ADHD As Hypervigilance Run Amok

People with ADHD often have a hypervigilant and hyper-responsive stress-sensing mechanism.

Image by Alexa from Pixabay

“Man can preserve a vestige of spiritual freedom, of independence of mind, even in such terrible conditions of psychic and physical stress.”
—Viktor Frankl, Man’s Search for Meaning

Looking at people with ADHD as the descendants of Hunters, with a neurochemistry and thalamic gain set-point which causes them to seek stimulation and sensation, puts a lot of behaviors and problems in context. However, there’s a third and final step in this perspective which, in part, answers the question: “What can be done to help these low-gain Hunters?”

Stress Responses

When we are faced with danger, real or perceived, we’re driven by our reptilian and mammalian brains, which have two primary instincts: fight or flight.

The stress doesn’t need to be something as obvious as the danger of a mugger. It can be the fear of being alone or rejected, the fear of not being loved, the fear of failure, the fear of criticism, or anything else that people interpret as a threat or attack.

People with ADHD often have a hypervigilant and hyper-responsive stress-sensing mechanism. This may be a vestigial Hunter survival mechanism: if you weren’t constantly vigilant in the jungle or forest, you’d get eaten. (This also may partly explain why one of the Adult ADHD diagnostic criteria suggested by psychiatrists John Ratey and Edward Hallowell was “A feeling of impending doom.” This feeling of doom would spur the hunter to constantly be looking over his shoulder.)

Distractability — The Effect of Hypervigilance

Whatever the cause or reason, though, the effect of this hypervigilance is what we often call distractability. The person with ADHD is constantly scanning his or her environment for danger. (Distractability is the first of the three primary characteristics of ADHD, the second is impulsivity and the third is sensation/risk-seeking behaviors.)

Impulsivity — A Response to Threat

When the person with ADHD senses a real or perceived threat, they tend to have a hair-trigger response to that threat. This often takes the form of interrupting, acting without thinking the consequences through first, or saying or doing whatever comes to mind. While it probably always begins as a response to stress/threat, it may also become a learned behavior which generalizes to other aspects of life. A person can thus end up responding very quickly to just about any sort of stimuli, including internal ones such as thoughts, impulses, and desires.

Forms of “Flight”

When confronted with a threat or stress, it’s usually inappropriate to “fight” in modern society. Punching out the manager who might fire us, throwing something at the person who jumped in front of us in line, or shooting out the windshield of the fellow who cut us off in traffic are generally regarded as less-than-useful behaviors. Most of us have learned to control our response to stress, at least to sublimate the “fight” component of the response.

This leaves us with “flight” as a response. Instead of confronting threats, problems, or individuals whom we perceive as a threat, we usually figure out a way to escape from the source of the stress. Common patterns here include changing relationships frequently, hopping from job to job, or even moving from town to town. Or the pattern may be more subtle than that, because the flight response has two submodalities: run or hide.

When running isn’t possible, as is usually the case in “civilized” society, then we often choose to “hide.” While for some people this takes an exaggerated form, in such conditions as agoraphobia where a person is afraid to even leave the house, the hiding behavior more often shows up in people who have learned how to avoid conflict to the point of paralysis, or who seem emotionally unresponsive. This is sometimes seen as a form of coldness or withdrawal, but, paradoxically, in persons with ADHD it may often show up as an exaggerated sociability or apparent extroversion. (The reason for this will become clear in a moment.)

Since it’s usually difficult to “run away” in modern society, a sub-mode of flight that’s commonly used is what I call the “opossum response”: overwhelm the brain with stimulation and cause it to be distracted or freed from the source of the stress. When an opossum rolls over and pretends to be dead, it actually slips into a comatose state brought about by the conscious brain being overwhelmed by a flood of sensation from the limbic brain.

Our culture is replete with stories of people who “throw themselves into” things, using work, sex, drugs, alcohol, or gambling in order to “get away from” some perceived stress or loss. When taken to an extreme, this throwing oneself into something shows up as addictive, compulsive, or obsessive behaviors, all of which seem to be over-represented among the ADHD population.

So we now have a person who is experiencing stress, is incapable of fighting, and can’t run away either. In order to cope they choose to hide, to bury themselves within something that’s sufficiently strong, high-stimulation, and/or overwhelming to provide enough of a distraction that they can then become oblivious to the stress. This is just like the opossum, so deeply gone when “hiding” that he won’t respond to being poked, rolled over, or even picked up and dropped.

In order to call up the hiding “opossum response,” a person finds either outside or within themselves an overwhelming distraction or point to focus on. It must be something so powerful, so stimulating, and occasionally so rewarding that it exceeds the strength and power of the threat/stress.

Some people with ADHD have trained their brains to become very efficient at collecting and seeking out high-energy, high-stimulation, powerfully-overwhelming stimuli. This provides them with a useful catalog of distracting behaviors to fall back into when the opossum response is necessary to flee from stress.

Collection and maintenance of these “distraction tools” often shows up as risk-taking and sensation-seeking behaviors.

Throughout their lives, these individuals have searched for and discovered ways to flood their brains with neurochemicals. We call this “feeling good,” or “getting high,” and people with ADHD are particularly well-tuned to this. These can include sex and masturbation; use of substances such as alcohol, tobacco, coffee, and other harder drugs; gambling; eating; extreme exercise (running, competitive sports); shopping; compulsive talking; compulsive promiscuity; extreme religious behaviors such as joining cults or becoming fanatic evangelists; criminal behaviors; workaholism; and other behaviors described as compulsive or addictive.

So, when stress or threat come along, and fight or flight aren’t available, the brain just naturally tumbles into the flight submodality of the opossum response. To do this, it will automatically seek out or roll into one of the modes it has historically used to overwhelm it with stimulation.

In other words, if a person has found that drugs, or sex, or running, or alcohol, or even work have given him or her a high or a strong charge, the brain will remember this and seek out that behavior again in order to bring up a flood of neurochemicals that blocks out the stress. This is why ADHD people report that engaging in compulsive or risk-taking behavior “reduces stress” or “relaxes” them, even though these behaviors would be described by a non-ADHD person as stressful, frightening, or overwhelming.

When Hiding becomes Addiction or Compulsion

If the stimulus is something that leaves a neurochemical crash afterwards, such as sex, alcohol, gambling, or drugs, among others, the resulting crash will itself then become a new source of stress. This new stress will cause the brain to again look for an overwhelming neurochemical wash, again triggering the behavior. The hangover, the departure of the sexual partner, or the results of the gambling loss, become the trigger, even when the original source of stress is long gone, resolved, or far less threatening than the addiction or behavior itself.

Once trapped into one of these addictive cycles, it’s extremely difficult for anybody, and particularly for the hypervigilant/hyper-responsive ADHD person to break out of the cycle.

Breaking the Addictive Cycle

Two methods are traditionally used to break this cycle of stress leading to addictive behavior.

The first way is to interrupt the neurotransmitter cycles. This is most often done with drugs such as the SSRIs (Selective Serotonin Reuptake Inhibitors) such as Prozac, which have been demonstrated to be useful in reducing compulsive, obsessive, and addictive behaviors.

While these drugs have an often miraculous short-term effect on breaking addictive or compulsive behavior patterns, the problem here is that the person is now dependent upon an external chemical. Unless the drug therapy is combined with good psychotherapy, the person hasn’t learned new ways to cope with stress or the addiction and so when the chemical is withdrawn the old pattern often emerges with a vengeance.

A second way to break the pattern is to create new responses to stress: giving the brain new addictions, essentially, but choosing those that hopefully are less destructive than the original ones.

Reports in the psychiatric literature show that this is a strategy the brain will adopt naturally. People in recovery from one addiction often quickly cycle into another one. The most common reports are of people going from substance abuse to sexual compulsion, or from substance abuse to alcohol abuse, although there are legions of examples with virtually every form of compulsive behavior.

These people will universally describe their compulsive substance, alcohol, or sexual acting-out as a response to stress, saying that it makes them feel “relieved,” or “calmer,” or using other similar terms. The results are unfortunately short-lived however, and a new addiction cycle is merely starting up.

The strategy of replacing one addiction with another (sexual with running, for example) may be useful in preventing people from engaging in self-destructive behavior, but the “new” addiction can often prove destructive itself. Witness the explosion in sports-related injuries from people who say they’re “hooked” by the “runner’s high,” or the number of people in AA who will die from smoking-related illnesses.

There is a third way to break the addictive cycle, and that is by building inner strength.

SOLUTIONS — The Third Way: Building Inner Strength

A third strategy, one that’s central to Gestalt therapy but often overlooked in mainstream addiction literature, is to address head-on the hypervigilance and hyper-responsiveness to stress: make a person so strong internally that they no longer need resort to the opossum response.

The basic premise which this strategy is founded on is the realization that much of our response to stress comes from not being in touch with our own inner strengths. We perceive things as stressful because we think of ourselves as weak.

After all, who would consider a child on a tricycle to be a threat, unless he thought of himself as an even smaller child? Who would be afraid of losing their job if they were absolutely confident and certain that they could get a better one in a matter of days? Who would be intimidated by somebody physically threatening them if they were a black-belt in karate?

When we operate out of a place of strength, then most things we’d normally find stressful become transformed into non-stressful events. We simply make appropriate choices, deal with them, and go on with life.

Consider the extreme example above of the karate black-belt. Gary Grooms is a Shao Lin martial arts master in Atlanta. He can literally kill a man with his hand, and do it in a matter of seconds. When I asked him how this sort of training transforms people’s experience of physical threats (do they get in more fights, for example?), Gary told me something that at first seemed counter-intuitive.

“My students report that they’re far less likely to get into a fight once they’ve mastered our techniques,” he told me. “When you know in advance that you’re going to win, that you could even seriously damage or kill the other person, then the urge to fight seems to go away. You don’t see the other person as a threat anymore, but more like an annoyance or a nuisance, and it’s easier to ignore them and carry on with your life.”

So a good way to address the hypervigilance and hyper-responsiveness of ADHD is to develop a strong inner core, an emotional strength that allows us to brush off the small stresses of life, the way Gary would ignore a rude person at a sporting event. As my mentor Gottfried Müller said, “When you walk through the world as a spiritual warrior, you quickly learn what is important and what you can ignore.”

Accessing Our Inner Strengths

The mind organizes itself into separate and discrete areas to deal with life’s circumstances. These areas are created, organized, and segregated from the conscious mind during childhood for the largest part, and represent much of what is often referred to as “the unconscious.” They work to keep us alive and protected, but because so many of them are created during childhood when cognitive abilities aren’t well-developed (regardless of age), they are developed at the level of instinct. These areas of the unconscious that control much of our conscious behavior often appear to act in an irrational fashion.

Thus, someone who is hypercritical of others may have developed this as a way of trying to train himself to be more competent. While this may occasionally be useful, more often than not hypercriticalness has destructive consequences. Because it’s operating at a level below consciousness, it’s nearly impossible to stop it with conscious interventions. Signs on the wall that say “Don’t criticize others,” or positive-thinking courses, or sessions with a therapist about how your mother was hypercritical herself don’t usually produce long-term change.

So, the Third Way is to rewire the brain’s response to stress in the first place. This involves two steps:

1. Reach through each of the various stress-response behaviors one at a time and find the inner strength for each that will enable a person to no longer see those “stress-producing” circumstances in life as being stressful. This acts the same way as the SSRI drugs, in that it breaks the cycle of stress-response-behavior-stress.

2. Give the unconscious mind permission and the ability to come up with new behaviors to use in response to formerly (or currently) stressful situations. When these new behaviors are grounded or rooted in this newly established inner strength, the intermediate behaviors that lead to the addiction/compulsion cycle are then no longer necessary and no longer are summoned by the mind.

Solutions

There is a specific set of steps that a therapist or friend can walk a person through to facilitate this process. I was first exposed to it in 1986 when I was living in Germany and working for the international relief organization, Salem. Herr Müller, Salem’s founder, sat me down a week before Christmas in his office and asked what was bothering me.

I’d just come back from spending most of November in Beijing studying acupuncture at the international teaching hospital there, and then working with Father Ben Carrion to try to raise money for his program in Manila to help the children living there in the garbage dumps. That had been exciting stuff which I’d enjoyed, but now I was back in Germany where it was gray and cold. I felt, culturally, like an alien and of course I literally was.

Herr Müller just kept asking me why I felt this way, and in response to every answer he would again ask, “Why do you feel that way?” Finally, we hit a bottom-line question where I said that I wanted to feel the presence of God all the time. The next time he probed, suddenly I felt that presence. Herr Muller was playing Handel’s Messiah in the background as we had the discussion, and to this day I always associate that music with the very real power of the love and presence of God that I felt in his office that day. Since that time, I’ve brought that feeling and presence into many situations in my life; it’s been a constant and powerful and enduring source of strength for me.

So, you can imagine my surprise when George Lynn, a psychotherapist in Washington state, suggested I pick up a book called Core Transformation by ConnieRae and Tamara Andreas. The book outlines a specific technique, rooted in NeuroLinguistic Programming (NLP) and Gestalt therapy, whereby a person is walked through a certain process. They start with a behavior or feeling they’d like to have better control over or be free from, and then use that behavior the way a deep-sea diver uses an air-hose. This carries a person all the way down through layers of consciousness, behavior, and response to what the Andreas’ refer to as a “core state.”

This core is the place where a feeling of oneness with God, or infinite bliss, or all-encompassing love lives. The person is then taught to bring that state up through the layers of behavior into their normal waking daily life. While the technique transforms people’s specific behaviors (and originally in NLP was probably developed largely just for that purpose), in the Andreas’ system that’s almost a by-product. The real goal is to dive into the core state, and then bring the power and strength from that back into normal life. It’s like becoming a spiritual and emotional black-belt!

While the Andreas’ don’t specifically address ADHD at all in their book, they do talk at length about issues of emotional fragility and building emotional strength. These are often weakness carried around by people with ADHD, perhaps as a result of a lifetime of paradox, confusion, and self-doubt. (“I know I’m smart, but then why can’t I do well in school?)

This posed for me the question: Could the technique Herr Müller had developed out of his experience as a prisoner-of-war and used on me, and the Andreas sisters had developed out of their training in NLP and Gestalt therapy, be useful in helping people with ADHD? Could this help to recover their balance, poise, and internal strength?

In theory, at least, if this system reduces hypervigilance and hyperresponsiveness, then the ADHD behaviors of distractibility and impulsivity could be reduced or eliminated. Since the person would now be operating from a sense of strength and core competency rather than hypervigilance and fear, the need for these behaviors would now be gone. Could the result be that their ADHD is fully or partly “cured?” Or at the least, could many of the side effects of ADHD — the pain and self-loathing and confusion — be resolved?

To test the hypothesis, I got together with a psychotherapist in Atlanta, and we lined up people to do the technique. The results aren’t in yet, but the preliminary results are very encouraging. On the other side of the country, George Lynn, the psychotherapist in Washington state, told me that he’s been using his version of the Core Transformation technique for some time with ADHD patients, and found that it had a significant and positive effect on them.