Article

Attention

Comment

Psychology

2 February 2024

6 min read

Paying attention to ADHD– is it really just a fad?

Media fixation with ADHD caught Henna Cundill’s eye, so she decided to investigate its struggles and superpowers.

Henna Cundill

Henna is a researcher with the Centre for Autism and Theology at the University of Aberdeen.

From a darkly shadowed face, a single illuminated eye stares.

Brands&People on Unsplash.

In a feat of irony, attention deficit hyperactivity disorder (commonly known as ADHD) is now getting a lot of attention. For example, between 28 and 31 January The Times newspaper published one article per day about ADHD. Intrigued, I looked back over the past few months, and I found that The Times has averaged 8 to 10 articles per month which are either partly or exclusively about this topic. These range from celebrity diagnoses to handwringing over the “troubling rise” in incidents of the condition, to concerns about parents gaming the system to get their children disability payments or extra time in exams.

With all this media hype, it is little wonder that some commentators are inclined to dismiss ADHD as a fad. Scroll through the comments beneath each article, and you will reliably find the rallying cry of, “We didn’t have ADHD in my day!” followed by the patient responses of those who try to correct this fallacy.

While the high public profile of ADHD is new, the condition itself is not. As early as the mid-1700s a Professor of Medicine called Melchior Adam Weikard was describing patients who were “unwary, careless, and flighty” – behaving in ways governed by impulse, and showing poor skills in punctuality, accuracy, and having an inability to complete tasks, to the detriment of their mental health. His description is of its day. For example, and somewhat amusingly, Weikard (himself German, but at this point living in Russia) also described his patients as follows:

Compared to an attentive and considerate person such a jumpy person may act like a young Frenchman does in comparison to a mature Englishman.

Even so, Weikard did not unconsciously adopt all the prejudices and stereotypes of his context: he broke firmly with existing medical consensus when he diagnosed these patients as having a “dysregulation in cerebral fibres” – rather than attributing their difficulties to astrological misalignments or demon possession.

By characterising ADHD as a brain-based condition, Weikard was ahead of his time, and we’ve come a long way since then. This is not the place to chart the whole biography of ADHD, suffice to say that when someone rolls their eyes and declares dismissively, “We didn’t have ADHD in my day…” – they are either over 300 years old or not talking like a mature Englishman, even if they read The Times.

The negative side of the condition as being in a constant fight with one’s own thoughts and senses – these are doughty opponents, they always know where to find you, and they only sleep when you do.

Another thing that is not new, despite what cynical commentators might seek to imply, is the treatment of some aspects of ADHD with medication.

Doctors have been prescribing amphetamines to patients with ADHD since at least the 1950s. Yet now those medications are in short supply. Contrary to the media hype, fewer than 1 in 10 people with an ADHD diagnosis take prescribed medication, but for some of those who do it can be a lifeline – calming down a washing machine mind that is stuck on constant spin.

One acquaintance of mine has taken to anxiously touring the local pharmacies, driving to neighbouring towns and villages, desperate to get her prescription filled.

Another is passing her own tablets on to her son, whose prescribed supply ran out sooner. Sharing prescription medication is, I am duty-bound to add, an illegal practice – but it is hard to expect a parent to medicate themselves whilst seeing their own child struggle to attend school, to complete exam papers and to just generally feel (and I quote) “like a normal person.”

People who have ADHD sometimes describe the negative side of the condition as being in a constant fight with one’s own thoughts and senses – these are doughty opponents, they always know where to find you, and they only sleep when you do.

This is not to overlook that there are positives to ADHD too – it is often pointed out that the condition entails a degree of “superpower.” A person living with ADHD may have an incredible ability to focus on one difficult problem to the exclusion of all else, and thus solve it, perhaps devising creative solutions that elude those with a more pedestrian style of thought.

Also, it is common for people who live with ADHD to be dynamic conversationalists, with high social intelligence and empathy, priming them for success at tasks like broadcasting and debating. Many elite athletes also live with ADHD and say that they able to strive for excellence due to their restless energy and resilience in the face of tough training regimes.

Given the mixed bag of struggles and superpowers, there is a raging debate about whether ADHD should even be considered as pathology, or just as a neurodivergent way of being human. I suspect there is no right or wrong answer to this – for each person who lives with ADHD it depends on their own experience and how they feel it helps or hinders them to live the life they choose. Neither is it a binary choice: more than one of my own acquaintances who live with ADHD has described themselves as being in a “love-hate relationship” with their neurodivergence.

ADHD challenges me to unfold my mind too – to become ever more aware and appreciative of the fact that there are many ways to be human.

Neurodiversity, like any kind of diversity, challenges the way we live to together in communities, choosing or refusing to show empathy towards those who are perceived as ‘other’. There are several places in the Bible where human interconnectedness is likened to the human body – made up of many different parts, with each member dependent on the other for the wellbeing of the body as a whole. In one of his letters, St Paul wrote, “If the whole body were an eye, where would the hearing be? Or if the whole body were an ear, where would the sense of smell be?” Society needs problem solvers, communicators, high achievers, even while society also needs people who can structure, plan and maintain consistency – and above all, society needs these different neurotypes to work together with a certain amount of mutual understanding and trust.

Reflecting further on the body metaphor, Paul also wrote this: “If one part of the body suffers, the whole body suffers with it.” It is estimated that about 5 per cent of people in the UK has ADHD, so it is likely that includes someone you know. The majority don’t take regular meds, but if you are connected to someone who is usually reliant on these, the next few months may be a time of particular stress and anxiety, as the current medication shortage is expected to continue into late spring. This affects not just those living with ADHD, but all of us, as we live together in our families, communities, and networks. Not everyone chooses to be open about having an ADHD diagnosis, but if they are, now might be a good time to ask them how they experience this condition, both with its positives and negatives, and how you can support them if they are managing without their usual prescription.

The body metaphor, and Paul’s teaching around it, reminds us that diversity is no accident, God has always been attentive to those who feel divergent or far from the centre, as Jesus affirmed when he announced his ministry would be for the poor, the prisoners, the disabled and the oppressed. The psalmist too, observes that God’s attention and concern for us is so complete, that one is “…hemmed in, before and behind” – even if one strays to the very ends of the Earth, or drives to the pharmacy in the next village. Thus, while the media circus may be new, we can be sure that God has always been attentive to those with ADHD, and wider society is called to be likewise.

Writing for The Times, Esther Walker describes ADHD as “…the health story that keeps unfolding.” Well, certainly every time I unfold my newspaper, there it is again. But ADHD challenges me to unfold my mind too – to become ever more aware and appreciative of the fact that there are many ways to be human: usually complex, sometimes difficult, often brilliant, and always interconnected.

Article

Change

Politics

Psychology

5 November 2024

5 min read

How to be a wise diplomat about the election result

It’s not just American citizens weighing-up and trading-off.

Emerson Csorba

Emerson writes on geopolitics. He is also a business executive and holds a doctorate in theology.

An ambassador presents credential to President Trump

President Trump accepts credentials from Indonesian ambassador M. Lutfi.

White House via Wikimedia Commons.

The American election result, whatever the case, is a landmark event in geopolitics. And here, it is unclear which result is better for the world in the long-term, given the ambiguous motives, interests and intentions of its main characters.

Whereas the Biden Administration led by the Democrats has been fraught with war, the Trump Administration was comparatively peaceful, with breakthroughs such as the historic Abraham Accords. Yet, the rhetoric of President Trump is aggressive and divisive.

Despite mainstream media assertions focused on the clear best choice in the election, a balanced perspective is necessary involving consideration of trade-offs between what the parties and their leaders each offer. This balance, however, is difficult to achieve as polarisation encourages retrenchment into simple views.

As the American election approaches, it is worth considering what a diplomatic approach to an election transition might entail. Here we can look to the example of Henry Kissinger, whose diplomatic mindset is illustrated in Barry Gewen’s The Inevitability of Tragedy. Gewen eloquently illustrates the Kissingerian – even if often cold-hearted – approach to the consideration of trade-offs in diplomacy.

Gewen traces the early-life experience of Kissinger, a German Jew forced to flee Nazi persecution, both serving in the US Army and attending Harvard. Unlike his American peers, Kissinger understood through personal experience that authoritarianism could rise through democratic means, Adolph Hitler the primary example.

It is partly for this reason that Kissinger was willing as US Secretary of State to intervene in the affairs of foreign states to halt dictators emerging through democratic processes. The trade-off was here between respect of democratic process and the possibility of dictatorship, a trade-off which Americans without German-Nazi experience would never understand and which they saw as deeply unsettling.

Kissinger is the archetypal diplomat. His example is worth reflecting on in the wake of the American elections. Kissinger approached geopolitics with little emotion, instead considering what course of action in a particular situation served as the least worst evil available.

He engaged across a wide variety of networks, talking with individuals who would not speak with each other. And he maintained a considerable sense of calm throughout his career as both an actor and commentator, responding to events as they developed.

An initial consideration in emerging from the American elections is that too much emotionality – amplified by political polarization – will expose politicians, diplomats and the public to risk. Emotion colours careful, strategic calculation of various scenarios and actions across potential scenarios.

‘People constantly show you who they are; we are just too busy to notice,’

An effective diplomatic (or strategist) will carefully consider what might happen and think through potential steps in case these realities actually transpire, while recognising that too much anticipation risks cascading into fantasy. Too much emotion impedes this careful process of reflection and deliberation as part of the development of strategy.

A second element of effective diplomacy and strategy is to consider people as they are, rather than rely on superficial descriptions in the media, biased second-hand accounts or who or what one hopes another person is. People’s motives, intentions and interests are not easily discernible at first glance, instead requiring careful probing and questioning.

At the same time, there are few more accurate sayings than ‘People constantly show you who they are; we are just too busy to notice,’ conveying that counterparts are always providing information as to who they are, few careful or disciplined enough to mask their real thinking.

An effective diplomat might consider the early upbringing – much like that of Kissinger – that shapes a person’s character and behaviour, if not their worldview informing action.

Consider Donald J. Trump, learning right from wrong on the streets of New York City via the mentorship of lawyer Roy Cohn, who served as Chief Counsel to Joseph McCarthy while McCarthy prosecuted potential American communist sympathisers.

Cohn’s rules of life, work and play were as follows (these summarized by a friend well-acquainted with Cohn and his colleagues): ‘One, attack, attack, attack! Two, deny everything! Three, always claim victory!’ The logic of these three rules of life are readily understandable when considering the harsh New York realities within which Cohn and later Trump operated.

These considerations are overlooked, however, amid the onslaught of media which fails to consider what really shapes the character of a man or woman.

Curiosity, a critical mindset and self-restraint in the face of the human temptation to reach rapid and satisfying answers are here necessary, as part of figuring out what exactly is driving action.

A wise diplomat would pay particular attention to these pivotal factors – such as the influence of a long-standing mentor or advisor – as they might manifest in the present. This requires an intellectually honest and serious consideration of the worldview that shapes a counterpart, rather than considering superficial media commentary.

Third, a wise diplomat will maintain relations across a wide variety of networks, understanding that it is fine to talk with two or multiple individuals whose own relations are fractured (in fact, these strains in relations can be beneficial within diplomacy, the diplomat in this case able to play broker as he or she needs or wishes).

The maintenance of broad networks is vital, because this enables action under a wide array of potential circumstances, understanding that anything can happen (we are here reminded of Harold MacMillan’s saying “Events, dear boy, events!”) And a key lesson in diplomacy and in the cultivation of strategy is that, once crises unfold, it is the preparatory work in developing networks and alliances that counts; little new network-formation is possible afterwards.

The previous two points suggest that a wise diplomat will not pay too much attention to what is in the media, but will instead consider their own learning gleaned through in-person interactions with others, as well as the perspective of their most trusted contacts. Curiosity, a critical mindset and self-restraint in the face of the human temptation to reach rapid and satisfying answers are here necessary, as part of figuring out what exactly is driving action, and what can in turn be done to shape action in accordance with interests.

Finally, an effective diplomat will not try to play God, serving as the arbiter of right or wrong, adopting instead a more considered approach anticipating and responding to circumstances as they gradually or quickly evolve. Effective strategy requires an aloof approach (caring – but not caring too much), removing the self from a given situation so as not to allow natural human vices such as presumptiveness, arrogance or short-term self-interest to affect judgment.

And the American election bring with them a number of trade-offs, these to be weighed carefully by American citizens, as well as by diplomats and strategists in other countries. These trade-offs will be considered most effectively if approached with calmness – the aloof, even if cold-hearted, approach personified by Henry Kissinger.

In an age of catastrophising, emphasing emotion, it is easy to descend rapidly into despair, rather than consider action from a long-term perspective. Diplomacy and strategy require the latter, which will be a key to success for those who emerge effective in advancing their interests in the wake of the American elections.