ADHD is Viewed as “Bad” Because Only “Bad” People Have Been Studied

I don’t know of a single study which went out into the real world of “normal” people and tried to ascertain how many of them have ADHD but succeeded anyway…

Image by Azmi Talib from Pixabay

That’s all we may expect of man, this side the grave: his good is — knowing he is bad.
—Robert Browning, The Ring and the Book, 1868

I was sitting in the back of the auditorium as a psychologist and self-professed “ADHD expert” lectured to a roomful of ADHD adults.

“Don’t you people realize you’re all sick?” he said, a tone of criticism in his voice. (He was following my presentation: I’d just said there might be some good sides to ADHD, a position with which he vehemently disagreed.)

“You have a disorder!” His voice became shrill: “When I worked in the prison system, I saw hundreds of people like you! They’re all ADHD in there! This is a mental illness, dammit, and if you don’t believe it let me take you into a jail for an afternoon!”

It was a thoroughly depressing speech. He gave the case histories of a compulsive rapist, a repeat burglar, a homeless man who’d died under an underpass, and two of his female patients currently in the mental hospital. One was now HIV positive either because of her drug abuse or her promiscuity. Even his own brother had died young “because of his ADHD.”

I could see shoulders drooping all over the room, heads hanging in shame and embarrassment, as this group of ADHD adults were told in graphic detail how severe was the mental illness with which they were afflicted.

Later in the week, I recounted the story to Dr. Dale Hammerschmidt, a physician in Minnesota on the faculty of a medical school and the parent of an ADHD child. His response to me was so commonsense it startled me, and I share it with his permission:

“When I was in medical school in the 1960s, we learned a lot about homosexuality and homosexuals. We learned about the nature of the homosexual relationship, the tendency to fleeting unions, the difficulty forming a durable attachment, the tendency to depression, the tendency to sexual aggression, and the often abnormal family dynamics.

“The problem was that the data were all gathered on the homosexuals who were available to be studied in the 1950s— almost exclusively ones who came to psychiatric attention because of problems related to their sexuality.

“So what we were really learning about, perhaps quite accurately, was a sub-set of homosexuals unhappy with their sexuality or those who had been convicted of (homo)sexual offenses. It was then quite common to generalize those data to all homosexuals.

“But that seems to have been way off the mark: now that the socially well-adjusted homosexuals are more open, we find that a lot of what was once thought to be true for all was true only for a small and unhappy fraction. This was particularly unfortunate, in that the earlier data, when uncritically extrapolated, gave grounds for defining homosexuality to be a mental illness, and lent support to all sorts of discrimination. The echoes are still being heard.

“It’s an example I’ve thought about often, in part because that earlier research has often been described in disparaging, even condescending terms by people writing now. They never seem to ask why those earlier results were obtained; and if they do, they claim it was just flagrant, homophobic bias.

“But like most things in life, the truth is a bit more complicated. We had a long-standing societal bias against homosexuals; that led to the facile assumption that the patients available for study were representative. So there was a (non-deliberate) ascertainment bias — the results were probably correct, but for a much narrower population than was guessed. The ‘homophobic’ bias was subtle, just enough to make it take several years to address the should-have- been-obvious question: How sure are we that these results apply to all homosexuals, rather than just those we’ve been able to study?”

Likewise, what is the population that has been studied with regard to ADD/ADHD over the past forty years? It’s been almost exclusively drawn from among children and adults who have failed or crashed in some way in their lives. They’ve ended up in special education, institutional settings, jail, mental hospitals, and in the offices of psychiatrists and psychologists.

I don’t know of a single study which went out into the real world of “normal” people and tried to ascertain how many of them have ADHD but succeeded anyway. Or, even more radical, succeeded in part because of their ADHD (I put myself in that category).

The mental health institutions and drug companies that fund research are interested largely in helping (and selling help to) people in pain and in need, not in figuring out why normal people are normal or successful people are successful.

So it should come as no surprise that a psychologist who had worked with ADHD prisoners would have a jaundiced view of the chances of an individual with ADHD: the only people he’d ever seen with ADHD were prisoners! Similarly, it shouldn’t surprise us that most of the literature on ADHD emphasizes pathology and illness, failure and consequence, rather than strength and success. The failing population was studied exclusively.

In the face of this observation, one could argue that the “normal” people weren’t studied because they couldn’t have ADHD. By definition ADHD is a “disorder,” and somebody who’s not suffering or failing isn’t disordered. But the large and growing number of adults I see at ADHD support group meetings and hear from on the internet don’t describe themselves as disordered. They are not having major crises with their lives, and yet they are diagnosed and medicated for ADHD.

The main reason ADHD may be so strongly argued by so many people to be a “bad thing” is because only the failing population has been evaluated. As ADHD moves more and more into the mainstream and the popular culture, we may see it viewed more as an attentional “difference” than a “disorder.”

ADHD is constantly being redefined. It wouldn’t surprise many ADHD experts to see a less severe diagnostic category emerge in the next few years to describe people with moderate levels of distractibility, impulsivity, and sensation-seeking. This category probably wouldn’t contain the word “disorder,” but would instead be described as a syndrome or personality type.

Stay tuned!