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.

Column

Character

Confession

Culture

Psychology

18 September 2024

8 min read

‘Yet All Shall Be Forgot?’ Saying sorry has never been more difficult

Acknowledging wrongdoing is vital for any society to flourish. So why do we find it so difficult to apologise, especially online?

Roger Bretherton

Roger Bretherton is Associate Professor of Psychology, at the University of Lincoln. He is a UK accredited Clinical Psychologist.

On a street, two men confront each other face to face.

Darwin Boaventura on Unsplash.

People in the UK don’t like to apologise. At least that’s what a recent poll reported by the Daily Mail claims. Of a thousand British people surveyed, about forty percent of them claimed they didn’t like to apologise because they were never wrong! At least that’s what the headline said. When you actually look at the survey itself, things get a bit more nuanced. 18 per cent don’t feel ‘comfortable’ making an apology. 15 per cent don’t like admitting they’re wrong. 23 per cent feel embarrassed at the thought of apologising. Sorry does indeed seem to be the hardest word. And Elton John seems to be the hardest person to avoid quoting whenever these things come up. Which they do - a lot!

We shouldn’t really be that surprised by the findings of this study. Contrary to the popular belief that the world is divided between goodies and baddies, upstanding citizens and immoral rotters, the ethical picture is much more complex than that. The line between good and bad, as Russian dissident Aleksandr Solzhenitsyn noted, runs through people not between them. Many moral qualities like kindness, forgiveness, gratitude, humility and so on, are trait-like. There are relatively few pure saints and absolute villains, most of us linger in the muddy moral middle, neither exceptionally good nor reprehensibly evil. And this is what the survey indicates. Despite all our reservations about apologising, the average 20 to 50-year-old says sorry about three times a week, totting up an annual total of 150 apologies per year. We may not like apologising, but we get there in the end.

Unfortunately, it’s not as simple as all that. Because while we may apologise, we don’t always mean it. If the need to apologise is a spectrum it not only includes those who NEVER apologise, but also those who ALWAYS apologise. If the non-apologisers sit at one extreme, the super-apologisers dwell at the other. These are the people who over-use apology, who never stop apologising for their existence. According to this survey, 41 per cent of us are first to apologise whether or not we think we are in the wrong, and 38 per cent apologise without meaning it. Ever found yourself inexplicably blurting out a sorry to the person who bumped into you at the supermarket? or gratuitously apologising for your emotions in an attempt to appease the workplace bully who caused them? I have. If that’s you, please pull up a chair and join me at the table of compulsive and unnecessary apologies- assuming you can sit down without apologising for taking up the air space.

With the wisdom of age most of us will learn to let things lie. Which is to say we will learn to forgive. Which is also to say we will learn to accept apologies.

It does seem, from this survey at least, that people are a bit confused about the nature of apology. ‘Sorry’, is a necessary part of the social vocabulary that makes community life possible. To say sorry is to acknowledge that we are embedded within a rich social network upon which we rely for our existence and without which human life would be untenable. It belongs alongside other basic words like ‘please’ and ‘thank you’, that recognise our social dependence. This applies everywhere: at home, at school, in the office, down the high street, at church. When we say Please, we acknowledge that there are things we cannot do and cannot know without the help of others. When we say Thank You, we accept that even our greatest achievements were team efforts, not wholly down to us. And when we say Sorry, we accept that this community of trust, this web of promises and fulfilments, is fragile. We can act in ways that fray or even break the threads that connect us to others. Sometimes we don’t show up when we said we would. Sometimes we lie to avoid shame. Sometimes we take far more than we should from those who can’t afford to give. Sometimes we are rude, hurtful, even hateful. Saying sorry is the way we recognise, renew and repair our damaged connections to the people on which our lives depend.

One of the most interesting findings in forgiveness research is that as people get older they generally become more forgiving. Now we can all think of exceptions to this - we all know people who seem to have become bitter rather than better with age - but that’s not the rule of it. Most of us will mellow and become more tolerant as the years pass. Partly because the passing of time diminishes our energy for grudges and plotting petty retaliations. But mainly because the older we get the fewer friends we have left. If young adulthood is awash with weddings, then later life is filled with funerals. To put it bluntly, as we get older more people we know have died. We increasingly realise that our connections to family and friends are priceless and irreplaceable and hardly worth severing over minor grievances. With the wisdom of age most of us will learn to let things lie. Which is to say we will learn to forgive. Which is also to say we will learn to accept apologies.

Why say sorry if there is no hope of social connectedness? This seems to be the zero-sum game played out in our digital lives.

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This by contrast sheds some light on why it might be that some people (the maligned 40 per cent of the survey) simply do not apologise. Admittedly it is likely that the tendency to offer apology varies alongside other personality traits like Agreeableness- our general tendency to get along with people. Those high in Agreeableness are more sensitive to ruptures in their relationships and therefore more likely to resolve these with a well-timed apology. And given that women tend to score more highly than men in measures of agreeableness and social intelligence, it seems equally likely that the league of super-apologisers who say sorry too often (like me) is predominantly populated by women (unlike me). By contrast those who do not apologise are likely to be at the tough-minded end of the personality spectrum, more ferociously individualistic, less emotionally aware, and not particularly sensitive to the fabric of social life into which they are inescapably stitched.

The apologiser and the non-apologiser then inhabit different universes. If apology belongs to a social network that needs to be tended, then the refusal to ever apologise is to deny the relational fabric of human life. Why say sorry if there is no hope of social connectedness? This seems to be the zero-sum game played out in our digital lives. Anyone can trawl the elephant’s graveyard of our online history and find things we said or did in our least thoughtful moments. And if they do, no amount of apology seems sufficient to rectify the mistake. Online apologies cannot erase online offences. It’s hard to imagine a better system for teaching us the futility of saying sorry.

There‘s a timing issue too. Quite often people who do not like to apologise assume their apology will result in humiliation. If they admit to being wrong, they will be publicly shamed, not restored to connectedness but excommunicated. As a result, if they ever do get round to apologising, they do so reluctantly or halfheartedly or under duress or just way too late, and consequently receive exactly the kind of vicious reaction they assume apologies usually receive. It’s a self-fulfilling prophecy: if we believe our apologies will be met with hostility, we tend to apologise in ways that make hostility more likely. It’s no wonder some people don’t see saying sorry as a viable social strategy.

To confess is to acknowledge and turn from our self-absorption, distraction, ignorance, inconsistency and whatever else detunes us from this heavenly wavelength.

It is a pity, because for those who care to look apology can address the deepest needs of the human soul. Apology restores us to the human community, reweaves the threads of trust that connect us to family, friends, colleagues, and neighbours. It assumes there is an invisible world we can rely upon, in which we can place our faith, and to which saying sorry can restore us. This is not just the logic of social apology but also the logic of spiritual apology, or to use the more traditional term, confession.

Just as we seem to be confused about apology, we are also pretty confused about confession. For many of us it belongs to movies where gangsters seek forgiveness for heinous acts through the screen of a confessional booth. Or even worse to the humiliation of being forced to publicly reveal our most shameful character flaws. But these are caricatures.

Confession, like apology, ultimately belongs to a benevolent view of reality. A view suggesting that, at all times and in all places we are in the presence of an utterly attentive, absolutely constant and unfailingly loving God. A God who is closer to us than we are to ourselves. A God who cannot help doing whatever it takes to close the distance between us, whose gentle presence hugs the contours of our lives the way the sea hugs the shore. And this divine reality is so permanent, so consistent that, like white noise, we live in complete ignorance of it most of the time. We tend to think that we are here and God is elsewhere, but actually it is God who is here and we who are absentmindedly elsewhere.

In this universe we don’t confess in the hope that our abject humiliation might possibly eke out a morsel of compassion from an otherwise indifferent deity. No. When we confess we acknowledge that while God may be unfailingly aligned with us we are less so with Him. We don’t seem capable of flying in formation with Him. If He moves in straight lines, our lines waver. To confess is to acknowledge and turn from our self-absorption, distraction, ignorance, inconsistency and whatever else detunes us from this heavenly wavelength. If apology restores us to a wider social reality than confession restores us to the deepest reality of all.