ADHD

Attention

The word attention gets a lot of play in the context of aspiration. We seem to want to individually and collectively achieve an unflappable state of “paying attention,” often joining the term with other aspirations, such as mindfulness, gratitude and intention.

I don’t like to call my forms of attention a ‘deficit,’ because that implies a lack, a less than.

Attention also happens to be a charged, and even controversial, word in many respects. An example that comes to the forefront is the way it’s been used in the diagnosis of children and adults who are deemed to have attention deficit hyperactivity disorder. ADHD seems to be one form of attention we want people to steer clear of, regardless of their age.

As I did some journaling around the question of attention today, the word “choice” appeared over and over. “Is the attention my choice,” I wrote in the upper-right corner of a hot-pink lined page. I also wrote “forced or given” coupled—just below the words—with the heaviest underline my Pilot Precise Grip Extra Fine tip could muster.

Many people who are dyslexic have differences in attention when compared with the norm. Some of us carry the dual diagnosis of dyslexia and ADHD. As an accompaniment to my recent dyslexia diagnosis, I have a provisional diagnosis of ADHD with overfocus, which means I can (and often do) go hours on end working away at something that’s captured my attention.

I also am able to take in a great deal of information all at once, and the sensory input / processing / synthesizing can sometimes be overwhelming, even draining. I actually find this aspect of my attention quite useful, however, as I pull seemingly disparate elements into my writing, in particular my poetry.

I don’t like to call my forms of attention a “deficit,” because that implies a lack, a less than, a “should aspire to be something else”—something feathering the perimeter of what’s considered normal. Instead, I like to refer to my dominant forms of attention as “focused attention” (notice I’ve dropped the “over-” prefix) and “wide,” or “roaming,” attention.

That’s where I am at with it right now, that is. Next year, or even next week, I might conceive of my attention in a new way.

I think “choice” and “force” come up for me when considering what attention is, and how it makes me feel, because I am often asked to perceive the world like other people: to think like them, to feel like them, to work like them, to learn and discover and believe like them. In short, I am asked to have forms of attention that are, or at least seem, congruous with theirs. I feel as if I am being asked to enter into a foreign way of paying attention at the expense of my own ways.

Given my ways of paying attention, my definition of attention will most likely differ from that of others. I don’t necessarily want to change the fundamental ways in which I filter and experience the world. I will probably never aspire to living in a way that depends on focused, central-task attention which neither verges on being “too invested” on the central task nor allows too many “tangential” elements in that could threaten that central task.

Still, my core definition of attention might have something in common with other people’s: something to do with noticing, with letting in, with experiencing, with using all “57 or so” senses in any encounter. Something to do with letting others in, letting the self in, letting mystery in, letting awe in.

My definition also includes staying with something, whatever that something happens to be at the moment, in the connection and expansion of moments: focusing like a camera lens on what’s in front of us, behind us, under us and above us. Focusing on each other and on ourselves.

In a nutshell, my definition of attention, then, seems to center on two seemingly contrary elements: focusing and letting in. I guess that’s in precise alignment with the focused and roaming forms of attention I’ve been blessed with and sometimes challenged by. Fancy that.

The Problem with Labels

I’ve been thinking a lot about this label of “overfocused” ADHD. I’ve gotten some feedback from advocates and specialists in this area who say they aren’t convinced of my diagnosis. While they agree that I have the qualities described in overfocused ADHD, these experts also note that there are politics involved in framing those qualities as “symptoms.”

Pharmaceutical companies are more concerned about patents than patients.

In their view, many people with dyslexia have these qualities, as well as almost everyone with high intelligence. (Their words, not mine, but I am also not going to pussyfoot around the fact that I am highly intelligent. That would be disingenuous nonsense.) One person pointed out that schools for gifted children see these qualities in their students and begin designing curriculum around those students as early as kindergarten.

In short, what’s seen as a disability by some is seen as an ability by others, as a characteristic to be accepted and harnessed, not obliterated through medication, negative reinforcement, or both.

I’ve also been stumbling a bit over the juxtaposition of the word “overfocused” against the words “attention deficit.” That feels like an oxymoron. Some descriptions of overfocused ADHD say that this subtype is not so much a lack of attention but too much attention and that the medicines typically used to treat ADHD won’t work on the overfocused variant because they will make the focus more intense, including aspects such as worry and rumination, which can in turn make the person with high focus feel worse.

How can you have “too much” attention and still be called “inattentive,” I’ve been wondering. Is there not a better term to describe the qualities of the person who can maintain focus for hours on end? For the mind that can execute a task in this manner? For this level of productivity? Why is this type of ADHD lumped in with ADHD at all? Simply because attention is concerned in some way?

Does the metacategory of ADHD even exist? Or is forcing disparate attention-based qualities under one overarching category an example of rigid adherence to a hierarchical construct, one that might wrap things up in a tidy framework but that ultimately says nothing in actuality about how these qualities are, or are not, related.

I would not have been able to be a music performance major if I had not been highly focused. That educational path requires four hours of practice each day, along with another three hours or so of practice in ensembles and in one-on-one study with your professor. That’s seven hours, at least, of intense focus in both mind and body, seven days a week. (Musicians get no days off, especially not flutists, otherwise the embouchure will fail.) You could easily categorize every single person in a conservatory as having overfocused ADHD, especially compared with the dawdling, low-grade focus many (neuro)typical jobs demand, with two days off each week.

Likewise, as a dyslexic English major, I would not have been able to consume all the novels, plays, poetry collections, essays, theoretical works and other reading materials required without high focus. Yes, it might have taken me four times as long to get through those materials, but high focus allowed me to do so. (As a dyslexic person, the qualities described as overfocused ADHD have allowed me to do everything that I do, and that’s been the case for decades.)

Furthermore, do graduate programs not require outright intense focus? What about those that involve research and lab work? My editorial work has largely been in the field of science and medicine. I believe every scientist and researcher I’ve worked with over the past decade and a half would easily qualify as having overfocused ADHD. One of those researchers even tried to recruit me into the field of biology not too long ago, perhaps because she could see I had a focus similar to her and her colleagues, as well as a mind that dissects ideas in the same way as them. (I tried to explain to her that I dissect language and concepts, not frogs, but she didn’t really get it. For her, talking about biology was so close to doing it, that I might as well have been doing it.)

And who says what’s too much attention, what’s not enough attention, where attention should be directed and, conversely, where it should not be directed? These, too, are political questions. What is championed is almost always what any given culture deems important. That is, what is deemed important is culturally constructed, not immutable. Even what we try to eliminate is important, though, because without those aspects of culture—those fringe aspects produced by the minority as opposed to the majority—culture would fold in on itself.

I suppose my concern is that the words “deficit” and “disorder” are part of this label. That’s the case because those lobbying for these clusters of qualities to be seen as a pathology needed (and still need) that framing in order to secure funding, build alliances and justify treatment options. In short, our health care and educational frameworks are built on, responsive to, and supportive of pathology.

Because medicine is involved in this, big money is involved, and big pharma is involved. I don’t really trust big pharma to define me and my life, or anyone’s life, given that their objectives often run contrary to those involving human welfare, human safety and human expression. Money colors everything, even making medicines unavailable to the masses because pharmaceutical companies are more concerned about patents than patients, therefore only the world’s relatively privileged can afford to get their hands on those medicines.

I’ll close by quoting from the book I recently reviewed, Thomas Armstrong’s Neuodiversity: Discovering the Extraordinary Gifts of Autism, ADHD, Dyslexia and Other Brain Differences:

One of the great disadvantages of the term ‘ADHD’ is that it speaks of a deficit in attention. Children (and adults) labeled ADHD are actually very good at paying attention. They excel in paying attention to what they’re not supposed to be paying attention to! This is called ‘incidental attention’ and is another trait of the creative person.

He continues:

People labeled with ADHD are also very good at paying attention to what interests them. Many parents have written to me saying that their ADHD-diagnosed kids will spend hours focused on building with Legos, dancing, operating video games, or engaging in other absorbing tasks. Unfortunately, the ADHD community has also taken this admirable trait and turned it into a negative. They call it ‘hyperfocus’ and consider it to be yet another ‘warning sign’ of attention deficit. But the ability to focus the mind for hours on a single topic has been considered for centuries to be the trait of an exceptional mind (otherwise, why do so many cultures and religious traditions cultivate the ability to concentrate?).

And here’s the last excerpt I will share:

The fact of the matter is that children and adults with ADHD have a different attentional style than neurotypical individuals. They have a ‘roaming’ attention that can notice many different things in a short period of time and a ‘homing’ attention that can fasten onto one thing of great interest and stay with it for a long period of time. It does a great disservice to those diagnosed with ADHD to say that they have a deficit in attention, when they are acutally good at two different forms of attention and have problems primarily with one other form, sometimes referred to as ‘central-task’ attention, where sustained attention must be paid to routine (and often boring) events that have often been externally imposed.