college to create associations strong enough to aid my retention; classical music at the right volume to keep my mind from wandering when I study or write (Schumann at the moment); as above, looking back not forward, and checking off tiny chunks of completed work along the way (like, say, blog posts instead of a BOOK), to build momentum, and which also allows for the likely toppled house of cards without the loss of everything; lots of little card lean-tos instead of a card mansion. And more....to come!

Onward! Upward!