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,
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!
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.
- I was not hyperactive,
- 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!