ADD From the Inside...

(rough draft 2, 29 Nov 94, Jim Hawtree, raph@fnalv.fnal.gov)
 
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Hunters and Farmers
ADD Characteristics
Accommodations
 

Hunters and Farmers

ADD, or attention-deficit disorder, is not new. In fact, it has been around for tens of thousands of years. Thom Hartmann, in his book, Attention Deficit Disorder: A New Perspective, gives the interesting hypothesis that ADD is an adaptation, genetically passed on, to optimize life as a "hunter." A hunter needs to be continually aware of his surroundings, so his attention will quickly focus on anything that may be a threat or opportunity. He (or, of course, she) must be instantly ready to drop everything and begin another task such as following a fresher trail, instantly responding to danger, etc. As a hunter, novelty, constantly monitoring the surroundings, and creativity are the most important requirements for success. There is no reason to be concerned with time, so when hunting is poor, there is no reason to be attentive or even to stay awake. On the other hand, when the game is afoot, the hunter is fully ready to jump into it totally, and takes no mind of time. Since this is an occupation where there are is little lattitude for mistakes, social niceties are not appropriate. ADD is not a personality trait, or a defect, but a specialized adaptation. Unfortunately, although it is highly adapted to one particular set of activities, it is not suited to some tasks which are very common in our society. It is highly effective for handling difficult and creative tasks that require the ability to see connections between highly disparate things, such as with engineering, or inventing or handling critical and emergency situations.

"Farmers" are totally different in makeup. While hunters need immediate feedback from their efforts, the "farmer" must wait months to get any response from his crops. He needs to be able to sustain a steady, even level of effort, even with no apparent clear gain in the immediate future. On the other hand, the hunter must get results immediately, or the hunter starves. Farmers are good at planning for the future, and especially good at following schedules and routines; that is the only way crops can be raised successfully. It is often necessary to coooperate, so they are naturally good at recognizing and responding to social cues. There is only a moderate need to react to danger and stress, but there is a great need to be very good at concentrating for long periods of time on fairly routine tasks (planting, watering, weeding, cleaning, etc.). The hunter is nearly the opposite of this: if something does not work immediately, then something else needs to be done. Scheduling is irrelevant; what is relevant is whatever opportunity presents itself unexpectedly. Time is linear and stable for the farmer, but the hunter has little need of scheduling; hunting takes place as long as there is an immediate pressing endeavor.

Our society, schools in particular, are made for the "farmer." So are most workplaces (not all!). Attention must be maintained for extended periods, and routine is very important. Timing and scheduling are extremely important. Unfortunately, the hunter's attention is not geared to this, making it very hard to concentrate on routine. Distractions are instantly the center of attention. And if there is not enough stimulation, then the awareness shuts down, causing "spacing out" or falling asleep or just plain distraction that leads to extremely poor performance.

ADD is a performance "disorder." It is actually a misnomer, because it is not an inability to concentrate. In fact, the ADDer has an extremely great ability to concentrate, as long as the task is suitable for it. In the proper surroundings, the ADDer can spend endless hours immersed in a task. This is called "hyperfocusing," and is an extremely focused and productive ability. We all are acquainted with individuals who read entire textbooks on highly technical matter in a couple of days, and learn it better than they could in months of classroom instruction; this is typical ADD hyperfocusing, It requires a tremendous expenditure of energy, and time disappears during this period. For the ADDer, this is highly pleasurable, because it is using the creative and focusing abilities to the maximum.

The problem is that in our culture, tasks are not suited to hyperfocusing; but instead are usually thankless but expected routines. Interestingly, many if not most Native cultures and religions seem to be based on the Hunter traits. Within those cultures, ADD is not at all dysfunctional. Many who are members of these groups find no boundary between culture, religion and the forces of the inner self. But our Western majority "farmer" culture is set up almost in opposition to this alternate view of the world. ADD is an invisible minority group that needs the same advocacy, protection and activism as any other minority group. The invisibility of the ADD person's problems makes things extremely difficult.

Many supervisors and teachers expect the steady concentration from everyone, but the ADDer is not suited to this. It is not a moral issue, or a lack of effort. If an otherwise sound car runs out of gas, the efforts of the driver are immaterial. And, ADD is a result of critically low levels of transmitters, most notably serotonin, norepinephrine (adrenaline) and dopamine. Dopamine is the equivalent of "gasoline" for a car. The average farmer type who is in the great majority have genetically and constitutionally a steady supply of this neurotransmitter, enabling attention to be focused and alertness to be sufficient. The hunter, though, has no steady supply, and constitutionally must rely on the environment to supply enough stimulation to secrete enough dopamine to function, or the hunter is left "high and dry" with a very low level, too low to keep focused on any non-novel task. What causes high levels of dopamine to be released is stimulation from the environment. This can be caused by anger, guilt, fear, enthusiasm, pain, or novelty; or with stimulant medication. Many ADDers find that they self-medicate with coffee, chocolate, loud music, provocative behavior, etc.; places and occupations where ADD is high is in entrepreneurial companies, project start-ups, prisons (estimated at 90%), and in physics and engineering. As a physicist with ADD once said, "... Nobody seems to understand that ADD doesn't mean you can't focus your attention. The name "ADD" is a stupid one, for that very reason. Maybe they should call it "Boredom Tolerance Deficiency". ... I think one reason it's hard for the rest of the world to accept ADD is that if it exists, it means we are terribly bored by "normal" people who generally have the mistaken impression they are interesting." ADDers often are criticized for not paying attention, interrupting, and wandering away in the middle of conversations. This is not intentional impoliteness. It is merely that some distraction has forced attention elsewhere; since the ADDer depends on outside stimulation to keep functioning, attention often gets focused on the greater source of stimulation, which may be other than what either party intends. This is just a fact of life. ADDers have an extremely fast and active attention, which constantly monitors the environment for any novelty stimulus. It may be annoying to the non-ADDer, but ADDers often have no problem with this, since they are "on the same wavelength," which is why their creativity is often extremely high, as reflected on testing, and why they are so good at brain-storming sessions. And, this is why "boredom" is so great an issue. ADD is a sort of reverse epilepsy; in epilepsy, the brain is over-stimulated, but with ADD, it is highly understimulated.

Consciousness occurs in the "forebrain." In normal waking consciousness, dopamine keeps the forebrain connected with the "reticular activating system," a primitive area that is the interface with the senses and motor areas. When there is little stimulation, the hunter finds that awareness and concentration slip away, and daydreaming occurs. The farmer seldom has this problem: there is a reliable supply to keep attention calm and focused. But when dopamine levels fall too far, restlessness occurs to keep some activity going; or the consciousness closes in on itself and begins uncontrollable daydreaming and spacing out. All of this is a result of physiology, and the ADDer has essentially no control over it. In a distracting environment, the ADDer is distracted; in a boring one, mentally out to lunch. Unfortunately this is not laziness; the ADDer just CANNOT function without stimulation. This is why ADDers are universally characterized from their first schooling throughout their lives as "lazy and stupid." In a crisis situation, such as an emergency or a test, the ADDer will equal or usually surpass the average non-ADDer. "Lack of sustained effort" is one of the most common criticisms of ADD; but the ADDer is in fact trying as hard as possible against an impossible barrier: boredom. It is not a mere unpleasant annoyance; it is a neurological barrier.

Of course, this happens to everyone, at some time or other. At some time, everyone may find that they have some symptoms of depression, bipolar disorder, schizophrenia, mania, or ADD. But with ADD, the symptoms may happen dozens to hundreds of times daily, and there is nothing that can be done about it; the ADDer is trying as hard as possible to cope by whatever means necessary. Of course teachers and parents and employers say to just try and concentrate, and stop being lazy. Novelty and challenge (and threat, guilt, suffering, anger, and a host of other unpleasant emotions) can stimulate enough neurotransmitters to keep alert at first, but if the environment is not cooperating, the ADDer just "runs out of gas." It is not a matter of lack of desire or effort; if your car is out of gas, trying hard and stomping on the gas petal will not work. As a result, attention begins to diminish, and anything at all that can catch the eye is focused on, providing some small amount of stimulation. One very common way the ADDer keeps attention active is to keep a storm of mental activity. Sometimes this is manifested outwardly as hyperactivity, and other times it is mainly mental and inward. This of course makes it extremely difficult to attend to what someone is saying; and it is the cause of distraction. It is also what makes them creative and very high-energy, or utterly distracted and spaced out.

The ADDer's attention is at the mercy of the external environment to an extremely large degree, and that means YOU. If you are not sufficiently involving and interactive in your communication, you risk becoming part of the background noise. Lists in writing are a great idea. Apparent disinterest is a bad idea. Lack of clarity is a bad idea, unless you want the typically highly imaginative ADDer to creatively interpret your statements in a few dozen ways, many of which you may not have considered. High intelligence, desire for involvement and activity, and creativity are usually indistinguishable from stupidity. This is the reason for ADD as a disability.

ADD characteristics

Distractibility and restlessness (mental and/or physical) are two of the hallmarks of ADD. Other symptoms are a sense of under achievement and poor self-esteem; difficulty in organization; procrastination; having too many projects going simultaneously; need for high stimulation to ward off boredom; frequent mood swings, though not manic-depressive in extent, and mainly towards depression; insecure and chronically worrying; impatient and intolerant of frustration, but handles crises well (because of the high stimulation it provides); often great at visualization, but often bad at taking serial verbal instructions. Distractibility causes very poor retention, especially verbally. Other characteristics often are: often being left-handed; trouble with auto-immune or allergic reactions; ear infections when young; excellent peripheral vision (all the better to be distracted); and very often, extremely high scores on SAT and intelligence tests, which leads to more poor self-esteem and accusations of laziness when goals are not met, which is very often. As a result of never-ending fights against insurmountable biochemical and environmental and social barriers daily, the ADD person can be extremely good at a wide spectrum of coping skills, and extremely resilient and determined in fighting these barriers, in spite of almost constant defeats, real or perceived. Time is irrelevant to the ADDer, making appointments difficult to remember; but this allows incredible efforts to be expended with no regards to passage of time. This is what is called hyper-focus: either the attention is very poorly focused in a normal environment; or in a highly stimulating environment, the attention is focused so highly that the rest of the world is cut off, allowing amazing feats of productive work; but this requires a subject that provides novelty and stimulation. They are also often non-conformists, and often insensitive to social cues, although this can be overcome with intensive therapy and training and study, which is very commonly pursued by ADD individuals. Another trait is that they are extremely skilled in visualization due to a unique brain wiring, but often at the expense of verbal ability (IQ scores may have a spread of twenty points or more). They are the source of the icons of the "absent-minded professor," the mystic, the entrepreneur, the "space cadet," weirdo, crazy guy, dumb blonde, computer hacker, the visionary. The ADD person is, to all appearances, either tirelessly enthusiastic, or impatient and distracted, with little in between. An intelligent employer can capitalize on the strong points of tireless energy and creativity with a few accommodations.

Accommodations

The main accommodation is by the ADDer, to seek diagnosis and treatment, usually with some seriously powerful stimulants such as amphetamines and Ritalin. Paradoxically, it works in just the opposite way for the ADDer than for the non-ADDer. It causes relaxation and focusing, because these drugs cause release of neurotransmitters that are normally in short supply. This allows attention to be focused on tasks that are not appropriate to hyperfocused effort.

Workplace accommodations include clear written instructions, rather than vague references to items discussed during long boring talks which were never noted by the ADD victim who would be thinking about something light-years away while his boss was still warming up to the subject.

Some ADDers find earplugs helpful in blocking out sound. Others find that music in the background keeps them centered better.

Since linear time is an alien abstraction, frequent reminders about meetings and deadlines are needed. This can be done with a pager, or electronic notepad.

Organization is the biggest problem for the ADDer. It is optimum to have someone else assist with the paperwork for routine stuff, and do the filing. Such routine tasks can range from very agonizing to literally impossible for an ADDer, although it is easy at first due to the novelty of a new project (and very frequently abandoned later).

Since ADDers have extremely fast and nimble minds with little tolerance for tedious details, it is important to give the ADDer a lot of feedback and attention.

There is one major accommodation that overrides all of them, and costs no money; in fact, it produces more work from the ADDer than everything else combined, produces more output easily than could be expected from a normal employee; and will provide a healthy workplace for the ADDer. That accommodation is to give the ADDer challenging and involving stuff to do. Novel stuff. Read this carefully: Normal people do the easy routine stuff easily, and have trouble with the hard stuff, but it is just the opposite with ADD. The more novel and challenging and difficult the task, the more productive the ADD person is, because of the challenge which focuses the attention and pent-up abilities. Many ADDers find little difficulty with advanced mathematics, but have very much trouble with simple arithmetic problems and seldom can keep a balanced checkbook. Immediate gratification and challenge are key factors. Following simple verbal instructions are difficult to impossible sometimes, but solving extremely difficult problems is a process that is natural. This is all because of the physiological neurological realities of ADD that require stimulation, and cannot cope with boredom.

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